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Sample records for breast brachytherapy d-shaped

  1. [Brachytherapy].

    Science.gov (United States)

    Itami, Jun

    2014-12-01

    Brachytherapy do require a minimal expansion of CTV to obtain PTV and it is called as ultimate high precision radiation therapy. In high-dose rate brachytherapy, applicators will be placed around or into the tumor and CT or MRI will be performed with the applicators in situ. With such image-guided brachytherapy (IGBT) 3-dimensional treatment planning becomes possible and DVH of the tumor and organs at risk can be obtained. It is now even possible to make forward planning satisfying dose constraints. Traditional subjective evaluation of brachytherapy can be improved to the objective one by IGBT. Brachytherapy of the prostate cancer, cervical cancer, and breast cancer with IGBT technique was described. PMID:25596048

  2. Dose determination in breast tumor in brachytherapy using Iridium-192

    International Nuclear Information System (INIS)

    Thermoluminescent dosimetry studies in vivo and in vitro aiming to determing radiation dose in the breast tumor, in brachytherapy using Iridium-192 was done. The correlation between radiation doses in tumor and external surface of the breast was investigated for correcting the time interval of radiation source implantation. (author)

  3. Image guided Brachytherapy: The paradigm of Gynecologic and Partial Breast HDR Brachytherapy

    Science.gov (United States)

    Diamantopoulos, S.; Kantemiris, I.; Konidari, A.; Zaverdinos, P.

    2015-09-01

    High dose rate (HDR) brachytherapy uses high strength radioactive sources and temporary interstitial implants to conform the dose to target and minimize the treatment time. The advances of imaging technology enable accurate reconstruction of the implant and exact delineation of high-risk CTV and the surrounding critical structures. Furthermore, with sophisticated treatment planning systems, applicator devices and stepping source afterloaders, brachytherapy evolved to a more precise, safe and individualized treatment. At the Radiation Oncology Department of Metropolitan Hospital Athens, MRI guided HDR gynecologic (GYN) brachytherapy and accelerated partial breast irradiation (APBI) with brachytherapy are performed routinely. Contouring and treatment planning are based on the recommendations of the GEC - ESTRO Working group. The task of this presentation is to reveal the advantages of 3D image guided brachytherapy over 2D brachytherapy. Thus, two patients treated at our department (one GYN and one APBI) will be presented. The advantage of having adequate dose coverage of the high risk CTV and simultaneous low doses to the OARs when using 3D image- based brachytherapy will be presented. The treatment techniques, equipment issues, as well as implantation, imaging and treatment planning procedures will be described. Quality assurance checks will be treated separately.

  4. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  5. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    International Nuclear Information System (INIS)

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  6. Tissue modeling schemes in low energy breast brachytherapy.

    Science.gov (United States)

    Afsharpour, Hossein; Landry, Guillaume; Reniers, Brigitte; Pignol, Jean-Philippe; Beaulieu, Luc; Verhaegen, Frank

    2011-11-21

    Breast tissue is heterogeneous and is mainly composed of glandular (G) and adipose (A) tissues. The proportion of G versus A varies considerably among the population. The absorbed dose distributions in accelerated partial breast irradiation therapy with low energy photon brachytherapy sources are very sensitive to tissue heterogeneities. Current clinical algorithms use the recommendations of the AAPM TG43 report which approximates the human tissues by unit density water. The aim of this study is to investigate various breast tissue modeling schemes for low energy brachytherapy. A special case of breast permanent seed implant is considered here. Six modeling schemes are considered. Uniform and non-uniform water breast (UWB and NUWB) consider the density but neglect the effect of the composition of tissues. The uniform and the non-uniform G/A breast (UGAB and NUGAB) as well the age-dependent breast (ADB) models consider the effect of the composition. The segmented breast tissue (SBT) method uses a density threshold to distinguish between G and A tissues. The PTV D(90) metric is used for the analysis and is based on the dose to water (D(90(w,m))). D(90(m,m)) is also reported for comparison to D(90(w,m)). The two-month post-implant D(90(w,m)) averaged over 38 patients is smaller in NUWB than in UWB by about 4.6% on average (ranging from 5% to 13%). Large average differences of G/A breast models with TG43 (17% and 26% in UGAB and NUGAB, respectively) show that the effect of the chemical composition dominates the effect of the density on dose distributions. D(90(w,m)) is 12% larger in SBT than in TG43 when averaged. These differences can be as low as 4% or as high as 20% when the individual patients are considered. The high sensitivity of dosimetry on the modeling scheme argues in favor of an agreement on a standard tissue modeling approach to be used in low energy breast brachytherapy. SBT appears to generate the most geometrically reliable breast tissue models in this

  7. Multidisciplinary treatment for advanced and recurrent breast cancer including brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsukiyama, Iwao; Ohno, Tatsuya (Tochigi Cancer Center, Utsunomiya (Japan). Hospital); Takizawa, Yoshikazu; Ikeda, Hiroshi; Egawa, Sunao; Ogino, Takashi

    1994-06-01

    Between 1986 and 1992, 10 patients (12 lesions) of advanced breast cancer were treated with multidisciplinary treatment including brachytherapy. The lesions treated included 5 primary breast tumors, 3 metastatic lesions in the contra lateral breast, 2 recurrences after external beam irradiation, 1 metastasis to the axillary lymph node and 1 metastasis to the upper arm skin. The interstitial irradiation techniques used were [sup 192]Ir low dose-rate irradiation for 5 lesions and high dose-rate for 7 lesions (including 3 with mould irradiation). External hyperthermia as performed for 6 lesions and interstitial hyperthermia were performed for 4 lesions. The local response was CR for 3 lesions, PRa for 8 lesions, PRb for 1 lesion with the local response rate being 100%. Excellent local control could be achieved by combination external and interstitial irradiation, indicating that radiotherapy is definitely useful for the treatment of advanced breast cancer. (author).

  8. Radiological response of ceramic and polymeric devices for breast brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Batista Nogueira, Luciana, E-mail: lucibn19@yahoo.com.br [Departamento de Propedeutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil); Passos Ribeiro de Campos, Tarcisio, E-mail: campos@nuclear.ufmg.br [Departamento de Engenharia Nuclear, Programa de Pos Graduacao em Ciencias e Tecnicas Nucleares, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil)

    2012-04-15

    In the present study, the radiological visibility of ceramic and polymeric devices implanted in breast phantom was investigated for future applications in brachytherapy. The main goal was to determine the radiological viability of ceramic and polymeric devices in vitro by performing simple radiological diagnostic methods such as conventional X-ray analysis and mammography due to its easy access to the population. The radiological response of ceramic and polymeric devices implanted in breast phantom was determined using conventional X-ray, mammography and CT analysis. - Highlights: Black-Right-Pointing-Pointer Radiological visibility of ceramic and polymeric devices implanted in breast phantom. Black-Right-Pointing-Pointer The barium incorporation in the seed improves the radiological contrast. Black-Right-Pointing-Pointer Radiological monitoring shows the position, orientation and degradation of devices. Black-Right-Pointing-Pointer Simple radiological methods such as X-ray and mammography were used for radiological monitoring.

  9. Study of dose calculation on breast brachytherapy using prism TPS

    Science.gov (United States)

    Fendriani, Yoza; Haryanto, Freddy

    2015-09-01

    PRISM is one of non-commercial Treatment Planning System (TPS) and is developed at the University of Washington. In Indonesia, many cancer hospitals use expensive commercial TPS. This study aims to investigate Prism TPS which been applied to the dose distribution of brachytherapy by taking into account the effect of source position and inhomogeneities. The results will be applicable for clinical Treatment Planning System. Dose calculation has been implemented for water phantom and CT scan images of breast cancer using point source and line source. This study used point source and line source and divided into two cases. On the first case, Ir-192 seed source is located at the center of treatment volume. On the second case, the source position is gradually changed. The dose calculation of every case performed on a homogeneous and inhomogeneous phantom with dimension 20 × 20 × 20 cm3. The inhomogeneous phantom has inhomogeneities volume 2 × 2 × 2 cm3. The results of dose calculations using PRISM TPS were compared to literature data. From the calculation of PRISM TPS, dose rates show good agreement with Plato TPS and other study as published by Ramdhani. No deviations greater than ±4% for all case. Dose calculation in inhomogeneous and homogenous cases show similar result. This results indicate that Prism TPS is good in dose calculation of brachytherapy but not sensitive for inhomogeneities. Thus, the dose calculation parameters developed in this study were found to be applicable for clinical treatment planning of brachytherapy.

  10. Study of dose calculation on breast brachytherapy using prism TPS

    International Nuclear Information System (INIS)

    PRISM is one of non-commercial Treatment Planning System (TPS) and is developed at the University of Washington. In Indonesia, many cancer hospitals use expensive commercial TPS. This study aims to investigate Prism TPS which been applied to the dose distribution of brachytherapy by taking into account the effect of source position and inhomogeneities. The results will be applicable for clinical Treatment Planning System. Dose calculation has been implemented for water phantom and CT scan images of breast cancer using point source and line source. This study used point source and line source and divided into two cases. On the first case, Ir-192 seed source is located at the center of treatment volume. On the second case, the source position is gradually changed. The dose calculation of every case performed on a homogeneous and inhomogeneous phantom with dimension 20 × 20 × 20 cm3. The inhomogeneous phantom has inhomogeneities volume 2 × 2 × 2 cm3. The results of dose calculations using PRISM TPS were compared to literature data. From the calculation of PRISM TPS, dose rates show good agreement with Plato TPS and other study as published by Ramdhani. No deviations greater than ±4% for all case. Dose calculation in inhomogeneous and homogenous cases show similar result. This results indicate that Prism TPS is good in dose calculation of brachytherapy but not sensitive for inhomogeneities. Thus, the dose calculation parameters developed in this study were found to be applicable for clinical treatment planning of brachytherapy

  11. Study of dose calculation on breast brachytherapy using prism TPS

    Energy Technology Data Exchange (ETDEWEB)

    Fendriani, Yoza; Haryanto, Freddy [Nuclear Physics and Biophysics Research Division, FMIPA Institut Teknologi Bandung, Physics Buildings, Jl. Ganesha 10, Bandung 40132 (Indonesia)

    2015-09-30

    PRISM is one of non-commercial Treatment Planning System (TPS) and is developed at the University of Washington. In Indonesia, many cancer hospitals use expensive commercial TPS. This study aims to investigate Prism TPS which been applied to the dose distribution of brachytherapy by taking into account the effect of source position and inhomogeneities. The results will be applicable for clinical Treatment Planning System. Dose calculation has been implemented for water phantom and CT scan images of breast cancer using point source and line source. This study used point source and line source and divided into two cases. On the first case, Ir-192 seed source is located at the center of treatment volume. On the second case, the source position is gradually changed. The dose calculation of every case performed on a homogeneous and inhomogeneous phantom with dimension 20 × 20 × 20 cm{sup 3}. The inhomogeneous phantom has inhomogeneities volume 2 × 2 × 2 cm{sup 3}. The results of dose calculations using PRISM TPS were compared to literature data. From the calculation of PRISM TPS, dose rates show good agreement with Plato TPS and other study as published by Ramdhani. No deviations greater than ±4% for all case. Dose calculation in inhomogeneous and homogenous cases show similar result. This results indicate that Prism TPS is good in dose calculation of brachytherapy but not sensitive for inhomogeneities. Thus, the dose calculation parameters developed in this study were found to be applicable for clinical treatment planning of brachytherapy.

  12. Towards real-time 3D ultrasound planning and personalized 3D printing for breast HDR brachytherapy treatment

    International Nuclear Information System (INIS)

    Two different end-to-end procedures were tested for real-time planning in breast HDR brachytherapy treatment. Both methods are using a 3D ultrasound (3DUS) system and a freehand catheter optimization algorithm. They were found fast and efficient. We demonstrated a proof-of-concept approach for personalized real-time guidance and planning to breast HDR brachytherapy treatments

  13. Benefit of Adjuvant Brachytherapy Versus External Beam Radiation for Early Breast Cancer: Impact of Patient Stratification on Breast Preservation

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jiang, Jing [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Xu, Ying [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-02-01

    Purpose: Brachytherapy after lumpectomy is an increasingly popular breast cancer treatment, but data concerning its effectiveness are conflicting. Recently proposed “suitability” criteria guiding patient selection for brachytherapy have never been empirically validated. Methods: Using the Surveillance, Epidemiology, and End Results–Medicare linked database, we compared women aged 66 years or older with invasive breast cancer (n=28,718) or ductal carcinoma in situ (n=7229) diagnosed from 2002 to 2007, treated with lumpectomy alone, brachytherapy, or external beam radiation therapy (EBRT). The likelihood of breast preservation, measured by subsequent mastectomy risk, was compared by use of multivariate proportional hazards, further stratified by American Society for Radiation Oncology (ASTRO) brachytherapy suitability groups. We compared 1-year postoperative complications using the χ{sup 2} test and 5-year local toxicities using the log-rank test. Results: For patients with invasive cancer, the 5-year subsequent mastectomy risk was 4.7% after lumpectomy alone (95% confidence interval [CI], 4.1%-5.4%), 2.8% after brachytherapy (95% CI, 1.8%-4.3%), and 1.3% after EBRT (95% CI, 1.1%-1.5%) (P<.001). Compared with lumpectomy alone, brachytherapy achieved a more modest reduction in adjusted risk (hazard ratio [HR], 0.61; 95% CI, 0.40-0.94) than achieved with EBRT (HR, 0.22; 95% CI, 0.18-0.28). Relative risks did not differ when stratified by ASTRO suitability group (P=.84 for interaction), although ASTRO “suitable” patients did show a low absolute subsequent mastectomy risk, with a minimal absolute difference in risk after brachytherapy (1.6%; 95% CI, 0.7%-3.5%) versus EBRT (0.8%; 95% CI, 0.6%-1.1%). For patients with ductal carcinoma in situ, EBRT maintained a reduced risk of subsequent mastectomy (HR, 0.40; 95% CI, 0.28-0.55; P<.001), whereas the small number of patients treated with brachytherapy (n=179) precluded definitive comparison with lumpectomy alone

  14. Partial breast irradiation with interstitial high dose-rate brachytherapy: acute and late toxicities and cosmetic results

    International Nuclear Information System (INIS)

    Accelerated partial breast irradiation aims at decreasing the overall treatment time and reducing toxicity. The study we report is for early stage breast cancer and is a multicentre clinical investigation of partial breast irradiation achieved by interstitial high dose-rate (HDR) brachytherapy with intraoperative placement of catheters. We have been able to conclude from the initial data that an interstitial perioperative brachytherapy implant is a feasible method of treatment with good tolerance and good cosmetic results. (author)

  15. Combined re-excision and perioperative interstitial brachytherapy for salvage of breast conservation therapy recurrences

    International Nuclear Information System (INIS)

    Purpose: To evaluate local control, survival and cosmetic outcome of combined second lumpectomy and interstitial brachytherapy as salvage treatment for isolated local recurrence of breast cancer after breast conserving therapy. Materials and Methods: Between 1983 and 1996, 32 patients with isolated breast recurrence previously treated by breast conserving therapy, underwent salvage lumpectomy and perioperative brachytherapy. Initial staging and treatment were performed between 1975 and 1994. Median age at diagnosis was 45 years (range 31-67 years), 79% were pre or peri menopausal. Tumors were staged according to the AJCC-system with pathologic findings. Distribution of stage was T1 (n=24), T2 (n=8), in 79% of the patients axillary lymph nodes were negative and all were free of systemic disease. Breast conserving treatment consisted of lumpectomy plus axillary lymph nodes dissection, the mean excised breast tissue volume was 290 cc. All patient received external beam radiation therapy to a dose of 50 Gy/25 fr delivered on breast and nodal areas. Tumor bed was boosted to a total dose of 56 Gy (range 52-66 Gy) by external beam irradiation. Cosmetic outcome after initial therapy was excellent to good in all patients. The mean interval from the initial treatment and first local recurrence was 51 months. The tumor size at recurrence range between 0.2-2.5cm (median 1cm). Recurrence occurs on the boost area of the primary tumor in 13 patients, in other part of the breast in 14 and in the field edge in 5 patients. Treatment of the recurrence consisted of salvage lumpectomy, with a mean excised tissue volume of 51 cc. In all cases perioperative brachytherapy was also performed by introperative plastic tubes positioning. The implant target volume was determined according to surgery findings. Iridium wires were placed into the tubes with a delay of 3 to 4 days. Brachytherapy set up included one (n=20) or two (n=12) planes implants. The mean implant volume determined according

  16. Timing of Chemotherapy After MammoSite Radiation Therapy System Breast Brachytherapy: Analysis of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate cosmetic outcome and radiation recall in the American Society of Breast Surgeons registry trial, as a function of the interval between accelerated partial breast irradiation (APBI) and initiation of chemotherapy (CTX). Methods and Materials: A total of 1440 patients at 97 institutions participated in this trial. After lumpectomy for early-stage breast cancer, patients received APBI (34 Gy in 10 fractions) with MammoSite RTS brachytherapy. A total of 148 patients received CTX within 90 days of APBI. Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good or fair/poor. Results: Chemotherapy was initiated at a mean of 3.9 weeks after the final MammoSite procedure and was administered ≤3 weeks after APBI in 54 patients (36%) and >3 weeks after APBI in 94 patients (64%). The early and delayed groups were well balanced with respect to multiple factors that may impact on cosmetic outcome. There was a superior cosmetic outcome in those receiving chemotherapy >3 weeks after APBI (excellent/good in 72.2% at ≤3 weeks vs. excellent/good in 93.8% at >3 weeks; p = 0.01). Radiation recall in those receiving CTX at ≤3 weeks was 9 of 50 (18%), compared with 6 of 81(7.4%) in those receiving chemotherapy at >3 weeks (p = 0.09). Conclusion: The majority of patients receiving CTX after APBI have excellent/good cosmetic outcomes, with a low rate of radiation recall. Chemotherapy initiated >3 weeks after the final MammoSite procedure seems to be associated with a better cosmetic outcome and lower rate of radiation recall. An excellent/good cosmetic outcome in patients receiving CTX after 3 weeks was similar to the cosmetic outcome of the overall patient population who did not receive CTX

  17. Quality control of the breast cancer treatments on Hdr brachytherapy with TLD-100

    Energy Technology Data Exchange (ETDEWEB)

    Torres H, F. [Universidad de Cordoba, Materials and Applied Physics Group, 230002 Monteria, Cordoba (Colombia); De la Espriella V, N. [Universidad de Cordoba, Grupo Avanzado de Materiales y Sistemas Complejos, 230002 Monteria, Cordoba (Colombia); Sanchez C, A., E-mail: franciscotorreshoyos@yahoo.com [Universidad de Cordoba, Departamento de Enfermeria, 230002 Monteria, Cordoba (Colombia)

    2014-07-01

    An anthropomorphic Phantom, a female trunk, was built with a natural bone structure and experimental material coated, glycerin and water-based material called JJT to build soft tissue equivalent to the muscle of human tissue, and a polymer (styrofoam) to build the lung as critical organ to simulate the treatment of breast cancer, with high dose rate brachytherapy (Hdr) and sources of Ir-192. The treatments were planned and calculated for the critical organ: Lung, and injury of 2 cm in diameter in breast with Micro Selectron Hdr system and the software Plato Brachytherapy V 14.1 of the Nucletron (Netherlands) which uses the standard protocol of radiotherapy for brachytherapy treatments. The dose experimentally measured with dosimeters TLD-100 LiF: Mg; Ti, which were previously calibrated, were placed in the same positions and bodies mentioned above, with less than 5% uncertainty. The reading dosimeters was carried out in a Harshaw TLD 4500. The results obtained for calculated treatments, using the standard simulator, and the experimental with TLD-100, show a high concordance, as they are on average a ± 1.1% making process becomes in a quality control of this type of treatments. (Author)

  18. Cosmetic results in early stage breast cancer patients with high-dose brachytherapy after conservative surgery

    International Nuclear Information System (INIS)

    Purpose: to reveal cosmetic results in patients at early stages of low risk breast cancer treated with partial accelerated radiotherapy using high dose rate brachytherapy. Methods and materials: from March 2001 to July 2003,14 stages l and ll breast cancer patients were treated at the Colombian national cancer institute in Bogota with conservative surgery and radiotherapy upon the tumor bed (partial accelerated radiotherapy), using interstitial implants with iridium 192 (high dose rate brachytherapy) with a dose of 32 Gys, over 4 days, at 8 fractions twice a day. Results: with an average follow up of 17.7 months, good cosmetic results were found among 71.4 % of patients and excellent results among 14.3% of patients, furthermore none of the patients neither local nor regional or distant relapses. Conclusion: among patients who suffer from breast cancer at early stages, it showed is possible to apply partial accelerated radiotherapy upon the tumor bed with high doses over 4 days with good to excellent cosmetic results

  19. Brachytherapy applications and techniques

    CERN Document Server

    Devlin, Phillip M

    2015-01-01

    Written by the foremost experts in the field, this volume is a comprehensive text and practical reference on contemporary brachytherapy. The book provides detailed, site-specific information on applications and techniques of brachytherapy in the head and neck, central nervous system, breast, thorax, gastrointestinal tract, and genitourinary tract, as well as on gynecologic brachytherapy, low dose rate and high dose rate sarcoma brachytherapy, vascular brachytherapy, and pediatric applications. The book thoroughly describes and compares the four major techniques used in brachytherapy-intraca

  20. Phase II investigation: partial breast irradiation with high-dose brachytherapy using intratissue multicatheter implant

    International Nuclear Information System (INIS)

    Local control, side-effects, and cosmetic results were analyzed in patients with early-stage breast cancer after organpreserving surgery and adjuvant partial accelerated irradiation of the breast using high dose rate brachytherapy and intratissue multicatheter implant. The patients over 50 with solitary tumors < 3 cm invasive ductal carcinoma, differentiation grade I-III, resection R0, N0 (axillary dissection or investigation of signal lymph node) were included in the study. The irradiation was performed twice a day with a 6-hour interval at a single dose of 4 Gy. Total focal dose of 32 Gy was delivered with 8 fractions. With a mean observation period of 31 months (13-46), a local relapse was diagnosed in one patient (1.7 %). Cosmetic results were assessed as good and excellent. Immediate complications of the treatment were minimal. The method can be indicated in a selected group of patients and cannot be a standard of treatment at present.

  1. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    International Nuclear Information System (INIS)

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was 35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (Dref = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (Dref = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects ≥Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  2. Toxicity and cosmetic result of partial breast high-dose-rate interstitial brachytherapy for conservatively operated early breast cancer

    International Nuclear Information System (INIS)

    Objective: Objective To study the method, side effects and cosmetic outcome of high- dose-rate (HDR) accelerated partial breast interstitial irradiation (APBI) alone in early stage breast cancer' after conservative surgery. Methods: From February 2002 to June 2003,47 breast cancer lesions from 46 patients suffering from stage I/II breast cancer were treated with HDR 192Ir APBI after conservative surgery. All patients were over 40 year-old, with T1-2N0-1 (≤3 lymph nodes positive), surgical margin > 1-2 mm, but those having lobular or inflammatory breast cancer were excluded. HDR brachytherapy with 34 Gy, 10 fractions/5 days was used after surgery, toxic reaction and cosmetic outcome were observed in one month, 6 and 12 months respectively. Results: Follow up of 1846 months, 34 months was carried out for the whole group. During the treatment, acute reactions including: erythema, edema, tenderness and infection, all under I-II grade, none of III-IV grade were observed in 21 patients(46%); late toxicity reactions: skin fibrosis, breast tenderness, fat necrosis, and telangiectasia, totally 20 patients (43%) were observed: 2 patients in III grade but one patient received 6 cycle chemotherapy. The result of cosmetic outcome evaluation was excellent or good, at 6 months 95% and 12 months 98%, respectively, but there was no recurfence. Conclusions: Excellent and favorable cosmetic results are noted after APBI by interstitial alone. Acute and late reactions are few. Long term observation is necessary for the rate of' local control. (authors)

  3. Dosimetry evaluation of SAVI-based HDR brachytherapy for partial breast irradiation

    Directory of Open Access Journals (Sweden)

    Manoharan Sivasubramanian

    2010-01-01

    Full Text Available Accelerated partial breast irradiation (APBI with high dose rate (HDR brachytherapy offers an excellent compact course of radiation due to its limited number of fractions for early-stage carcinoma of breast. One of the recent devices is SAVI (strut-adjusted volume implant, which has 6, 8 or 10 peripheral source channels with one center channel. Each channel can be differentially loaded. This paper focuses on the treatment planning, dosimetry and quality assurance aspects of HDR brachytherapy implant with GammaMed Plus HDR afterloader unit. The accelerated PBI balloon devices normally inflate above 35 cc range, and hence these balloon type devices cannot be accommodated in small lumpectomy cavity sizes. CT images were obtained and 3-D dosimetric plans were done with Brachyvision planning system. The 3-D treatment planning and dosimetric data were evaluated with planning target volume (PTV_eval V90, V95, V150, V200 skin dose and minimum distance to skin. With the use of the SAVI 6-1 mini device, we were able to accomplish an excellent coverage - V90, V95, V150 and V200 to 98%, 95%, 37 cc (<50 cc volume and 16 cc (<20 cc volume, respectively. Maximum skin dose was between 73% and 90%, much below the prescribed dose of 34 Gy. The minimum skin distance achieved was 5 to 11 mm. The volume that received 50% of the prescribed radiation dose was found to be lower with SAVI. The multi-channel SAVI-based implants reduced the maximum skin dose to markedly lower levels as compared to other modalities, simultaneously achieving best dose coverage to target volume. Differential-source dwell-loading allows modulation of the radiation dose distribution in symmetric or asymmetric opening of the catheter shapes and is also advantageous in cavities close to chest wall.

  4. Long-Term Results From the Contura Multilumen Balloon Breast Brachytherapy Catheter Phase 4 Registry Trial

    Energy Technology Data Exchange (ETDEWEB)

    Cuttino, Laurie W., E-mail: lcuttino@mcvh-vcu.edu [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Vicini, Frank [Michigan Healthcare Professionals/21st Century Onoclogy, Farmington Hills, Michigan (United States); Todor, Dorin [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Julian, Thomas [Allegheny Hospital, Temple School of Medicine, Pittsburgh, Pennsylvania (United States); Mukhopadhyay, Nitai [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States)

    2014-12-01

    Purpose: To describe the long-term outcomes from a completed, multi-institutional phase 4 registry trial using the Contura multilumen balloon (CMLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer. Methods and Materials: Three hundred forty-two evaluable patients were enrolled by 23 institutions between January 2008 and February 2011. All patients received 34 Gy in 10 fractions, delivered twice daily. Rigorous target coverage and normal tissue dose constraints were observed. Results: The median follow-up time was 36 months (range, 1-54 months). For the entire patient cohort of 342 patients, 10 patients experienced an ipsilateral breast tumor recurrence (IBTR). Eight of these IBTR were classified as true recurrences/marginal miss (TRMM), and 2 were elsewhere failures (EF). Local recurrence-free survival was 97.8% at 3 years. For the entire cohort, 88% of patients had good to excellent overall cosmesis. The overall incidence of infection was 8.5%. Symptomatic seroma was reported in only 4.4% of patients. A separate analysis was performed to determine whether improved outcomes would be observed for patients treated at high-volume centers with extensive brachytherapy experience. Three IBTR were observed in this cohort, only 1 of which was classified as a TRMM. Local recurrence-free survival at high-volume centers was 98.1% at 3 years. Overall cosmetic outcome and toxicity were superior in patients treated at high-volume centers. In these patients, 95% had good to excellent overall cosmesis. Infection was observed in only 2.9% of patients, and symptomatic seroma was reported in only 1.9%. Conclusion: Use of the CMLB for APBI delivery is associated with acceptable long-term local control and toxicity. Local recurrence-free survival was 97.8% at 3 years. Significant (grade 3) toxicity was uncommon, and no grade 4 toxicity was observed. Treatment at high-volume centers was associated

  5. Ceramic and polymeric devices for breast brachytherapy - Mammographic and CT response

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Luciana B.; Campos, Tarcisio P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares], e-mail: campos@nuclear.ufmg.br

    2009-07-01

    The present research investigates the radiological visibility of ceramic and polymeric devices implanted in breast phantom (in vitro) for future applications in brachytherapy treatments. The main research goal is to investigate the viability of monitoring ceramic and polymeric devices, in vitro based on simple methods of radiological diagnostic, maintaining the easiest access to the population, represented by the conventional X-ray and mammography. The methodology involves the processing of ceramic devices constituted by bioglasses of Sm, SmBa, Ho, HoBa and the production of polymeric devices, such as polymeric membranes incorporating Ho e HoBa. Contrast agent of Barium was introduced in the syntheses of those devices to improve the radiological visibility in breast equivalent-tissue (TE) phantom. The breast phantom is constituted of glandular, adipose and skin TE, reproducing a 5 cm compressed real breast. In the compressed breast phantom, all types of ceramic and polymeric devices were implanted side by side. Radiological images were generated through X-ray equipment, mammography and computerized tomography (TC), for the samples implanted in the compressed breast phantom. The results show that SmBa and HoBa seeds on breast phantom presented suitable radiological visibility, on all the radiological diagnostic methods. However, the X-rays radiological visibility of Sm seeds without contrast was discreet. On mammography and TC images, it was not possible to identify those seeds, because the same ones were degraded after two months immersed in the glandular TE, after placed on the phantom. The Ho seeds were identified on all radiological diagnostic images, although non contrast agent in its constitution was added. However, the holmium polymeric membranes in direct contact with TE did not show Xray radiological visibility. However, the polymeric membranes of HoBa in the same conditions presented efficient X-rays radiological response. For mammography and TC methods

  6. Contura Multi-Lumen Balloon Breast Brachytherapy Catheter: Comparative Dosimetric Findings of a Phase 4 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Arthur, Douglas W., E-mail: darthur@mcvh-vcu.edu [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Vicini, Frank A. [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States); Todor, Dorin A. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Julian, Thomas B. [Allegheny General Hospital, Temple University School of Medicine, Pittsburgh, Pennsylvania (United States); Cuttino, Laurie W.; Mukhopadhyay, Nitai D. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States)

    2013-06-01

    Purpose: Final dosimetric findings of a completed, multi-institutional phase 4 registry trial using the Contura Multi-Lumen Balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer are presented. Methods and Materials: Three dosimetric plans with identical target coverage were generated for each patient for comparison: multilumen multidwell (MLMD); central-lumen multidwell (CLMD); and central-lumen single-dwell (CLSD) loading of the Contura catheter. For this study, a successful treatment plan achieved ideal dosimetric goals and included the following: ≥95% of the prescribed dose (PD) covering ≥95% of the target volume (TV); maximum skin dose ≤125% of the PD; maximum rib dose ≤145% of the PD; and V150 ≤50 cc and V200 ≤10 cc. Results: Between January 2008 and February 2011, 23 institutions participated. A total of 318 patients were available for dosimetric review. Using the Contura MLB, all dosimetric criteria were met in 78.93% of cases planned with MLMD versus 55.38% with the CLMD versus 37.66% with the CLSD (P≤.0001). Evaluating all patients with the full range of skin to balloon distance represented, median maximum skin dose was reduced by 12% and median maximum rib dose by 13.9% when using MLMD-based dosimetric plans compared to CLSD. The dosimetric benefit of MLMD was further demonstrated in the subgroup of patients where skin thickness was <5 mm, where MLMD use allowed a 38% reduction in median maximum skin dose over CLSD. For patients with rib distance <5 mm, the median maximum rib dose reduction was 27%. Conclusions: Use of the Contura MLB catheter produced statistically significant improvements in dosimetric capabilities between CLSD and CLMD treatments. This device approach demonstrates the ability not only to overcome the barriers of limited skin thickness and close rib proximity, but to consistently achieve a higher standard of dosimetric planning goals.

  7. Dosimetric characterization of round HDR {sup 192}Ir AccuBoost applicators for breast brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, Mark J.; Melhus, Christopher S.; Wazer, David E.; Bricault, Raymond J. Jr. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States); Advanced Radiation Therapy, Billerica, Massachusetts 01821 (United States)

    2009-11-15

    Purpose: The AccuBoost brachytherapy system applies HDR {sup 192}Ir beams peripherally to the breast using collimating applicators. The purpose of this study was to benchmark Monte Carlo simulations of the HDR {sup 192}Ir source, to dosimetrically characterize the round applicators using established Monte Carlo simulation and radiation measurement techniques and to gather data for clinical use. Methods: Dosimetric measurements were performed in a polystyrene phantom, while simulations estimated dose in air, liquid water, polystyrene and ICRU 44 breast tissue. Dose distribution characterization of the 4-8 cm diameter collimators was performed using radiochromic EBT film and air ionization chambers. Results: The central axis dose falloff was steeper for the 4 cm diameter applicator in comparison to the 8 cm diameter applicator, with surface to 3 cm depth-dose ratios of 3.65 and 2.44, respectively. These ratios did not considerably change when varying the phantom composition from breast tissue to polystyrene, phantom thickness from 4 to 8 cm, or phantom radius from 8 to 15 cm. Dose distributions on the central axis were fitted to sixth-order polynomials for clinical use in a hand calculation spreadsheet (i.e., nomogram). Dose uniformity within the useful applicator apertures decreased as depth-dose increased. Conclusions: Monte Carlo benchmarking simulations of the HDR {sup 192}Ir source using the MCNP5 radiation transport code indicated agreement within 1% of the published results over the radial/angular region of interest. Changes in phantom size and radius did not cause noteworthy changes in the central axis depth-dose. Polynomial fit depth-dose curves provide a simple and accurate basis for a nomogram.

  8. Dosimetric characterization of round HDR 192Ir AccuBoost applicators for breast brachytherapy

    International Nuclear Information System (INIS)

    Purpose: The AccuBoost brachytherapy system applies HDR 192Ir beams peripherally to the breast using collimating applicators. The purpose of this study was to benchmark Monte Carlo simulations of the HDR 192Ir source, to dosimetrically characterize the round applicators using established Monte Carlo simulation and radiation measurement techniques and to gather data for clinical use. Methods: Dosimetric measurements were performed in a polystyrene phantom, while simulations estimated dose in air, liquid water, polystyrene and ICRU 44 breast tissue. Dose distribution characterization of the 4-8 cm diameter collimators was performed using radiochromic EBT film and air ionization chambers. Results: The central axis dose falloff was steeper for the 4 cm diameter applicator in comparison to the 8 cm diameter applicator, with surface to 3 cm depth-dose ratios of 3.65 and 2.44, respectively. These ratios did not considerably change when varying the phantom composition from breast tissue to polystyrene, phantom thickness from 4 to 8 cm, or phantom radius from 8 to 15 cm. Dose distributions on the central axis were fitted to sixth-order polynomials for clinical use in a hand calculation spreadsheet (i.e., nomogram). Dose uniformity within the useful applicator apertures decreased as depth-dose increased. Conclusions: Monte Carlo benchmarking simulations of the HDR 192Ir source using the MCNP5 radiation transport code indicated agreement within 1% of the published results over the radial/angular region of interest. Changes in phantom size and radius did not cause noteworthy changes in the central axis depth-dose. Polynomial fit depth-dose curves provide a simple and accurate basis for a nomogram.

  9. Patient-specific Monte Carlo dose calculations for 103Pd breast brachytherapy

    Science.gov (United States)

    Miksys, N.; Cygler, J. E.; Caudrelier, J. M.; Thomson, R. M.

    2016-04-01

    This work retrospectively investigates patient-specific Monte Carlo (MC) dose calculations for 103Pd permanent implant breast brachytherapy, exploring various necessary assumptions for deriving virtual patient models: post-implant CT image metallic artifact reduction (MAR), tissue assignment schemes (TAS), and elemental tissue compositions. Three MAR methods (thresholding, 3D median filter, virtual sinogram) are applied to CT images; resulting images are compared to each other and to uncorrected images. Virtual patient models are then derived by application of different TAS ranging from TG-186 basic recommendations (mixed adipose and gland tissue at uniform literature-derived density) to detailed schemes (segmented adipose and gland with CT-derived densities). For detailed schemes, alternate mass density segmentation thresholds between adipose and gland are considered. Several literature-derived elemental compositions for adipose, gland and skin are compared. MC models derived from uncorrected CT images can yield large errors in dose calculations especially when used with detailed TAS. Differences in MAR method result in large differences in local doses when variations in CT number cause differences in tissue assignment. Between different MAR models (same TAS), PTV {{D}90} and skin {{D}1~\\text{c{{\\text{m}}3}}} each vary by up to 6%. Basic TAS (mixed adipose/gland tissue) generally yield higher dose metrics than detailed segmented schemes: PTV {{D}90} and skin {{D}1~\\text{c{{\\text{m}}3}}} are higher by up to 13% and 9% respectively. Employing alternate adipose, gland and skin elemental compositions can cause variations in PTV {{D}90} of up to 11% and skin {{D}1~\\text{c{{\\text{m}}3}}} of up to 30%. Overall, AAPM TG-43 overestimates dose to the PTV ({{D}90} on average 10% and up to 27%) and underestimates dose to the skin ({{D}1~\\text{c{{\\text{m}}3}}} on average 29% and up to 48%) compared to the various MC models derived using the post-MAR CT images studied

  10. Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Sharon M., E-mail: sharonlu@ucsd.edu [Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies (CART), University of California, San Diego, La Jolla, CA (United States); Scanderbeg, Daniel J.; Barna, Patrick; Yashar, William; Yashar, Catheryn [Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies (CART), University of California, San Diego, La Jolla, CA (United States)

    2012-04-01

    The SAVI and Contura breast brachytherapy applicators represent 2 recent advancements in brachytherapy technology that have expanded the number of women eligible for accelerated partial breast irradiation in the treatment of early-stage breast cancer. Early clinical experience with these 2 single-entry, multichannel high-dose-rate brachytherapy devices confirms their ease of use and dosimetric versatility. However, current clinical guidelines for SAVI and Contura brachytherapy may result in a smaller or less optimal volume of treated tissue compared with traditional interstitial brachytherapy. This study evaluates the feasibility of using the SAVI and Contura to irradiate larger and irregularly shaped target volumes, approaching what is treatable with the interstitial technique. To investigate whether additional tissue can be treated, 17 patients treated with the SAVI and 3 with the Contura were selected. For each patient, the planning target volume (PTV) was modified to extend 1.1 cm, 1.3 cm, and 1.5 cm beyond the tumor bed cavity. To evaluate dose conformance to an irregularly shaped target volume, 9 patients treated with the SAVI and 3 with the Contura were selected from the original 20 patients. The following asymmetric PTV margin combinations were assessed for each patient: 1.5/0.3, 1.3/0.3, and 1.1/0.3 cm. For all patients, treatment planning was performed, adopting the National Surgical Adjuvant Breast and Bowel Project guidelines, and dosimetric comparisons were made. The 6-1 and 8-1 SAVI devices can theoretically treat a maximal tissue margin of 1.5 cm and an asymmetric PTV with margins ranging from 0.3 to 1.5 cm. The 10-1 SAVI and Contura can treat a maximal margin of 1.3 cm and 1.1 cm, respectively, and asymmetric PTV with margins ranging from 0.3-1.3 cm. Compared with the Contura, the SAVI demonstrated greater dosimetric flexibility. Risk of developing excessive hot spots increased with the size of the SAVI device. Both the SAVI and Contura appear

  11. Monte Carlo study of LDR seed dosimetry with an application in a clinical brachytherapy breast implant

    Energy Technology Data Exchange (ETDEWEB)

    Furstoss, C.; Reniers, B.; Bertrand, M. J.; Poon, E.; Carrier, J.-F.; Keller, B. M.; Pignol, J. P.; Beaulieu, L.; Verhaegen, F. [Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4 (Canada) and Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht 6202 AZ (Netherlands); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Departement de Radio-Oncologie et Centre de Recherche du CHUM, Hopital Notre-Dame, 1560 rue Sherbrooke Est, Montreal, Quebec H2L 4M1 (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, CHUQ Pavillon L' Hotel-Dieu de Quebec, 11 Cote du Palais, Quebec G1R 2J6 (Canada) and Departement de Physique, de Genie Physique et d' Optique, Universite Laval, Quebec G1K 7P4 (Canada); Medical Physics Unit, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada) and Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht 6202 AZ (Netherlands)

    2009-05-15

    A Monte Carlo (MC) study was carried out to evaluate the effects of the interseed attenuation and the tissue composition for two models of {sup 125}I low dose rate (LDR) brachytherapy seeds (Medi-Physics 6711, IBt InterSource) in a permanent breast implant. The effect of the tissue composition was investigated because the breast localization presents heterogeneities such as glandular and adipose tissue surrounded by air, lungs, and ribs. The absolute MC dose calculations were benchmarked by comparison to the absolute dose obtained from experimental results. Before modeling a clinical case of an implant in heterogeneous breast, the effects of the tissue composition and the interseed attenuation were studied in homogeneous phantoms. To investigate the tissue composition effect, the dose along the transverse axis of the two seed models were calculated and compared in different materials. For each seed model, three seeds sharing the same transverse axis were simulated to evaluate the interseed effect in water as a function of the distance from the seed. A clinical study of a permanent breast {sup 125}I implant for a single patient was carried out using four dose calculation techniques: (1) A TG-43 based calculation, (2) a full MC simulation with realistic tissues and seed models, (3) a MC simulation in water and modeled seeds, and (4) a MC simulation without modeling the seed geometry but with realistic tissues. In the latter, a phase space file corresponding to the particles emitted from the external surface of the seed is used at each seed location. The results were compared by calculating the relevant clinical metrics V{sub 85}, V{sub 100}, and V{sub 200} for this kind of treatment in the target. D{sub 90} and D{sub 50} were also determined to evaluate the differences in dose and compare the results to the studies published for permanent prostate seed implants in literature. The experimental results are in agreement with the MC absolute doses (within 5% for EBT

  12. Breast-Conservative Surgery With Close or Positive Margins: Can the Breast Be Preserved With High-Dose-Rate Brachytherapy Boost?

    International Nuclear Information System (INIS)

    Purpose: To evaluate the likelihood of preserving the breast in women who show close or positive margins after conservative surgery for early breast carcinoma. Methods and Materials: Since 1996, 125 women with less than 5 mm or positive margins and positive separate cavity margin sampling were entered in a prospective trial with high-dose radiotherapy. A standard dose of 50 Gy to the whole breast was followed by a high-dose-rate brachytherapy application delivering 3 fractions of 4.4 Gy in 24 hours. The median follow-up was 84 months. Results: There were only seven local recurrences, with an actuarial local control rate of 95.8% at 5 years and 91.1% at 9 years. Actuarial overall and cause-specific survival rates were 92.6% and 95% at 5 years and 86.7% and 90.4% at 9 years, respectively. Late fibrosis was the most common complication, in 30% of patients, with good or excellent cosmetic results in 77%. The final result was that 95.2% of breasts were preserved. Conclusions: Close or positive-margin breast cancer can be well managed with a high-dose boost in a wide tumor bed by means of high-dose-rate brachytherapy. This technique can avoid mastectomy or poor cosmetic resection, with minimal risk of local or general failure

  13. Dosimetric and clinical comparison between MammoSite and interstitial HDR brachytherapy in treatment of early stage breast cancer after conserving surgery

    International Nuclear Information System (INIS)

    Objective: To comparatively study dosimetric evaluation, side effects in early and late stage, and cosmetic outcome between MammoSite and interstitial using high-dose-rate (HDR) brachytherapy accelerated partial breast irradiation (APBI) in early stage breast cancer patient after conserving surgery. Methods: From January 2004 to December 2004, 10 breast cancer cases were treated with HDR 192Ir APBI after Lumpectomy surgery, 6 cases with interstitial brachytherapy, 4 cases with MammoSite. Sources were placed during the operation in all patients, distance from cavity to skin > 5-7 mm in interstitial brachytherapy group, one case is 6.5 mm, 3 cases > 10 mm in MammoSite group. Treatment Target area is 20 mm away from cavity in interstitial brachytherapy group with DHI 0.77, 10 mm away from Balloon margin in MammoSite with DHI 0.73. Results: Follow up 12-24 months while median follow-up was 18 months for the whole group (100%). During the treatment, grade III acute reactions were not seen in both group, grade I or II were seen including: erythema, edema, tenderness and infection. More late toxicity reaction including skin fibrosis, breast tenderness and fat necrosis were observed in interstitial brachytherapy group than that of MammoSite group. Cosmetic outcome evaluation were excellent in 12 months 100% (patient) and 83% (doctor) in interstitial brachytherapy, 100% in MammoSite group, respectively, none recurrence. Conclusions: Interstitial brachytherapy shows more uniformity in dose distribution as well as larger treatment volume, while MammoSite tends to be stable in repeatability and easy in use. Both groups show excellent cosmetic results, with same acute and late reactions. (authors)

  14. Preliminary results of a phase I/II study of HDR brachytherapy alone for T1/T2 breast cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate the feasibility, toxicity, cosmetic outcome, and local control of high-dose-rate (HDR) brachytherapy alone without whole breast external beam irradiation for early-stage breast carcinoma. Methods and Materials: Between June 1997 and August 1999, 32 women diagnosed with a total of 33 AJCC Stage I/II breast carcinomas underwent surgical breast excision and postoperative irradiation using HDR brachytherapy interstitial implantation as part of a multi-institutional clinical Phase I/II protocol. Eligible patients included those with T1, T2, N0, N1 (≤3 nodes positive), and M0 tumors of nonlobular histologic features with negative surgical margins, no extracapsular lymph node extension, and a negative postexcision mammogram. Brachytherapy catheters were placed at the initial excision, reexcision, or either sentinel or full-axillary sampling. Direct visualization, surgical clips, and ultrasound and/or CT scan assisted in the delineation of the target volume, defined as the excision cavity plus a 2-cm margin. High-activity 192Ir (3-10 Ci) was used to deliver 340 cGy/fraction, 2 fractions/d, for 5 consecutive days, to a total dose of 34 Gy to the target volume. Source position and dwell times were calculated using standard volume optimization techniques. Results: The median follow-up of all patients was 33 months, and the mean patient age was 63 years. The mean tumor size was 1.3 cm, and 55% had an extensive intraductal component. Three patients had positive axillary nodes. Two patients experienced moderate perioperative pain that required narcotic analgesics. No peri- or postoperative infections occurred. No wound healing problems and no significant skin reactions related to the implant developed. The Radiation Therapy Oncology Group late radiation morbidity scoring scheme was applied to the entire 33-case cohort. In the assessment of the skin, 30 cases were Grade 0-1 and 3 cases were Grade 2. Subcutaneous toxicity was scored as 11 patients with

  15. Breast conserving therapy with sole high-dose-rate interstitial brachytherapy. Results of Osaka Medical Center for Cancer and Cardiovascular Diseases

    International Nuclear Information System (INIS)

    The results of breast conserving surgery combined with sole high-dose-rate interstitial brachytherapy were analyzed. Between May 1998 and May 2003, 20 patients with breast cancer smaller than 2 cm, without clinically lymph node metastases were recruited in our study. The 5-year local control rate, distant-free survival and overall survival were 92.9%, 92.9% and 92.9%, respectively. These results were the equal to those of breast conserving surgery with conventional whole breast 45-50 Gy irradiation in our institute. Though fat necrosis was occurred in one of 20 patients and radiation induced pneumonitis was also seen in one patient, the safety and cosmetic results of brachytherapy was acceptable. This technique can shorten the period of the breast conserving therapy and can become one of the treatment options of it. (author)

  16. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-03-15

    Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA.

  17. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    International Nuclear Information System (INIS)

    Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA

  18. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast-Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Deshields, Teresa L. [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A.; Cyr, Amy E. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A.; Ochoa, Laura L. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-12-01

    Purpose: To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods and Materials: Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment. Results: The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions: HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment.

  19. PDR brachytherapy with flexible implants for interstitial boost after breast-conserving surgery and external beam radiation therapy

    International Nuclear Information System (INIS)

    Background and purpose: For radiobiological reasons the new concept of pulsed dose rate (PDR) brachytherapy seems to be suitable to replace traditional CLDR brachytherapy with line sources. PDR brachytherapy using a stepping source seems to be particularly suitable for the interstitial boost of breast carcinoma after breast-conserving surgery and external beam irradiation since in these cases the exact adjustment of the active lengths is essential in order to prevent unwanted skin dose and consequential unfavorable cosmetic results. The purpose of this study was to assess the feasibility and morbidity of a PDR boost with flexible breast implants. Materials and methods: Sixty-five high risk patients were treated with an interstitial PDR boost. The criteria for an interstitial boost were positive margin or close margin, extensive intraductal component (EIC), intralymphatic extension, lobular carcinoma, T2 tumors and high nuclear grade (GIII). Dose calculation and specification were performed following the rules of the Paris system. The dose per pulse was 1 Gy. The pulse pauses were kept constant at 1 h. A geometrically optimized dose distribution was used for all patients. The treatment schedule was 50 Gy external beam to the whole breast and 20 Gy boost. PDR irradiations were carried out with a nominal 37 GBq 192-Ir source. Results: The median follow-up was 30 months (minimum 12 months, maximum 54 months). Sixty percent of the patients judged their cosmetic result as excellent, 27% judged it as good, 11% judged it as fair and 2% judged it as poor. Eighty-six percent of the patients had no radiogenous skin changes in the boost area. In 11% of patients minimal punctiform telangiectasia appeared at single puncture sites. In 3% ((2(65))) of patients planar telangiectasia appeared on the medial side of the implant. The rate of isolated local recurrences was 1.5%. In most cases geometrical volume optimization (GVO) yields improved dose distributions with respect to

  20. Changes in dose with segmentation of breast tissues in Monte Carlo calculations for low-energy brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, J. G. H.; Thomson, R. M.; Rogers, D. W. O. [Carleton Laboratory for Radiotherapy Physics, Department of Physics, Carleton University, Ottawa K1S 5B6 (Canada)

    2011-08-15

    Purpose: To investigate the use of various breast tissue segmentation models in Monte Carlo dose calculations for low-energy brachytherapy. Methods: The EGSnrc user-code BrachyDose is used to perform Monte Carlo simulations of a breast brachytherapy treatment using TheraSeed Pd-103 seeds with various breast tissue segmentation models. Models used include a phantom where voxels are randomly assigned to be gland or adipose (randomly segmented), a phantom where a single tissue of averaged gland and adipose is present (averaged tissue), and a realistically segmented phantom created from previously published numerical phantoms. Radiation transport in averaged tissue while scoring in gland along with other combinations is investigated. The inclusion of calcifications in the breast is also studied in averaged tissue and randomly segmented phantoms. Results: In randomly segmented and averaged tissue phantoms, the photon energy fluence is approximately the same; however, differences occur in the dose volume histograms (DVHs) as a result of scoring in the different tissues (gland and adipose versus averaged tissue), whose mass energy absorption coefficients differ by 30%. A realistically segmented phantom is shown to significantly change the photon energy fluence compared to that in averaged tissue or randomly segmented phantoms. Despite this, resulting DVHs for the entire treatment volume agree reasonably because fluence differences are compensated by dose scoring differences. DVHs for the dose to only the gland voxels in a realistically segmented phantom do not agree with those for dose to gland in an averaged tissue phantom. Calcifications affect photon energy fluence to such a degree that the differences in fluence are not compensated for (as they are in the no calcification case) by dose scoring in averaged tissue phantoms. Conclusions: For low-energy brachytherapy, if photon transport and dose scoring both occur in an averaged tissue, the resulting DVH for the entire

  1. A neutron activation system for Ho, HoZr and Sm brachytherapy seeds for breast radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Wagner L., E-mail: wagner.leite@ifmg.edu.br [Instituto Federal de Minas Gerais (IFMG), Congonhas, MG (Brazil). Departamento de Fisica; Campos, Tarcisio P.R., E-mail: tprcampos@pq.cnpq.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

    2015-07-01

    This paper addresses a device designed for transmuting nuclides by means of neutron capture reactions. The device is composed by a neutron generator based on d-d reactions, a neutron moderator and a reflection system, enclosed by a radiation shield. The project was modeled on the CST electromagnetic code. Afterwards, a nuclear investigation was carried out by MCNP5 code, where the final activities of a large set of 0.5 x 1.8 mm cylindrical, biodegradable and biocompatible, Ho-165 (Ho and HoZr) and Sm-152 breast brachytherapy seeds were evaluated, considering the neutron capture reactions. The accelerator-head equipotential profiles and the optical beam of deuterons with its energy map were presented. The neutronic evaluation allowed estimating a neutron yield of 10{sup 13} n s{sup -1}. From the seed's group, an individual Ho-166 seed reached activity of 100 MBq in 58 h operation time. Moreover, Sm-153 seed reached 120 MBq during a period of 64 h of operation. The system shows to be able to provide the neutron activation of brachytherapy seeds with suitable individual specific activity able for controlling breast tumors. (author)

  2. A comparison of the relative biological effectiveness of low energy electronic brachytherapy sources in breast tissue: a Monte Carlo study

    Science.gov (United States)

    White, Shane A.; Reniers, Brigitte; de Jong, Evelyn E. C.; Rusch, Thomas; Verhaegen, Frank

    2016-01-01

    Electronic brachytherapy sources use low energy photons to treat the tumor bed during or after breast-conserving surgery. The relative biological effectiveness of two electronic brachytherapy sources was explored to determine if spectral differences due to source design influenced radiation quality and if radiation quality decreased with distance in the breast. The RBE was calculated through the number of DNA double strand breaks (RBEDSB) using the Monte Carlo damage simulator (MCDS) in combination with other Monte Carlo electron/photon spectrum calculations. 50kVp photons from the Intrabeam (Carl Zeiss Surgical) and Axxent (Xoft) through 40-mm spherical applicators were simulated to account for applicator and tissue attenuation in a variety of breast tissue compositions. 40kVp Axxent photons were also simulated. Secondary electrons (known to be responsible for most DNA damage) spectra at different distance were inputted into MCDS to calculate the RBEDSB. All RBEDSB used a cobalt-60 reference. RBEDSB data was combined with corresponding average photon spectrum energy for the Axxent and applied to model-based average photon energy distributions to produce an RBEDSB map of an accelerated partial breast irradiation (APBI) patient. Both Axxent and Intrabeam 50kVp spectra were shown to have a comparable RBEDSB of between 1.4 and 1.6 at all distances in spite of progressive beam hardening. The Axxent 40kVp also demonstrated a similar RBEDSB at distances. Most RBEDSB variability was dependent on the tissue type as was seen in rib (RBEDSB  ≈  1.4), gland (≈1.55), adipose (≈1.59), skin (≈1.52) and lung (≈1.50). RBEDSB variability between both sources was within 2%. A correlation was shown between RBEDSB and average photon energy and used to produce an RBEDSB map of a dose distribution in an APBI patient dataset. Radiation quality is very similar between electronic brachytherapy sources studied. No significant reductions in RBEDSB were observed with

  3. A dosimetric comparison of 169Yb and 192Ir for HDR brachytherapy of the breast, accounting for the effect of finite patient dimensions and tissue inhomogeneities.

    Science.gov (United States)

    Lymperopoulou, G; Papagiannis, P; Angelopoulos, A; Karaiskos, P; Georgiou, E; Baltas, D

    2006-12-01

    Monte Carlo simulation dosimetry is used to compare 169Yb to 192Ir for breast high dose rate (HDR) brachytherapy applications using multiple catheter implants. Results for bare point sources show that while 169Yb delivers a greater dose rate per unit air kerma strength at the radial distance range of interest to brachytherapy in homogeneous water phantoms, it suffers a greater dose rate deficit in missing scatter conditions relative to 192Ir. As a result of these two opposing factors, in the scatter conditions defined by the presence of the lung and the finite patient dimensions in breast brachytherapy the dose distributions calculated in a patient equivalent mathematical phantom by Monte Carlo simulations for the same implant of either 169Yb or 1921r commercially available sources are found comparable. Dose volume histogram results support that 169Yb could be at least as effective as 192Ir delivering the same dose to the lung and slightly reduced dose to the breast skin. The current treatment planning systems' approach of employing dosimetry data precalculated in a homogeneous water phantom of given shape and dimensions, however, is shown to notably overestimate the delivered dose distribution for 169Yb. Especially at the skin and the lung, the treatment planning system dose overestimation is on the order of 15%-30%. These findings do not undermine the potential of 169Yb HDR sources for breast brachytherapy relative to the most commonly used 192Ir HDR sources. They imply, however, that there could be a need for the amendment of dose calculation algorithms employed in clinical treatment planning of particular brachytherapy applications, especially for intermediate photon energy sources such as 169Yb.

  4. Dose volume histogram analysis of normal structures associated with accelerated partial breast irradiation delivered by high dose rate brachytherapy and comparison with whole breast external beam radiotherapy fields

    Directory of Open Access Journals (Sweden)

    Mutyala Subhakar

    2008-11-01

    Full Text Available Abstract Purpose To assess the radiation dose delivered to the heart and ipsilateral lung during accelerated partial breast brachytherapy using a MammoSite™ applicator and compare to those produced by whole breast external beam radiotherapy (WBRT. Materials and methods Dosimetric analysis was conducted on patients receiving MammoSite breast brachytherapy following conservative surgery for invasive ductal carcinoma. Cardiac dose was evaluated for patients with left breast tumors with a CT scan encompassing the entire heart. Lung dose was evaluated for patients in whom the entire lung was scanned. The prescription dose of 3400 cGy was 1 cm from the balloon surface. MammoSite dosimetry was compared to simulated WBRT fields with and without radiobiological correction for the effects of dose and fractionation. Dose parameters such as the volume of the structure receiving 10 Gy or more (V10 and the dose received by 20 cc of the structure (D20, were calculated as well as the maximum and mean doses received. Results Fifteen patients were studied, five had complete lung data and six had left-sided tumors with complete cardiac data. Ipsilateral lung volumes ranged from 925–1380 cc. Cardiac volumes ranged from 337–551 cc. MammoSite resulted in a significantly lower percentage lung V30 and lung and cardiac V20 than the WBRT fields, with and without radiobiological correction. Conclusion This study gives low values for incidental radiation received by the heart and ipsilateral lung using the MammoSite applicator. The volume of heart and lung irradiated to clinically significant levels was significantly lower with the MammoSite applicator than using simulated WBRT fields of the same CT data sets. Trial registration Dana Farber Trial Registry number 03-179

  5. A Multi-Institutional Study of Feasibility, Implementation, and Early Clinical Results With Noninvasive Breast Brachytherapy for Tumor Bed Boost

    Energy Technology Data Exchange (ETDEWEB)

    Hamid, Subarna, E-mail: shamid@tuftsmedicalcenter.org [Department of Radiation Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA (United States); Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (United States); Rocchio, Kathy [Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (United States); Arthur, Douglas; Vera, Robyn [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA (United States); Sha, Sandra; Jolly, Michele [Central Florida Cancer Institute, Davenport, FL (United States); Cavanaugh, Sean; Wooten, Eric [Atlanta Oncology Associates, Hawkinsville, GA (United States); Benda, Rashmi; Greenfield, Brad [Department of Radiation Oncology, Boca Raton Community Hospital, Boca Raton, FL (United States); Prestidge, Bradley [Texas Cancer Clinic, San Antonio, TX (United States); Ackerman, Scot [First Coast Oncology, Jacksonville, FL (United States); Kuske, Robert; Quiet, Coral; Snyder, Margaret [Arizona Breast Cancer Specialists, Phoenix, AZ (United States); Wazer, David E. [Department of Radiation Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA (United States); Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (United States)

    2012-08-01

    Purpose: To evaluate the feasibility, implementation, and early results of noninvasive breast brachytherapy (NIBB) for tumor bed boost with whole breast radiation therapy (WBRT). Methods and Materials: NIBB is a commercially available (AccuBoost, Billerica, MA) mammography-based, brachytherapy system in which the treatment applicators are centered on the planning target volume (PTV) to direct {sup 192}Ir emissions along orthogonal axes. A privacy-encrypted online data registry collected information from 8 independent academic and community-based institutions. Data were from 146 consecutive women with early-stage breast cancer after lumpectomy and WBRT receiving boost with NIBB between July 2007 and March 2010. Toxicity and cosmesis were graded according to the Common Toxicity Criteria (v. 3.0) and the Harvard scale. Median follow-up was 6 months (1-39 months). Results: Grade 1-2 skin toxicity was observed in 64%, 48%, and 21% during the acute (1-3 weeks), intermediate (4-26 weeks), and late-intermediate (>26 weeks) periods. There was no Grade 4 toxicity. At 6 months, for the entire cohort, cosmesis was excellent/good in 62%/38%. The subset receiving NIBB before WBRT had cosmetic scores of 32% and 63%, whereas during WBRT, 58% and 37% were rated as excellent and good, respectively. Breast compression was scored as 'uncomfortable' in 12%, 29%, and 59% when NIBB was delivered before, during, or after WBRT. For each patient, the fraction-to-fraction variability in PTV was low. Skin flash was associated with a higher proportion of excellent cosmesis (58% vs. 42%) relative to having the applicator all within breast tissue. Conclusions: These data indicate that NIBB is feasible and can be consistently implemented in a broad array of practice settings. Preliminary evaluation suggests that NIBB is associated with acceptably mild normal tissue toxicity and favorable early cosmesis. The application of NIBB before WBRT may be associated with better patient tolerance

  6. Applications of tissue heterogeneity corrections and biologically effective dose volume histograms in assessing the doses for accelerated partial breast irradiation using an electronic brachytherapy source

    Energy Technology Data Exchange (ETDEWEB)

    Shi Chengyu; Guo Bingqi; Eng, Tony; Papanikolaou, Nikos [Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, TX 78229 (United States); Cheng, Chih-Yao, E-mail: shic@uthscsa.ed [Radiation Oncology Department, Oklahoma University Health Science Center, Oklahoma, OK 73104 (United States)

    2010-09-21

    A low-energy electronic brachytherapy source (EBS), the model S700 Axxent(TM) x-ray device developed by Xoft Inc., has been used in high dose rate (HDR) intracavitary accelerated partial breast irradiation (APBI) as an alternative to an Ir-192 source. The prescription dose and delivery schema of the electronic brachytherapy APBI plan are the same as the Ir-192 plan. However, due to its lower mean energy than the Ir-192 source, an EBS plan has dosimetric and biological features different from an Ir-192 source plan. Current brachytherapy treatment planning methods may have large errors in treatment outcome prediction for an EBS plan. Two main factors contribute to the errors: the dosimetric influence of tissue heterogeneities and the enhancement of relative biological effectiveness (RBE) of electronic brachytherapy. This study quantified the effects of these two factors and revisited the plan quality of electronic brachytherapy APBI. The influence of tissue heterogeneities is studied by a Monte Carlo method and heterogeneous 'virtual patient' phantoms created from CT images and structure contours; the effect of RBE enhancement in the treatment outcome was estimated by biologically effective dose (BED) distribution. Ten electronic brachytherapy APBI cases were studied. The results showed that, for electronic brachytherapy cases, tissue heterogeneities and patient boundary effect decreased dose to the target and skin but increased dose to the bones. On average, the target dose coverage PTV V{sub 100} reduced from 95.0% in water phantoms (planned) to only 66.7% in virtual patient phantoms (actual). The actual maximum dose to the ribs is 3.3 times higher than the planned dose; the actual mean dose to the ipsilateral breast and maximum dose to the skin were reduced by 22% and 17%, respectively. Combining the effect of tissue heterogeneities and RBE enhancement, BED coverage of the target was 89.9% in virtual patient phantoms with RBE enhancement (actual BED) as

  7. High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the local control rate and complications of a single fraction of high-dose-rate brachytherapy (HDR BT) boost in women aged 45 yeas and younger after breast-conserving therapy. Methods and Materials: Between 1999 and 2007, 167 patients between the ages of 26 and 45 years old (72 were 40 years old or younger), with stages T1 to T2 invasive breast cancer with disease-free margin status of at least 5 mm after breast-conserving surgery received 46 to 50 Gy whole-breast irradiation plus a 7-Gy HDR-BT boost (“fast boost”). An axillary dissection was performed in 72.5% of the patients and sentinel lymph node biopsy in 27.5%. A supraclavicular area was irradiated in 19% of the patients. Chemotherapy was used in 86% of the patients and hormone treatment in 77%. Clinical nodes were present in 18% and pathological nodes in 29%. The pathological stage was pT0: 5%, pTis: 3%, pT1: 69% and pT2: 23%. Intraductal component was present in 40% and 28% were G3. Results: At a median follow-up of 92 months, 9 patients relapsed on the margin of the implant, and 1 patient in another quadrant, resulting in a 10-year local relapse rate of 4.3% and a breast relapse rate of 4.9%, with breast preservation in 93.4%; no case of mastectomy due to poor cosmesis arose. Actuarial 5- and 10-year disease-free, cause-specific, and overall survival rates were 87.9% and 85.8%, and 92.1% and 88.4%, and 92.1% and 87.3%, respectively. In a univariate analysis, triple-negative cases and negative hormone receptors did worse, but in a multivariate analysis, only the last factor was significant for local and breast control. Asymptomatic fibrosis G2 was recorded in 3 cases, and there were no other late complications. Cosmetic results were good to excellent in 97% of cases. Conclusions: A single dose of 7 Gy using the fast-boost technique is well tolerated, with a low rate of late complications and improved local tumor control in women aged 45 and younger, compared to published data

  8. High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Guinot, Jose-Luis, E-mail: jguinot@fivo.org [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Baixauli-Perez, Cristobal [Health Services Research Unit, Center for Public Health Research, Valencia (Spain); Soler, Pablo; Tortajada, Maria Isabel; Moreno, Araceli; Santos, Miguel Angel; Mut, Alejandro [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Gozalbo, Francisco [Department of Pathology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Arribas, Leoncio [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain)

    2015-01-01

    Purpose: To evaluate the local control rate and complications of a single fraction of high-dose-rate brachytherapy (HDR BT) boost in women aged 45 yeas and younger after breast-conserving therapy. Methods and Materials: Between 1999 and 2007, 167 patients between the ages of 26 and 45 years old (72 were 40 years old or younger), with stages T1 to T2 invasive breast cancer with disease-free margin status of at least 5 mm after breast-conserving surgery received 46 to 50 Gy whole-breast irradiation plus a 7-Gy HDR-BT boost (“fast boost”). An axillary dissection was performed in 72.5% of the patients and sentinel lymph node biopsy in 27.5%. A supraclavicular area was irradiated in 19% of the patients. Chemotherapy was used in 86% of the patients and hormone treatment in 77%. Clinical nodes were present in 18% and pathological nodes in 29%. The pathological stage was pT0: 5%, pTis: 3%, pT1: 69% and pT2: 23%. Intraductal component was present in 40% and 28% were G3. Results: At a median follow-up of 92 months, 9 patients relapsed on the margin of the implant, and 1 patient in another quadrant, resulting in a 10-year local relapse rate of 4.3% and a breast relapse rate of 4.9%, with breast preservation in 93.4%; no case of mastectomy due to poor cosmesis arose. Actuarial 5- and 10-year disease-free, cause-specific, and overall survival rates were 87.9% and 85.8%, and 92.1% and 88.4%, and 92.1% and 87.3%, respectively. In a univariate analysis, triple-negative cases and negative hormone receptors did worse, but in a multivariate analysis, only the last factor was significant for local and breast control. Asymptomatic fibrosis G2 was recorded in 3 cases, and there were no other late complications. Cosmetic results were good to excellent in 97% of cases. Conclusions: A single dose of 7 Gy using the fast-boost technique is well tolerated, with a low rate of late complications and improved local tumor control in women aged 45 and younger, compared to published data

  9. Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study

    International Nuclear Information System (INIS)

    Background and purpose: To report the 12-year updated results of accelerated partial-breast irradiation (APBI) using multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT). Patients and methods: Forty-five prospectively selected patients with T1N0-N1mi, nonlobular breast cancer without the presence of an extensive intraductal component and with negative surgical margins were treated with APBI after breast-conserving surgery (BCS) using interstitial HDR BT. A total dose of 30.3 Gy (n = 8) and 36.4 Gy (n = 37) in seven fractions within 4 days was delivered to the tumour bed plus a 1-2 cm margin. The median follow-up time was 133 months for surviving patients. Local and regional control, disease-free (DFS), cancer-specific (CSS), and overall survival (OS), as well as late side effects, and cosmetic results were assessed. Results: Four (8.9%) ipsilateral breast tumour recurrences were observed, for a 5-, 10-, and 12-year actuarial rate of 4.4%, 9.3%, and 9.3%, respectively. A total of two regional nodal failures were observed for a 12-year actuarial rate of 4.4%. The 12-year DFS, CSS, and OS was 75.3%, 91.1%, and 88.9%, respectively. Grade 3 fibrosis was observed in one patient (2.2%). No patient developed grade 3 teleangiectasia. Fat necrosis requiring surgical intervention occurred in one woman (2.2%). Cosmetic results were rated excellent or good in 35 patients (77.8%). Conclusions: Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects.

  10. Long-term outcome with interstitial brachytherapy in the management of patients with early-stage breast cancer treated with breast-conserving therapy

    International Nuclear Information System (INIS)

    Purpose: We reviewed our institution's experience with interstitial implant boosts to determine their long-term impact on local control and cosmetic results. Methods and Materials: Between January 1, 1980 and December 31, 1987, 390 women with 400 cases of Stage I and II breast cancer were managed with breast-conserving therapy (BCT) at William Beaumont Hospital. All patients were treated with an excisional biopsy and 253 (63%) underwent reexcision. Radiation consisted of 45-50 Gy external beam irradiation to the whole breast followed by a boost to the tumor bed to at least 60 Gy using either electrons [108], photons [15], or an interstitial implant [277] with either 192Ir [190] or 125I [87]. Long-term local control and cosmetic outcome were assessed and contrasted between patients boosted with either interstitial implants, electrons, or photons. Results: With a median follow-up of 81 months, 25 patients have recurred in the treated breast for a 5- and 8-year actuarial rate of local recurrence of 4 and 8%, respectively. There were no statistically significant differences in the 5- or 8-year actuarial rates of local recurrence using either electrons, photons, or an interstitial implant. Greater than 90% of patients obtained a good or excellent cosmetic result, and no statistically significant differences in cosmetic outcome were seen whether electrons, photons, or implants were used. Conclusions: We conclude that patients with Stage I and II breast cancer undergoing BCT and judged to be candidates for boosts can be effectively managed with LDR interstitial brachytherapy. Long-term local control and cosmetic outcome are excellent and similar to patients boosted with either electrons or photons

  11. Implementation of the technique of partial irradiation accelerated the breast with high doses (HDR) brachytherapy; Puesta en marcha de la tecnica de irradiacion parcial acelerada de la mama con braquterapia de alta tasa de dosis (HDR)

    Energy Technology Data Exchange (ETDEWEB)

    Molina Lopez, M. Y.; Pardo Perez, E.; Castro Novais, J.; Martinez Ortega, J.; Ruiz Maqueda, S.; Cerro Penalver, E. del

    2013-07-01

    The objective of this work is presents procedure carried out in our Centre for the implementation of the accelerated partial breast irradiation (APBI, accelerated partial-breast irradiation) with high-rate brachytherapy (HDR), using plastic tubes as applicators. Carried out measures, the evaluation of the dosimetric parameters analyzing and presenting the results. (Author)

  12. Five-Year Analysis of Treatment Efficacy and Cosmesis by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in Patients Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Purpose: To present 5-year data on treatment efficacy, cosmetic results, and toxicities for patients enrolled on the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial. Methods and Materials: A total of 1440 patients (1449 cases) with early-stage breast cancer receiving breast-conserving therapy were treated with the MammoSite device to deliver accelerated partial-breast irradiation (APBI) (34 Gy in 3.4-Gy fractions). Of 1449 cases, 1255 (87%) had invasive breast cancer (IBC) (median size, 10 mm) and 194 (13%) had ductal carcinoma in situ (DCIS) (median size, 8 mm). Median follow-up was 54 months. Results: Thirty-seven cases (2.6%) developed an ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial rate of 3.80% (3.86% for IBC and 3.39% for DCIS). Negative estrogen receptor status (p = 0.0011) was the only clinical, pathologic, or treatment-related variable associated with IBTR for patients with IBC and young age (<50 years; p = 0.0096) and positive margin status (p = 0.0126) in those with DCIS. The percentage of breasts with good/excellent cosmetic results at 60 months (n = 371) was 90.6%. Symptomatic breast seromas were reported in 13.0% of cases, and 2.3% developed fat necrosis. A subset analysis of the first 400 consecutive cases enrolled was performed (352 with IBC, 48 DCIS). With a median follow-up of 60.5 months, the 5-year actuarial rate of IBTR was 3.04%. Conclusion: Treatment efficacy, cosmesis, and toxicity 5 years after treatment with APBI using the MammoSite device are good and similar to those reported with other forms of APBI with similar follow-up.

  13. Partial breast irradiation as sole therapy for low risk breast carcinoma: Early toxicity, cosmesis and quality of life results of a MammoSite brachytherapy phase II study

    International Nuclear Information System (INIS)

    Purpose: The MammoSite is a device that was developed with the goal of making breast-conserving surgery (BCT) more widely available. Our objective was to evaluate the MammoSite device performances after an open cavity placement procedure and quality of life in highly selected patients with early-stage breast cancer. Methods and materials: From March 2003 to March 2005, 43 patients with T1 breast cancer were enrolled in a phase II study. The median age was 72 years. Twenty-five (58%) patients were treated with high-dose rate brachytherapy using the MammoSite applicator to deliver 34 Gy in 10 fractions. The main disqualifying factor was pathologic sentinel node involvement (10/43; 23%). There were no device malfunctions, migration or rupture of the balloon. Results: After a median follow-up of 13 months, there were no local recurrences and one contralateral lobular carcinoma. Seventeen (68%), 13 (52%), 8 (32%), 5 (20%) and 2 (8%) patients had erythema, seroma, inflammation, hematoma and sever infection, respectively. Only 2 patients developed telangiectasia. At 1 year the rate of 'good to excellent' cosmetic results was 84%. Significant changes in QoL were observed for emotional and social well-being between 3 and 12 months. At 24 months, only emotional well-being subscore changes were statistically significant (p = 0.015). Conclusions: Our data in patients older than 60 years support the previously published data. Histologic features were the main disqualifying criteria. With higher skin spacing levels we observed very low incidence of telangiectasia. QoL evaluation indicates that baseline scores were satisfactory. Changes concerned emotional and social well-being

  14. Clinical experience with the MammoSite[reg] radiation therapy system for brachytherapy of breast cancer: Results from an international phase II trial

    International Nuclear Information System (INIS)

    Background and purpose: In a prospective multi-center phase II trial, we investigated the MammoSite[reg] Radiation Therapy System, a new device for delivering intracavitary brachytherapy following breast conserving surgery. The MammoSite[reg] is a dual lumen, closed ended catheter with a small, spherical inflatable balloon and a port for connecting a remote afterloader to the central lumen. We analyzed the surgical procedure and placement of the MammoSite[reg], treatment planning and radiation delivery complications and cosmesis, as well the comfort for the patients. Patients and methods: Between 2002 and 2004 a total of 32 patients (pts) were implanted using the MammoSite[reg]. The reference isodose was defined 1 cm from the balloon surface. We analyzed the post-implant anatomic position of the applicator and the geometric form of the balloon via ultrasound, CT and X-ray, related side effects, cosmetic outcome and patient quality of life. Results: Twenty-three out of 32 patients (72%) were eligible for MammoSite[reg] intracavitary brachytherapy. Twenty-eight percentage had to be excluded because of different reasons. Eleven patients were treated with primary brachytherapy with a total dose of 34 Gy (2x3.4 Gy) and 12 had a boost with a mean dose of 13.3 Gy (range: 7.5-15 Gy; 2x2.5 Gy) combined with EBRT and doses ranged between 46 and 50 Gy. In three cases a balloon rupture occurred. We observed two abscesses within 3 months of implantation and serious seroma development in 10 patients (39%). Skin related side effects were erythema in 21 patients (91%), hyperpigmentation in 13 patients (56%) and teleangiectasia in six patients (26%) after mean follow-up 20 months. Conclusions: The MammoSite[reg] Radiation Therapy System is a feasible treatment modality for intracavitary brachytherapy of breast cancer after breast conserving surgery. The advantage of the system is only one applicator is necessary for the delivery of a fractionated radiotherapy. In addition, patient

  15. Photon counting readout pixel array in 0.18-μm CMOS technology for on-line gamma-ray imaging of 103palladium seeds for permanent breast seed implant (PBSI) brachytherapy

    Science.gov (United States)

    Goldan, A. H.; Karim, K. S.; Reznik, A.; Caldwell, C. B.; Rowlands, J. A.

    2008-03-01

    Permanent breast seed implant (PBSI) brachytherapy technique was recently introduced as an alternative to high dose rate (HDR) brachytherapy and involves the permanent implantation of radioactive 103Palladium seeds into the surgical cavity of the breast for cancer treatment. To enable accurate seed implantation, this research introduces a gamma camera based on a hybrid amorphous selenium detector and CMOS readout pixel architecture for real-time imaging of 103Palladium seeds during the PBSI procedure. A prototype chip was designed and fabricated in 0.18-μm n-well CMOS process. We present the experimental results obtained from this integrated photon counting readout pixel.

  16. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    Energy Technology Data Exchange (ETDEWEB)

    Hattangadi, Jona A. [Harvard Radiation Oncology Program, Boston, MA (United States); Powell, Simon N. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); MacDonald, Shannon M.; Mauceri, Thomas; Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Freer, Phoebe [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Lawenda, Brian [21st Century Oncology, Las Vegas, NV (United States); Alm El-Din, Mohamed A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Department of Clinical Oncology, Tanta University Hospital, Tanta (Egypt); Gadd, Michele A.; Smith, Barbara L. [Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

    2012-07-01

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall's tau ({tau}{sub {beta}}) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4-14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome ({tau}{sub {beta}} 0.6, p < .0001), lower patient satisfaction ({tau}{sub {beta}} 0.5, p < .001), and worse fibrosis ({tau}{sub {beta}} 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias {>=}1 cm{sup 2}. Grade 3-4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose ({tau}{sub {beta}} 0.3-0.5, p {<=} .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence

  17. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall’s tau (τβ) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4–14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome (τβ 0.6, p β 0.5, p β 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias ≥1 cm2. Grade 3–4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose (τβ 0.3–0.5, p ≤ .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence-free survival, and overall survival rate was 85% (95% confidence interval, 70–97%), 72% (95% confidence interval, 54–86%), and 87% (95% confidence

  18. SU-E-J-96: Multi-Axis Dose Accumulation of Noninvasive Image-Guided Breast Brachytherapy Through Biomechanical Modeling of Tissue Deformation Using the Finite Element Method

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, MJ [Tufts University School of Medicine, Boston, MA (United States); Ghadyani, HR [SUNY Farmingdale State College, Farmingdale, NY (United States); Bastien, AD; Lutz, NN [Univeristy Massachusetts Lowell, Lowell, MA (United States); Hepel, JT [Rhode Island Hospital, Providence, RI (United States)

    2015-06-15

    Purpose: Noninvasive image-guided breast brachytherapy delivers conformal HDR Ir-192 brachytherapy treatments with the breast compressed, and treated in the cranial-caudal and medial-lateral directions. This technique subjects breast tissue to extreme deformations not observed for other disease sites. Given that, commercially-available software for deformable image registration cannot accurately co-register image sets obtained in these two states, a finite element analysis based on a biomechanical model was developed to deform dose distributions for each compression circumstance for dose summation. Methods: The model assumed the breast was under planar stress with values of 30 kPa for Young’s modulus and 0.3 for Poisson’s ratio. Dose distributions from round and skin-dose optimized applicators in cranial-caudal and medial-lateral compressions were deformed using 0.1 cm planar resolution. Dose distributions, skin doses, and dose-volume histograms were generated. Results were examined as a function of breast thickness, applicator size, target size, and offset distance from the center. Results: Over the range of examined thicknesses, target size increased several millimeters as compression thickness decreased. This trend increased with increasing offset distances. Applicator size minimally affected target coverage, until applicator size was less than the compressed target size. In all cases, with an applicator larger or equal to the compressed target size, > 90% of the target covered by > 90% of the prescription dose. In all cases, dose coverage became less uniform as offset distance increased and average dose increased. This effect was more pronounced for smaller target-applicator combinations. Conclusions: The model exhibited skin dose trends that matched MC-generated benchmarking results and clinical measurements within 2% over a similar range of breast thicknesses and target sizes. The model provided quantitative insight on dosimetric treatment variables over

  19. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Vargo, John A.; Verma, Vivek; Kim, Hayeon; Kalash, Ronny; Heron, Dwight E.; Johnson, Ronald; Beriwal, Sushil, E-mail: beriwals@upmc.edu

    2014-02-01

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy

  20. Outcome of a phase II prospective study on partial breast irradiation with interstitial multi-catheter high-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Background and purpose: Partial breast irradiation (PBI) is an alternative to whole-breast irradiation after breast-conserving surgery in selected patients. Until the results of randomized phase III studies are available, phase II studies inform about PBI. We report the 5 year results of a phase II prospective study with PBI using interstitial multi-catheter high-dose-rate brachytherapy (ClinicalTrials.gov Identifier: (NCT00499057)). Methods: Hundred patients received PBI (4 Gy, twice a day for 4 days, until 32 Gy). Inclusion criteria were: age ⩾40 years, infiltrating carcinoma without lobular histology, ductal in situ carcinoma, tumor size ⩽2.5 cm, negative surgical margins and axillary lymph nodes. Results: At a median follow-up of 60 months late toxicity occurred in 25 patients; the 5-year probability of freedom from late toxicity was 72.6% (95% CI: 63.7–81.7). Tamoxifen was the only significant risk factor for late toxicity. Cosmetic results, judged by physicians and patients, were good/excellent in 98 patients. Three local relapses (1 true, 2 elsewhere) and 1 regional relapse occurred. The 5-year probability of local or regional relapse-free survival was 97.7% (95% CI: 91.1–99.4) and 99.0% (95% CI: 92.9–99.8), respectively. Conclusion: PBI with interstitial multi-catheter brachytherapy is associated with low relapse and late toxicity rates

  1. Pulsed dose rate brachytherapy as the sole adjuvant radiotherapy after breast-conserving surgery of T1-T2 breast cancer: First long time results from a clinical study

    International Nuclear Information System (INIS)

    Background and purpose: To evaluate the long time outcome with regard to local tumour control, cosmetic outcome and side effects of a short (5 days) accelerated interstitial brachytherapy treatment delivered to the surroundings of the operated sector. Patients and methods: Between 1993 and 2003 we treated 50 women with early T1 and T2 breast cancer. Radical sector resection was performed and followed later with an interstitial pulsed dose rate (PDR) brachytherapy of 50 Gy in 5 days. The treatment was centred on the tumour with a margin of 30 mm. One patient was treated bilaterally. The patients were followed for a median of 86 (32-126) months. Results: Ipsilateral breast cancer recurrence was seen in 3 patients (6%). Two of them occurred outside the treated volume. The 5- and 7-year rates of actuarial local control were 96% and 96%, respectively, overall survival 88% and 85%, disease free survival 88% and 88%, respectively. A dosimetrical analysis showed that the partial breast irradiation covered a median of 31% of the total breast volume. Fat necrosis was seen in 12% and local (moderate-strong) fibrosis in 26% of the patients. Independent cosmetic scoring showed good or excellent result in 56% of the patients. Conclusions: Local outcome is favourable and very similar to other published studies of accelerated partial breast irradiation. Our long time cosmetic results are lower than other published results

  2. SU-E-J-215: Towards MR-Only Image Guided Identification of Calcifications and Brachytherapy Seeds: Application to Prostate and Breast LDR Implant Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Elzibak, A; Fatemi-Ardekani, A; Soliman, A; Mashouf, S; Safigholi, H; Ravi, A; Morton, G; Song, WY [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Han, D [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); University of California, San Diego, La Jolla, CA (United States)

    2015-06-15

    Purpose: To identify and analyze the appearance of calcifications and brachytherapy seeds on magnitude and phase MRI images and to investigate whether they can be distinguished from each other on corrected phase images for application to prostate and breast low dose rate (LDR) implant dosimetry. Methods: An agar-based gel phantom containing two LDR brachytherapy seeds (Advantage Pd-103, IsoAid, 0.8mm diameter, 4.5mm length) and two spherical calcifications (large: 7mm diameter and small: 4mm diameter) was constructed and imaged on a 3T Philips MR scanner using a 16-channel head coil and a susceptibility weighted imaging (SWI) sequence (2mm slices, 320mm FOV, TR/ TE= 26.5/5.3ms, 15 degree flip angle). The phase images were unwrapped and corrected using a 32×32, 2D Hanning high pass filter to remove background phase noise. Appearance of the seeds and calcifications was assessed visually and quantitatively using Osirix (http://www.osirix-viewer.com/). Results: As expected, calcifications and brachytherapy seeds appeared dark (hypointense) relative to the surrounding gel on the magnitude MRI images. The diameter of each seed without the surrounding artifact was measured to be 0.1 cm on the magnitude image, while diameters of 0.79 and 0.37 cm were measured for the larger and smaller calcifications, respectively. On the corrected phase images, the brachytherapy seeds and the calcifications appeared bright (hyperintense). The diameter of the seeds was larger on the phase images (0.17 cm) likely due to the dipole effect. Conclusion: MRI has the best soft tissue contrast for accurate organ delineation leading to most accurate implant dosimetry. This work demonstrated that phase images can potentially be useful in identifying brachytherapy seeds and calcifications in the prostate and breast due to their bright appearance, which helps in their visualization and quantification for accurate dosimetry using MR-only. Future work includes optimizing phase filters to best identify

  3. Factors Associated With Optimal Long-Term Cosmetic Results in Patients Treated With Accelerated Partial Breast Irradiation Using Balloon-Based Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate factors associated with optimal cosmetic results at 72 months for early-stage breast cancer patients treated with Mammosite balloon-based accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,440 patients (1,449 cases) with early-stage breast cancer undergoing breast-conserving therapy were treated with balloon-based brachytherapy to deliver APBI (34 Gy in 3.4-Gy fractions). Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good (E/G) or fair/poor (F/P). Follow-up was evaluated at 36 and 72 months to establish long-term cosmesis, stability of cosmesis, and factors associated with optimal results. Results: The percentage of evaluable patients with excellent/good (E/G) cosmetic results at 36 months and more than 72 months were 93.3% (n = 708/759) and 90.4% (n = 235/260). Factors associated with optimal cosmetic results at 72 months included: larger skin spacing (p = 0.04) and T1 tumors (p = 0.02). Using multiple regression analysis, the only factors predictive of worse cosmetic outcome at 72 months were smaller skin spacing (odds ratio [OR], 0.89; confidence interval [CI], 0.80–0.99) and tumors greater than 2 cm (OR, 4.96, CI, 1.53–16.07). In all, 227 patients had both a 36-month and a 72-month cosmetic evaluation. The number of patients with E/G cosmetic results decreased only slightly from 93.4% at 3 years to 90.8% (p = 0.13) at 6 years, respectively. Conclusions: APBI delivered with balloon-based brachytherapy produced E/G cosmetic results in 90.4% of cases at 6 years. Larger tumors (T2) and smaller skin spacing were found to be the two most important independent predictors of cosmesis.

  4. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Eiichi [Department of Radiation Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Yamazaki, Hideya, E-mail: hideya10@hotmail.com [Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto (Japan); Yoshida, Ken; Takenaka, Tadashi [Department of Radiation Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Masuda, Norikazu [Department of Surgery and Breast Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Kotsuma, Tadayuki; Yoshioka, Yasuo; Inoue, Takehiro [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita (Japan)

    2011-11-15

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50-60 Gy in 25-30 fractions within 5-6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a Asterisk-Operator (reddish) and reduction in L Asterisk-Operator (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6-12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b Asterisk-Operator values, and EBRT did not, demonstrating that the reduction in b Asterisk-Operator values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  5. SU-E-T-58: Calculation of Dose Distribution of Accuboost Brachytherapy in Deformable Polyvinil Alcohol Breast Phantom Using Biomechanical Modeling and Monte Carlo Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Mohammadyari, P [Nuclear Engineering Department, School of Mechanical Engineering, Shiraz Un, Ilam (Iran, Islamic Republic of); Faghihi, R [Nuclear Engineering Department, Shiraz University, Shiraz (Iran, Islamic Republic of); Shirazi, M Mosleh [Radiotherapy and Oncology Department, Namazi Hospital, Shiraz University of M, Shiraz (Iran, Islamic Republic of); Lotfi, M [Shiraz University of Medical Sciences, Medical Imaging Research Center, Shiraz (Iran, Islamic Republic of); Meigooni, A [Comprehensive cancer center of Nevada - University of Nevada Las Vegas UNL, Las Vegas, NV (United States)

    2014-06-01

    Purpose: the accuboost is the most modern method of breast brachytherapy that is a boost method in compressed tissue by a mammography unit. the dose distribution in uncompressed tissue, as compressed tissue is important that should be characterized. Methods: In this study, the mechanical behavior of breast in mammography loading, the displacement of breast tissue and the dose distribution in compressed and uncompressed tissue, are investigated. Dosimetry was performed by two dosimeter methods of Monte Carlo simulations using MCNP5 code and thermoluminescence dosimeters. For Monte Carlo simulations, the dose values in cubical lattice were calculated using tally F6. The displacement of the breast elements was simulated by Finite element model and calculated using ABAQUS software, from which the 3D dose distribution in uncompressed tissue was determined. The geometry of the model is constructed from MR images of 6 volunteers. Experimental dosimetery was performed by placing the thermoluminescence dosimeters into the polyvinyl alcohol breast equivalent phantom and on the proximal edge of compression plates to the chest. Results: The results indicate that using the cone applicators would deliver more than 95% of dose to the depth of 5 to 17mm, while round applicator will increase the skin dose. Nodal displacement, in presence of gravity and 60N forces, i.e. in mammography compression, was determined with 43% contraction in the loading direction and 37% expansion in orthogonal orientation. Finally, in comparison of the acquired from thermoluminescence dosimeters with MCNP5, they are consistent with each other in breast phantom and in chest's skin with average different percentage of 13.7±5.7 and 7.7±2.3, respectively. Conclusion: The major advantage of this kind of dosimetry is the ability of 3D dose calculation by FE Modeling. Finally, polyvinyl alcohol is a reliable material as a breast tissue equivalent dosimetric phantom that provides the ability of TLD

  6. Validation of a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial HDR brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, Eric; Beaulieu, Luc, E-mail: Luc.Beaulieu@phy.ulaval.ca [Département de Physique, de Génie Physique et d’optique et Centre de Recherche sur le Cancer de l’Université Laval, Université Laval, Québec, Québec G1V 0A6, Canada and Département de Radio-oncologie et Axe Oncologie du Centre de Recherche du CHU de Québec, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Gardi, Lori; Barker, Kevin; Montreuil, Jacques; Fenster, Aaron [Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive, London, Ontario N6A 5K8 (Canada)

    2015-12-15

    Purpose: In current clinical practice, there is no integrated 3D ultrasound (3DUS) guidance system clinically available for breast brachytherapy. In this study, the authors present a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial high dose rate (HDR) brachytherapy treatment. Methods: For this work, a new computer controlled robotic 3DUS system was built to perform a hybrid motion scan, which is a combination of a 6 cm linear translation with a 30° rotation at both ends. The new 3DUS scanner was designed to fit on a modified Kuske assembly, keeping the current template grid configuration but modifying the frame to allow the mounting of the 3DUS system at several positions. A finer grid was also tested. A user interface was developed to perform image reconstruction, semiautomatic segmentation of the surgical bed as well as catheter reconstruction and tracking. A 3D string phantom was used to validate the geometric accuracy of the reconstruction. The volumetric accuracy of the system was validated with phantoms using magnetic resonance imaging (MRI) and computed tomography (CT) images. In order to accurately determine whether 3DUS can effectively replace CT for treatment planning, the authors have compared the 3DUS catheter reconstruction to the one obtained from CT images. In addition, in agarose-based phantoms, an end-to-end procedure was performed by executing six independent complete procedures with both 14 and 16 catheters, and for both standard and finer Kuske grids. Finally, in phantoms, five end-to-end procedures were performed with the final CT planning for the validation of 3DUS preplanning. Results: The 3DUS acquisition time is approximately 10 s. A paired Student t-test showed that there was no statistical significant difference between known and measured values of string separations in each direction. Both MRI and CT volume measurements were not statistically different from 3DUS volume (Student t-test: p > 0

  7. Multi-catheter interstitial brachytherapy for partial breast irradiation: an audit of implant quality based on dosimetric evaluation comparing intra-operative versus post-operative placement

    Science.gov (United States)

    Gurram, Lavanya; Joshi, Kishor; Phurailatpam, Reena; Paul, Siji; Sarin, Rajiv

    2016-01-01

    Purpose The use of multicatheter interstitial brachytherapy (MIB) for accelerated partial breast irradiation (APBI) in early breast cancer (EBC) patients outside the trial setting has increased. Hence, there is a need to critically evaluate implant quality. Moreover, there is a scarcity of reports using an open cavity technique. We report the dosimetric indices of open and closed cavity MIB techniques. Material and methods The dosimetric parameters of 60 EBC patients treated with MIB (open and closed cavity) who underwent three dimensional, computerized tomography (CT) based planning for APBI from November 2011 to July 2015 were evaluated. Coverage Index (CI), Dose Homogeneity Index (DHI), Conformity Index (COIN), Plan Quality Index (PQI), and Dose Non-uniformity Index (DNR) were assessed. Results Forty-one patients underwent open cavity and 19 patients underwent closed cavity placement of brachytherapy catheters. The median number of planes was 4 and median number of needles was 20. Median dose was 34 Gy with dose per fraction of 3.4 Gy, given twice a day, 6 hours apart. The D90 of the cavity and clinical target volume (CTV) were 105% and 89%, respectively. The median doses to the surgical clips were greater than 100%. The median CI of the cavity and CTV was 0.96 and 0.82, respectively. The DHI and COIN index of the CTV was 0.73 and 0.67. There were no significant differences in the dosimetric parameters based on whether the technique was done open or closed. Conclusions Critical evaluation of the dosimetric parameters of MIB-APBI is important for optimal results. While the open and closed techniques have similar dosimetry, our institutional preference is for an open technique which eases the procedure due to direct visualization of the tumor cavity. PMID:27257415

  8. A Japanese prospective multi-institutional feasibility study on accelerated partial breast irradiation using interstitial brachytherapy: treatment planning and quality assurance

    International Nuclear Information System (INIS)

    In Japan, breast-conserving surgery with closed cavity has generally been performed for breast cancer patients, and accelerated partial breast irradiation (APBI) is considered difficult because Asian females generally have smaller breast sizes than Western females. Therefore, common identification of target and treatment plan method in APBI is required. A prospective multicenter study was conducted in Japan to determine institutional compliance with APBI using high-dose-rate interstitial brachytherapy (ISBT) designed for Japanese female patients. For this study, 46 patients were recruited at eight institutions from January 2009 to December 2011. The reproducibility of the ISBT–APBI plan was evaluated using three criteria: (1) minimum clinical target volume dose with a clip dose ≥ 6 Gy/fraction, (2) irradiated volume constraint of 40-150 cm3, and (3) uniformity of dose distribution, expressed as the dose non-uniformity ratio (DNR, V150/V100) < 0.35. The ISBT–APBI plan for each patient was considered reproducible when all three criteria were met. When the number of non-reproducible patients was ≤ 4 at study completion, APBI at this institution was considered statistically reproducible. Half of the patients (52 %) had a small bra size (A/B cup). The mean values of the dose-constrained parameters were as follows: Vref, 117 cm3 (range, 40-282), DNR, 0.30 (range, 0.22-0.51), and clip dose, 784 cGy (range, 469-3146). A total of 43/46 treatment plans were judged to be compliant and ISBT–APBI was concluded to be reproducible. This study showed that multi-institutional ISBT–APBI treatment plan was reproducible for small breast patient with closed cavity

  9. The role of high-dose-rate brachytherapy boost in breast-conserving therapy: Long-term results of the Hungarian National Institute of Oncology

    International Nuclear Information System (INIS)

    Aim: To report the long-term results of high-dose-rate (HDR) brachytherapy (BT) boost for breast cancer patients treated with conservative surgery and radiotherapy. Materials and methods: Between 1995 and 2007, 100 early-stage breast cancer patients received an HDR BT boost after conservative surgery and whole breast irradiation. Ten patients (10%) received a single-fraction HDR boost of 8 - 10.35 Gy using rigid needles, while 90 (90%) were treated with a fractionated multi-catheter HDR BT boost. The latter consisted of 3 x 4 Gy (n = 19), 4.75 Gy (n = 70), and 2 x 6.4 Gy (n = 1). Breast cancer related events, cosmetic results and side effects were assessed. Results: At a median follow-up time of 94 months (range: 8 - 152) only 7 (7%) ipsilateral breast failures were observed for a 5- and 8-year actuarial rate of 4.5 and 7.0%, respectively. The 8-year disease-free, cancer-specific, and overall survival was 76.1, 82.8, and 80.4%, respectively. Cosmetic outcome was rated excellent in 17%, good in 39%, fair in 33%, and poor in 11%. Data on late radiation side effects were available for 91 patients (91%). Grade 3 fibrosis and grade 3 telangiectasia occurred in 6 (6.6%) and 2 (2.2%) patients, respectively. In univariate analysis only positive margin status had a significant negative effect on local control. Conclusions: HDR BT boost using multi-catheter implants produce excellent long-term local tumour control with acceptable cosmetic outcome and low rate of grade 3 late radiation side effects. (authors)

  10. External radiation and HDR-brachytherapy in the treatment of breast cancer. Externe Bestrahlung und interstitielle HDR-Brachytherapie in der Bestrahlung des Mammakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Track, C. (Abt. fuer Radioonkologie, Krankenhaus der Barmherzigen Schwestern, Linz (Austria)); Seewald, D.H. (Abt. fuer Radioonkologie, Krankenhaus der Barmherzigen Schwestern, Linz (Austria)); Zoidl, J.P. (Abt. fuer Radioonkologie, Krankenhaus der Barmherzigen Schwestern, Linz (Austria)); Hammer, J. (Abt. fuer Radioonkologie, Krankenhaus der Barmherzigen Schwestern, Linz (Austria))

    1994-04-01

    In the breast conserving management of mammary cancer a high-dose-rate (HDR)-Iridium-192 source is used for interstitial boosting of the primary tumor site after external radiotherapy. We want to show the clinical results and side effects and to demonstrate the safe use of a HDR source. From December 1984 until November 1988, 154 patients with breast cancer stage T1-2, N0-1 were treated by conservative surgery and radiation. A dose of 45 to 50 Gy was given to the whole breast by external radiotherapy, and the previous tumor area was boosted by an interstitial implant with Iridium-192 HDR. We applied 10 Gy in one or two fractions. The mean follow-up period of survivors is 76 months (range 57 to 107 months). In 36 patients failures occured: eight patients (5%) developed local recurrences, 31 patients (20%) had distant metastases, and 19 (12%) died with cancer. The Kaplan-Meier estimation for five year overall survival is 86.9%, for disease-specific survival 89.3%, for local control 95.8%, and for disease free survival 80.1%. The most frequent late effects were telangiectasia (11%), fibrotic masses in the previous tumor area (6.5%), and lymphedema of the arm (6.5%). No serious complications could be observed. (orig./MG)

  11. Density-Based 3D Shape Descriptors

    Directory of Open Access Journals (Sweden)

    Schmitt Francis

    2007-01-01

    Full Text Available We propose a novel probabilistic framework for the extraction of density-based 3D shape descriptors using kernel density estimation. Our descriptors are derived from the probability density functions (pdf of local surface features characterizing the 3D object geometry. Assuming that the shape of the 3D object is represented as a mesh consisting of triangles with arbitrary size and shape, we provide efficient means to approximate the moments of geometric features on a triangle basis. Our framework produces a number of 3D shape descriptors that prove to be quite discriminative in retrieval applications. We test our descriptors and compare them with several other histogram-based methods on two 3D model databases, Princeton Shape Benchmark and Sculpteur, which are fundamentally different in semantic content and mesh quality. Experimental results show that our methodology not only improves the performance of existing descriptors, but also provides a rigorous framework to advance and to test new ones.

  12. Robust and resistant 2D shape alignment

    DEFF Research Database (Denmark)

    Larsen, Rasmus; Eiriksson, Hrafnkell

    2001-01-01

    We express the alignment of 2D shapes as the minimization of the norm of a linear vector function. The minimization is done in the \\$l\\_1\\$, \\$l\\_2\\$ and the \\$l\\_\\$\\backslash\\$infty\\$ norms using well known standard numerical methods. In particular, the \\$l\\_1\\$ and the \\$l\\_\\$\\backslash\\$infty\\......We express the alignment of 2D shapes as the minimization of the norm of a linear vector function. The minimization is done in the \\$l\\_1\\$, \\$l\\_2\\$ and the \\$l\\_\\$\\backslash\\$infty\\$ norms using well known standard numerical methods. In particular, the \\$l\\_1\\$ and the \\$l......\\_\\$\\backslash\\$infty\\$ norm alignments are formulated as linear programming problems. The linear vector function formulation along with the different norms results in alignment methods that are both resistant from influence from outliers, robust wrt. errors in the annotation and capable of handling missing datapoints...

  13. Accelerated partial breast irradiation: An analysis of variables associated with late toxicity and long-term cosmetic outcome after high-dose-rate interstitial brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To perform a detailed analysis of variables associated with late tissue effects of high-dose-rate (HDR) interstitial brachytherapy accelerated partial breast irradiation (APBI) in a large cohort of patients with prolonged follow-up. Methods and Materials: Beginning in 1995, 75 women with Stage I/II breast cancer were enrolled in identical institutional trials evaluating APBI as monotherapy after lumpectomy. Patients eligible included those with T1-2, N0-1 (≤3 nodes positive), M0 tumors of nonlobular histology with negative surgical margins, no extracapsular nodal extension, and negative results on postexcision mammogram. All patients underwent surgical excision and postoperative irradiation with HDR interstitial brachytherapy. The planning target volume was defined as the excision cavity plus a 2-cm margin. Treatment was delivered with a high-activity Ir-192 source at 3.4 Gy per fraction twice daily for 5 days to a total dose of 34 Gy. Dosimetric analyses were performed with three-dimensional postimplant dose and volume reconstructions. All patients were evaluated at 3-6-month intervals and assessed with a standardized cosmetic rating scale and according to Radiation Therapy Oncology Group late normal tissue toxicity scoring criteria. Clinical and therapy-related features were analyzed for their relationship to cosmetic outcome and toxicity rating. Clinical features analyzed included age, volume of resection, history of diabetes or hypertension, extent of axillary surgery, and systemic therapies. Therapy-related features analyzed included volume of tissue encompassed by the 100%, 150%, and 200% isodose lines (V100, V150, and V200, respectively), the dose homogeneity index (DHI), number of source dwell positions, and planar separation. Results: The median follow-up of all patients was 73 months (range, 43-118 months). The cosmetic outcome at last follow-up was rated as excellent, good, and fair/poor in 67%, 24%, and 9% of patients, respectively

  14. High dose rate brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. (author)

  15. Comparison of organ doses for patients undergoing balloon brachytherapy of the breast with HDR {sup 192}Ir or electronic sources using Monte Carlo simulations in a heterogeneous human phantom

    Energy Technology Data Exchange (ETDEWEB)

    Mille, Matthew M.; Xu, X. George; Rivard, Mark J. [Nuclear Engineering and Engineering Physics Program, Rensselaer Polytechnic Institute, Troy, New York 12180 (United States); Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States)

    2010-02-15

    Purpose: Accelerated partial breast irradiation via interstitial balloon brachytherapy is a fast and effective treatment method for certain early stage breast cancers. The radiation can be delivered using a conventional high-dose rate (HDR) {sup 192}Ir gamma-emitting source or a novel electronic brachytherapy (eBx) source which uses lower energy x rays that do not penetrate as far within the patient. A previous study [A. Dickler, M. C. Kirk, N. Seif, K. Griem, K. Dowlatshahi, D. Francescatti, and R. A. Abrams, ''A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy,'' Brachytherapy 6, 164-168 (2007)] showed that the target dose is similar for HDR {sup 192}Ir and eBx. This study compares these sources based on the dose received by healthy organs and tissues away from the treatment site. Methods: A virtual patient with left breast cancer was represented by a whole-body, tissue-heterogeneous female voxel phantom. Monte Carlo methods were used to calculate the dose to healthy organs in a virtual patient undergoing balloon brachytherapy of the left breast with HDR {sup 192}Ir or eBx sources. The dose-volume histograms for a few organs which received large doses were also calculated. Additional simulations were performed with all tissues in the phantom defined as water to study the effect of tissue inhomogeneities. Results: For both HDR {sup 192}Ir and eBx, the largest mean organ doses were received by the ribs, thymus gland, left lung, heart, and sternum which were close to the brachytherapy source in the left breast. eBx yielded mean healthy organ doses that were more than a factor of {approx}1.4 smaller than for HDR {sup 192}Ir for all organs considered, except for the three closest ribs. Excluding these ribs, the average and median dose-reduction factors were {approx}28 and {approx}11, respectively. The volume distribution of doses in nearby soft tissue organs that were outside the PTV were also

  16. Clinical application of a OneDose(TM) MOSFET for skin dose measurements during internal mammary chain irradiation with high dose rate brachytherapy in carcinoma of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Kinhikar, Rajesh A [Department of Medical Physics, Tata Memorial Hospital, Parel, Mumbai 400 012 (India); Sharma, Pramod K [Department of Medical Physics, Tata Memorial Hospital, Parel, Mumbai 400 012 (India); Tambe, Chandrashekhar M [Department of Medical Physics, Tata Memorial Hospital, Parel, Mumbai 400 012 (India); Mahantshetty, Umesh M [Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai 400 012 (India); Sarin, Rajiv [Advanced Centre for Training Research and Education in Cancer, Kharghar, Navi Mumbai (India); Deshpande, Deepak D [Department of Medical Physics, Tata Memorial Hospital, Parel, Mumbai 400 012 (India); Shrivastava, Shyam K [Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai 400 012 (India)

    2006-07-21

    In our earlier study, we experimentally evaluated the characteristics of a newly designed metal oxide semiconductor field effect transistor (MOSFET) OneDose(TM) in-vivo dosimetry system for Ir-192 (380 keV) energy and the results were compared with thermoluminescent dosimeters (TLDs). We have now extended the same study to the clinical application of this MOSFET as an in-vivo dosimetry system. The MOSFET was used during high dose rate brachytherapy (HDRBT) of internal mammary chain (IMC) irradiation for a carcinoma of the breast. The aim of this study was to measure the skin dose during IMC irradiation with a MOSFET and a TLD and compare it with the calculated dose with a treatment planning system (TPS). The skin dose was measured for ten patients. All the patients' treatment was planned on a PLATO treatment planning system. TLD measurements were performed to compare the accuracy of the measured results from the MOSFET. The mean doses measured with the MOSFET and the TLD were identical (0.5392 Gy, 15.85% of the prescribed dose). The mean dose was overestimated by the TPS and was 0.5923 Gy (17.42% of the prescribed dose). The TPS overestimated the skin dose by 9% as verified by the MOSFET and TLD. The MOSFET provides adequate in-vivo dosimetry for HDRBT. Immediate readout after irradiation, small size, permanent storage of dose and ease of use make the MOSFET a viable alternative for TLDs. (note)

  17. Electron and high-dose-rate brachytherapy boost in the conservative treatment of stage I-II breast cancer. First results of the randomized Budapest boost trial

    Energy Technology Data Exchange (ETDEWEB)

    Polgar, C.; Fodor, J. [National Institute of Oncology, Department of Radiotherapy, Budapest (Hungary); Orosz, Z. [National Institute of Oncology, Center of Experimental and Human Tumor Pathology Budapest (HU)] [and others

    2002-11-01

    Background and Aims: To evaluate the effect of electron and high-dose-rate brachytherapy (HDR BT) boost on local tumor control (LTC), side effects and cosmesis after breast-conserving surgery (BCS) in a prospective randomized study. Patients and Methods: 207 women with stage I-II breast cancer who underwent BCS were treated by 50 Gy irradiation to the whole breast and then randomly assigned to receive either a boost to the tumor bed (n=104) or no further radiotherapy (n=103). Boost treatments consisted of either 16 Gy electron irradiation (n=52) or 12-14.25 Gy HDR BT (n=52). Breast cancer-related events, side effects, and cosmetic results were assessed. Results: At a median follow-up of 5.3 years, the crude rate of local recurrence was 6.7% (7/104) with and 15.5% (16/103) without boost. The 5-year probability of LTC, relapse-free survival (RFS), and cancer-specific survival (CSS) was 92.7% vs 84.9% (p=0.049), 76.6% vs 66.2% (p=0.044), and 90.4% vs. 82.1% (p=0.053), respectively. There was no significant difference in LTC between patients treated with electron or HDR BT boost (94.2% vs 91.4%; p=0.74). On multivariate analysis, patient age <40 years (RR: 4.53), positive margin status (RR: 4.17), and high mitotic activity index (RR: 3.60) were found to be significant risk factors for local recurrence. The incidence of grade 2-3 side effects was higher in the boost arm (17.3% vs 7.8%; p=0.03). However, the rate of excellent/good cosmetic results was similar for the two arms (85.6% vs 91.3%; p=0.14). Cosmesis was rated as excellent/good in 88.5% of patients treated with HDR BT and 82.7% of patients with electron boost (p=0.29). Conclusions: Boost dose significantly improves LTC and RFS in patients treated with BCS and radiotherapy. In spite of the higher incidence of late side effects in the boost arm, boost dose is strongly recommended for patients at high risk for local recurrence. Positive or close margin status, high mitotic activity index, and young patient age

  18. Electron and high-dose-rate brachytherapy boost in the conservative treatment of stage I-II breast cancer. First results of the randomized Budapest boost trial

    International Nuclear Information System (INIS)

    Background and Aims: To evaluate the effect of electron and high-dose-rate brachytherapy (HDR BT) boost on local tumor control (LTC), side effects and cosmesis after breast-conserving surgery (BCS) in a prospective randomized study. Patients and Methods: 207 women with stage I-II breast cancer who underwent BCS were treated by 50 Gy irradiation to the whole breast and then randomly assigned to receive either a boost to the tumor bed (n=104) or no further radiotherapy (n=103). Boost treatments consisted of either 16 Gy electron irradiation (n=52) or 12-14.25 Gy HDR BT (n=52). Breast cancer-related events, side effects, and cosmetic results were assessed. Results: At a median follow-up of 5.3 years, the crude rate of local recurrence was 6.7% (7/104) with and 15.5% (16/103) without boost. The 5-year probability of LTC, relapse-free survival (RFS), and cancer-specific survival (CSS) was 92.7% vs 84.9% (p=0.049), 76.6% vs 66.2% (p=0.044), and 90.4% vs. 82.1% (p=0.053), respectively. There was no significant difference in LTC between patients treated with electron or HDR BT boost (94.2% vs 91.4%; p=0.74). On multivariate analysis, patient age <40 years (RR: 4.53), positive margin status (RR: 4.17), and high mitotic activity index (RR: 3.60) were found to be significant risk factors for local recurrence. The incidence of grade 2-3 side effects was higher in the boost arm (17.3% vs 7.8%; p=0.03). However, the rate of excellent/good cosmetic results was similar for the two arms (85.6% vs 91.3%; p=0.14). Cosmesis was rated as excellent/good in 88.5% of patients treated with HDR BT and 82.7% of patients with electron boost (p=0.29). Conclusions: Boost dose significantly improves LTC and RFS in patients treated with BCS and radiotherapy. In spite of the higher incidence of late side effects in the boost arm, boost dose is strongly recommended for patients at high risk for local recurrence. Positive or close margin status, high mitotic activity index, and young patient age

  19. Deep Learning Representation using Autoencoder for 3D Shape Retrieval

    OpenAIRE

    Zhu, Zhuotun; Wang, Xinggang; Bai, Song; Yao, Cong; Bai, Xiang

    2014-01-01

    We study the problem of how to build a deep learning representation for 3D shape. Deep learning has shown to be very effective in variety of visual applications, such as image classification and object detection. However, it has not been successfully applied to 3D shape recognition. This is because 3D shape has complex structure in 3D space and there are limited number of 3D shapes for feature learning. To address these problems, we project 3D shapes into 2D space and use autoencoder for feat...

  20. Low-dose-rate brachytherapy as the sole radiation modality in the management of patients with early-stage breast cancer treated with breast-conserving therapy: preliminary results of a pilot trial

    International Nuclear Information System (INIS)

    Purpose: We present the preliminary findings of our in-house protocol treating the tumor bed alone after lumpectomy with low-dose-rate (LDR) interstitial brachytherapy in selected patients with early-stage breast cancer treated with breast-conserving therapy (BCT). Methods and Materials: Since March 1, 1993, 60 women with early-stage breast cancer were entered into a protocol of tumor bed irradiation only using an interstitial LDR implant with iodine-125. Patients were eligible if the tumor was ≤3 cm, margins were ≥2 mm, there was no extensive intraductal component, the axilla was surgically staged, and a postoperative mammogram was performed. Implants were placed using a standardized template either at the time of reexcision or shortly after lumpectomy. A total of 50 Gy was delivered at 0.52 Gy/h over a period of 96 h to the lumpectomy bed plus a 2-cm margin. Perioperative complications, cosmetic outcome, and local control were assessed. Results: The median follow-up for all patients is 20 months. Three patients experienced minimal perioperative pain that required temporary nonnarcotic analgesics. There have been four postoperative infections which resolved with oral antibiotics. No significant skin reactions related to the implant were noted and no patient experienced impaired would healing. Early cosmetic results reveal minimal changes consisting of transient hyperpigmentation of the skin at the puncture sites and temporary induration in the tumor bed. Good to excellent cosmetic results were noted in all 19 patients followed up a minimum of 24 months posttherapy. To date, 51 women have obtained 6-12-month follow-up mammograms and no recurrences have been noted. All patients currently have no physical signs of recurrence, and no patient has failed regionally or distantly. Conclusion: Treatment of the tumor bed alone with LDR interstitial brachytherapy appears to be well tolerated, and early results are promising. Long-term follow-up of these patients is

  1. Comprehensive brachytherapy physical and clinical aspects

    CERN Document Server

    Baltas, Dimos; Meigooni, Ali S; Hoskin, Peter J

    2013-01-01

    Modern brachytherapy is one of the most important oncological treatment modalities requiring an integrated approach that utilizes new technologies, advanced clinical imaging facilities, and a thorough understanding of the radiobiological effects on different tissues, the principles of physics, dosimetry techniques and protocols, and clinical expertise. A complete overview of the field, Comprehensive Brachytherapy: Physical and Clinical Aspects is a landmark publication, presenting a detailed account of the underlying physics, design, and implementation of the techniques, along with practical guidance for practitioners. Bridging the gap between research and application, this single source brings together the technological basis, radiation dosimetry, quality assurance, and fundamentals of brachytherapy. In addition, it presents discussion of the most recent clinical practice in brachytherapy including prostate, gynecology, breast, and other clinical treatment sites. Along with exploring new clinical protocols, ...

  2. SU-E-T-548: Modeling of Breast IORT Using the Xoft 50 KV Brachytherapy Source and 316L Steel Rigid Shield

    Energy Technology Data Exchange (ETDEWEB)

    Burnside, W [Mountain View, CA (United States)

    2015-06-15

    Purpose: Xoft provides a set of 316L Stainless Steel Rigid Shields to be used with their 50 kV X-ray source for Breast IORT treatments. Modeling the different shield sizes in MCNP provides information to help make clinical decisions for selecting the appropriate shield size. Methods: The Xoft Axxent 50 kV Electronic Brachytherapy System has several applications in radiation therapy, one of which is treating cancer of the breast intraoperatively by placing the miniaturized X-ray tube inside an applicator balloon that is expanded to fill the lumpectomy bed immediately following tumor removal. The ribs, lung, and muscular chest wall are all regions at risk to receive undesired dose during the treatment. A Xoft 316L Stainless Steel Rigid Shield can be placed between the intracostal muscles of the chest wall and the remaining breast tissue near the balloon to attenuate the beam and protect these organs. These shields are provided in 5 different sizes, and the effects on dose to the surrounding tissues vary with shield size. MCNP was used to model this environment and tally dose rate to certain regions of interest. Results: The average rib dose rate calculated using 0cm (i.e., no shield), 3cm, and 5cm diameter shields were 26.89, 15.43, and 8.91 Gy/hr respectively. The maximum dose rates within the rib reached 94.74 Gy/hr, 53.56 Gy/hr, and 31.44 Gy/hr for the 0cm, 3cm, and 5cm cases respectively. The shadowing effect caused by the steel shields was seen in the 3-D meshes and line profiles. Conclusion: This model predicts a higher dose rate to the underlying rib region with the 3cm shield compared to the 5cm shield; it may be useful to select the largest possible diameter when choosing a shield size for a particular IORT patient. The ability to attenuate the beam to reduce rib dose was also confirmed. Research sponsored by Xoft Inc, a subsidiary of iCAD.

  3. Accelerated partial breast irradiation with iridium-192 multicatheter PDR/HDR brachytherapy. Preliminary results of the German-Austrian multicenter trial

    International Nuclear Information System (INIS)

    Purpose: to evaluate perioperative morbidity, toxicity, and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole irradiation modality after breast-conserving surgery. Patients and methods: from November 1, 2000 to January 31, 2004, 176 women with early-stage breast cancer became partakers in a protocol of tumor bed irradiation alone using pulsed-dose-rate (PDR) or high-dose-rate (HDR) interstitial multicatheter implants. Patients became eligible, if their tumor was an infiltrating carcinoma ≤ 3 cm in diameter, the surgical margins were clear by at least 2 mm, the axilla was surgically staged node-negative, the tumor was estrogen and/or progesterone receptor-positive, well or moderately differentiated (G1/2), the tumor did not contain an extensive intraductal component (EIC) and the patient's age was > 35 years. Implants were positioned using a template guide, delivering either 49.8 Gy in 83 consecutive hours (PDR) or 32.0 Gy in two daily fractions over 4 days (HDR). Perioperative morbidity, toxicity, and cosmetic outcome were assessed. Interim findings of the first 69 patients, who were treated in this multicenter trial, after a median follow-up of 24 months (range, 15-39 months) are presented. Results: one of the 69 patients (1.4%) developed a bacterial infection of the implant. No other perioperative complications, for example bleeding or hematoma, were observed. Acute toxicity was low: 2.9% of the patients (2/69) experienced mild radiodermatitis. Late toxicity: hypersensation/mild pain 7.2% (5/69), intermittent but tolerable pain 1.4% (1/69), mild dyspigmentation 10.1% (7/69), mild fibrosis 11.6% (8/69), moderate fibrosis 1.4% (1/69), mild telangiectasia (2) 11.6% (8/69), and moderate teleangiectasia (1-4 cm2) 1.4% (1/69). Good to excellent cosmetic results were observed in 92.4% of the patients evaluated. All patients (n = 176) remained disease-free to the date of evaluation. Conclusion: this analysis indicates

  4. Accelerated partial breast irradiation with iridium-192 multicatheter PDR/HDR brachytherapy. Preliminary results of the German-Austrian multicenter trial

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [Dept. of Radiation Oncology, Univ. Hospital Erlangen, Erlangen (Germany); Poetter, R.; Resch, A. [Dept. of Radiotherapy and Radiobiology, Univ. Hospital AKH Wien, Vienna (Austria); Hammer, J. [Dept. of Radiation Oncology, Barmherzige Schwestern Hospital Linz, Linz (Austria); Hildebrandt, G. [Dept. of Radiation Oncology, Univ. Hospital Leipzig, Leipzig (Germany); Poehls, U.; Beckmann, M.W. [Dept. of Gynecology, Univ. Hospital Erlangen, Erlangen (Germany)

    2004-10-01

    Purpose: to evaluate perioperative morbidity, toxicity, and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole irradiation modality after breast-conserving surgery. Patients and methods: from November 1, 2000 to January 31, 2004, 176 women with early-stage breast cancer became partakers in a protocol of tumor bed irradiation alone using pulsed-dose-rate (PDR) or high-dose-rate (HDR) interstitial multicatheter implants. Patients became eligible, if their tumor was an infiltrating carcinoma {<=} 3 cm in diameter, the surgical margins were clear by at least 2 mm, the axilla was surgically staged node-negative, the tumor was estrogen and/or progesterone receptor-positive, well or moderately differentiated (G1/2), the tumor did not contain an extensive intraductal component (EIC) and the patient's age was > 35 years. Implants were positioned using a template guide, delivering either 49.8 Gy in 83 consecutive hours (PDR) or 32.0 Gy in two daily fractions over 4 days (HDR). Perioperative morbidity, toxicity, and cosmetic outcome were assessed. Interim findings of the first 69 patients, who were treated in this multicenter trial, after a median follow-up of 24 months (range, 15-39 months) are presented. Results: one of the 69 patients (1.4%) developed a bacterial infection of the implant. No other perioperative complications, for example bleeding or hematoma, were observed. Acute toxicity was low: 2.9% of the patients (2/69) experienced mild radiodermatitis. Late toxicity: hypersensation/mild pain 7.2% (5/69), intermittent but tolerable pain 1.4% (1/69), mild dyspigmentation 10.1% (7/69), mild fibrosis 11.6% (8/69), moderate fibrosis 1.4% (1/69), mild telangiectasia (< 1 cm{sup 2}) 11.6% (8/69), and moderate teleangiectasia (1-4 cm{sup 2}) 1.4% (1/69). Good to excellent cosmetic results were observed in 92.4% of the patients evaluated. All patients (n = 176) remained disease-free to the date of evaluation. Conclusion

  5. SU-E-T-548: Modeling of Breast IORT Using the Xoft 50 KV Brachytherapy Source and 316L Steel Rigid Shield

    International Nuclear Information System (INIS)

    Purpose: Xoft provides a set of 316L Stainless Steel Rigid Shields to be used with their 50 kV X-ray source for Breast IORT treatments. Modeling the different shield sizes in MCNP provides information to help make clinical decisions for selecting the appropriate shield size. Methods: The Xoft Axxent 50 kV Electronic Brachytherapy System has several applications in radiation therapy, one of which is treating cancer of the breast intraoperatively by placing the miniaturized X-ray tube inside an applicator balloon that is expanded to fill the lumpectomy bed immediately following tumor removal. The ribs, lung, and muscular chest wall are all regions at risk to receive undesired dose during the treatment. A Xoft 316L Stainless Steel Rigid Shield can be placed between the intracostal muscles of the chest wall and the remaining breast tissue near the balloon to attenuate the beam and protect these organs. These shields are provided in 5 different sizes, and the effects on dose to the surrounding tissues vary with shield size. MCNP was used to model this environment and tally dose rate to certain regions of interest. Results: The average rib dose rate calculated using 0cm (i.e., no shield), 3cm, and 5cm diameter shields were 26.89, 15.43, and 8.91 Gy/hr respectively. The maximum dose rates within the rib reached 94.74 Gy/hr, 53.56 Gy/hr, and 31.44 Gy/hr for the 0cm, 3cm, and 5cm cases respectively. The shadowing effect caused by the steel shields was seen in the 3-D meshes and line profiles. Conclusion: This model predicts a higher dose rate to the underlying rib region with the 3cm shield compared to the 5cm shield; it may be useful to select the largest possible diameter when choosing a shield size for a particular IORT patient. The ability to attenuate the beam to reduce rib dose was also confirmed. Research sponsored by Xoft Inc, a subsidiary of iCAD

  6. SU-E-T-580: On the Significance of Model Based Dosimetry for Breast and Head and Neck 192Ir HDR Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Peppa, V; Pappas, E; Pantelis, E; Papagiannis, P [Medical Physics Laboratory, Medical School, University of Athens, Athens (Greece); Major, T; Polgar, C [National Institute of Oncology, Budapest (Hungary)

    2015-06-15

    Purpose: To assess the dosimetric and radiobiological differences between TG43-based and model-based dosimetry in the treatment planning of {sup 192}Ir HDR brachytherapy for breast and head and neck cancer. Methods: Two cohorts of 57 Accelerated Partial Breast Irradiation (APBI) and 22 head and neck (H&N) patients with oral cavity carcinoma were studied. Dosimetry for the treatment plans was performed using the TG43 algorithm of the Oncentra Brachy v4.4 treatment planning system (TPS). Corresponding Monte Carlo (MC) simulations were performed using MCNP6 with input files automatically prepared by the BrachyGuide software tool from DICOM RT plan data. TG43 and MC data were compared in terms of % dose differences, Dose Volume Histograms (DVHs) and related indices of clinical interest for the Planning Target Volume (PTV) and the Organs-At-Risk (OARs). A radiobiological analysis was also performed using the Equivalent Uniform Dose (EUD), mean survival fraction (S) and Tumor Control Probability (TCP) for the PTV, and the Normal Tissue Control Probability (N TCP) and the generalized EUD (gEUD) for the OARs. Significance testing of the observed differences performed using the Wilcoxon paired sample test. Results: Differences between TG43 and MC DVH indices, associated with the increased corresponding local % dose differences observed, were statistically significant. This is mainly attributed to their consistency however, since TG43 agrees closely with MC for the majority of DVH and radiobiological parameters in both patient cohorts. Differences varied considerably among patients only for the ipsilateral lung and ribs in the APBI cohort, with a strong correlation to target location. Conclusion: While the consistency and magnitude of differences in the majority of clinically relevant DVH indices imply that no change is needed in the treatment planning practice, individualized dosimetry improves accuracy and addresses instances of inter-patient variability observed. Research

  7. Integer Programs for High Dose Rate Brachytherapy Needle and Dose Planning that Directly Optimize Clinical Objectives

    OpenAIRE

    Siauw, Ko-Ay Timmy

    2012-01-01

    High dose rate (HDR) brachytherapy is a radiation therapy for cancer in the prostate, cervix, breast, head, and neck, including other sites. In HDR brachytherapy, hollow needles are inserted or placed near the cancer site. Radiation is delivered to the patient by a radioactive source which is sequentially threaded through the needles. The dose distribution is controlled by altering the dwell times, the time spent at pre-defined positions on the needles.HDR brachytherapy has a 90\\% cancer-free...

  8. Accelerated partial breast irradiation with multi-catheter brachytherapy: Local control, side effects and cosmetic outcome for 274 patients. Results of the German-Austrian multi-centre trial

    International Nuclear Information System (INIS)

    Background and purpose: To evaluate the safety and effectiveness of accelerated partial breast irradiation (APBI) with multi-catheter brachytherapy. Patients and methods: Between 11/2000 and 04/2005, 274 patients participated. Patients were eligible for APBI if they had histologically confirmed breast cancer, a tumour diameter ≤3 cm, complete resection with clear margins ≥2 mm, negative axillary lymph nodes or singular nodal micro-metastasis, no distant metastases, hormone receptor-positive tumours, and were ≥35 years. Patients were excluded if mammographically they showed a multicentric invasive growth pattern, poorly differentiated tumours, residual diffuse micro-calcifications, extensive intraductal component, or vessel invasion. Median follow-up was 32 months (range; 8-68). Results: The local control rate was 99.3% (272/274), the 3 year-local-recurrence-free survival probability, 99.6%. Peri-operative complications occurred in 5.5% (15/274): 9 (3.3%) experienced implant infection and 6 (2.2%) hematoma. Acute toxicity (Grade 1/2 radio-dermatitis) was seen in 6.6% (18/274). Late side effects ≥ Grade 3 (fibrosis, telangiectasia) occurred in 1.8% (4/274). Cosmetic results were excellent/good in 94% (253/274). Conclusions: This analysis underlined the safety and effectiveness of APBI in a carefully selected subgroup with favourable disease characteristics. Of course, longer follow-up and randomised trials are necessary to conclusively assess the potential of APBI

  9. Recommendations from GEC ESTRO Breast Cancer Working Group (I): Target definition and target delineation for accelerated or boost Partial Breast Irradiation using multicatheter interstitial brachytherapy after breast conserving closed cavity surgery

    International Nuclear Information System (INIS)

    Objective: The aim was to develop a delineation guideline for target definition for APBI or boost by consensus of the Breast Working Group of GEC-ESTRO. Proposed recommendations: Appropriate delineation of CTV (PTV) with low inter- and intra-observer variability in clinical practice is complex and needs various steps as: (1) Detailed knowledge of primary surgical procedure, of all details of pathology, as well as of preoperative imaging. (2) Definition of tumour localization before breast conserving surgery inside the breast and translation of this information in the postoperative CT imaging data set. (3) Calculation of the size of total safety margins. The size should be at least 2 cm. (4) Definition of the target. (5) Delineation of the target according to defined rules. Conclusion: Providing guidelines based on the consensus of a group of experts should make it possible to achieve a reproducible and consistent definition of CTV (PTV) for Accelerated Partial Breast Irradiation (APBI) or boost irradiation after breast conserving closed cavity surgery, and helps to define it after selected cases of oncoplastic surgery

  10. ALGEBRA: ALgorithm for the heterogeneous dosimetry based on GEANT4 for BRAchytherapy.

    Science.gov (United States)

    Afsharpour, H; Landry, G; D'Amours, M; Enger, S; Reniers, B; Poon, E; Carrier, J-F; Verhaegen, F; Beaulieu, L

    2012-06-01

    Task group 43 (TG43)-based dosimetry algorithms are efficient for brachytherapy dose calculation in water. However, human tissues have chemical compositions and densities different than water. Moreover, the mutual shielding effect of seeds on each other (interseed attenuation) is neglected in the TG43-based dosimetry platforms. The scientific community has expressed the need for an accurate dosimetry platform in brachytherapy. The purpose of this paper is to present ALGEBRA, a Monte Carlo platform for dosimetry in brachytherapy which is sufficiently fast and accurate for clinical and research purposes. ALGEBRA is based on the GEANT4 Monte Carlo code and is capable of handling the DICOM RT standard to recreate a virtual model of the treated site. Here, the performance of ALGEBRA is presented for the special case of LDR brachytherapy in permanent prostate and breast seed implants. However, the algorithm is also capable of handling other treatments such as HDR brachytherapy.

  11. Exploration of continuous variability in collections of 3D shapes

    KAUST Repository

    Ovsjanikov, Maks

    2011-07-01

    As large public repositories of 3D shapes continue to grow, the amount of shape variability in such collections also increases, both in terms of the number of different classes of shapes, as well as the geometric variability of shapes within each class. While this gives users more choice for shape selection, it can be difficult to explore large collections and understand the range of variations amongst the shapes. Exploration is particularly challenging for public shape repositories, which are often only loosely tagged and contain neither point-based nor part-based correspondences. In this paper, we present a method for discovering and exploring continuous variability in a collection of 3D shapes without correspondences. Our method is based on a novel navigation interface that allows users to explore a collection of related shapes by deforming a base template shape through a set of intuitive deformation controls. We also help the user to select the most meaningful deformations using a novel technique for learning shape variability in terms of deformations of the template. Our technique assumes that the set of shapes lies near a low-dimensional manifold in a certain descriptor space, which allows us to avoid establishing correspondences between shapes, while being rotation and scaling invariant. We present results on several shape collections taken directly from public repositories. © 2011 ACM.

  12. Aesthetic preference recognition of 3D shapes using EEG.

    Science.gov (United States)

    Chew, Lin Hou; Teo, Jason; Mountstephens, James

    2016-04-01

    Recognition and identification of aesthetic preference is indispensable in industrial design. Humans tend to pursue products with aesthetic values and make buying decisions based on their aesthetic preferences. The existence of neuromarketing is to understand consumer responses toward marketing stimuli by using imaging techniques and recognition of physiological parameters. Numerous studies have been done to understand the relationship between human, art and aesthetics. In this paper, we present a novel preference-based measurement of user aesthetics using electroencephalogram (EEG) signals for virtual 3D shapes with motion. The 3D shapes are designed to appear like bracelets, which is generated by using the Gielis superformula. EEG signals were collected by using a medical grade device, the B-Alert X10 from advance brain monitoring, with a sampling frequency of 256 Hz and resolution of 16 bits. The signals obtained when viewing 3D bracelet shapes were decomposed into alpha, beta, theta, gamma and delta rhythm by using time-frequency analysis, then classified into two classes, namely like and dislike by using support vector machines and K-nearest neighbors (KNN) classifiers respectively. Classification accuracy of up to 80 % was obtained by using KNN with the alpha, theta and delta rhythms as the features extracted from frontal channels, Fz, F3 and F4 to classify two classes, like and dislike.

  13. Aesthetic preference recognition of 3D shapes using EEG.

    Science.gov (United States)

    Chew, Lin Hou; Teo, Jason; Mountstephens, James

    2016-04-01

    Recognition and identification of aesthetic preference is indispensable in industrial design. Humans tend to pursue products with aesthetic values and make buying decisions based on their aesthetic preferences. The existence of neuromarketing is to understand consumer responses toward marketing stimuli by using imaging techniques and recognition of physiological parameters. Numerous studies have been done to understand the relationship between human, art and aesthetics. In this paper, we present a novel preference-based measurement of user aesthetics using electroencephalogram (EEG) signals for virtual 3D shapes with motion. The 3D shapes are designed to appear like bracelets, which is generated by using the Gielis superformula. EEG signals were collected by using a medical grade device, the B-Alert X10 from advance brain monitoring, with a sampling frequency of 256 Hz and resolution of 16 bits. The signals obtained when viewing 3D bracelet shapes were decomposed into alpha, beta, theta, gamma and delta rhythm by using time-frequency analysis, then classified into two classes, namely like and dislike by using support vector machines and K-nearest neighbors (KNN) classifiers respectively. Classification accuracy of up to 80 % was obtained by using KNN with the alpha, theta and delta rhythms as the features extracted from frontal channels, Fz, F3 and F4 to classify two classes, like and dislike. PMID:27066153

  14. Stress analysis studies in optimised 'D' shaped TOKAMAK magnet designs

    International Nuclear Information System (INIS)

    A suite of computer programs TOK was developed which enabled simple data input to be used for computation of magnetic fields and forces in a toroidal system of coils with either D-shaped or circular cross section. An additional requirement was that input data to the Swansea stress analysis program FINESSE could be output from the TOK fields and forces program, and that graphical output from either program should be available. A further program was required to optimise the coil shape. This used the field calculating routines from the TOK program. The starting point for these studies was the proposed 40 coil Princeton design. The stresses resulting from three different shapes of D-coil were compared. (author)

  15. Salient Local 3D Features for 3D Shape Retrieval

    CERN Document Server

    Godil, Afzal

    2011-01-01

    In this paper we describe a new formulation for the 3D salient local features based on the voxel grid inspired by the Scale Invariant Feature Transform (SIFT). We use it to identify the salient keypoints (invariant points) on a 3D voxelized model and calculate invariant 3D local feature descriptors at these keypoints. We then use the bag of words approach on the 3D local features to represent the 3D models for shape retrieval. The advantages of the method are that it can be applied to rigid as well as to articulated and deformable 3D models. Finally, this approach is applied for 3D Shape Retrieval on the McGill articulated shape benchmark and then the retrieval results are presented and compared to other methods.

  16. Parameterization adaption for 3D shape optimization in aerodynamics

    Directory of Open Access Journals (Sweden)

    Badr Abou El Majd

    2013-10-01

    Full Text Available When solving a PDE problem numerically, a certain mesh-refinement process is always implicit, and very classically, mesh adaptivity is a very effective means to accelerate grid convergence. Similarly, when optimizing a shape by means of an explicit geometrical representation, it is natural to seek for an analogous concept of parameterization adaptivity. We propose here an adaptive parameterization for three-dimensional optimum design in aerodynamics by using the so-called “Free-Form Deformation” approach based on 3D tensorial Bézier parameterization. The proposed procedure leads to efficient numerical simulations with highly reduced computational costs.[How to cite this article:  Majd, B.A.. 2014. Parameterization adaption for 3D shape optimization in aerodynamics. International Journal of Science and Engineering, 6(1:61-69. Doi: 10.12777/ijse.6.1.61-69

  17. Restenosis: Intracoronary Brachytherapy.

    Science.gov (United States)

    Drachman, Douglas E.; Simon, Daniel I.

    2002-04-01

    Though interventional strategies have revolutionized the management of patients with symptomatic coronary artery disease, in-stent restenosis has emerged as the single most important limitation of long-term success following percutaneous coronary intervention. Once present, in-stent restenosis is extraordinarily difficult to treat, with conventional revascularization techniques failing in 50% to 80% of patients. Intracoronary radiation, or brachytherapy, targets cellular proliferation within the culprit neointima. Clinical trials have demonstrated that brachytherapy is a highly effective treatment for in-stent restenosis, reducing angiographic restenosis by 50% to 60% and the need for target vessel revascularization by 40% to 50%. The benefits of intracoronary brachytherapy may be particularly pronounced in certain patient subgroups (eg, those with diabetes, long lesions, or lesions in saphenous vein bypass grafts), but comes at the cost of an increased rate of late stent thrombosis and the need for extended antiplatelet therapy. The role of brachytherapy in the arsenal of the interventional cardiologist will continue to evolve, particularly in light of the unprecedented recent advances with the use of drug-eluting stents for restenosis prevention. PMID:11858773

  18. Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES

    Energy Technology Data Exchange (ETDEWEB)

    Park, Su Gyong; Chang, Hye Sook; Choi, Eun Kyong; Yi, Byong Yong [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    1992-12-15

    Remote afterloading high dose rate brachytherapy(HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures performed at Asan Medical Center for 3 years. From Sep. 1985 to Aug 1992, 471 procedures of intracavitary radiation in 55 patients of cervical cancer and 26 of nasopharyngeal cancer, 79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range 1-31 months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, 80% achieves palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

  19. An approach to using conventional brachytherapy software for clinical treatment planning of complex, Monte Carlo-based brachytherapy dose distributions

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, Mark J.; Melhus, Christopher S.; Granero, Domingo; Perez-Calatayud, Jose; Ballester, Facundo [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States); Radiation Oncology Department, Physics Section, ' ' La Fe' ' University Hospital, Avenida Campanar 21, E-46009 Valencia (Spain); Department of Atomic, Molecular, and Nuclear Physics, University of Valencia, C/Dr. Moliner 50, E-46100 Burjassot, Spain and IFIC (University of Valencia-CSIC), C/Dr. Moliner 50, E-46100 Burjassot (Spain)

    2009-06-15

    Certain brachytherapy dose distributions, such as those for LDR prostate implants, are readily modeled by treatment planning systems (TPS) that use the superposition principle of individual seed dose distributions to calculate the total dose distribution. However, dose distributions for brachytherapy treatments using high-Z shields or having significant material heterogeneities are not currently well modeled using conventional TPS. The purpose of this study is to establish a new treatment planning technique (Tufts technique) that could be applied in some clinical situations where the conventional approach is not acceptable and dose distributions present cylindrical symmetry. Dose distributions from complex brachytherapy source configurations determined with Monte Carlo methods were used as input data. These source distributions included the 2 and 3 cm diameter Valencia skin applicators from Nucletron, 4-8 cm diameter AccuBoost peripheral breast brachytherapy applicators from Advanced Radiation Therapy, and a 16 mm COMS-based eye plaque using {sup 103}Pd, {sup 125}I, and {sup 131}Cs seeds. Radial dose functions and 2D anisotropy functions were obtained by positioning the coordinate system origin along the dose distribution cylindrical axis of symmetry. Origin:tissue distance and active length were chosen to minimize TPS interpolation errors. Dosimetry parameters were entered into the PINNACLE TPS, and dose distributions were subsequently calculated and compared to the original Monte Carlo-derived dose distributions. The new planning technique was able to reproduce brachytherapy dose distributions for all three applicator types, producing dosimetric agreement typically within 2% when compared with Monte Carlo-derived dose distributions. Agreement between Monte Carlo-derived and planned dose distributions improved as the spatial resolution of the fitted dosimetry parameters improved. For agreement within 5% throughout the clinical volume, spatial resolution of

  20. Intra coronary brachytherapy

    International Nuclear Information System (INIS)

    Despite the initial promise of vasculopathy intervention restenosis- a consequence of the (normal) would healing process-has emerged as a major problem. Angiographic restenosis has been reported in 40-60% of patients after successful P TCA. The basic mechanism of restenosis, (acute recoil, negative remodeling and neo intimal hyperplasia), are only partially counteracted by endovascular prosthetic devices (s tents). The rate of in-s tent restenosis, which is primarily caused by neo intimal hyperplasia due to the (micro) trauma of the arterial wall by the s tent struts, has been reduced to 18-32%. Ionizing (beta or gamma) radiations has been established as a potent treatment for malignant disorders. In recent years, there has also been increasing interest among clinicians in the management of benign lesions with radiation. Over the past several years, there has been a growing body of evidence that endovascular brachytherapy has a major impact on the biology of the restenosis. It must be underlined that understanding the biology and pathophysiology of restenosis and assessing various treatment options should preferably be a team effort, with the three gracesbeing interventional cardiologist, nuclear oncologist, and industrial partners. The vast amount of data in over 20000 patients from a wide range of randomized controlled trials, has shown that brachytherapy is the only effective treatment for in-s tent restenosis. We are learning more and more about how to improve brachytherapy. While the new coated s tents that we heard about today is fascinating and extremely promising, brachytherapy still has a very important place in difficult patients, such as those with total occlusions, osti al lesions, left main lesions, multivessel disease and diabetes. Regarding to above mentioned tips, we (a research team work, in the Nuclear Research Center Of the Atomic Energy Organization Of Iran), focused on synthesis and preparation of radioactive materials for use in I c-B T. We

  1. Breast conserving treatment of breast carcinoma T2 ({<=} 4 cm) and T3 by neoadjuvant chemotherapy, quadrantectomy, high dose rate brachytherapy as a boost, external beam radiotherapy and adjuvant chemotherapy: local control and overall survival analysis; Tratamento conservador do cancer de mama T2 ({<=} 4 cm) e T3 por quimioterapia neoadjuvante, quadrantectomia, braquiterapia com alta taxa de dose como reforco de dose, teleterapia complementar e quimioterapia adjuvante: analise de controle local e sobrevida global

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Celia Regina; Miziara Filho, Miguel Abrao; Fogaroli, Ricardo Cesar; Baraldi, Helena Espindola; Pellizzon, Antonio Cassio Assis; Pelosi, Edilson Lopes [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil). Servico de Radioterapia], e-mail: celiarsoares@terra.com.br; Fristachi, Carlos Elias [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil). Servico de Onco-Ginecologia e Mastologia; Paes, Roberto Pinto [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil)

    2008-12-15

    Objective: to assess the treatment of breast cancer T2 ({<=} 4 cm) and T3 through neoadjuvant chemotherapy, quadrantectomy and high dose rate brachytherapy as a boost, complementary radiotherapy and adjuvant chemotherapy, considering local control and overall survival. Material and method: this clinical prospective descriptive study was based on the evaluation of 88 patients ranging from 30 to 70 years old, with infiltrating ductal carcinoma, clinical stage IIb and IIIa, responsive to the neoadjuvant chemotherapy, treated from June/1995 to December/2006. Median follow-up was 58 months. Using clinical methods the tumor was evaluated before and after three or four cycles of chemotherapy based on anthracyclines. Overall survival and local control were assessed according to Kaplan-Meier methodology. Results: Local control and overall survival in five years were 90% and 73.5%, respectively. Conclusion: local control and overall survival were comparable to other forms of treatment. (author)

  2. Plasmonic-enhanced fluorescence emission using D-shape microstructured optical fiber

    International Nuclear Information System (INIS)

    Highly sensitive side-polished D-shaped optical fiber sensors have been fabricated based on surface plasmon resonance (SPR) technology. Current techniques in plasmonic-enhanced total internal reflection microscopy (TIRM) and evanescent wave microscopy, although advantageous, require cumbersome set-ups and encompass large coupling losses. A gold coated D-shaped optical fiber was demonstrated to provide fluorescence enhanced spectroscopy. Comparison was made between a gold coated and uncoated D-shaped microstructured optical fiber (MOF) with respect to excitation of Rhodamine B (Rh B). Results highlighted improved fluorescence emission intensity and heightened sensitivity in fluorescence spectroscopy in the gold coated device, indicating potential in enhanced bio-imaging applications.

  3. Research and development of fringe projection-based methods in 3D shape reconstruction

    Institute of Scientific and Technical Information of China (English)

    WU Lu-shen; PENG Qing-jin

    2006-01-01

    This paper discusses current research and development of fringe projection-based techniques. A system based on Fourier transform profilometry (FTP) is proposed for three-dimensional (3D) shape recovery. The system improves the method of phase unwrapping to gain accurate 3D shapes of objects. The method uses a region-growing algorithm for the path prediction guided by the quality map to increase the recovering accuracy and provides a fast and simple tool for 3D shape recovery. The shape measurement and data recovery are integrated to offer a new method of 3D modelling. Examples are presented to verify the feasibility of the proposed method.

  4. Brachytherapy in childhood rhabdomyosarcoma treatment

    International Nuclear Information System (INIS)

    A retrospective study of 21 children with rhabdomyosarcoma treated by brachytherapy to the primary site of the tumor at the Radiotherapy Department of the A.C.Camargo Hospital between january/1980 to june/1993 was undertaken. The main objectives were to comprove the utility of brachytherapy in childhood rhabdomyosarcoma, to evaluate the local control and survival, in association with chemotherapy, to analyze the late effects of the treatment and to determinate the preferential technique to each clinical situation. All patients received brachytherapy to the tumor site. The radioactive isotopes employed were Gold198, Cesium137 and Iridium192. The brachytherapy techniques depended on the tumor site, period of treatment, availability of the radioactive material and stage of the disease. Patients treated exclusively by brachytherapy received 40 Gy to 60 Gy. When brachytherapy was associated with external radiotherapy the dose ranged from 20 Gy to 40 Gy. Local control was achieved in 18 of 20 patients (90%). The global survival and local control survival rates were 61.9% (13/21 patients) and 72,2% (13/18 patients) respectively. (author)

  5. Development of a forced-cooling d-shaped superconducting coil by supercritical helium

    International Nuclear Information System (INIS)

    A D-shaped 12 Tesla superconducting coil with forced cooling Nb3Sn superconductor is developed. Cryogenic stability and conduit stress analyses, result of winding test of copper dummy coil, and cooing system for the test coil are presented

  6. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  7. American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

    International Nuclear Information System (INIS)

    High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal, breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.

  8. New approach to the perception of 3D shape based on veridicality, complexity, symmetry and volume.

    Science.gov (United States)

    Pizlo, Zygmunt; Sawada, Tadamasa; Li, Yunfeng; Kropatsch, Walter G; Steinman, Robert M

    2010-01-01

    This paper reviews recent progress towards understanding 3D shape perception made possible by appreciating the significant role that veridicality and complexity play in the natural visual environment. The ability to see objects as they really are "out there" is derived from the complexity inherent in the 3D object's shape. The importance of both veridicality and complexity was ignored in most prior research. Appreciating their importance made it possible to devise a computational model that recovers the 3D shape of an object from only one of its 2D images. This model uses a simplicity principle consisting of only four a priori constraints representing properties of 3D shapes, primarily their symmetry and volume. The model recovers 3D shapes from a single 2D image as well, and sometimes even better, than a human being. In the rare recoveries in which errors are observed, the errors made by the model and human subjects are very similar. The model makes no use of depth, surfaces or learning. Recent elaborations of this model include: (i) the recovery of the shapes of natural objects, including human and animal bodies with limbs in varying positions (ii) providing the model with two input images that allowed it to achieve virtually perfect shape constancy from almost all viewing directions. The review concludes with a comparison of some of the highlights of our novel, successful approach to the recovery of 3D shape from a 2D image with prior, less successful approaches. PMID:19800910

  9. Embodied collaboration support system for 3D shape evaluation in virtual space

    Science.gov (United States)

    Okubo, Masashi; Watanabe, Tomio

    2005-12-01

    Collaboration mainly consists of two tasks; one is each partner's task that is performed by the individual, the other is communication with each other. Both of them are very important objectives for all the collaboration support system. In this paper, a collaboration support system for 3D shape evaluation in virtual space is proposed on the basis of both studies in 3D shape evaluation and communication support in virtual space. The proposed system provides the two viewpoints for each task. One is the viewpoint of back side of user's own avatar for the smooth communication. The other is that of avatar's eye for 3D shape evaluation. Switching the viewpoints satisfies the task conditions for 3D shape evaluation and communication. The system basically consists of PC, HMD and magnetic sensors, and users can share the embodied interaction by observing interaction between their avatars in virtual space. However, the HMD and magnetic sensors, which are put on the users, would restrict the nonverbal communication. Then, we have tried to compensate the loss of nodding of partner's avatar by introducing the speech-driven embodied interactive actor InterActor. Sensory evaluation by paired comparison of 3D shapes in the collaborative situation in virtual space and in real space and the questionnaire are performed. The result demonstrates the effectiveness of InterActor's nodding in the collaborative situation.

  10. The role of long half-life isotopes for use in LDR brachytherapy. Report of the advisory group meeting (325-E3-AG-1086)

    International Nuclear Information System (INIS)

    Brachytherapy is a growing activity in the management of cancer. Where indications exist for brachytherapy, LDR still retains a significant but decreasingly important role in the overall management. It remains the preferred form of brachytherapy in a few sites such as the nose, lip, vagina and penis. It is well tested in the paediatric population where long-term sequelae are highly significant and have not yet been evaluated for mHDR. Prostatic cancer permanent seed implant boosts is currently the only application where LDR is receiving increasing clinical support. LDR still can play an equally effective role when brachytherapy is required in gynaecological, breast and head and neck cancer and soft tissue sarcomas. The meeting recognised the growing role of mHDR as the major modality in brachytherapy administration. It is further noted that changing circumstances and opinions regarding mHDR may exert a major influence on the continued future of LDR as a treatment modality. LDR brachytherapy special techniques are becoming less widely distributed and less frequently performed. Only a few centres remain where sufficient procedures are performed to give adequate training in a period of a few months. The meeting recommended that the Agency should promote the creation of regional training centres of excellence where the practice of LDR brachytherapy should be available. The meeting recommended that the Member States should continue support for LDR brachytherapy techniques beyond gynaecological techniques until such time as clear evidence is presented for discontinuation

  11. Energy confinement of ohmically heated D-shaped plasma in Doublet III

    International Nuclear Information System (INIS)

    Energy confinement properties were compared for D-shaped and circular cross section plasmas with an identical horizontal minor radius as functions of plasma current, electron density, and vertical elongation under a wide range of discharge conditions. The improvement of the energy confinement time with vertical elongation can be explained with an electron energy transport determined by anti n sub(e)q* and approximately neoclassical ion energy transport, both include the geometrical effect of vertical elongation. Particularly high current operation capability of D-shaped plasma produces remarkable improvement of energy confinement at high density region due to the reduction of neoclassical heat loss of ions. The highest energy confinement time (75 msec) is realized for a high current and high density D-shaped discharge. (author)

  12. Genetic Fuzzy Prediction of Mass Perception in Non-Functional 3D Shapes

    DEFF Research Database (Denmark)

    Achiche, Sofiane

    2010-01-01

    and their perception by observers. The link between geometry and human perception is created using a genetic learning algorithm combined with a fuzzy logic decision support system. Human evaluations of the non-functional 3D shapes against two contrary perception adjectives (massive versus lightweight) are used...... as the learning data set. The non-functional 3D shapes were designed by engineering design students from the Technical University of Denmark who were asked to design non-functional 3D shapes evoking either the adjective massive or light. Eight fuzzy models were developed: three (3) models constructed manually...... by the author and five (5) genetically generated. The fuzzy models were constructed using different sets of inputs of quantitative geometric properties. Combination of the different inputs resulted in different sets of fuzzy rules that can eventually be used as design guidelines for designers. The results...

  13. Holographic and weak-phase projection system for 3D shape reconstruction using temporal phase unwrapping

    Science.gov (United States)

    González, C. A.; Dávila, A.; Garnica, G.

    2007-09-01

    Two projection systems that use an LCoS phase modulator are proposed for 3D shape reconstruction. The LCoS is used as an holographic system or as a weak phase projector, both configurations project a set of fringe patterns that are processed by the technique known as temporal phase unwrapping. To minimize the influence of camera sampling, and the speckle noise in the projected fringes, an speckle noise reduction technique is applied to the speckle patterns generated by the holographic optical system. Experiments with 3D shape reconstruction of ophthalmic mold and other testing specimens show the viability of the proposed techniques.

  14. Fast 3D shape measurement using Fourier transform profilometry without phase unwrapping

    Science.gov (United States)

    Song, Kechen; Hu, Shaopeng; Wen, Xin; Yan, Yunhui

    2016-09-01

    This paper presents a novel, simple, yet fast 3D shape measurement method using Fourier transform profilometry. Different from the conventional Fourier transform profilometry, this proposed method introduces the binocular stereo vision and employs two image pairs (i.e., original image pairs and fringe image pairs) to restructure 3D shape. In this proposed method, instead of phase unwrapping algorithm, a coarse disparity map is adopted as a constraint condition to realize phase matching using wrapped phase. Since the local phase matching and sub-pixel disparity refinement are proposed to obtain high measuring accuracy, high-quality phase is not required. The validity of the proposed method is verified by experiments.

  15. High-dose-rate interstitial brachytherapy for the treatment of penile carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Petera, J.; Odrazka, K.; Zouhar, M.; Bedrosova, J.; Dolezel, M. [Dept. of Oncology and Radiotherapy, Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic)

    2004-02-01

    Background: interstitial low-dose-rate (LDR) brachytherapy allows conservative treatment of T1-T2 penile carcinoma. High-dose-rate (HDR) is often considered to be dangerous for interstitial implants because of a higher risk of complications, but numerous reports suggest that results may be comparable to LDR. Nevertheless, there are no data in the literature available regarding HDR interstitial brachytherapy for carcinoma of the penis. Case report: a 64-year-old man with T1 NO MO epidermoid carcinoma of the glans is reported. Interstitial HDR brachytherapy was performed using the stainless hollow needle technique and a breast template for fixation and good geometry. The dose delivered was 18 x 3 Gy twice daily. Results: after 232 days from brachytherapy, the patient was without any evidence of the tumor, experienced no serious radiation-induced complications, and had a fully functional organ. Conclusion: HDR interstitial brachytherapy is feasible in selected case of penis carcinoma, when careful planning and small single fractions are used. (orig.)

  16. Brachytherapy in Gynecologic Cancers: Why Is It Underused?

    Science.gov (United States)

    Han, Kathy; Viswanathan, Akila N

    2016-04-01

    Despite its established efficacy, brachytherapy is underused in the management of cervical and vaginal cancers in some parts of the world. Possible reasons for the underutilization of brachytherapy include the adoption of less invasive techniques, such as intensity-modulated radiotherapy; reimbursement policies favoring these techniques over brachytherapy; poor physician or patient access to brachytherapy; inadequate maintenance of brachytherapy skills among practicing radiation oncologists; transitioning to high-dose-rate (HDR) brachytherapy with increased time requirements; and insufficient training of radiation oncology residents.

  17. Novel Use of the Contura for High Dose Rate Cranial Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Scanderbeg, Daniel J., E-mail: dscanderbeg@ucsd.edu [Department of Radiation Oncology, University of California at San Diego, La Jolla, CA (United States); Center for Advanced Radiotherapy Technologies, Rebecca and John Moores Comprehensive Cancer Center, University of California at San Diego, La Jolla, CA (United States); Alksne, John F. [Division of Neurological Surgery, University of California at San Diego, La Jolla, CA (United States); Lawson, Joshua D. [Department of Radiation Oncology, University of California at San Diego, La Jolla, CA (United States); Center for Advanced Radiotherapy Technologies, Rebecca and John Moores Comprehensive Cancer Center, University of California at San Diego, La Jolla, CA (United States); Murphy, Kevin T. [Department of Radiation Oncology, University of California at San Diego, La Jolla, CA (United States)

    2011-01-01

    A popular choice for treatment of recurrent gliomas was cranial brachytherapy using the GliaSite Radiation Therapy System. However, this device was taken off the market in late 2008, thus leaving a treatment void. This case study presents our experience treating a cranial lesion for the first time using a Contura multilumen, high-dose-rate (HDR) brachytherapy balloon applicator. The patient was a 47-year-old male who was diagnosed with a recurrent right frontal anaplastic oligodendroglioma. Previous radiosurgery made him a good candidate for brachytherapy. An intracavitary HDR balloon brachytherapy device (Contura) was placed in the resection cavity and treated with a single fraction of 20 Gy. The implant, treatment, and removal of the device were all completed without incident. Dosimetry of the device was excellent because the dose conformed very well to the target. V90, V100, V150, and V200 were 98.9%, 95.7%, 27.2, and 8.8 cc, respectively. This patient was treated successfully using the Contura multilumen balloon. Contura was originally designed for deployment in a postlumpectomy breast for treatment by accelerated partial breast irradiation. Being an intracavitary balloon device, its similarity to the GliaSite system makes it a viable replacement candidate. Multiple lumens in the device also make it possible to shape the dose delivered to the target, something not possible before with the GliaSite applicator.

  18. Brachytherapy in coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Chun [Chonnam National University Medicine School, Gwangju (Korea, Republic of)

    2006-04-15

    Coronary artery disease is a leading cause of morbidity and mortality across the world. Percutaneous coronary intervention has become the major technique of revascularization. However, restenosis remains a major limitation of this procedure. Recently the need for repeat intervention due to restenosis, the most vexing long-term failure of percutaneous coronary intervention, has been significantly reduced owing to the introduction to two major advances, intracoronary brachytherapy and the drug-eluting stents, intracoronary brachytherapy has been employed in recent years to prevent restenosis lesions with effective results, principally in in-stent restenosis. Restenosis is generally considered as an excessive form of normal wound healing divided up in processes: elastic recoil, neointimal hyperplasia, and negative vascular remodeling. Restenosis has previously been regarded as a proliferative process in which neointimal thickening, mediated by a cascade of inflammatory mediators and other factors, is the key factor. Ionizing radiation has been shown to decrease the proliferative response to injury in animal models of restenosis. Subsequently, several randomized, double-blind trials have demonstrated that intracoronary brachytherapy can reduce the rates to both angiographic restenosis and clinical event rates in patients undergoing percutaneous coronary intervention for in-stent restenosis. Some problems, such as late thrombosis and edge restenosis, have been identified as limiting factors of this technique. Brachytherapy is a promising method of preventing and treating coronary artery restenosis.

  19. Interstitial brachytherapy of intracranial germinomas

    Institute of Scientific and Technical Information of China (English)

    王金林; 肖湘生; 施增儒; 陶晓峰; 肖珊; 丁学华; 卢亦成; 张耀范

    2004-01-01

    Objective: To observe the process of tumor response to interstitial brachytherapy of intracranial germinomas during and immediately after the therapy. Methods: Fractionated brachytherapy using 192Ir was used in 13 patients with intracranial germinomas. The average age at diagnosis was 14.3 years (range 5 - 27 years). The frequency of fractionation had been increased stepwise from 3 fractionations within 5 d in the past to 26 - 30 fractionations in 15 - 20 d at present, Results: Of 9 pineal tumors, the average reduction of tumor volume was 73.2% at a cumulated radiation dose of 20 Gy and85.3 % at 30 Gy, respectively. In 4 cases of basal ganglia and thalamus areas tumors, the reduction of tumor volume was from an average 56.1% at a cumulated radiation dose of 30 Gy to 75.2% at the end of therapy. That intratumoral hemorrhage was absorbed quickly accompanying tumor regression was demonstrated in all but one patient; 6 patients died; 7 patients were still in follow-up without any evidence of tumor recurrence. Conclusion: Interstitial brachytherapy could be given as the first optional therapy for intraeranial germinomas. The histological diagnosis of germinomas can be verified by stereotactic biopsy simultaneously. Germinoma is one of the sensitive tumors to interstitial brachytberapy. The radiation injury to surrounding brain tissue could be reduced by using a conformal dynamic brachytherapy.

  20. Dosimetry in intravascular brachytherapy

    International Nuclear Information System (INIS)

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing 32 P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  1. Single-mode D-shaped optical fiber sensor for the refractive index monitoring of liquid

    Science.gov (United States)

    Qazi, Hummad Habib; Mohammad, Abu Bakar bin; Ahmad, Harith; Zamani Zulkifli, Mohd; Wadi Harun, Sulaiman

    2016-04-01

    A new fabrication method is introduced for the production of D-shaped optical fiber. A mechanical end and edge polishing system with aluminum oxide polishing film is utilized to perform sequential polishing on one side (lengthwise) of single-mode optical fiber in order to obtain a D-shaped cross section. Adjusting specific mechanical parameters allows for control of the volume of the D-shaped zone, while the fiber surface smoothness is governed by selection of polishing film grit size. To meet the accuracy and repeatability requirements, optical power loss is monitored during the entire polishing process in situ and in real time. This proposed technique possesses advantages of rapidity, safety, simplicity, repeatability and stability with high precision in comparison with contemporary methods for production. Sensor performance tests on the fiber reveal a linear response with linearity up to R2 = 0.984 for surrounding refractive index in the range of 1.320-1.342 refractive index, which corresponds to different concentrations of the glucose solution test environment. The produced D-shaped optical fiber has potential sensing and monitoring applications in chemical, environmental, biological and biochemical fields.

  2. The effect of rib and lung heterogeneities on the computed dose to lung in Ir-192 High-Dose-Rate breast brachytherapy: Monte Carlo versus a treatment planning system

    Directory of Open Access Journals (Sweden)

    Hossein Salehi Yazdi

    2012-01-01

    Conclusions: Taking into account the ribs and entering the actual data for breasts, ribs, and lungs, revealed an average overestimation of the dose by a factor of 8% in the lung for TPS calculations. Therefore, the accuracy of the TPS results may be limited to regions near the implants where the treatment is planned, and is a more conservative approach for regions at boundaries with curvatures or tissues with a different material than that in the breast.

  3. D-Shaped Polarization Maintaining Fiber Sensor for Strain and Temperature Monitoring

    Directory of Open Access Journals (Sweden)

    Hummad Habib Qazi

    2016-09-01

    Full Text Available A D-shaped polarization-maintaining fiber (PMF as fiber optic sensor for the simultaneous monitoring of strain and the surrounding temperature is presented. A mechanical end and edge polishing system with aluminum oxide polishing film is utilized to perform sequential polishing on one side (lengthwise of the PMF in order to fabricate a D-shaped cross-section. Experimental results show that the proposed sensor has high sensitivity of 46 pm/µε and 130 pm/°C for strain and temperature, respectively, which is significantly higher than other recently reported work (mainly from 2013 related to fiber optic sensors. The easy fabrication method, high sensitivity, and good linearity make this sensing device applicable in various applications such as health monitoring and spatial analysis of engineering structures.

  4. D-shaped fiber grating refractive index sensor induced by an ultrashort pulse laser.

    Science.gov (United States)

    Liao, Changrui; Wang, Qiao; Xu, Lei; Liu, Shen; He, Jun; Zhao, Jing; Li, Zhengyong; Wang, Yiping

    2016-03-01

    The fabrication of fiber Bragg gratings was here demonstrated using ultrashort pulse laser point-by-point inscription. This is a very convenient means of creating fiber Bragg gratings with different grating periods and works by changing the translation speed of the fiber. The laser energy was first optimized in order to improve the spectral properties of the fiber gratings. Then, fiber Bragg gratings were formed into D-shaped fibers for use as refractive index sensors. A nonlinear relationship was observed between the Bragg wavelength and liquid refractive index, and a sensitivity of ∼30  nm/RIU was observed at 1.450. This shows that D-shaped fiber Bragg gratings might be used to develop promising biochemical sensors. PMID:26974608

  5. D-Shaped Polarization Maintaining Fiber Sensor for Strain and Temperature Monitoring.

    Science.gov (United States)

    Qazi, Hummad Habib; Mohammad, Abu Bakar; Ahmad, Harith; Zulkifli, Mohd Zamani

    2016-01-01

    A D-shaped polarization-maintaining fiber (PMF) as fiber optic sensor for the simultaneous monitoring of strain and the surrounding temperature is presented. A mechanical end and edge polishing system with aluminum oxide polishing film is utilized to perform sequential polishing on one side (lengthwise) of the PMF in order to fabricate a D-shaped cross-section. Experimental results show that the proposed sensor has high sensitivity of 46 pm/µε and 130 pm/°C for strain and temperature, respectively, which is significantly higher than other recently reported work (mainly from 2013) related to fiber optic sensors. The easy fabrication method, high sensitivity, and good linearity make this sensing device applicable in various applications such as health monitoring and spatial analysis of engineering structures. PMID:27649195

  6. D-Shaped Polarization Maintaining Fiber Sensor for Strain and Temperature Monitoring

    Science.gov (United States)

    Qazi, Hummad Habib; Mohammad, Abu Bakar; Ahmad, Harith; Zulkifli, Mohd Zamani

    2016-01-01

    A D-shaped polarization-maintaining fiber (PMF) as fiber optic sensor for the simultaneous monitoring of strain and the surrounding temperature is presented. A mechanical end and edge polishing system with aluminum oxide polishing film is utilized to perform sequential polishing on one side (lengthwise) of the PMF in order to fabricate a D-shaped cross-section. Experimental results show that the proposed sensor has high sensitivity of 46 pm/µε and 130 pm/°C for strain and temperature, respectively, which is significantly higher than other recently reported work (mainly from 2013) related to fiber optic sensors. The easy fabrication method, high sensitivity, and good linearity make this sensing device applicable in various applications such as health monitoring and spatial analysis of engineering structures. PMID:27649195

  7. Physical aspects of radioisotope brachytherapy

    International Nuclear Information System (INIS)

    The present report represents an attempt to provide, within a necessarily limited compass, an authoritative guide to all important physical aspects of the use of sealed gamma sources in radiotherapy. Within the report, reference is made wherever necessary to the more extensive but scattered literature on this subject. While this report attempts to cover all the physical aspects of radioisotope 'brachytherapy' it does not, of course, deal exhaustively with any one part of the subject. 384 refs, 3 figs, 6 tabs

  8. A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns

    OpenAIRE

    Sean Guo-Dong Tan; Sangho Kim; Jimmy Kim Fatt Hon; Hwa Liang Leo

    2016-01-01

    Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve) has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry...

  9. Polar rings and the 3D-shape of dark matter

    CERN Document Server

    Combes, Francoise

    2013-01-01

    Polar ring galaxies (PRG) are unique to give insight on the 3D-shape of dark matter haloes. Some caveats have prevented to draw clear conclusions in previous works. Also the formation mechanisms need to be well known. All available information on the topic is reviewed, and criteria are defined for an ideal PRG system, in the hope of removing the ambiguities and make progress in the domain.

  10. Biologically Inspired Model for Inference of 3D Shape from Texture.

    Science.gov (United States)

    Gomez, Olman; Neumann, Heiko

    2016-01-01

    A biologically inspired model architecture for inferring 3D shape from texture is proposed. The model is hierarchically organized into modules roughly corresponding to visual cortical areas in the ventral stream. Initial orientation selective filtering decomposes the input into low-level orientation and spatial frequency representations. Grouping of spatially anisotropic orientation responses builds sketch-like representations of surface shape. Gradients in orientation fields and subsequent integration infers local surface geometry and globally consistent 3D depth. From the distributions in orientation responses summed in frequency, an estimate of the tilt and slant of the local surface can be obtained. The model suggests how 3D shape can be inferred from texture patterns and their image appearance in a hierarchically organized processing cascade along the cortical ventral stream. The proposed model integrates oriented texture gradient information that is encoded in distributed maps of orientation-frequency representations. The texture energy gradient information is defined by changes in the grouped summed normalized orientation-frequency response activity extracted from the textured object image. This activity is integrated by directed fields to generate a 3D shape representation of a complex object with depth ordering proportional to the fields output, with higher activity denoting larger distance in relative depth away from the viewer.

  11. Biologically Inspired Model for Inference of 3D Shape from Texture.

    Science.gov (United States)

    Gomez, Olman; Neumann, Heiko

    2016-01-01

    A biologically inspired model architecture for inferring 3D shape from texture is proposed. The model is hierarchically organized into modules roughly corresponding to visual cortical areas in the ventral stream. Initial orientation selective filtering decomposes the input into low-level orientation and spatial frequency representations. Grouping of spatially anisotropic orientation responses builds sketch-like representations of surface shape. Gradients in orientation fields and subsequent integration infers local surface geometry and globally consistent 3D depth. From the distributions in orientation responses summed in frequency, an estimate of the tilt and slant of the local surface can be obtained. The model suggests how 3D shape can be inferred from texture patterns and their image appearance in a hierarchically organized processing cascade along the cortical ventral stream. The proposed model integrates oriented texture gradient information that is encoded in distributed maps of orientation-frequency representations. The texture energy gradient information is defined by changes in the grouped summed normalized orientation-frequency response activity extracted from the textured object image. This activity is integrated by directed fields to generate a 3D shape representation of a complex object with depth ordering proportional to the fields output, with higher activity denoting larger distance in relative depth away from the viewer. PMID:27649387

  12. Interstitial prostate brachytherapy. LDR-PDR-HDR

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, Gyoergy [Luebeck Univ. (Germany). Interdiscipliary Brachytherapy Unit; Hoskin, Peter (ed.) [London Univ. College (United Kingdom). Mount Vernon Cancer Centre

    2013-07-01

    The first comprehensive overview of interstitial brachytherapy for the management of local or locally advanced prostate cancer. Written by an interdisciplinary team who have been responsible for the successful GEC-ESTRO/EAU Teaching Course. Discusses in detail patient selection, the results of different methods, the role of imaging, and medical physics issues. Prostate brachytherapy has been the subject of heated debate among surgeons and the proponents of the various brachytherapy methods. This very first interdisciplinary book on the subject provides a comprehensive overview of innovations in low dose rate (LDR), high dose rate (HDR), and pulsed dose rate (PDR) interstitial brachytherapy for the management of local or locally advanced prostate cancer. In addition to detailed chapters on patient selection and the use of imaging in diagnostics, treatment guidance, and implantation control, background chapters are included on related medical physics issues such as treatment planning and quality assurance. The results obtained with the different treatment options and the difficult task of salvage treatment are fully discussed. All chapters have been written by internationally recognized experts in their fields who for more than a decade have formed the teaching staff responsible for the successful GEC-ESTRO/EAU Prostate Brachytherapy Teaching Course. This book will be invaluable in informing residents and others of the scientific background and potential of modern prostate brachytherapy. It will also prove a useful source of up-to-date information for those who specialize in prostate brachytherapy or intend to start an interstitial brachytherapy service.

  13. Afterloading: The Technique That Rescued Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Aronowitz, Jesse N., E-mail: jesse.aronowitz@umassmemorial.org

    2015-07-01

    Although brachytherapy had been established as a highly effective modality for the treatment of cancer, its application was threatened by mid-20th century due to appreciation of the radiation hazard to health care workers. This review examines how the introduction of afterloading eliminated exposure and ushered in a brachytherapy renaissance.

  14. Exact and approximate geometric calculations for toroidal D-shaped plasmas: Application to Ignitor-Ult

    International Nuclear Information System (INIS)

    For a toroidal D-shaped plasma, this paper presents exact formulas to calculate geometrical quantities of interest to plasma physicists and engineers. Each quantity (plasma cross section, volume, circumference and surface, including outboard and inboard fractions) can be expressed in the form Q=QcircFQ, where Q is the quantity pertaining to the D-shaped plasma (characterized by major radius R0, minor radii a, b and triangularity τ); Qcirc is the corresponding quantity for the circular plasma of parameters R0, a; and FQ is an adimensional factor (only containing simple integrals) which depends on τ, on the elongation κ=b/a and on the aspect ratio A=R0/a. Besides giving exact formulas, it is proposed two approximating procedures, one graphical and one numerical. Within their validity limits (0<=τ<=1, 1.4<=κ<=2.6 and any A) the approximating formulas - only derived for plasma cross section, volume, circumference and surface - allow a quick determination of the quantities Q with an accuracy better than 1%. As an example, it is presented the results of calculations performed by exact formulas and by approximating procedures for the triangular plasma of the Ignitor-Ult tokamak

  15. PCA-based 3D Shape Reconstruction of Human Foot Using Multiple Viewpoint Cameras

    Institute of Scientific and Technical Information of China (English)

    Edmée Amstutz; Tomoaki Teshima; Makoto Kimura; Masaaki Mochimaru; Hideo Saito

    2008-01-01

    This paper describes a multiple camera-based method to reconstruct the 3D shape of a human foot. From a foot database,an initial 3D model of the foot represented by a cloud of points is built. The shape parameters, which can characterize more than 92% of a foot, are defined by using the principal component analysis method. Then, using "active shape models", the initial 3D model is adapted to the real foot captured in multiple images by applying some constraints (edge points' distance and color variance). We insist here on the experiment part where we demonstrate the efficiency of the proposed method on a plastic foot model, and also on real human feet with various shapes. We propose and compare different ways of texturing the foot which is needed for reconstruction. We present an experiment performed on the plastic foot model and on human feet and propose two different ways to improve the final 3D shape's accuracy according to the previous experiments' results. The first improvement proposed is the densification of the cloud of points used to represent the initial model and the foot database. The second improvement concerns the projected patterns used to texture the foot. We conclude by showing the obtained results for a human foot with the average computed shape error being only 1.06mm.

  16. A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns.

    Directory of Open Access Journals (Sweden)

    Sean Guo-Dong Tan

    Full Text Available Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation. An in-vitro experiment using two dimensional particle velocimetry imaging was carried out to determine the hemodynamic performance of the new bileaflet design and then compared to that of the well-established St. Jude Epic valve which functioned as a control in the experiment. Although both valves were found to have similar Reynolds shear stress and Turbulent Kinetic Energy levels, the novel D-shape valve was found to have lower turbulence intensity and greater mean kinetic energy conservation.

  17. A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns.

    Science.gov (United States)

    Tan, Sean Guo-Dong; Kim, Sangho; Hon, Jimmy Kim Fatt; Leo, Hwa Liang

    2016-01-01

    Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve) has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation. An in-vitro experiment using two dimensional particle velocimetry imaging was carried out to determine the hemodynamic performance of the new bileaflet design and then compared to that of the well-established St. Jude Epic valve which functioned as a control in the experiment. Although both valves were found to have similar Reynolds shear stress and Turbulent Kinetic Energy levels, the novel D-shape valve was found to have lower turbulence intensity and greater mean kinetic energy conservation. PMID:27258099

  18. The American Brachytherapy Society recommendations for low-dose-rate brachytherapy for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: This report presents guidelines for using low-dose-rate (LDR) brachytherapy in the management of patients with cervical cancer. Methods: Members of the American Brachytherapy Society (ABS) with expertise in LDR brachytherapy for cervical cancer performed a literature review, supplemented by their clinical experience, to formulate guidelines for LDR brachytherapy of cervical cancer. Results: The ABS strongly recommends that radiation treatment for cervical carcinoma (with or without chemotherapy) should include brachytherapy as a component. Precise applicator placement is essential for improved local control and reduced morbidity. The outcome of brachytherapy depends, in part, on the skill of the brachytherapist. Doses given by external beam radiotherapy and brachytherapy depend upon the initial volume of disease, the ability to displace the bladder and rectum, the degree of tumor regression during pelvic irradiation, and institutional practice. The ABS recognizes that intracavitary brachytherapy is the standard technique for brachytherapy for cervical carcinoma. Interstitial brachytherapy should be considered for patients with disease that cannot be optimally encompassed by intracavitary brachytherapy. The ABS recommends completion of treatment within 8 weeks, when possible. Prolonging total treatment duration can adversely affect local control and survival. Recommendations are made for definitive and postoperative therapy after hysterectomy. Although recognizing that many efficacious LDR dose schedules exist, the ABS presents suggested dose and fractionation schemes for combining external beam radiotherapy with LDR brachytherapy for each stage of disease. The dose prescription point (point A) is defined for intracavitary insertions. Dose rates of 0.50 to 0.65 Gy/h are suggested for intracavitary brachytherapy. Dose rates of 0.50 to 0.70 Gy/h to the periphery of the implant are suggested for interstitial implant. Use of differential source activity or

  19. ANSIG - An Analytic Signature for Arbitrary 2D Shapes (or Bags of Unlabeled Points)

    CERN Document Server

    Rodrigues, José J; Aguiar, Pedro M Q

    2010-01-01

    In image analysis, many tasks require representing two-dimensional (2D) shape, often specified by a set of 2D points, for comparison purposes. The challenge of the representation is that it must not only capture the characteristics of the shape but also be invariant to relevant transformations. Invariance to geometric transformations, such as translation, rotation, and scale, has received attention in the past, usually under the assumption that the points are previously labeled, i.e., that the shape is characterized by an ordered set of landmarks. However, in many practical scenarios, the points describing the shape are obtained from automatic processes, e.g., edge or corner detection, thus without labels or natural ordering. Obviously, the combinatorial problem of computing the correspondences between the points of two shapes in the presence of the aforementioned geometrical distortions becomes a quagmire when the number of points is large. We circumvent this problem by representing shapes in a way that is i...

  20. Integrated phase unwrapping algorithm for the measurement of 3D shapes by Fourier transform profilometry

    Institute of Scientific and Technical Information of China (English)

    Shuang-qing WU; Yin ZHANG; San-yuan ZHANG; Xiu-zi YE

    2009-01-01

    An integrated and reliable phase unwrapping algorithm is proposed based on residues and blocking-lines detection,closed contour extraction and quality map ordering for the measurement of 3D shapes by Fourier-transform profilometry (FTP).The proposed algorithm first detects the residues on the wrapped phase image, applies wavelet analysis to generate the blockinglines that can just connect the residues of opposite polarity, then carries out the morphology operation to extract the closed contour of the shape, and finally uses the modulation intensity information and the Laplacian of Gaussian operation of the wrapped phase image as the quality map. The unwrapping process is completed from a region of high reliability to that of low reliability and the blocking-lines can prevent the phase error propagation effectively. Furthermore, by using the extracted closed contour to exclude the invalid areas from the phase unwrapping process, the algorithm becomes more efficient. The experiment shows the effectiveness of the new algorithm.

  1. Quantitative model for the generic 3D shape of ICMEs at 1 AU

    CERN Document Server

    Démoulin, P; Masías-Meza, J J; Dasso, S

    2016-01-01

    Interplanetary imagers provide 2D projected views of the densest plasma parts of interplanetary coronal mass ejections (ICMEs) while in situ measurements provide magnetic field and plasma parameter measurements along the spacecraft trajectory, so along a 1D cut. As such, the data only give a partial view of their 3D structures. By studying a large number of ICMEs, crossed at different distances from their apex, we develop statistical methods to obtain a quantitative generic 3D shape of ICMEs. In a first approach we theoretically obtain the expected statistical distribution of the shock-normal orientation from assuming simple models of 3D shock shapes, including distorted profiles, and compare their compatibility with observed distributions. In a second approach we use the shock normal and the flux rope axis orientations, as well as the impact parameter, to provide statistical information across the spacecraft trajectory. The study of different 3D shock models shows that the observations are compatible with a ...

  2. Intraluminal brachytherapy in treatment of malignant obstructive jaundice

    International Nuclear Information System (INIS)

    Objective: To study the practicability and preliminary effect of intraluminal brachytherapy in treatment of malignant obstructive jaundice. Methods: Intraluminal brachytherapy was performed in 4 patients who had been treated with biliary stent implantation. Results: No complications related to intraluminal brachytherapy had happened. One patient was followed up by means of CT, showing reduction in tumor size. Conclusion: Intraluminal brachytherapy is a safe and effective method in treating malignant tumor causing obstructive jaundice

  3. Brachytherapy next generation: robotic systems.

    Science.gov (United States)

    Popescu, Tiberiu; Kacsó, Alex Cristian; Pisla, Doina; Kacsó, Gabriel

    2015-12-01

    In a field dominated by external beam radiation therapy (EBRT), both the therapeutic and technical possibilities of brachytherapy (BT) are underrated, shadowed by protons and intensity modulated radiotherapy. Decreasing expertise and indications, as well as increasing lack of specific BT training for radiation therapy (RT) residents led to the real need of shortening its learning curve and making it more popular. Developing robotic BT devices can be a way to mitigate the above issues. There are many teams working at custom-made robotic BT platforms to perfect and overcome the limitations of the existing systems. This paper provides a picture of the current state-of-the-art in robotic assisted BT, as it also conveys the author's solution to the problem, a parallel robot that uses CT-guidance. PMID:26816510

  4. Dosimetric study of a brachytherapy treatment of esophagus with Brazilian 192Ir sources using an anthropomorphic phantom

    International Nuclear Information System (INIS)

    Several radioisotopes are produced at Instituto de Pesquisas Energéticas e Nucleares for the use in medical treatments, including the activation of 192Ir sources. These sources are suitable for brachytherapy treatments, due to their low or high activity, depending on the concentration of 192Ir, easiness to manufacture, small size, stable daughter products and the possibility of re-utilization. They may be used for the treatment of prostate, cervix, head and neck, skin, breast, gallbladder, uterus, vagina, lung, rectum, and eye cancer treatment. In this work, the use of some 192Ir sources was studied for the treatment of esophagus cancer, especially the dose determination of important structures, such as those on the mediastinum. This was carried out utilizing a FASH anthropomorphic phantom and the MCNP5 Monte Carlo code to transport the radiation through matter. It was possible to observe that the doses at lungs, breast, esophagus, thyroid and heart were the highest, which was expected due to their proximity to the source. Therefore, the data are useful to assess the representative dose specific to brachytherapy treatments on the esophagus for radiation protection purposes. - Author-Highlights: • The use of brachytherapy sources was studied for the treatment of esophagus cancer. • FASH anthropomorphic phantom and MCNP5 Monte Carlo code were employed. • The doses at lungs, breast, esophagus, thyroid and heart were the highest. • The data is useful to assess the representative doses of treatments on the esophagus

  5. A computational model that recovers the 3D shape of an object from a single 2D retinal representation.

    Science.gov (United States)

    Li, Yunfeng; Pizlo, Zygmunt; Steinman, Robert M

    2009-05-01

    Human beings perceive 3D shapes veridically, but the underlying mechanisms remain unknown. The problem of producing veridical shape percepts is computationally difficult because the 3D shapes have to be recovered from 2D retinal images. This paper describes a new model, based on a regularization approach, that does this very well. It uses a new simplicity principle composed of four shape constraints: viz., symmetry, planarity, maximum compactness and minimum surface. Maximum compactness and minimum surface have never been used before. The model was tested with random symmetrical polyhedra. It recovered their 3D shapes from a single randomly-chosen 2D image. Neither learning, nor depth perception, was required. The effectiveness of the maximum compactness and the minimum surface constraints were measured by how well the aspect ratio of the 3D shapes was recovered. These constraints were effective; they recovered the aspect ratio of the 3D shapes very well. Aspect ratios recovered by the model were compared to aspect ratios adjusted by four human observers. They also adjusted aspect ratios very well. In those rare cases, in which the human observers showed large errors in adjusted aspect ratios, their errors were very similar to the errors made by the model. PMID:18621410

  6. A widely tunable wavelength converter based on nonlinear polarization rotation in a carbon-nanotube-deposited D-shaped fiber.

    Science.gov (United States)

    Chow, K K; Yamashita, S; Song, Y W

    2009-04-27

    We demonstrate widely tunable wavelength conversion based on cross-phase modulation induced nonlinear polarization rotation in a carbon nanotubes (CNTs) deposited D-shaped fiber. A 5-centimeter-long CNT-deposited D-shaped fiber is used as the nonlinear medium for wavelength conversion of a 10 Gb/s non-return-to-zero signal. Wavelength tunable converted signal over 40 nm is obtained with around 2.5-dB power penalty in the bit-error-rate measurements. PMID:19399145

  7. ACPSEM brachytherapy working group recommendations for quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups in 2011 to develop recommendation papers for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, have been subject to independent expert reviews and have also been approved by the ACPSEM Council. For the Australian audience, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Practice Standards. This publication presents the recommendations of the ACPSEM Brachytherapy Working Group (BTWG) and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendation papers. It is hoped that the users of this and other ACPSEM recommendation papers will contribute to the development of future versions through the Radiation Oncology Specialty Group of the ACPSEM.

  8. Drag of a D-shaped bluff body under small amplitude harmonic actuation

    Directory of Open Access Journals (Sweden)

    Yaqing Li

    2015-01-01

    Full Text Available Open-loop flow control method was used to affect the development of a turbulent wake behind a D-shaped bluff body. Loud speakers were embedded inside the bluff body to produce two zero-net-mass-flux jets through 2 mm-wide span-wise slots located along the upper and lower edges on the rear wall. The drag forces for different actuation amplitudes (Cμ, the ratio between the momentum of the actuating jets and the moment deficit caused by the bluff body and frequencies (StA were examined. The effects of the phase difference in the two jets (0 and π were also studied. It was found that when Cμ was 0.1%, a drag reduction up to 5% was achieved when the velocities of the two jets varied in phase at a frequency of StA=0.16. When the velocities of the two jets varied π out of phase, significant drag increase was observed.

  9. Two conformational states in D-shaped DNA: Effects of local denaturation

    Science.gov (United States)

    Lee, O.-Chul; Kim, Cheolhee; Kim, Jae-Yeol; Lee, Nam Ki; Sung, Wokyung

    2016-06-01

    The bending of double-stranded(ds) DNA on the nano-meter scale plays a key role in many cellular processes such as nucleosome packing, transcription-control, and viral-genome packing. In our recent study, a nanometer-sized dsDNA bent into a D shape was formed by hybridizing a circular single-stranded(ss) DNA and a complementary linear ssDNA. Our fluorescence resonance energy transfer (FRET) measurement of D-DNA revealed two types of conformational states: a less-bent state and a kinked state, which can transform into each other. To understand the origin of the two deformed states of D-DNA, here we study the presence of open base-pairs in the ds portion by using the breathing-DNA model to simulate the system. We provide strong evidence that the two states are due to the emergence of local denaturation, i.e., a bubble in the middle and two forks at ends of the dsDNA portion. We also study the system analytically and find that the free-energy landscape is bistable with two minima representative of the two states. The kink and fork sizes estimated by the analytical calculation are also in excellent agreement with the results of the simulation. Thus, this combined experimental-simulation-analytical study corroborates that highly bent D-DNA reduces bending stress via local denaturation.

  10. KOALA: 3-D shape of asteroids from multi-data inversion

    Science.gov (United States)

    Carry, B.; Kaasalainen, M.; Merline, W. J.; Drummond, J. D.; Durech, J.; Berthier, J.; Conrad, A.

    2011-10-01

    We describe our on-going observing program to determine the physical properties of asteroids from groundbased facilities. We combine disk-resolved images from adaptive optics, optical lightcurves, and stellar occultations to put tighter constraints on the spin, 3-D shape, and size of asteroids. We will discuss the relevance of the determination of physical properties to help understand the asteroid population (e.g., density, composition, and non-gravitational forces). We will then briefly describe our multi-data inversion algorithm KOALA (Carry et al. 2010a, Kaasalainen 2011, see also Kaasalainen et al., same meeting), which allows the determination of certain physical properties of an asteroid from the combination of different techniques of observation. A comparison of results obtained with KOALA on asteroid (21) Lutetia, prior to the ESA Rosetta flyby, with the high spatial resolution images returned from that flyby, will then be presented, showing the high accuracy of KOALA inversion. Finally, we will describe our current development of the algorithm, and focus on examples of other asteroids currently being studied with KOALA.

  11. Enhanced high dynamic range 3D shape measurement based on generalized phase-shifting algorithm

    CERN Document Server

    Wang, Minmin; Zhou, Canlin; Zhang, Chaorui; Si, Shuchun; Li, Hui; Lei, Zhenkun; Li, YanJie

    2016-01-01

    It is a challenge for Phase Measurement Profilometry (PMP) to measure objects with a large range of reflectivity variation across the surface. Saturated or dark pixels in the deformed fringe patterns captured by the camera will lead to phase fluctuations and errors. Jiang et al. proposed a high dynamic range real-time 3D shape measurement method without changing camera exposures. Three inverted phase-shifted fringe patterns are used to complement three regular phase-shifted fringe patterns for phase retrieval when any of the regular fringe patterns are saturated. But Jiang's method still has some drawbacks: (1) The phases in saturated pixels are respectively estimated by different formulas for different cases. It is shortage of an universal formula; (2) it cannot be extended to four-step phase-shifting algorithm because inverted fringe patterns are the repetition of regular fringe patterns; (3) only three unsaturated intensity values at every pixel of fringe patterns are chosen for phase demodulation, lying i...

  12. Measuring the 3D shape of high temperature objects using blue sinusoidal structured light

    Science.gov (United States)

    Zhao, Xianling; Liu, Jiansheng; Zhang, Huayu; Wu, Yingchun

    2015-12-01

    The visible light radiated by some high temperature objects (less than 1200 °C) almost lies in the red and infrared waves. It will interfere with structured light projected on a forging surface if phase measurement profilometry (PMP) is used to measure the shapes of objects. In order to obtain a clear deformed pattern image, a 3D measurement method based on blue sinusoidal structured light is proposed in this present work. Moreover, a method for filtering deformed pattern images is presented for correction of the unwrapping phase. Blue sinusoidal phase-shifting fringe pattern images are projected on the surface by a digital light processing (DLP) projector, and then the deformed patterns are captured by a 3-CCD camera. The deformed pattern images are separated into R, G and B color components by the software. The B color images filtered by a low-pass filter are used to calculate the fringe order. Consequently, the 3D shape of a high temperature object is obtained by the unwrapping phase and the calibration parameter matrixes of the DLP projector and 3-CCD camera. The experimental results show that the unwrapping phase is completely corrected with the filtering method by removing the high frequency noise from the first harmonic of the B color images. The measurement system can complete the measurement in a few seconds with a relative error of less than 1 : 1000.

  13. Measuring the 3D shape of high temperature objects using blue sinusoidal structured light

    International Nuclear Information System (INIS)

    The visible light radiated by some high temperature objects (less than 1200 °C) almost lies in the red and infrared waves. It will interfere with structured light projected on a forging surface if phase measurement profilometry (PMP) is used to measure the shapes of objects. In order to obtain a clear deformed pattern image, a 3D measurement method based on blue sinusoidal structured light is proposed in this present work. Moreover, a method for filtering deformed pattern images is presented for correction of the unwrapping phase. Blue sinusoidal phase-shifting fringe pattern images are projected on the surface by a digital light processing (DLP) projector, and then the deformed patterns are captured by a 3-CCD camera. The deformed pattern images are separated into R, G and B color components by the software. The B color images filtered by a low-pass filter are used to calculate the fringe order. Consequently, the 3D shape of a high temperature object is obtained by the unwrapping phase and the calibration parameter matrixes of the DLP projector and 3-CCD camera. The experimental results show that the unwrapping phase is completely corrected with the filtering method by removing the high frequency noise from the first harmonic of the B color images. The measurement system can complete the measurement in a few seconds with a relative error of less than 1 : 1000. (paper)

  14. Statistical 3D shape analysis of gender differences in lateral ventricles

    Science.gov (United States)

    He, Qing; Karpman, Dmitriy; Duan, Ye

    2010-03-01

    This paper aims at analyzing gender differences in the 3D shapes of lateral ventricles, which will provide reference for the analysis of brain abnormalities related to neurological disorders. Previous studies mostly focused on volume analysis, and the main challenge in shape analysis is the required step of establishing shape correspondence among individual shapes. We developed a simple and efficient method based on anatomical landmarks. 14 females and 10 males with matching ages participated in this study. 3D ventricle models were segmented from MR images by a semiautomatic method. Six anatomically meaningful landmarks were identified by detecting the maximum curvature point in a small neighborhood of a manually clicked point on the 3D model. Thin-plate spline was used to transform a randomly selected template shape to each of the rest shape instances, and the point correspondence was established according to Euclidean distance and surface normal. All shapes were spatially aligned by Generalized Procrustes Analysis. Hotelling T2 twosample metric was used to compare the ventricle shapes between males and females, and False Discovery Rate estimation was used to correct for the multiple comparison. The results revealed significant differences in the anterior horn of the right ventricle.

  15. Sensitivity of low energy brachytherapy Monte Carlo dose calculations to uncertainties in human tissue composition

    Energy Technology Data Exchange (ETDEWEB)

    Landry, Guillaume; Reniers, Brigitte; Murrer, Lars; Lutgens, Ludy; Bloemen-Van Gurp, Esther; Pignol, Jean-Philippe; Keller, Brian; Beaulieu, Luc; Verhaegen, Frank [Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, de l' Universite Laval, CHUQ, Pavillon L' Hotel-Dieu de Quebec, Quebec G1R 2J6 (Canada) and Departement de Physique, de Genie Physique et d' Optique, Universite Laval, Quebec G1K 7P4 (Canada); Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands) and Medical Physics Unit, McGill University, Montreal General Hospital, Montreal, Quebec H3G 1A4 (Canada)

    2010-10-15

    Purpose: The objective of this work is to assess the sensitivity of Monte Carlo (MC) dose calculations to uncertainties in human tissue composition for a range of low photon energy brachytherapy sources: {sup 125}I, {sup 103}Pd, {sup 131}Cs, and an electronic brachytherapy source (EBS). The low energy photons emitted by these sources make the dosimetry sensitive to variations in tissue atomic number due to the dominance of the photoelectric effect. This work reports dose to a small mass of water in medium D{sub w,m} as opposed to dose to a small mass of medium in medium D{sub m,m}. Methods: Mean adipose, mammary gland, and breast tissues (as uniform mixture of the aforementioned tissues) are investigated as well as compositions corresponding to one standard deviation from the mean. Prostate mean compositions from three different literature sources are also investigated. Three sets of MC simulations are performed with the GEANT4 code: (1) Dose calculations for idealized TG-43-like spherical geometries using point sources. Radial dose profiles obtained in different media are compared to assess the influence of compositional uncertainties. (2) Dose calculations for four clinical prostate LDR brachytherapy permanent seed implants using {sup 125}I seeds (Model 2301, Best Medical, Springfield, VA). The effect of varying the prostate composition in the planning target volume (PTV) is investigated by comparing PTV D{sub 90} values. (3) Dose calculations for four clinical breast LDR brachytherapy permanent seed implants using {sup 103}Pd seeds (Model 2335, Best Medical). The effects of varying the adipose/gland ratio in the PTV and of varying the elemental composition of adipose and gland within one standard deviation of the assumed mean composition are investigated by comparing PTV D{sub 90} values. For (2) and (3), the influence of using the mass density from CT scans instead of unit mass density is also assessed. Results: Results from simulation (1) show that variations

  16. Sensitivity of low energy brachytherapy Monte Carlo dose calculations to uncertainties in human tissue composition

    International Nuclear Information System (INIS)

    Purpose: The objective of this work is to assess the sensitivity of Monte Carlo (MC) dose calculations to uncertainties in human tissue composition for a range of low photon energy brachytherapy sources: 125I, 103Pd, 131Cs, and an electronic brachytherapy source (EBS). The low energy photons emitted by these sources make the dosimetry sensitive to variations in tissue atomic number due to the dominance of the photoelectric effect. This work reports dose to a small mass of water in medium Dw,m as opposed to dose to a small mass of medium in medium Dm,m. Methods: Mean adipose, mammary gland, and breast tissues (as uniform mixture of the aforementioned tissues) are investigated as well as compositions corresponding to one standard deviation from the mean. Prostate mean compositions from three different literature sources are also investigated. Three sets of MC simulations are performed with the GEANT4 code: (1) Dose calculations for idealized TG-43-like spherical geometries using point sources. Radial dose profiles obtained in different media are compared to assess the influence of compositional uncertainties. (2) Dose calculations for four clinical prostate LDR brachytherapy permanent seed implants using 125I seeds (Model 2301, Best Medical, Springfield, VA). The effect of varying the prostate composition in the planning target volume (PTV) is investigated by comparing PTV D90 values. (3) Dose calculations for four clinical breast LDR brachytherapy permanent seed implants using 103Pd seeds (Model 2335, Best Medical). The effects of varying the adipose/gland ratio in the PTV and of varying the elemental composition of adipose and gland within one standard deviation of the assumed mean composition are investigated by comparing PTV D90 values. For (2) and (3), the influence of using the mass density from CT scans instead of unit mass density is also assessed. Results: Results from simulation (1) show that variations in the mean compositions of tissues affect low energy

  17. Dosimetric calculus in intravascular brachytherapy

    International Nuclear Information System (INIS)

    Among the cardiovascular diseases, the most common is acute myocardial infarction, which occurs because of the occlusion of one or more coronary arteries. Balloon angioplasty has been a popular treatment which is less invasive than surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment). Known as Intravascular Brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis. In order to study the radiation dosimetry in the patient and radiological protection for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, 0.30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several radionuclides. Two stent sources employing 32P are also simulated. Advantages and disadvantages of the radionuclides and source geometries are discussed and the dosimetry developed here will aid in the realization of the benefits obtained in patients. (author)

  18. Stereotactic Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Rationale, Feasibility, and Early Experience Using the CyberKnife Radiosurgery Delivery Platform

    OpenAIRE

    Obayomi-Davies, Olusola; Kole, Thomas P.; Oppong, Bridget; Rudra, Sonali; Makariou, Erini V.; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Unger, Keith; WILLEY, SHAWNA; Tousimis, Eleni; Collins, Brian T.

    2016-01-01

    Purpose The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early-stage breast cancer treated with breast-conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rati...

  19. Stereotactic Accelerated Partial Breast Irradiation (SAPBI) for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    OpenAIRE

    Olusola eOBAYOMI-DAVIES; Kole, Thomas P.; Bridget eOppong; Sonali eRudra; Erini eMakariou; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Keith eUnger; Willey, Shawna C.; Eleni A Tousimis; Brian Timothy Collins

    2016-01-01

    Purpose: The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early stage breast cancer treated with breast conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rat...

  20. Review of MammoSite brachytherapy: Advantages, disadvantages and clinical outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Bensaleh, Saleh; Bezak, Eva; Borg, Martin (Dept. of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia))

    2009-05-15

    Background. The MammoSite radiotherapy system is an alternative treatment option for patients with early-stage breast cancer to overcome the longer schedules associated with external beam radiation therapy. The device is placed inside the breast surgical cavity and inflated with a combination of saline and radiographic contrast to completely fill the cavity. The treatment schedule for the MammoSite monotherapy is 34 Gy delivered in 10 fractions at 1.0 cm from the balloon surface with a minimum of 6 hours between fractions on the same day. Material and methods. This review article presents the advantages, disadvantages, uncertainties and clinical outcomes associated with the MammoSite brachytherapy (MSB). Results. Potential advantages of MSB are: high localised dose with rapid falloff for normal tissue sparing, minimum delay between surgery and RT, catheter moves with breast, improved local control, no exposure to staff, likely side-effects reduction and potential cost/time saving (e.g. for country patients). The optimal cosmetic results depend on the balloon-to-skin distance. Good-to-excellent cosmetic results are achieved for patients with balloon-skin spacing of =7 mm. There have been very few published data regarding the long term tumour control and cosmesis associated with the MSB. The available data on the local control achieved with the MSB were comparable with other accelerated partial breast irradiation techniques. The contrast medium inside the balloon causes dose reduction at the prescription point. Current brachytherapy treatment planning systems (BTPS) do not take into account the increased photon attenuation due to high Z of contrast. Some BTPS predicted up to 10% higher dose near the balloon surface compared with Monte Carlo calculations using various contrast concentrations (5-25%). Conclusion. Initial clinical results have shown that the MammoSite device could be used as a sole radiation treatment for selected patients with early stage breast cancer

  1. Object Recognition in Flight: How Do Bees Distinguish between 3D Shapes?

    Science.gov (United States)

    Werner, Annette; Stürzl, Wolfgang; Zanker, Johannes

    2016-01-01

    Honeybees (Apis mellifera) discriminate multiple object features such as colour, pattern and 2D shape, but it remains unknown whether and how bees recover three-dimensional shape. Here we show that bees can recognize objects by their three-dimensional form, whereby they employ an active strategy to uncover the depth profiles. We trained individual, free flying honeybees to collect sugar water from small three-dimensional objects made of styrofoam (sphere, cylinder, cuboids) or folded paper (convex, concave, planar) and found that bees can easily discriminate between these stimuli. We also tested possible strategies employed by the bees to uncover the depth profiles. For the card stimuli, we excluded overall shape and pictorial features (shading, texture gradients) as cues for discrimination. Lacking sufficient stereo vision, bees are known to use speed gradients in optic flow to detect edges; could the bees apply this strategy also to recover the fine details of a surface depth profile? Analysing the bees’ flight tracks in front of the stimuli revealed specific combinations of flight maneuvers (lateral translations in combination with yaw rotations), which are particularly suitable to extract depth cues from motion parallax. We modelled the generated optic flow and found characteristic patterns of angular displacement corresponding to the depth profiles of our stimuli: optic flow patterns from pure translations successfully recovered depth relations from the magnitude of angular displacements, additional rotation provided robust depth information based on the direction of the displacements; thus, the bees flight maneuvers may reflect an optimized visuo-motor strategy to extract depth structure from motion signals. The robustness and simplicity of this strategy offers an efficient solution for 3D-object-recognition without stereo vision, and could be employed by other flying insects, or mobile robots. PMID:26886006

  2. The allegheny general modification of the Harvard Breast Cosmesis Scale for the retreated breast.

    Science.gov (United States)

    Trombetta, Mark; Julian, Thomas B; Kim, Yongbok; Werts, E Day; Parda, David

    2009-10-01

    The use of brachytherapy--and to a lesser extent, external-beam radiotherapy--in the management of locally recurrent breast cancer following ipsilateral breast tumor recurrence (IBTR) followed by repeat breast-conservation surgery and irradiation is currently an area of intense study. The current cosmetic scoring system is inadequate to score the outcome resulting from retreatment because it does not account for the cosmetic effect of the initial treatment. We propose a modification of the scale for patients who undergo retreatment--the Allegheny General Modification of the Harvard/NSABP/RTOG scoring scale.

  3. Early voiding dysfunction associated with prostate brachytherapy.

    Science.gov (United States)

    Wagner; Nag; Young; Bahnson

    2000-12-15

    Introduction: Transperineal prostate brachytherapy is gaining popularity as a treatment for clinically localized carcinoma of the prostate. Very little prospective data exists addressing the issue of complications associated with this procedure. We present an analysis of the early voiding dysfunction associated with prostate brachytherapy. Materials and Methods: Forty-six consecutive patients who underwent Palladium-103 (Pd-103) seed placement for clinically localized prostate carcinoma were evaluated prospectively for any morbidity associated with the procedure. Twenty-three patients completed an International Prostate Symptom Score (IPSS) questionnaire preoperatively, at their first postoperative visit, and at their second postoperative visit. The total IPSS, each of the seven individual components, and the "bother" score were evaluated separately for each visit, and statistical significance was determined. Results: Urinary retention occurred in 7/46 patients (15%). Of these, 5 were able to void spontaneously after catheter removal. One patient is maintained with a suprapubic tube, and one patient is currently on continuous intermittent catheterization. Baseline IPSS was 7.1 and this went to 20.0 at the first postoperative visit (p<0.001). By the second postoperative visit, the IPSS was 8.0. Conclusions: In our experience, prostate brachytherapy for localized carcinoma of the prostate is associated with a 15% catheterization rate and a significant increase in the IPSS (7.1 to 20.0). This increase in the IPSS seems to be self-limited. Patients need to be educated on these issues prior to prostate brachytherapy. PMID:11113369

  4. Dose optimisation in single plane interstitial brachytherapy

    DEFF Research Database (Denmark)

    Tanderup, Kari; Hellebust, Taran Paulsen; Honoré, Henriette Benedicte;

    2006-01-01

    BACKGROUND AND PURPOSE: Brachytherapy dose distributions can be optimised       by modulation of source dwell times. In this study dose optimisation in       single planar interstitial implants was evaluated in order to quantify the       potential benefit in patients. MATERIAL AND METHODS: In 14...

  5. Determination of exit skin dose for 192Ir intracavitary accelerated partial breast irradiation with thermoluminescent dosimeters

    OpenAIRE

    Raffi, Julie A.; Stephen D. Davis; Hammer, Cliff G.; Micka, John A.; Kunugi, Keith A.; Musgrove, Jana E.; Winston, John W.; Ricci-Ott, Terresa J.; DeWerd, Larry A.

    2010-01-01

    Purpose: Intracavitary accelerated partial breast irradiation (APBI) has become a popular treatment for early stage breast cancer in recent years due to its shortened course of treatment and simplified treatment planning compared to traditional external beam breast conservation therapy. However, the exit dose to the skin is a major concern and can be a limiting factor for these treatments. Most treatment planning systems (TPSs) currently used for high dose-rate (HDR) 192Ir brachytherapy overe...

  6. Interstitial high-dose-rate brachytherapy boost: The feasibility and cosmetic outcome of a fractionated outpatient delivery scheme

    International Nuclear Information System (INIS)

    Purpose: To evaluate the feasibility, potential toxicity, and cosmetic outcome of fractionated interstitial high dose rate (HDR) brachytherapy boost for the management of patients with breast cancer at increased risk for local recurrence. Methods and Materials: From 1994 to 1996, 18 women with early stage breast cancer underwent conventionally fractionated whole breast radiotherapy (50-50.4 Gy) followed by interstitial HDR brachytherapy boost. All were considered to be at high risk for local failure. Seventeen had pathologically confirmed final surgical margins of less than 2 mm or focally positive. Brachytherapy catheter placement and treatment delivery were conducted on an outpatient basis. Preplanning was used to determine optimal catheter positions to enhance dose homogeneity of dose delivery. The total HDR boost dose was 15 Gy delivered in 6 fractions of 2.5 Gy over 3 days. Local control, survival, late toxicities (LENT-SOMA), and cosmetic outcome were recorded in follow-up. In addition, factors potentially influencing cosmesis were analyzed by logistic regression analysis. Results: The minimum follow-up is 40 months with a median 50 months. Sixteen patients were alive without disease at last follow-up. There have been no in-breast failures observed. One patient died with brain metastases, and another died of unrelated causes without evidence of disease. Grade 1-2 late toxicities included 39% with hyperpigmentation, 56% with detectable fibrosis, 28% with occasional discomfort, and 11% with visible telangiectasias. Grade 3 toxicity was reported in one patient as persistent discomfort. Sixty-seven percent of patients were considered to have experienced good/excellent cosmetic outcomes. Factors with a direct relationship to adverse cosmetic outcome were extent of surgical defect (p = 0.00001), primary excision volume (p = 0.017), and total excision volume (p = 0.015). Conclusions: For high risk patients who may benefit from increased doses, interstitial HDR

  7. Langzeitergebnisse bei Aderhautmelanom nach 106Ruthenium-Brachytherapie

    OpenAIRE

    Krause, Nona

    2015-01-01

    Introduction: 106Ruthenium-brachytherapy (106Ru-brachytherapy) is an established therapy for small and medium-sized uveal melanomas. The aim of this study was to examine the long-time results in regard to recurrence rate, complication rate, ocular preservation, metastasis rate and survival with malignant uveal and ciliary body melanoma, as well as relevant prognosis factors, subsequent to 106Ru-brachytherapy. Methodology: In this retrospective study of all cases with uveal or with ciliary ...

  8. Simultaneous acquisition of 3D shape and deformation by combination of interferometric and correlation-based laser speckle metrology.

    Science.gov (United States)

    Dekiff, Markus; Berssenbrügge, Philipp; Kemper, Björn; Denz, Cornelia; Dirksen, Dieter

    2015-12-01

    A metrology system combining three laser speckle measurement techniques for simultaneous determination of 3D shape and micro- and macroscopic deformations is presented. While microscopic deformations are determined by a combination of Digital Holographic Interferometry (DHI) and Digital Speckle Photography (DSP), macroscopic 3D shape, position and deformation are retrieved by photogrammetry based on digital image correlation of a projected laser speckle pattern. The photogrammetrically obtained data extend the measurement range of the DHI-DSP system and also increase the accuracy of the calculation of the sensitivity vector. Furthermore, a precise assignment of microscopic displacements to the object's macroscopic shape for enhanced visualization is achieved. The approach allows for fast measurements with a simple setup. Key parameters of the system are optimized, and its precision and measurement range are demonstrated. As application examples, the deformation of a mandible model and the shrinkage of dental impression material are measured.

  9. Simultaneous acquisition of 3D shape and deformation by combination of interferometric and correlation-based laser speckle metrology.

    Science.gov (United States)

    Dekiff, Markus; Berssenbrügge, Philipp; Kemper, Björn; Denz, Cornelia; Dirksen, Dieter

    2015-12-01

    A metrology system combining three laser speckle measurement techniques for simultaneous determination of 3D shape and micro- and macroscopic deformations is presented. While microscopic deformations are determined by a combination of Digital Holographic Interferometry (DHI) and Digital Speckle Photography (DSP), macroscopic 3D shape, position and deformation are retrieved by photogrammetry based on digital image correlation of a projected laser speckle pattern. The photogrammetrically obtained data extend the measurement range of the DHI-DSP system and also increase the accuracy of the calculation of the sensitivity vector. Furthermore, a precise assignment of microscopic displacements to the object's macroscopic shape for enhanced visualization is achieved. The approach allows for fast measurements with a simple setup. Key parameters of the system are optimized, and its precision and measurement range are demonstrated. As application examples, the deformation of a mandible model and the shrinkage of dental impression material are measured. PMID:26713197

  10. Relations between 1D shape invariant potentials and the commutation relations of the Lie algebra sl(2,c)

    Energy Technology Data Exchange (ETDEWEB)

    Fakhri, H

    2003-02-24

    A wide range of 1D shape invariant potentials lie in two different classes. In either of these classes the quantum states are distinguished by both of the main and the secondary quantum numbers n and m. We show that quantum states of the first and of the second classes represent shape invariance with respect to n and m, respectively. We also analyze the relationship between these two classes with Lie algebra sl(2,c)

  11. Relations between 1D shape invariant potentials and the commutation relations of the Lie algebra /sl(2,c)

    Science.gov (United States)

    Fakhri, H.

    2003-02-01

    A wide range of 1D shape invariant potentials lie in two different classes. In either of these classes the quantum states are distinguished by both of the main and the secondary quantum numbers n and m. We show that quantum states of the first and of the second classes represent shape invariance with respect to n and m, respectively. We also analyze the relationship between these two classes with Lie algebra sl(2, c).

  12. Real-time 3-D shape measurement with composite phase-shifting fringes and multi-view system.

    Science.gov (United States)

    Tao, Tianyang; Chen, Qian; Da, Jian; Feng, Shijie; Hu, Yan; Zuo, Chao

    2016-09-01

    In recent years, fringe projection has become an established and essential method for dynamic three-dimensional (3-D) shape measurement in different fields such as online inspection and real-time quality control. Numerous high-speed 3-D shape measurement methods have been developed by either employing high-speed hardware, minimizing the number of pattern projection, or both. However, dynamic 3-D shape measurement of arbitrarily-shaped objects with full sensor resolution without the necessity of additional pattern projections is still a big challenge. In this work, we introduce a high-speed 3-D shape measurement technique based on composite phase-shifting fringes and a multi-view system. The geometry constraint is adopted to search the corresponding points independently without additional images. Meanwhile, by analysing the 3-D position and the main wrapped phase of the corresponding point, pairs with an incorrect 3-D position or a considerable phase difference are effectively rejected. All of the qualified corresponding points are then corrected, and the unique one as well as the related period order is selected through the embedded triangular wave. Finally, considering that some points can only be captured by one of the cameras due to the occlusions, these points may have different fringe orders in the two views, so a left-right consistency check is employed to eliminate those erroneous period orders in this case. Several experiments on both static and dynamic scenes are performed, verifying that our method can achieve a speed of 120 frames per second (fps) with 25-period fringe patterns for fast, dense, and accurate 3-D measurement. PMID:27607632

  13. Real-time 3-D shape measurement with composite phase-shifting fringes and multi-view system.

    Science.gov (United States)

    Tao, Tianyang; Chen, Qian; Da, Jian; Feng, Shijie; Hu, Yan; Zuo, Chao

    2016-09-01

    In recent years, fringe projection has become an established and essential method for dynamic three-dimensional (3-D) shape measurement in different fields such as online inspection and real-time quality control. Numerous high-speed 3-D shape measurement methods have been developed by either employing high-speed hardware, minimizing the number of pattern projection, or both. However, dynamic 3-D shape measurement of arbitrarily-shaped objects with full sensor resolution without the necessity of additional pattern projections is still a big challenge. In this work, we introduce a high-speed 3-D shape measurement technique based on composite phase-shifting fringes and a multi-view system. The geometry constraint is adopted to search the corresponding points independently without additional images. Meanwhile, by analysing the 3-D position and the main wrapped phase of the corresponding point, pairs with an incorrect 3-D position or a considerable phase difference are effectively rejected. All of the qualified corresponding points are then corrected, and the unique one as well as the related period order is selected through the embedded triangular wave. Finally, considering that some points can only be captured by one of the cameras due to the occlusions, these points may have different fringe orders in the two views, so a left-right consistency check is employed to eliminate those erroneous period orders in this case. Several experiments on both static and dynamic scenes are performed, verifying that our method can achieve a speed of 120 frames per second (fps) with 25-period fringe patterns for fast, dense, and accurate 3-D measurement.

  14. A spherical harmonics intensity model for 3D segmentation and 3D shape analysis of heterochromatin foci.

    Science.gov (United States)

    Eck, Simon; Wörz, Stefan; Müller-Ott, Katharina; Hahn, Matthias; Biesdorf, Andreas; Schotta, Gunnar; Rippe, Karsten; Rohr, Karl

    2016-08-01

    The genome is partitioned into regions of euchromatin and heterochromatin. The organization of heterochromatin is important for the regulation of cellular processes such as chromosome segregation and gene silencing, and their misregulation is linked to cancer and other diseases. We present a model-based approach for automatic 3D segmentation and 3D shape analysis of heterochromatin foci from 3D confocal light microscopy images. Our approach employs a novel 3D intensity model based on spherical harmonics, which analytically describes the shape and intensities of the foci. The model parameters are determined by fitting the model to the image intensities using least-squares minimization. To characterize the 3D shape of the foci, we exploit the computed spherical harmonics coefficients and determine a shape descriptor. We applied our approach to 3D synthetic image data as well as real 3D static and real 3D time-lapse microscopy images, and compared the performance with that of previous approaches. It turned out that our approach yields accurate 3D segmentation results and performs better than previous approaches. We also show that our approach can be used for quantifying 3D shape differences of heterochromatin foci. PMID:27037463

  15. Feasibility study on 3-D shape analysis of high-aspect-ratio features using through-focus scanning optical microscopy

    Science.gov (United States)

    Attota, Ravi Kiran; Weck, Peter; Kramar, John A.; Bunday, Benjamin; Vartanian, Victor

    2016-01-01

    In-line metrologies currently used in the semiconductor industry are being challenged by the aggressive pace of device scaling and the adoption of novel device architectures. Metrology and process control of three-dimensional (3-D) high-aspect-ratio (HAR) features are becoming increasingly important and also challenging. In this paper we present a feasibility study of through-focus scanning optical microscopy (TSOM) for 3-D shape analysis of HAR features. TSOM makes use of 3-D optical data collected using a conventional optical microscope for 3-D shape analysis. Simulation results of trenches and holes down to the 11 nm node are presented. The ability of TSOM to analyze an array of HAR features or a single isolated HAR feature is also presented. This allows for the use of targets with area over 100 times smaller than that of conventional gratings, saving valuable real estate on the wafers. Indications are that the sensitivity of TSOM may match or exceed the International Technology Roadmap for Semiconductors (ITRS) measurement requirements for the next several years. Both simulations and preliminary experimental results are presented. The simplicity, lowcost, high throughput, and nanometer scale 3-D shape sensitivity of TSOM make it an attractive inspection and process monitoring solution for nanomanufacturing. PMID:27464112

  16. Feasibility study on 3-D shape analysis of high-aspect-ratio features using through-focus scanning optical microscopy.

    Science.gov (United States)

    Attota, Ravi Kiran; Weck, Peter; Kramar, John A; Bunday, Benjamin; Vartanian, Victor

    2016-07-25

    In-line metrologies currently used in the semiconductor industry are being challenged by the aggressive pace of device scaling and the adoption of novel device architectures. Metrology and process control of three-dimensional (3-D) high-aspect-ratio (HAR) features are becoming increasingly important and also challenging. In this paper we present a feasibility study of through-focus scanning optical microscopy (TSOM) for 3-D shape analysis of HAR features. TSOM makes use of 3-D optical data collected using a conventional optical microscope for 3-D shape analysis. Simulation results of trenches and holes down to the 11 nm node are presented. The ability of TSOM to analyze an array of HAR features or a single isolated HAR feature is also presented. This allows for the use of targets with area over 100 times smaller than that of conventional gratings, saving valuable real estate on the wafers. Indications are that the sensitivity of TSOM may match or exceed the International Technology Roadmap for Semiconductors (ITRS) measurement requirements for the next several years. Both simulations and preliminary experimental results are presented. The simplicity, lowcost, high throughput, and nanometer scale 3-D shape sensitivity of TSOM make it an attractive inspection and process monitoring solution for nanomanufacturing. PMID:27464112

  17. Development of a Remote Handling Robot for the Maintenance of an ITER-Like D-Shaped Vessel

    Directory of Open Access Journals (Sweden)

    Peihua Chen

    2014-01-01

    Full Text Available Robotic operation is one of the major challenges in the remote maintenance of ITER vacuum vessel (VV and future fusion reactors as inner operations of Tokamak have to be done by robots due to the internal adverse conditions. This paper introduces a novel remote handling robot (RHR for the maintenance of ITER-like D-shaped vessel. The modular designed RHR, which is an important part of the remote handling system for ITER, consists of three parts: an omnidirectional transfer vehicle (OTV, a planar articulated arm (PAA, and an articulated teleoperated manipulator (ATM. The task of RHR is to carry processing tools, such as the viewing system, leakage detector, and electric screwdriver, to inspect and maintain the components installed inside the D-shaped vessel. The kinematics of the OTV, as well as the kinematic analyses of the PAA and ATM, is studied in this paper. Because of its special length and heavy payload, the dynamics of the PAA is also investigated through a dynamic simulation system based on robot technology middleware (RTM. The results of the path planning, workspace simulations, and dynamic simulation indicate that the RHR has good mobility together with satisfying kinematic and dynamic performances and can well accomplish its maintenance tasks in the ITER-like D-shaped vessel.

  18. Development of a Brachytherapy Software Nomogram Equivalent

    International Nuclear Information System (INIS)

    The main objective of this project is developing a software nomogram equivalent. A nomogram is a graph typically comprised of three parallel lines. Each of the lines is graduated for a different variable, often in a non-linear scale. The lines are oriented in such a manner that if a straight line is drawn connecting two of the three variables, the value of the third variable is uniquely determined by the intersection of the connecting line and the graduated line of the third variable. The value of the third variable is determined by reading the graduated scale at the point of intersection. A nomogram as applied in brachytherapy is used for determining the required amount of radioactive material to be implanted in a diseased site. A typical brachytherapy nomogram relates the average dimension of a site, the air kerma strength per source and the number of sources required for yielding a therapeutic radiation dose to the site. More sophisticated nomograms also provide scales for recommending source and needle spacings. For decades the nomogram has been clinically employed as a brachytherapy treatment planning tool. Imaging modalities such as CT and ultrasound ushered in modern image-based brachytherapy treatment planning. These modern imaging techniques dramatically advanced the state of the art of brachytherapy, often obviating the use of nomograms. Although the routine use of nomograms has decreased, there are clinical situations where nomograms still prove useful for brachytherapy treatment planning. Often times the dimensions of a tumor or tumor bed are not known prior to surgery and delineated images of the site are not available. In such situations the tumor dimensions can be measured in the OR and a nomogram applied for rapid treatment planning. By definition a nomogram is a graphical tool, which is fixed and cannot be modified. Differences of opinion and treatment philosophies exist among physicians and institutions. These varying approaches can lead to

  19. Experimental and computational development of a natural breast phantom for dosimetry studies

    International Nuclear Information System (INIS)

    This paper describes the experimental and computational development of a natural breast phantom, anthropomorphic and anthropometric for studies in dosimetry of brachytherapy and teletherapy of breast. The natural breast phantom developed corresponding to fibroadipose breasts of women aged 30 to 50 years, presenting radiographically medium density. The experimental breast phantom was constituted of three tissue-equivalents (TE's): glandular TE, adipose TE and skin TE. These TE's were developed according to chemical composition of human breast and present radiological response to exposure. Completed the construction of experimental breast phantom this was mounted on a thorax phantom previously developed by the research group NRI/UFMG. Then the computational breast phantom was constructed by performing a computed tomography (CT) by axial slices of the chest phantom. Through the images generated by CT a computational model of voxels of the thorax phantom was developed by SISCODES computational program, being the computational breast phantom represented by the same TE's of the experimental breast phantom. The images generated by CT allowed evaluating the radiological equivalence of the tissues. The breast phantom is being used in studies of experimental dosimetry both in brachytherapy as in teletherapy of breast. Dosimetry studies by MCNP-5 code using the computational model of the phantom breast are in progress. (author)

  20. Experimental and computational development of a natural breast phantom for dosimetry studies

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Luciana B.; Campos, Tarcisio P.R., E-mail: lucibn19@yahoo.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2013-07-01

    This paper describes the experimental and computational development of a natural breast phantom, anthropomorphic and anthropometric for studies in dosimetry of brachytherapy and teletherapy of breast. The natural breast phantom developed corresponding to fibroadipose breasts of women aged 30 to 50 years, presenting radiographically medium density. The experimental breast phantom was constituted of three tissue-equivalents (TE's): glandular TE, adipose TE and skin TE. These TE's were developed according to chemical composition of human breast and present radiological response to exposure. Completed the construction of experimental breast phantom this was mounted on a thorax phantom previously developed by the research group NRI/UFMG. Then the computational breast phantom was constructed by performing a computed tomography (CT) by axial slices of the chest phantom. Through the images generated by CT a computational model of voxels of the thorax phantom was developed by SISCODES computational program, being the computational breast phantom represented by the same TE's of the experimental breast phantom. The images generated by CT allowed evaluating the radiological equivalence of the tissues. The breast phantom is being used in studies of experimental dosimetry both in brachytherapy as in teletherapy of breast. Dosimetry studies by MCNP-5 code using the computational model of the phantom breast are in progress. (author)

  1. Breast conserving treatment of locally advanced carcinoma T2 and T3 after neoadjuvant chemotherapy followed by quadrantectomy and high dose-rate brachytherapy, as a boost, complementary teletherapy and adjuvant chemotherapy; Tratamento conservador dos carcinomas de mama localmente avancados T2 e T3, apos quimioterapia neoadjuvante, com quadrantectomia e braquiterapia de alta taxa de dose como reforco de dose, teleterapia complementar e quimioterapia adjuvante

    Energy Technology Data Exchange (ETDEWEB)

    Fristachi, Carlos Elias [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil). Servico de Onco-Ginecologia e Mastologia]. E-mail: cefristachi@uol.com.br; Miziara Filho, Miguel Abrao; Soares, Celia Regina; Fogaroli, Ricardo Cesar; Pelosi, Edilson Lopes; Martins, Homero Lavieri Martins [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil). Servico de Radioterapia; Baracat, Fausto Farah [Hospital do Servidor Publico Estadual de Sao Paulo (HSPE), SP (Brazil). Servico de Ginecologia e Mastologia; Piato, Sebastiao [Irmandade da Santa Casa de Misericordia de Sao Paulo, SP (Brazil). Dept. de Obstetricia e Ginecologia (DOGI)

    2005-07-01

    Objective: to assess the treatment of breast cancer T2 and T3(T > = 4 cm), through neoadjuvant chemotherapy, quadrantectomy and high-dose-rate (HDR) brachytherapy as a boost, complementary radiotherapy and adjuvant chemotherapy, considering its method problems, its esthetics results, the aspect of local control, overall survival, and disease-free survival. Patients and method: this clinical prospective descriptive study was based on the evaluation of 26 patients ranging from 30 to 70 years old, with infiltrating ductal carcinoma, clinical stage IIB and IIIA, responsive to the neoadjuvant chemotherapy. Early and late radiotherapy complications were evaluated according to the criteria established by the RTOG/EORTC (Radiotherapy and Oncology Group /European Organization for Research and Treatment of Cancer) groups. Esthetics evaluation was done in accordance with the criteria set by a plastic surgeon. Local control was evaluated by clinical method, mammography and ultrasonography. Overall survival (OS) and the disease-free survival (DFS) were assessed according to Kaplan-Meier methodology. All the patients were treated at the Dr. Arnaldo Vieira de Carvalho Cancer Institute, from June/1995 to November/2001, and evaluated in March, 2002, with median follow-up of 28.7 months. Results: early complications were observed in 8 patients (30.6%). Two patients were classified as G3 and G4 (RTOG/EORTC). Six patients had late complications and three of them (11.5%) were classified as G3 and G4. One patient (3.8%) had local recurrence, 64 months after having local treatment. Esthetics results were considered good or regular in 16 patients (60.5%) out of 24 patients who were examined. Overall survival and disease-free survival in 24, 36 and 60 months were 100%, 92.3% and 83.1% respectively. Conclusion: early and late radiotherapy complications were considerate high when compared to literature, but esthetic results were considered acceptable. RL, OS and DFS were comparable to other

  2. Breast boost - why, how, when...?

    International Nuclear Information System (INIS)

    Background: Breast conservation management including tumorectomy or quadrantectomy and external beam radiotherapy with a dose of 45 to 50 Gy in the treatment of small breast carcinomas is generally accepted. The use of a radiation boost - in particular for specific subgroups - has not been clarified. With regard to the boost technique there is some controversy between groups emphasizing the value of electron boost treatment and groups pointing out the value of interstitial boost treatment. This controversy has become even more complicated as there is an increasing number of institutions reporting the use of HDR interstitial brachytherapy for boost treatment. The most critical issue with regard to interstitial HDR brachytherapy is the assumed serious long-term morbidity after a high single radiation dose as used in HDR-treatments. Methods and Results: This article gives a perspective and recommendations on some aspects of this issue (indication, timing, target volume, dose and dose rate). Conclusion: More information about the indication for a boost is to be expected from the EORTC trial 22881/10882. Careful selection of treatment procedures for specific subgroups of patients and refinement in surgical procedures and radiotherapy techniques may be useful in improving the clinical and cosmetic results in breast conservation therapy. Prospective trials comparing on the one hand different boost techniques and on the other hand particular morphologic criteria in treatments with boost and without boost are needed to give more detailed recommendations for boost indication and for boost techniques. (orig.)

  3. Adaptation of the CVT algorithm for catheter optimization in high dose rate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, Eric; Fekete, Charles-Antoine Collins; Beaulieu, Luc [Département de Physique, de Génie Physique et d’Optique et Centre de recherche sur le cancer de l’Université Laval, Université Laval, Québec, Québec G1V 0A6, Canada and Département de Radio-Oncologie et Axe oncologie du Centre de Recherche du CHU de Québec, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Létourneau, Mélanie [Département de Radio-Oncologie, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Fenster, Aaron [Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive, London, Ontario N6A 5K8 (United Kingdom); Pouliot, Jean [Department of Radiation Oncology, University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, 1600 Divisadero Street, San Francisco, California 94143-1708 (United States)

    2013-11-15

    Purpose: An innovative, simple, and fast method to optimize the number and position of catheters is presented for prostate and breast high dose rate (HDR) brachytherapy, both for arbitrary templates or template-free implants (such as robotic templates).Methods: Eight clinical cases were chosen randomly from a bank of patients, previously treated in our clinic to test our method. The 2D Centroidal Voronoi Tessellations (CVT) algorithm was adapted to distribute catheters uniformly in space, within the maximum external contour of the planning target volume. The catheters optimization procedure includes the inverse planning simulated annealing algorithm (IPSA). Complete treatment plans can then be generated from the algorithm for different number of catheters. The best plan is chosen from different dosimetry criteria and will automatically provide the number of catheters and their positions. After the CVT algorithm parameters were optimized for speed and dosimetric results, it was validated against prostate clinical cases, using clinically relevant dose parameters. The robustness to implantation error was also evaluated. Finally, the efficiency of the method was tested in breast interstitial HDR brachytherapy cases.Results: The effect of the number and locations of the catheters on prostate cancer patients was studied. Treatment plans with a better or equivalent dose distributions could be obtained with fewer catheters. A better or equal prostate V100 was obtained down to 12 catheters. Plans with nine or less catheters would not be clinically acceptable in terms of prostate V100 and D90. Implantation errors up to 3 mm were acceptable since no statistical difference was found when compared to 0 mm error (p > 0.05). No significant difference in dosimetric indices was observed for the different combination of parameters within the CVT algorithm. A linear relation was found between the number of random points and the optimization time of the CVT algorithm. Because the

  4. Photoacoustic imaging of prostate brachytherapy seeds

    OpenAIRE

    Su, Jimmy L.; Bouchard, Richard R.; Karpiouk, Andrei B.; Hazle, John D.; Emelianov, Stanislav Y.

    2011-01-01

    Brachytherapy seed therapy is an increasingly common way to treat prostate cancer through localized radiation. The current standard of care relies on transrectal ultrasound (TRUS) for imaging guidance during the seed placement procedure. As visualization of individual metallic seeds tends to be difficult or inaccurate under TRUS guidance, guide needles are generally tracked to infer seed placement. In an effort to improve seed visualization and placement accuracy, the use of photoacoustic (PA...

  5. Brachytherapy in treatment of vaginal cancer

    OpenAIRE

    A. D. Kaprin; V. N. Galkin; S. A. Ivanov; V. A. Solodkiy; V. A. Titova

    2016-01-01

    Characteristics of diagnosis and treatment of different types of primary vaginal cancer are highlighted, the role and place of brachytherapy as independent method or combined treatment modality for this pathology is shown in the review. Epidemiological data on incidence of vaginal cancer in Russia are represented, presumptive mechanisms for development of the disease, risk factors, histological types, features of the course, clinical presentation, diagnostic algorithm are described. Treatment...

  6. Design and optimization of a brachytherapy robot

    Science.gov (United States)

    Meltsner, Michael A.

    Trans-rectal ultrasound guided (TRUS) low dose rate (LDR) interstitial brachytherapy has become a popular procedure for the treatment of prostate cancer, the most common type of non-skin cancer among men. The current TRUS technique of LDR implantation may result in less than ideal coverage of the tumor with increased risk of negative response such as rectal toxicity and urinary retention. This technique is limited by the skill of the physician performing the implant, the accuracy of needle localization, and the inherent weaknesses of the procedure itself. The treatment may require 100 or more sources and 25 needles, compounding the inaccuracy of the needle localization procedure. A robot designed for prostate brachytherapy may increase the accuracy of needle placement while minimizing the effect of physician technique in the TRUS procedure. Furthermore, a robot may improve associated toxicities by utilizing angled insertions and freeing implantations from constraints applied by the 0.5 cm-spaced template used in the TRUS method. Within our group, Lin et al. have designed a new type of LDR source. The "directional" source is a seed designed to be partially shielded. Thus, a directional, or anisotropic, source does not emit radiation in all directions. The source can be oriented to irradiate cancerous tissues while sparing normal ones. This type of source necessitates a new, highly accurate method for localization in 6 degrees of freedom. A robot is the best way to accomplish this task accurately. The following presentation of work describes the invention and optimization of a new prostate brachytherapy robot that fulfills these goals. Furthermore, some research has been dedicated to the use of the robot to perform needle insertion tasks (brachytherapy, biopsy, RF ablation, etc.) in nearly any other soft tissue in the body. This can be accomplished with the robot combined with automatic, magnetic tracking.

  7. A robotic device for MRI-guided prostate brachytherapy

    NARCIS (Netherlands)

    Lagerburg, V.

    2008-01-01

    One of the treatment options for prostate cancer is brachytherapy with iodine-125 sources. In prostate brachytherapy a high radiation dose is delivered to the prostate with a steep dose fall off to critical surrounding organs. The implantation of the iodine sources is currently performed under ultra

  8. Braquiterapia guiada por imagen Image-guided brachytherapy

    Directory of Open Access Journals (Sweden)

    E. Villafranca

    2009-01-01

    calculation possible. In recent years there have been changes affecting two aspects of brachytherapy. In the first place, the incorporation of imaging techniques such as echography, computerised tomography (CT and magnetic resonance (MR, indispensable for diagnosis and tumoural staging. Their use when the implant is being done helps in guiding and carrying out the operation with greater precision. In the second place, the use of CT, MR and echography makes better coverage of the tumour possible, or reduces the dose to healthy organs. They are used in inverse planning systems, which carry out dose calculation on the basis of the doses to be administered to the tumour and healthy organs. In these planning programs it is possible to make calculations more rapidly, taking account of the placement of the source at each moment in time. This technique, called real-time planning, is starting to show advantages in the treatment of prostate cancer. Incorporation of imaging techniques and improvements in calculation systems mean that brachytherapy is currently playing an important role in treating cancer of the prostate, cervix, breast, head and neck tumours, bronchial tubes or oesophagus.

  9. Quality assurance for high dose rate brachytherapy treatment planning optimization: using a simple optimization to verify a complex optimization

    International Nuclear Information System (INIS)

    As dose optimization for high dose rate brachytherapy becomes more complex, it becomes increasingly important to have a means of verifying that optimization results are reasonable. A method is presented for using a simple optimization as quality assurance for the more complex optimization algorithms typically found in commercial brachytherapy treatment planning systems. Quality assurance tests may be performed during commissioning, at regular intervals, and/or on a patient specific basis. A simple optimization method is provided that optimizes conformal target coverage using an exact, variance-based, algebraic approach. Metrics such as dose volume histogram, conformality index, and total reference air kerma agree closely between simple and complex optimizations for breast, cervix, prostate, and planar applicators. The simple optimization is shown to be a sensitive measure for identifying failures in a commercial treatment planning system that are possibly due to operator error or weaknesses in planning system optimization algorithms. Results from the simple optimization are surprisingly similar to the results from a more complex, commercial optimization for several clinical applications. This suggests that there are only modest gains to be made from making brachytherapy optimization more complex. The improvements expected from sophisticated linear optimizations, such as PARETO methods, will largely be in making systems more user friendly and efficient, rather than in finding dramatically better source strength distributions. (paper)

  10. Breast Cancer and its Radiotherapeutic Methods

    International Nuclear Information System (INIS)

    Breast cancer is the most common cancer in women after skin cancer. In Iran, the presentation age of this cancer is younger than the global average. There are different therapeutic methods for treatment of breast cancer and the choice of treatment depends on the stage of the disease as well as its type and characteristics. Therapeutic methods include surgery, radiotherapy, and systemic therapies, each consisting of a variety of techniques. The two main surgical techniques are lumpectomy and mastectomy. The main systemic methods are biological therapy (immunotherapy), hormone therapy, and chemotherapy. Radiotherapy is mainly categorized into external-beam radiotherapy and brachytherapy. In this paper, we present a brief review of the different types of breast cancer and their treatments using conventional and modern radiotherapy methods, as well as the treatment efficacy and side effects of breast radiotherapy.

  11. A 3D shape retrieval method for orthogonal fringe projection based on a combination of variational image decomposition and variational mode decomposition

    Science.gov (United States)

    Li, Biyuan; Tang, Chen; Zhu, Xinjun; Chen, Xia; Su, Yonggang; Cai, Yuanxue

    2016-11-01

    The orthogonal fringe projection technique has as wide as long practical application nowadays. In this paper, we propose a 3D shape retrieval method for orthogonal composite fringe projection based on a combination of variational image decomposition (VID) and variational mode decomposition (VMD). We propose a new image decomposition model to extract the orthogonal fringe. Then we introduce the VMD method to separate the horizontal and vertical fringe from the orthogonal fringe. Lastly, the 3D shape information is obtained by the differential 3D shape retrieval method (D3D). We test the proposed method on a simulated pattern and two actual objects with edges or abrupt changes in height, and compare with the recent, related and advanced differential 3D shape retrieval method (D3D) in terms of both quantitative evaluation and visual quality. The experimental results have demonstrated the validity of the proposed method.

  12. An accurate 3D shape context based non-rigid registration method for mouse whole-body skeleton registration

    Science.gov (United States)

    Xiao, Di; Zahra, David; Bourgeat, Pierrick; Berghofer, Paula; Acosta Tamayo, Oscar; Wimberley, Catriona; Gregoire, Marie C.; Salvado, Olivier

    2011-03-01

    Small animal image registration is challenging because of its joint structure, and posture and position difference in each acquisition without a standard scan protocol. In this paper, we face the issue of mouse whole-body skeleton registration from CT images. A novel method is developed for analyzing mouse hind-limb and fore-limb postures based on geodesic path descriptor and then registering the major skeletons and fore limb skeletons initially by thin-plate spline (TPS) transform based on the obtained geodesic paths and their enhanced correspondence fields. A target landmark correction method is proposed for improving the registration accuracy of the improved 3D shape context non-rigid registration method we previously proposed. A novel non-rigid registration framework, combining the skeleton posture analysis, geodesic path based initial alignment and 3D shape context model, is proposed for mouse whole-body skeleton registration. The performance of the proposed methods and framework was tested on 12 pairs of mouse whole-body skeletons. The experimental results demonstrated the flexibility, stability and accuracy of the proposed framework for automatic mouse whole body skeleton registration.

  13. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    OpenAIRE

    Samia de Freitas Brandao; Tarcisio Passos Ribeiro de Campos

    2013-01-01

    Objective Comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and Methods Simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted int...

  14. Multihelix rotating shield brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States); Kim, Yusung; Flynn, Ryan T., E-mail: ryan-flynn@uiowa.edu [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Wu, Xiaodong [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States)

    2015-11-15

    Purpose: To present a novel brachytherapy technique, called multihelix rotating shield brachytherapy (H-RSBT), for the precise angular and linear positioning of a partial shield in a curved applicator. H-RSBT mechanically enables the dose delivery using only linear translational motion of the radiation source/shield combination. The previously proposed approach of serial rotating shield brachytherapy (S-RSBT), in which the partial shield is rotated to several angular positions at each source dwell position [W. Yang et al., “Rotating-shield brachytherapy for cervical cancer,” Phys. Med. Biol. 58, 3931–3941 (2013)], is mechanically challenging to implement in a curved applicator, and H-RSBT is proposed as a feasible solution. Methods: A Henschke-type applicator, designed for an electronic brachytherapy source (Xoft Axxent™) and a 0.5 mm thick tungsten partial shield with 180° or 45° azimuthal emission angles and 116° asymmetric zenith angle, is proposed. The interior wall of the applicator contains six evenly spaced helical keyways that rigidly define the emission direction of the partial radiation shield as a function of depth in the applicator. The shield contains three uniformly distributed protruding keys on its exterior wall and is attached to the source such that it rotates freely, thus longitudinal translational motion of the source is transferred to rotational motion of the shield. S-RSBT and H-RSBT treatment plans with 180° and 45° azimuthal emission angles were generated for five cervical cancer patients with a diverse range of high-risk target volume (HR-CTV) shapes and applicator positions. For each patient, the total number of emission angles was held nearly constant for S-RSBT and H-RSBT by using dwell positions separated by 5 and 1.7 mm, respectively, and emission directions separated by 22.5° and 60°, respectively. Treatment delivery time and tumor coverage (D{sub 90} of HR-CTV) were the two metrics used as the basis for evaluation and

  15. Perioperative interstitial brachytherapy for recurrent keloid scars

    International Nuclear Information System (INIS)

    Purpose: Evaluation of the results of perioperative interstitial brachytherapy with low dose-rate (L.D.R.) Ir-192 in the treatment of keloid scars. Patients and methods: We performed a retrospective analysis of 73 histologically confirmed keloids (from 58 patients) resistant to medico surgical treated by surgical excision plus early perioperative brachytherapy. All lesions were initially symptomatic. Local control was evaluated by clinical evaluation. Functional and cosmetic results were assessed in terms of patient responses to a self-administered questionnaire. Results: Median age was 28 years (range 13-71 years). Scars were located as follows: 37% on the face, 32% on the trunk or abdomen, 16% on the neck, and 15% on the arms or legs. The mean delay before loading was four hours (range, 1-6 h). The median dose was 20 Gy (range, 15-40 Gy). Sixty-four scars (from 53 patients) were evaluated. Local control was 86% (follow-up, 44.5 months; range, 14-150 months). All relapses occurred early within 2 years posttreatment. At 20 months, survival without recurrence was significantly lower when treated lengths were more than 6 cm long. The rate was 100% for treated scars below 4.5 cm in length, 95% (95% CI: 55-96) for those 4.5-6 cm long, and 75% (95% CI: 56-88) beyond 6 cm (p = 0.038). Of the 35 scars (28 patients) whose results were reassessed, six remained symptomatic and the esthetic results were considered to be good in 51% (18/35) and average in 37% (13/35) (median follow-up, 70 months; range, 16-181 months). Conclusion: Early perioperative L.D.R. brachytherapy delivering 20 Gy at 5 mm reduced the rate of recurrent keloids resistant to other treatments and gave good functional results. (authors)

  16. Iridium-192 sources production for brachytherapy use

    International Nuclear Information System (INIS)

    The incidence of cancer increases every year in Brazil and turns out to be one of the most important causes of mortality. Some of the patients are treated with brachytherapy, a form of lesion treatment which is based on the insertion of sources into tumors, in this particular case, activated iridium wires. During this process, the ionizing radiation efficiently destroys the malignant cells. These iridium wires have a nucleus made out of an iridium-platinum alloy 20-30/70-80 of 0,1 mm in diameter either coated by platinum or encased in a platinum tube. The technique consists in irradiating the wire in the reactor neutron flux in order to produce iridium-192. The linear activity goes from 1 mCi/cm to 4 mCi/cm and the basic characteristic, which is required, is the homogeneity of the activation along the wire. It should not present a dispersion exceeding 5% on a wire measuring 50 cm in length, 0.5 mm or 0.3 mm in diameter. Several experiments were carried out in order to define the activation parameters. Wires from different origins were analyzed. It was concluded that United States of America and France wires were found to be perfectly adequate for brachytherapy purposes and have therefore been sent to specialized hospitals and successfully applied to cancer patients. Considering that the major purpose of this work is to make this product more accessible in Brazil, at a cost reflecting the Brazilian reality, the IPEN is promoting the preparation of iridium-192 sources to be used in brachytherapy, on a national level. (author)

  17. Radiation recall secondary to adjuvant docetaxel after balloon-catheter based accelerated partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Nathan W. [Summer Intern, Mayo Clinic Arizona, Scottsdale, AZ (United States); Wong, William W., E-mail: wong.william@mayo.ed [Department of Radiation Oncology, Mayo Clinic Arizona, 13400 E. Shea Boulevard, Scottsdale, AZ 85259 (United States); Karlin, Nina J. [Division of Oncology, Mayo Clinic Arizona, Scottsdale, AZ (United States); Gray, Richard J. [Department of Surgery, Mayo Clinic Arizona, Scottsdale, AZ (United States)

    2010-08-15

    For early stage breast cancer, wide local excision and post-operative whole breast irradiation is a standard treatment. If adjuvant chemotherapy is recommended, radiation is usually given after completion of chemotherapy. In recent years, accelerated partial breast irradiation (APBI) with balloon-cathetered based brachytherapy has become an option for selected patients. For these patients, adjuvant chemotherapy would have to be administered after radiation. The sequence of treatment with radiation followed by chemotherapy results in increased risk of radiation recall reaction (RRD) in these patients. Docetaxel is becoming a more commonly used drug as adjuvant treatment for breast cancer. Here we report a case of docetaxel induced RRD after APBI with balloon-cathetered based brachytherapy. Such reaction would have an adverse impact on the cosmetic outcome and quality of life of the patient. For patients who develop an intense skin reaction after the administration of docetaxel following APBI, RRD should be considered in the differential diagnosis.

  18. Experiences with alanine dosimetry in afterloading brachytherapy

    International Nuclear Information System (INIS)

    At the present, the most commonly used dosimetry for radiotherapy applications are ionisation chambers and thermoluminescent dosimeters (TLD). However, there are some undesirable characteristics of these dosimetry systems, such as large detection volume (ionisation chamber) as well as fading of the radiation induced signal with time and destructive readout (TLG). The present study is an investigation into the use of the alanine/ESR dosimetry in fractionated afterloading brachytherapy during the whole radiotherapy course. There are some qualities which make alanine dosimetry attractive. These are the linear energy response, low fading under standard conditions, and the nondestructive readout. Thus the alanine dosimetry makes possible cumulative dose measurements during the radiotherapy course and an archival storage. By ionizing radiation (gamma, e, n, p, charged particles) free radicals (unpaired electrons) are produced in the amino acid alanine. The continuous wave electron spin resonance (ESR) spectroscopy is used to determine the number of free radicals, which is proportional to the absorbed dose and the alanine content of the dosimeter. The ESR measurements were made at room temperature using a Bruker EPR analyzer EMS-104. The dosimeters used in the test are alanine pellets (23.72 mg weight, 4.9 mm diameter, 1 mm height) as well as flexible alanine film dosimeters (thickness about 500 μm). The dosimeters consist of a blend of L-alpha-alanine and a binder. The alanine content of the pellets and the film dosimeters is about 88 % and 50 % by weight, respectively. The dosimeters for the calculation of the dose-effect-relationship were irradiated at the Physical-Technical Bundesanstalt in Braunschweig by a standard 60Co source. The maximum deviation from the calculated linear function is about 0.12 Gy in the dose range up to 80 Gy. The goal of medical applications was the superficial dose measurement in afterloading brachytherapy during the radiotherapy course in

  19. The application of Geant4 simulation code for brachytherapy treatment

    CERN Document Server

    Agostinelli, S; Garelli, S; Paoli, G; Nieminen, P; Pia, M G

    2000-01-01

    Brachytherapy is a radiotherapeutic modality that makes use of radionuclides to deliver a high radiation dose to a well-defined volume while sparing surrounding healthy structures. At the National Institute for Cancer Research of Genova a High Dose Rate remote afterloading system provides Ir(192) endocavitary brachytherapy treatments. We studied the possibility to use the Geant4 Monte Carlo simulation toolkit in brachytherapy for calculation of complex physical parameters, not directly available by experiment al measurements, used in treatment planning dose deposition models.

  20. 三维形状特征提取技术研究进展%Review of 3D Shapes Feature Extraction

    Institute of Scientific and Technical Information of China (English)

    刘璇; 李海生; 蔡强; 曹健

    2014-01-01

    三维形状模型广泛应用于工业设计、教育、生物医药、动画娱乐、文物保护等多个领域中。三维形状模型的特征提取是计算机图形学和模式识别领域的重要问题,近年来受到学者的广泛关注。尤其是具有铰链、关节等的非刚性三维形状通常会发生变形,进一步增加了形状特征提取的难度。主要研究、分析、总结了近几年出现的刚性三维形状和非刚性三维形状的特征提取算法,分析了三维形状特征提取的难点,给出了三维形状特征提取的发展进程。介绍了近年来三维形状特征匹配研究领域中常用的一些测试数据库,重点探讨了非刚性三维形状的特征匹配方法,并展望了三维形状特征提取、特征匹配的未来发展方向。%3D shapes have been applied in many fields, such as industrial design, education, biological medicine, animation entertainment and preservation of cultural relics, etc. Feature extraction of 3D shapes is an important branch of computer graphics and pattern recognition, attracting more attention from many researchers of late years. In particular, the deformations of non-rigid 3D shapes, which mostly contain articulated structure, increase the diffi-culty of feature extraction of 3D shapes. This paper focuses on feature extraction algorithms of rigid 3D shapes and non-rigid 3D shapes, which are proposed in recent years, analyzes the difficulties of feature extraction, and provides the development process of 3D shapes feature extraction. Moreover, this paper introduces some common test datasets of 3D shapes, mainly discusses feature extraction algorithms of non-rigid 3D shapes, and prospects the future of 3D shapes feature extraction and feature matching.

  1. Evaluation of resins for use in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, Luiz Claudio F.M. Garcia; Ferraz, Wilmar Barbosa; Chrcanovic, Bruno Ramos; Santos, Ana Maria M., E-mail: ferrazw@cdtn.b, E-mail: amms@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    Brachytherapy is an advanced cancer treatment where radioactive seeds or sources are placed near or directly into the tumor thus reducing the radiation exposure in the surrounding healthy tissues. Prostate cancer can be treated with interstitial brachytherapy in initial stage of the disease in which tiny radioactive seeds with cylindrical geometry are used. Several kinds of seeds have been developed in order to obtain a better dose distribution around them and with a lower cost manufacturing. These seeds consist of an encapsulation, a radionuclide carrier, and X-ray marker. Among the materials that have potential for innovation in the construction of seeds, biocompatible resins appear as an important option. In this paper, we present some characterization results with Fourier transform infrared spectroscopic (FTIR) and ultraviolet-visible spectroscopy (UV-vis) performed on two types of resins in which curing temperatures for each one were varied as also the results of coatings with these resins under titanium substrates. Interactions of these resins in contact with the simulated body fluid were evaluated by atomic force microscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy. (author)

  2. The Activity Check of Brachytherapy Isotope

    International Nuclear Information System (INIS)

    An isotope Ir-192, which is used in brachytherapy depends on import in whole quantities. There are a few ways for its activity. measurement using Welltype chamber or the way to rely on authentic decay table of manufacturer. In-air dosimetry using Farmer Chamber, etc. In this paper, let me introduce the way using Farmer chamber which is easier and simple. With the Farmer chamber and source calibration jig, take a measurement the activity of an isotope Ir-192 and compare the value with the value from decay table of manufacturer and check the activity of source. The result of measurement, compared the value from decay table, by ±2.1. (which belongs to recommendable value for AAPM ±5% as difference of error range). It is possible to use on clinical medicine. With the increase in use of brachytherapy, the increase of import is essential. And an accurate activity check of source is compulsory. For the activity check of source, it was possible to use Farmer chamber and source calibration jig without additional purchase of Well type chamber.

  3. A study of brachytherapy for intraocular tumor

    International Nuclear Information System (INIS)

    Our purpose of this study is to perform brachytherapy for intraocular tumor. The result were as followed. 1. Eye model was determined as a 25 mm diameter sphere. Ir-192 was considered the most appropriate as radioisotope for brachytherapy, because of the size, half, energy and availability. 2. Considering the biological response with human tissue and protection of exposed dose, we made the plaques with gold, of which size were 15 mm, 17 mm and 20 mm in diameter, and 1.5 mm in thickness. 3. Transmission factor of plaques are all 0.71 with TLD and film dosimetry at the surface of plaques and 0.45, 0.49 at 1.5 mm distance of surface, respectively. 4. As compared the measured data for the plaque with Ir-192 seeds to results of computer dose calculation model by Gary Luxton et al. and CAP-PLAN (Radiation Treatment Planning System), absorbed doses are within ±10% and distance deviations are within 0.4 mm. Maximum error is -11.3% and 0.8 mm, respectively. 7 figs, 2 tabs, 28 refs. (Author)

  4. Brachytherapy in thetreatment of the oral and oropharyngeal cancer

    Directory of Open Access Journals (Sweden)

    A. M. Zhumankulov

    2015-01-01

    Full Text Available Background. One of the methods of radiotherapy of malignant tumors of oral cavity and oropharyngeal region today is interstitial radiation therapy – brachytherapy, allowing you to create the optimum dose of irradiation to the tumor, necessary for its destruction, without severe radiation reactions in the surrounding tissues unchanged. Brachytherapy has the following advantages: high precision – the ability of the local summarization of high single doses in a limited volume of tissue; good tolerability; a short time of treatment. At this time, brachytherapy is the method of choice used as palliative therapy and as a component of radical treatment.Objective: The purpose of this article is a literature review about the latest achievements of interstitial brachytherapy in malignant tumors of the oral cavity and oropharynx.

  5. Nursing intervention in gynecologic brachytherapy under general anesthesia

    International Nuclear Information System (INIS)

    We reconsidered our nursing intervention in gynecologic intracavitary brachytherapy as general anesthesia was introduced. We recognized that safety, comfort, privacy protection and relief of anxiety of the patients were important points for nursing with corporation of other medical staffs. (author)

  6. Image-Based Brachytherapy for the Treatment of Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Harkenrider, Matthew M., E-mail: mharkenrider@lumc.edu; Alite, Fiori; Silva, Scott R.; Small, William

    2015-07-15

    Cervical cancer is a disease that requires considerable multidisciplinary coordination of care and labor in order to maximize tumor control and survival while minimizing treatment-related toxicity. As with external beam radiation therapy, the use of advanced imaging and 3-dimensional treatment planning has generated a paradigm shift in the delivery of brachytherapy for the treatment of cervical cancer. The use of image-based brachytherapy, most commonly with magnetic resonance imaging (MRI), requires additional attention and effort by the treating physician to prescribe dose to the proper volume and account for adjacent organs at risk. This represents a dramatic change from the classic Manchester approach of orthogonal radiographic images and prescribing dose to point A. We reviewed the history and currently evolving data and recommendations for the clinical use of image-based brachytherapy with an emphasis on MRI-based brachytherapy.

  7. Radiotherapy and Brachytherapy : Proceedings of the NATO Advanced Study Institute on Physics of Modern Radiotherapy & Brachytherapy

    CERN Document Server

    Lemoigne, Yves

    2009-01-01

    This volume collects a series of lectures presented at the tenth ESI School held at Archamps (FR) in November 2007 and dedicated to radiotherapy and brachytherapy. The lectures focus on the multiple facets of radiotherapy in general, including external radiotherapy (often called teletherapy) as well as internal radiotherapy (called brachytherapy). Radiotherapy strategy and dose management as well as the decisive role of digital imaging in the associated clinical practice are developed in several articles. Grouped under the discipline of Conformal Radiotherapy (CRT), numerous modern techniques, from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT), are explained in detail. The importance of treatment planning based upon patient data from digital imaging (Computed Tomography) is also underlined. Finally, despite the quasi- totality of patients being presently treated with gamma and X-rays, novel powerful tools are emerging using proton and light ions (like carbon ions) beams, bound to bec...

  8. Breast pain

    Science.gov (United States)

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  9. A CT-based analytical dose calculation method for HDR 192Ir brachytherapy

    International Nuclear Information System (INIS)

    Purpose: This article presents an analytical dose calculation method for high-dose-rate 192Ir brachytherapy, taking into account the effects of inhomogeneities and reduced photon backscatter near the skin. The adequacy of the Task Group 43 (TG-43) two-dimensional formalism for treatment planning is also assessed. Methods: The proposed method uses material composition and density data derived from computed tomography images. The primary and scatter dose distributions for each dwell position are calculated first as if the patient is an infinite water phantom. This is done using either TG-43 or a database of Monte Carlo (MC) dose distributions. The latter can be used to account for the effects of shielding in water. Subsequently, corrections for photon attenuation, scatter, and spectral variations along medium- or low-Z inhomogeneities are made according to the radiological paths determined by ray tracing. The scatter dose is then scaled by a correction factor that depends on the distances between the point of interest, the body contour, and the source position. Dose calculations are done for phantoms with tissue and lead inserts, as well as patient plans for head-and-neck, esophagus, and MammoSite balloon breast brachytherapy treatments. Gamma indices are evaluated using a dose-difference criterion of 3% and a distance-to-agreement criterion of 2 mm. PTRANCT MC calculations are used as the reference dose distributions. Results: For the phantom with tissue and lead inserts, the percentages of the voxels of interest passing the gamma criteria (Pγ≥1) are 100% for the analytical calculation and 91% for TG-43. For the breast patient plan, TG-43 overestimates the target volume receiving the prescribed dose by 4% and the dose to the hottest 0.1 cm3 of the skin by 9%, whereas the analytical and MC results agree within 0.4%. Pγ≥1 are 100% and 48% for the analytical and TG-43 calculations, respectively. For the head-and-neck and esophagus patient plans, Pγ≥1 are ≥99

  10. Predictors of Metastatic Disease After Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To identify predictors of metastatic disease after brachytherapy treatment for prostate cancer. Methods and Materials: All patients who received either brachytherapy alone (implant) or brachytherapy in combination with external beam radiation therapy for treatment of localized prostate cancer at The Mount Sinai Hospital between June 1990 and March 2007 with a minimum follow-up of 2 years were included. Univariate and multivariable analyses were performed on the following variables: risk group, Gleason score (GS), clinical T stage, pretreatment prostate-specific antigen level, post-treatment prostate-specific antigen doubling time (PSA-DT), treatment type (implant vs. implant plus external beam radiation therapy), treatment era, total biological effective dose, use of androgen deprivation therapy, age at diagnosis, and race. PSA-DT was analyzed in the following ordinate groups: 0 to 90 days, 91 to 180 days, 180 to 360 days, and greater than 360 days. Results: We included 1,887 patients in this study. Metastases developed in 47 of these patients. The 10-year freedom from distant metastasis (FFDM) rate for the entire population was 95.1%. Median follow-up was 6 years (range, 2–15 years). The only two significant predictors of metastatic disease by multivariable analyses were GS and PSA-DT (p < 0.001 for both variables). Estimated 10-year FFDM rates for GS of 6 or less, GS of 7, and GS of 8 or greater were 97.9%, 94.3%, and 76.1%, respectively (p < 0.001). Estimated FFDM rates for PSA-DT of 0 to 90 days, 91 to 180 days, 181 to 360 days, and greater than 360 days were 17.5%, 67.9%, 74%, and 94.8%, respectively (p < 0.001). Estimated 10-year FFDM rates for the low-, intermediate-, and high-risk groups were 98.6%, 96.2%, and 86.7%, respectively. A demographic shift to patients presenting with higher-grade disease in more recent years was observed. Conclusions: GS and post-treatment PSA-DT are both statistically significant independent predictors of metastatic

  11. Epoxy resins used to seal brachytherapy seed

    International Nuclear Information System (INIS)

    Prostate cancer treatment with brachytherapy is recommended for patients with cancer at an early stage. In this treatment, small radioactive seeds are implanted directly in the prostate gland. These seeds are composed at least of one radionuclide carrier and an X-ray marker enclosed within a metallic tube usually sealed by laser process. This process is expensive and, furthermore, it can provoke a partial volatilization of the radionuclide and change the isotropy in dose distribution around the seed. In this paper, we present a new sealing process using epoxy resin. Three kinds of resins were utilized and characterized by scanning electron microscopy (SEM), energy dispersive X ray (EDS) and by differential scanning calorimetry (DSC) after immersion in simulated body fluid (SBF) and in sodium iodine solution (NaI). The sealing process showed excellent potential to replace the sealing laser usually employed. (author)

  12. Paddle-based rotating-shield brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yunlong; Xu, Weiyu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 (United States); Flynn, Ryan T.; Kim, Yusung; Bhatia, Sudershan K.; Buatti, John M. [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, Iowa 52242 (United States); Wu, Xiaodong, E-mail: xiaodong-wu@uiowa.edu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 and Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)

    2015-10-15

    Purpose: The authors present a novel paddle-based rotating-shield brachytherapy (P-RSBT) method, whose radiation-attenuating shields are formed with a multileaf collimator (MLC), consisting of retractable paddles, to achieve intensity modulation in high-dose-rate brachytherapy. Methods: Five cervical cancer patients using an intrauterine tandem applicator were considered to assess the potential benefit of the P-RSBT method. The P-RSBT source used was a 50 kV electronic brachytherapy source (Xoft Axxent™). The paddles can be retracted independently to form multiple emission windows around the source for radiation delivery. The MLC was assumed to be rotatable. P-RSBT treatment plans were generated using the asymmetric dose–volume optimization with smoothness control method [Liu et al., Med. Phys. 41(11), 111709 (11pp.) (2014)] with a delivery time constraint, different paddle sizes, and different rotation strides. The number of treatment fractions (fx) was assumed to be five. As brachytherapy is delivered as a boost for cervical cancer, the dose distribution for each case includes the dose from external beam radiotherapy as well, which is 45 Gy in 25 fx. The high-risk clinical target volume (HR-CTV) doses were escalated until the minimum dose to the hottest 2 cm{sup 3} (D{sub 2cm{sup 3}}) of either the rectum, sigmoid colon, or bladder reached their tolerance doses of 75, 75, and 90 Gy{sub 3}, respectively, expressed as equivalent doses in 2 Gy fractions (EQD2 with α/β = 3 Gy). Results: P-RSBT outperformed the two other RSBT delivery techniques, single-shield RSBT (S-RSBT) and dynamic-shield RSBT (D-RSBT), with a properly selected paddle size. If the paddle size was angled at 60°, the average D{sub 90} increases for the delivery plans by P-RSBT on the five cases, compared to S-RSBT, were 2.2, 8.3, 12.6, 11.9, and 9.1 Gy{sub 10}, respectively, with delivery times of 10, 15, 20, 25, and 30 min/fx. The increases in HR-CTV D{sub 90}, compared to D-RSBT, were 16

  13. Harmony search optimization for HDR prostate brachytherapy

    Science.gov (United States)

    Panchal, Aditya

    In high dose-rate (HDR) prostate brachytherapy, multiple catheters are inserted interstitially into the target volume. The process of treating the prostate involves calculating and determining the best dose distribution to the target and organs-at-risk by means of optimizing the time that the radioactive source dwells at specified positions within the catheters. It is the goal of this work to investigate the use of a new optimization algorithm, known as Harmony Search, in order to optimize dwell times for HDR prostate brachytherapy. The new algorithm was tested on 9 different patients and also compared with the genetic algorithm. Simulations were performed to determine the optimal value of the Harmony Search parameters. Finally, multithreading of the simulation was examined to determine potential benefits. First, a simulation environment was created using the Python programming language and the wxPython graphical interface toolkit, which was necessary to run repeated optimizations. DICOM RT data from Varian BrachyVision was parsed and used to obtain patient anatomy and HDR catheter information. Once the structures were indexed, the volume of each structure was determined and compared to the original volume calculated in BrachyVision for validation. Dose was calculated using the AAPM TG-43 point source model of the GammaMed 192Ir HDR source and was validated against Varian BrachyVision. A DVH-based objective function was created and used for the optimization simulation. Harmony Search and the genetic algorithm were implemented as optimization algorithms for the simulation and were compared against each other. The optimal values for Harmony Search parameters (Harmony Memory Size [HMS], Harmony Memory Considering Rate [HMCR], and Pitch Adjusting Rate [PAR]) were also determined. Lastly, the simulation was modified to use multiple threads of execution in order to achieve faster computational times. Experimental results show that the volume calculation that was

  14. Interstitial brachytherapy in carcinoma of the penis

    Energy Technology Data Exchange (ETDEWEB)

    Chaudhary, A.J.; Ghosh, S.; Bhalavat, R.L. [Tata Memorial Hospital, Mumbai (India). Dept. of Radiation Oncology; Kulkarni, J.N. [Tata Memorial Hospital, Mumbai (India). Dept. of Surgery; Sequeira, B.V.E. [Tata Memorial Hospital, Mumbai (India). Dept. of Medical Physics

    1999-01-01

    Aim: Keeping in line with the increasing emphasis on organ preservation, we at the Tata Memorial Hospital have evaluated the role of Ir-192 interstitial implant as regards local control, functional and cosmetic outcome in early as well as locally recurrent carcinoma of the distal penis. Patients and Methods: From October 1988 to December 1996, 23 patients with histopathologically proven cancer of the penis were treated with radical radiation therapy using Ir-192 temporary interstitial implant. Our patients were in the age group of 20 to 60 years. The primary lesions were T1 and 7, T2 in 7 and recurrent in 9 patients. Only 7 patients had palpable groin nodes at presentation, all of which were pathologically negative. The median dose of implant was 50 Gy (range 40 to 60 Gy), using the LDR afterloading system and the Paris system of implant rules for dosimetry. Follow-up ranged from 4 to 117 months (median 24 months). Results: At last follow-up 18 of the 23 patients remained locally controlled with implant alone. Three patients failed only locally, 2 locoregionally and 1 only at the groin. Of the 5 patients who failed locally, 4 were successfully salvaged with partial penectomy and remained controlled when last seen. Local control with implant alone at 8 years was 70% by life table analysis. The patients had excellent functional and cosmetic outcome. We did not record any case of skin or softtissue necrosis. Only 2 patients developed meatal stenosis, both of which were treated endoscopically. Conclusion: Our results lead us to interpret that interstitial brachytherapy with Ir-192 offers excellent local control rates with preservation of organ and function. Penectomy can be reserved as a means for effective salvage. (orig.) [Deutsch] Ziel: Das Prinzip des Organerhalts gewinnt in der Onkologie zunehmend an Bedeutung. Ziel dieser Untersuchung war es, die Rolle der interstitiellen Brachytherapie mit Ir-192 zur Behandlung des fruehen und rezidivierten Peniskarzinoms zu

  15. A dynamic dosimetry system for prostate brachytherapy

    Science.gov (United States)

    Kuo, Nathanael; Dehghan, Ehsan; Deguet, Anton; Song, Danny Y.; Prince, Jerry L.; Lee, Junghoon

    2013-03-01

    The lack of dynamic dosimetry tools for permanent prostate brachytherapy causes otherwise avoidable problems in prostate cancer patient care. The goal of this work is to satisfy this need in a readily adoptable manner. Using the ubiquitous ultrasound scanner and mobile non-isocentric C-arm, we show that dynamic dosimetry is now possible with only the addition of an arbitrarily configured marker-based fiducial. Not only is the system easily configured from accessible hardware, but it is also simple and convenient, requiring little training from technicians. Furthermore, the proposed system is built upon robust algorithms of seed segmentation, fiducial detection, seed reconstruction, and image registration. All individual steps of the pipeline have been thoroughly tested, and the system as a whole has been validated on a study of 25 patients. The system has shown excellent results of accurately computing dose, and does so with minimal manual intervention, therefore showing promise for widespread adoption of dynamic dosimetry.

  16. Verification of ophthalmic brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Ophthalmic brachytherapy dose calculations were performed as an independent verification of commercial dosimetry software (BEBIG Plaque Simulator). Excel spreadsheets were constructed to follow the formalism of the AAPM Task Group No. 43. As a software commissioning tool, TG43 seed-based coordinates were reformatted to be compatible with plaque-based BEBIG dose tables for centrally positioned seeds. Plaque central axis doses were also calculated for rings of seeds. Close agreement with BEBIG doses was obtained in both cases. Tailored spreadsheet versions were subsequently created to verify patient treatment plans. Treatment time and dose to a specified central-axis point are calculated for ROPES plaques fully loaded with I-125 model 6702 seeds. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

  17. What Is Breast Cancer?

    Science.gov (United States)

    ... Next Topic Types of breast cancers What is breast cancer? Breast cancer starts when cells in the breast ... breast cancer? ” and Non-cancerous Breast Conditions . How Breast Cancer Spreads Breast cancer can spread through the lymph ...

  18. Methods for prostate stabilization during transperineal LDR brachytherapy

    International Nuclear Information System (INIS)

    In traditional prostate brachytherapy procedures for a low-dose-rate (LDR) radiation seed implant, stabilizing needles are first inserted to provide some rigidity and support to the prostate. Ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of two types of needle geometries (regular brachytherapy needle and hooked needle) and several clinically feasible configurations of the stabilization needles. To understand and assess the prostate movement during seed implantation, we collected in vivo data from patients during actual brachytherapy procedures. In vitro experimentation with tissue-equivalent phantoms allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization with the hooked needles compared to the regular brachytherapy needles (more than 40% in bilateral parallel needle configuration). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (more than 60%). When the hooked needles were angulated for stabilization, further reduction in prostate displacement was observed. In general, for convenience of dosimetric planning and to avoid needle collision, all needles are desired to be in a parallel configuration. In this configuration, hooked needles provide improved stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in seed implantation using a robotic system. We have developed nonlinear spring-damper model for the prostate movement which can be used for adapting dosimetric planning during brachytherapy as well as for developing more realistic haptic devices and

  19. Accelerated partial breast irradiation. Techniques and clinical implementation. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Wazer, David E. [Tufts Medical Center, Boston, MA (United States). Dept. of Radiation Oncology; Arthur, Douglas W. [Virginia Commonwealth Univ., Richmond, VA (United States). Dept. of Radiation Oncology; Vicini, Frank, A. (eds.) [William Beaumont Hospital, Royal Oak, MI (United States). Dept. of Radiation Oncology

    2009-07-01

    Accelerated partial breast irradiation (APBI) is being rapidly introduced into the clinical management of early breast cancer. APBI, in fact, encompasses a number of different techniques and approaches that include brachytherapy, intraoperative, and external beam techniques. There is currently no single source that describes these techniques and their clinical implementation. This text is a concise handbook designed to assist the clinician in the implementation of APBI. This includes a review of the principles that underlie APBI, a practical and detailed description of each technique for APBI, a review of current clinical results of APBI, and a review of the incidence and management of treatment related complications. (orig.)

  20. Shape optimization of active and passive drag-reducing devices on a D-shaped bluff body

    CERN Document Server

    Semaan, Richard

    2016-01-01

    Shape optimization of an active and a passive drag-reducing device on a two-dimensional D-shaped bluff body is performed. The two devices are: Coanda actuator, and randomly-shaped trailing-edge flap. The optimization sequence is performed by coupling the genetic algorithm software DAKOTA to the mesh generator Pointwise and to the CFD solver OpenFOAM. For the the active device the cost functional is the power ratio, whereas for the passive device it is the drag coefficient. The optimization leads to total power savings of $\\approx 70\\%$ for the optimal Coanda actuator, and a 40\\% drag reduction for the optimal flap. This reduction is mainly achieved through streamlining the base flow and suppressing the vortex shedding. The addition of either an active or a passive device creates two additional smaller recirculation regions in the base cavity that shifts the larger recirculation region away from the body and increases the base pressure. The results are validated against more refined URANS simulations for selec...

  1. Improved grid-noise removal in single-frame digital moiré 3D shape measurement

    Science.gov (United States)

    Mohammadi, Fatemeh; Kofman, Jonathan

    2016-11-01

    A single-frame grid-noise removal technique was developed for application in single-frame digital-moiré 3D shape measurement. The ability of the stationary wavelet transform (SWT) to prevent oscillation artifacts near discontinuities, and the ability of the Fourier transform (FFT) applied to wavelet coefficients to separate grid-noise from useful image information, were combined in a new technique, SWT-FFT, to remove grid-noise from moiré-pattern images generated by digital moiré. In comparison to previous grid-noise removal techniques in moiré, SWT-FFT avoids the requirement for mechanical translation of optical components and capture of multiple frames, to enable single-frame moiré-based measurement. Experiments using FFT, Discrete Wavelet Transform (DWT), DWT-FFT, and SWT-FFT were performed on moiré-pattern images containing grid noise, generated by digital moiré, for several test objects. SWT-FFT had the best performance in removing high-frequency grid-noise, both straight and curved lines, minimizing artifacts, and preserving the moiré pattern without blurring and degradation. SWT-FFT also had the lowest noise amplitude in the reconstructed height and lowest roughness index for all test objects, indicating best grid-noise removal in comparison to the other techniques.

  2. Multi-frequency color-marked fringe projection profilometry for fast 3D shape measurement of complex objects.

    Science.gov (United States)

    Jiang, Chao; Jia, Shuhai; Dong, Jun; Bao, Qingchen; Yang, Jia; Lian, Qin; Li, Dichen

    2015-09-21

    We propose a novel multi-frequency color-marked fringe projection profilometry approach to measure the 3D shape of objects with depth discontinuities. A digital micromirror device projector is used to project a color map consisting of a series of different-frequency color-marked fringe patterns onto the target object. We use a chromaticity curve to calculate the color change caused by the height of the object. The related algorithm to measure the height is also described in this paper. To improve the measurement accuracy, a chromaticity curve correction method is presented. This correction method greatly reduces the influence of color fluctuations and measurement error on the chromaticity curve and the calculation of the object height. The simulation and experimental results validate the utility of our method. Our method avoids the conventional phase shifting and unwrapping process, as well as the independent calculation of the object height required by existing techniques. Thus, it can be used to measure complex and dynamic objects with depth discontinuities. These advantages are particularly promising for industrial applications. PMID:26406621

  3. The role of brachytherapy in radiation and isotopes centre of Khartoum (RICK)

    CERN Document Server

    Ali, A M

    2000-01-01

    As there are many efforts devoted in order to manage the cancer, here the researcher handle one of these efforts that play a major part in treating the cancer internationally, it is a brachytherapy system. Brachytherapy was carried out mostly with radium sources, but recently some artificial sources are incorporated in this mode of treatment such as Cs-137, Ir-192, Au-198, P-32, Sr-90 and I-125. The research cover history of brachytherapy and radioactive sources used in, techniques of implementation, radiation protection and methods of brachytherapy dose calculation, as well as brachytherapy in radiation and isotopes centre in Khartoum.

  4. Percutaneous interstitial brachytherapy for adrenal metastasis. Technical report

    International Nuclear Information System (INIS)

    We developed and evaluated the feasibility of a brachytherapy technique as a safe and effective treatment for adrenal metastasis. Adapting a paravertebral insertion technique in radiofrequency ablation of adrenal tumors, we developed an interstitial brachytherapy for adrenal metastasis achievable on an outpatient basis. Under local anesthesia and under X-ray CT guidance, brachytherapy applicator needles were percutaneously inserted into the target. A treatment plan was created to eradicate the tumor while preserving normal organs including the spinal cord and kidney. We applied this interstitial brachytherapy technique to two patients: one who developed adrenal metastasis as the third recurrence of uterine cervical cancer after reirradiation, and one who developed metachronous multiple metastases from malignant melanoma. The whole procedure was completed in 2.5 hours. There were no procedure-related or radiation-related early/late complications. 18F-fluorodeoxyglucose positron emission tomography (FDG PET)-CT images at two and three months after treatment showed absence of FDG uptake, and no recurrence of the adrenal tumor was observed for over seven months until expiration, and for six months until the present, respectively. This interventional interstitial brachytherapy procedure may be useful as a safe and eradicative treatment for adrenal metastasis. (author)

  5. Wavelength-switchable multiwavelength erbium-doped fiber laser based on a D-shaped fiber with a photoresist thin-film overlay

    International Nuclear Information System (INIS)

    A wavelength-switchable multiwavelength erbium-doped fiber (EDF) laser based on a D-shaped fiber with a photoresist (PR) thin-film overlay is proposed and experimentally demonstrated. The D-shaped fiber with a PR thin-film overlay is implemented as a multichannel filter. Based on the evanescent field coupling between the D-shaped fiber and the PR thin-film overlay, periodic transmission characteristics are obtained. The wavelength spacing of the D-shaped fiber with the PR thin-film overlay is controlled by changing the thickness and the refractive index of the PR thin film overlay. By inserting the proposed multichannel filter into an EDF ring laser, a multiwavelength EDF laser is achieved. The homogenous line broadening of erbium ions for the realization of stable operation of the multiwavelength EDF ring laser is suppressed by using a nonlinear polarization rotation. A high-quality multiwavelength output with a high extinction ratio of ∼0 dB is realized. The output fluctuation of the proposed multiwavelength EDF ring laser is measured to be less than 0.3 dB. Since the transmission characteristics of the proposed multichannel filter are controlled by using two orthogonal input polarization states, multiwavelength lasing outputs are switched.

  6. Source localisation and dose verification for a novel brachytherapy unit

    Science.gov (United States)

    Metaxas, Marinos G.

    A recent development in the field of radiotherapy has been the introduction of the PRS Intrabeam system (Carl Zeiss Surgical GmbH, Oberkochen, Germany). This is essentially a portable, miniaturised, electron-driven photon generator that allows high intensity, soft-energy x-rays (50 kVp) to be delivered directly to the tumour site in a single fraction. The system has been used for the interstitial radiation treatment of both brain and breast tumours. At present, a standardised in-vivo dose verification technique is not available for the PRS treatments. The isotropical distribution of photons about the tip of the PRS probe inserted in the tissue can effectively be viewed as a point source of radiation buried in the body. This work has looked into ways of localising the PRS source utilising its own radiation field. Moreover, the response of monoenergetic sources, mimicking realistic brachytherapy sources, has also been investigated. The purpose of this project was to attempt to localise the source as well as derive important dosimetric information from the resulting image. A detection system comprised of a well-collimated Germanium detector (HPGe) has been devised in a rotate-translate Emission Computed Tomography (ECT) modality. The superior energy resolving ability of the detection system allowed for energy selective reconstruction to be carried out in the case of the monoenergetic source (241Am). Results showed that the monoenergetic source can be localised to within 1 mm and the continuous PRS x-ray source to within 3mm. For the PRS dose map derivation, Monte Carlo studies have been employed in order to extract information on the dosimetric aspect of the resulting image. The final goal of this work was therefore to formulate a direct mathematical relation (Transform Map) between the image created by the escaping photons and the dose map as predicted by the theoretical model. The formation therefore of the in-vivo PRS image could allow for a real-time monitoring

  7. Radiological protection of patients in brachytherapy

    International Nuclear Information System (INIS)

    Full text: The prefix 'brachy' means short-range, so brachytherapy is the administration of radiation therapy using small radioactive sources in the form of needles, tubes, wires or seeds, which are placed within the tumor -interstitial form- or very near of it, superficially or in an endo-cavity form. This technique, which was limited by the size of the primary tumor, has the advantage, that the radiation, can be adjusted to the size and shape of the tumor volume and the radioisotope used, - short range -, is selected with the criteria of getting the dose in the organs at risk, as low as possible, making what it is known as conformal radiotherapy. Radioactive sources may be permanent or temporary implants. The application of radioactive material, can be manually or automatically. In the first case, a major breakthrough from the radioprotection point of view, was the use of afterloading devices, methodology highly recommended to reduce the radiation exposure to staff. With the development of technology, remotely controlled afterloading devices were introduced, which in addition to complying with the above requirement, allow the source to move in different positions along catheters housed in one or more channels, making therapeutic brachytherapy treatments in tumor volumes possible, that due to its length, decades ago would have been an unthinkable deal. In all cases, sources, which may vary from the 3 mm in length, 125 Iodine or 198 Gold seeds, to extensive wires of 192 Iridium, are encapsulated for two main purposes: preventing leakage of radioactive material and absorption of unwanted radiation, alpha and beta, produced by the radioactive decay. Consequently, it should be highly unlikely that the radioactive material, could be lost or located in the patient, in a different place of the one that was planned. However, history shows us the opposite. Its is known the kind of deterministic effect that radiation is going to produce in the tumor, where the severity of

  8. Progress on system for applying simultaneous heat and brachytherapy to large-area surface disease (Invited Paper)

    Science.gov (United States)

    Stauffer, Paul R.; Schlorff, Jaime L.; Juang, Titania; Neuman, Daniel G., Jr.; Johnson, Jessi E.; Maccarini, Paolo F.; Pouliot, Jean

    2005-04-01

    Laboratory experiments have shown that thermal enhancement of radiation response increases substantially for higher thermal dose (approaching 100 CEM43) and when hyperthermia and radiation are delivered simultaneously. Unfortunately, equipment capable of delivering uniform doses of heat and radiation simultaneously has not been available to test the clinical potential of this approach. We present recent progress on the clinical implementation of a system that combines the uniform heating capabilities of flexible printed circuit board microwave array applicators with an array of brachytherapy catheters held a fixed distance from the skin for uniform radiation of tissue deep with a scanning high dose rate (HDR) brachytherapy source. The system is based on the Combination Applicator which consists of an array of up to 32 Dual Concentric Conductor (DCC) apertures driven at 915 MHz for heating tissue, coupled with an array of 1 cm spaced catheters for HDR therapy. Efforts to optimize the clinical interface and move from rectangular to more complex shape applicators that accommodate the entire disease in a larger number of patients are described. Improvements to the system for powering and controlling the applicator are also described. Radiation dosimetry and experimental performance results of a prototype 15 x 15 cm dual-purpose applicator demonstrate dose distributions with good homogeneity under large contoured surfaces typical of diffuse chestwall recurrence of breast carcinoma. Investigations of potential interaction between heat and brachytherapy components of a Combination Applicator demonstrate no perceptible perturbation of the heating field from an HDR source or leadwire, no perceptible effect of a scanning HDR source on fiberoptic thermometry, and heat and radiation simultaneously for maximum synergism of modalities, this dual therapy system should expand the number of patients that can benefit from effective thermoradiotherapy treatments.

  9. Breast lump

    Science.gov (United States)

    Breast mass ... males and females of all ages have normal breast tissue. This tissue responds to hormone changes. Because of this, lumps can come and go. Breast lumps may appear at any age: Both male ...

  10. Breast Diseases

    Science.gov (United States)

    Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk). If you have a breast lump, pain, ...

  11. The efficacy of a "double-D-shaped" wire marker for radiographic measurement of acetabular cup orientation and wear.

    Science.gov (United States)

    Derbyshire, Brian; Raut, Videshnandan V

    2013-01-01

    Historically, wire markers were attached to cemented all-plastic acetabular cups to demarcate the periphery and to measure socket wear. The wire shape was either a semi-circle passing over the pole of the cup, or a circle around the cup equator. More recently, "double-D" shaped markers were introduced with a part-circular aspect passing over the pole and a semi-circular aspect parallel to the equatorial plane. This configuration enabled cup retroversion to be distinguished from anteversion. In this study, the accuracy of radiographic measurement of cup orientation and wear was assessed for cups with "double-D" and circular markers. Each cup was attached to a measurement jig which could vary the anteversion/retroversion and internal/external rotation of the cup. A metal femoral head was fixed within the socket and radiographic images were created for all combinations of cup orientation settings. The images were measured using software with automatic edge detection, and cup orientation and zero-wear accuracies were determined for each setting. The median error for cup version measurements was similar for both types of wire marker (0.2° double-D marker, -0.24° circular marker), but measurements of the circular marker were more repeatable. The median inclination errors were 2.05° (double-D marker) and 0.23° (circular marker). The median overall "zero wear" errors were 0.19 mm (double-D marker) and 0.03 mm (circular marker). Measurements of the circular wire marker were much more repeatable.

  12. Prostate brachytherapy in patients with prior evidence of prostatitis

    International Nuclear Information System (INIS)

    Purpose: To refute a misconception that a prior history of prostatitis is a contraindication to prostate brachytherapy. Methods and Materials: Five patients with clinical or pathologic evidence of prior prostatitis were treated with transperineal brachytherapy. Four of the patients received a single i.v. dose of ciprofloxacin (500 mg) intraoperatively. Postimplant antibiotics were not given. The pretreatment biopsy slides were reviewed. Results: Two of the five patients developed postimplant urinary retention requiring short-term catheterization, and both resolved spontaneously. One patient developed what appeared to be an exacerbation of his chronic prostatitis. Conclusion: We continue to recommend prostate brachytherapy for the treatment of clinically organ-confined cancer, with no concern about prior clinical or pathologic evidence of prostatitis

  13. HDR neutron brachytherapy for prostatic cancer in lithuania

    International Nuclear Information System (INIS)

    The purpose of this report is to analyse the physical and radiobiological background of the HDR Cf-252 Neutron brachytherapy boost in the combined radiation therapy for locally advanced prostatic cancer. The treatment schedule:two fractions of the Cf-252 brachytherapy(5Gy-eq at the dose point 2 cm from source movement trajectory) with interval 24 hours; 5-8 fractions of the photon beam external radiation therapy(5 fractions per week, 2 Gy per fraction) to the prostate, two fractions of the Cf-252 brachytherapy and after that external beam radiation therapy is continued till total dose 40-45 Gy. Six patients completed the proposed combined radiation therapy. The results of this trial will be discussed

  14. The Adoption of New Adjuvant Radiation Therapy Modalities Among Medicare Beneficiaries With Breast Cancer: Clinical Correlates and Cost Implications

    International Nuclear Information System (INIS)

    Purpose: New radiation therapy modalities have broadened treatment options for older women with breast cancer, but it is unclear how clinical factors, geographic region, and physician preference affect the choice of radiation therapy modality. Methods and Materials: We used the Surveillance, Epidemiology, and End Results-Medicare database to identify women diagnosed with stage I-III breast cancer from 1998 to 2007 who underwent breast-conserving surgery. We assessed the temporal trends in, and costs of, the adoption of intensity modulated radiation therapy (IMRT) and brachytherapy. Using hierarchical logistic regression, we evaluated the relationship between the use of these new modalities and patient and regional characteristics. Results: Of 35,060 patients, 69.9% received conventional external beam radiation therapy (EBRT). Although overall radiation therapy use remained constant, the use of IMRT increased from 0.0% to 12.6% from 1998 to 2007, and brachytherapy increased from 0.7% to 9.0%. The statistical variation in brachytherapy use attributable to the radiation oncologist and geographic region was 41.4% and 9.5%, respectively (for IMRT: 23.8% and 22.1%, respectively). Women undergoing treatment at a free-standing radiation facility were significantly more likely to receive IMRT than were women treated at a hospital-based facility (odds ratio for IMRT vs EBRT: 3.89 [95% confidence interval, 2.78-5.45]). No such association was seen for brachytherapy. The median radiation therapy cost per treated patient increased from $5389 in 2001 to $8539 in 2007. Conclusions: IMRT and brachytherapy use increased substantially from 1998 to 2007; overall, radiation therapy costs increased by more than 50%. Radiation oncologists played an important role in treatment choice for both types of radiation therapy, whereas geographic region played a bigger role in the use of IMRT than brachytherapy

  15. The Adoption of New Adjuvant Radiation Therapy Modalities Among Medicare Beneficiaries With Breast Cancer: Clinical Correlates and Cost Implications

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, Kenneth B. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Soulos, Pamela R. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut (United States); Herrin, Jeph [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Health Research and Educational Trust, Chicago, Illinois (United States); Yu, James B. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Long, Jessica B. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut (United States); Dostaler, Edward [Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut (United States); and others

    2013-04-01

    Purpose: New radiation therapy modalities have broadened treatment options for older women with breast cancer, but it is unclear how clinical factors, geographic region, and physician preference affect the choice of radiation therapy modality. Methods and Materials: We used the Surveillance, Epidemiology, and End Results-Medicare database to identify women diagnosed with stage I-III breast cancer from 1998 to 2007 who underwent breast-conserving surgery. We assessed the temporal trends in, and costs of, the adoption of intensity modulated radiation therapy (IMRT) and brachytherapy. Using hierarchical logistic regression, we evaluated the relationship between the use of these new modalities and patient and regional characteristics. Results: Of 35,060 patients, 69.9% received conventional external beam radiation therapy (EBRT). Although overall radiation therapy use remained constant, the use of IMRT increased from 0.0% to 12.6% from 1998 to 2007, and brachytherapy increased from 0.7% to 9.0%. The statistical variation in brachytherapy use attributable to the radiation oncologist and geographic region was 41.4% and 9.5%, respectively (for IMRT: 23.8% and 22.1%, respectively). Women undergoing treatment at a free-standing radiation facility were significantly more likely to receive IMRT than were women treated at a hospital-based facility (odds ratio for IMRT vs EBRT: 3.89 [95% confidence interval, 2.78-5.45]). No such association was seen for brachytherapy. The median radiation therapy cost per treated patient increased from $5389 in 2001 to $8539 in 2007. Conclusions: IMRT and brachytherapy use increased substantially from 1998 to 2007; overall, radiation therapy costs increased by more than 50%. Radiation oncologists played an important role in treatment choice for both types of radiation therapy, whereas geographic region played a bigger role in the use of IMRT than brachytherapy.

  16. The difference of scoring dose to water or tissues in Monte Carlo dose calculations for low energy brachytherapy photon sources

    Energy Technology Data Exchange (ETDEWEB)

    Landry, Guillaume; Reniers, Brigitte; Pignol, Jean-Philippe; Beaulieu, Luc; Verhaegen, Frank [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Universite Laval, CHUQ Pavillon L' Hotel-Dieu de Quebec, Quebec G1R 2J6 (Canada) and Departement de Physique, de Genie Physique et d' Optique, Universite Laval, Quebec G1K 7P4 (Canada); Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands) and Department of Oncology, McGill University, Montreal General Hospital, Montreal, Quebec H3G 1A4 (Canada)

    2011-03-15

    Purpose: The goal of this work is to compare D{sub m,m} (radiation transported in medium; dose scored in medium) and D{sub w,m} (radiation transported in medium; dose scored in water) obtained from Monte Carlo (MC) simulations for a subset of human tissues of interest in low energy photon brachytherapy. Using low dose rate seeds and an electronic brachytherapy source (EBS), the authors quantify the large cavity theory conversion factors required. The authors also assess whether applying large cavity theory utilizing the sources' initial photon spectra and average photon energy induces errors related to spatial spectral variations. First, ideal spherical geometries were investigated, followed by clinical brachytherapy LDR seed implants for breast and prostate cancer patients. Methods: Two types of dose calculations are performed with the GEANT4 MC code. (1) For several human tissues, dose profiles are obtained in spherical geometries centered on four types of low energy brachytherapy sources: {sup 125}I, {sup 103}Pd, and {sup 131}Cs seeds, as well as an EBS operating at 50 kV. Ratios of D{sub w,m} over D{sub m,m} are evaluated in the 0-6 cm range. In addition to mean tissue composition, compositions corresponding to one standard deviation from the mean are also studied. (2) Four clinical breast (using {sup 103}Pd) and prostate (using {sup 125}I) brachytherapy seed implants are considered. MC dose calculations are performed based on postimplant CT scans using prostate and breast tissue compositions. PTV D{sub 90} values are compared for D{sub w,m} and D{sub m,m}. Results: (1) Differences (D{sub w,m}/D{sub m,m}-1) of -3% to 70% are observed for the investigated tissues. For a given tissue, D{sub w,m}/D{sub m,m} is similar for all sources within 4% and does not vary more than 2% with distance due to very moderate spectral shifts. Variations of tissue composition about the assumed mean composition influence the conversion factors up to 38%. (2) The ratio of D

  17. Uncertainty analysis in MCNP5 calculations for brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Gerardy, I., E-mail: gerardy@isib.be [Institut Superieur Industriel de Bruxelles, 150, Rue Royale, B-1000 Brussels (Belgium); Rodenas, J.; Gallardo, S. [Departamento de Ingenieria Quimica y Nuclear, Universidad Politecnica de Valencia (Spain)

    2011-08-15

    The Monte Carlo (MC) method can be applied to simulate brachytherapy treatment planning. The MCNP5 code gives, together with results, a statistical uncertainty associated with them. However, the latter is not the only existing uncertainty related to the simulation and other uncertainties must be taken into account. A complete analysis of all sources of uncertainty having some influence on results of the simulation of brachytherapy treatment is presented in this paper. This analysis has been based on the recommendations of the American Association for Physicist in Medicine (AAPM) and of the International Standard Organisation (ISO).

  18. Brachytherapy optimal planning with application to intravascular radiation therapy

    DEFF Research Database (Denmark)

    Sadegh, Payman; Mourtada, Firas A.; Taylor, Russell H.;

    1999-01-01

    . Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes......We have been studying brachytherapy planning with the objective of manimizing the maximum deviation of the delivered dose from prescribed dose bounds for treatment volumes. A general framework for optimal treatment planning is presented and the minmax optimization is formulated as a linear program...

  19. Brachytherapy in vulvar cancer: analysis of 18 patients

    International Nuclear Information System (INIS)

    INTRODUCTION: Vulvar cancer is a rather common neoplasm in elderly patients. Surgery, followed eventually by postoperative radiotherapy, is the treatment of choice. The results of exclusive radiotherapy (external beam irradiation and/or brachytherapy) are not well defined and in the recent literature only small series are reported. Radiotherapy however is the only therapeutic option in patients who are not fit for radical surgery. It is thus necessary to review its indications and its modalities. PATIENTS METHODS AND RESULTS: From 1990 to 1994 18 pts with a diagnosis of squamous cell carcinoma of the vulva have been submitted to brachytherapy. Age ranged from 60 to 92 years (mean age 76, 1 ys). 14 pts were treated at diagnosis (11 pts) or for recurrent disease after surgery (3 pts). In 8 of them brachytherapy (total dose 35-45 Gy, dose rate: 0,4-0,78 Gy/h) was preceded by external beam irradiation (Co60 or electron beam, 40-50 Gy to primary and inguinal nodes); 6 pts were treated with brachytherapy alone (58-60 Gy; dose rate 0,44-0,63 Gy/h). 4 pts underwent to brachytherapy alone for local recurrence after surgery and postoperative radiotherapy (total dose 45-60 Gy; dose rate 0,37-0,49 Gy/h). Brachytherapy was always performed with 192 Ir. Plastic tubes (2 to 5 lines) were used for single plane implantation of small exophytic lesions limited to the labia (8 cases); a perineal template (10 cases) was employed in lesions extended to the vaginal mucosa or involving the clitoris or the area of the perineum. (10(14)) pts treated at diagnosis are alive and free from local recurrence after 11-48 mos. 3 of them, treated with brachytherapy alone, have presented a nodal recurrence in the groin after 14, 15 and 27 mos. respectively. All of them are alive and free from disease after surgery and external radiotherapy. None of the pts treated for recurrent disease after surgery + external beam radiotherapy has achieved a local control. CONCLUSION: Brachytherapy alone or

  20. Validation of GPUMCD for low-energy brachytherapy seed dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Hissoiny, Sami; Ozell, Benoit; Despres, Philippe; Carrier, Jean-Francois [Ecole polytechnique de Montreal, Departement de genie informatique et genie logiciel, 2500 chemin de Polytechnique, Montreal, QC, H3T 1J4 (Canada); Departement de radio-oncologie, Centre hospitalier universitaire de Quebec (CHUQ), 11 Cote du Palais, Quebec, QC, G1R 2J6 (Canada); Departement de physique, Universite de Montreal, Montreal, QC (Canada) and Departement de radio-oncologie and Centre de recherche du CHUM, Centre hospitalier de l' Universite de Montreal (CHUM), Montreal, QC, H2L 4M1 (Canada)

    2011-07-15

    Purpose: To validate GPUMCD, a new package for fast Monte Carlo dose calculations based on the GPU (graphics processing unit), as a tool for low-energy single seed brachytherapy dosimetry for specific seed models. As the currently accepted method of dose calculation in low-energy brachytherapy computations relies on severe approximations, a Monte Carlo based approach would result in more accurate dose calculations, taking in to consideration the patient anatomy as well as interseed attenuation. The first step is to evaluate the capability of GPUMCD to reproduce low-energy, single source, brachytherapy calculations which could ultimately result in fast and accurate, Monte Carlo based, brachytherapy dose calculations for routine planning. Methods: A mixed geometry engine was integrated to GPUMCD capable of handling parametric as well as voxelized geometries. In order to evaluate GPUMCD for brachytherapy calculations, several dosimetry parameters were computed and compared to values found in the literature. These parameters, defined by the AAPM Task-Group No. 43, are the radial dose function, the 2D anisotropy function, and the dose rate constant. These three parameters were computed for two different brachytherapy sources: the Amersham OncoSeed 6711 and the Imagyn IsoStar IS-12501. Results: GPUMCD was shown to yield dosimetric parameters similar to those found in the literature. It reproduces radial dose functions to within 1.25% for both sources in the 0.5< r <10 cm range. The 2D anisotropy function was found to be within 3% at r = 5 cm and within 4% at r = 1 cm. The dose rate constants obtained were within the range of other values reported in the literature.Conclusion: GPUMCD was shown to be able to reproduce various TG-43 parameters for two different low-energy brachytherapy sources found in the literature. The next step is to test GPUMCD as a fast clinical Monte Carlo brachytherapy dose calculations with multiple seeds and patient geometry, potentially providing

  1. Halo's production in vitro on brachytherapy experiments

    International Nuclear Information System (INIS)

    Since earlier of 1960, one of the most significant contributions of radiation biology has been the theory of cell killing as a function of increasing doses of a cytotoxic agent, as well as the demonstration of repair of sublethal or potentially lethal damage after irradiation. The impact of cellular and molecular radiobiology, by exploitation of cellular mechanisms related to apoptosis, may be the cell killing with irradiation by including changes other than unrepaired DNA damage. Based on the understanding of the tumor microenvironment and how growth factors and proteins produced by irradiated cells may alter cellular processes, improved combined-modality strategies may emerge. This effect was show since 1960's, but here we propose to demonstrate this phenomenon in Brachytherapy. The present goal is to verify the macroscopic response through the production and analysis of clonogenic control based on halos generation by radioactive seeds of Ho-165 and Sm-153, aiming to study the effect of this type of irradiation. Confluent cell culture flasks with HeLa cell line were subjected to radiation in a period up to five half-lives of radionuclide, respectively. Devices were introduced which set the polymer-ceramic Ho-165 and Sm-153 seeds in the vials. After a period of exposure, the flasks were stained with violet Gensiana. The results showed the formation of halos control of confluent cancer cells. This paper will describe these experiments in the current stage of the research and report the implications of this new way of therapy for cancer treatment. (author)

  2. Radiation Protection Training in Intracoronary Brachytherapy

    International Nuclear Information System (INIS)

    To report the educational objectives and contents on Radiation Protection (RP) for the practice of Intracoronary Brachytherapy (ICB) procedures. The wide international experience on training programs for ICB as well as our own experience organizing several courses aimed at Cardiologists, Radio therapists and Medical Physicists has been used to elaborate specific RP objectives and contents. The objectives, differentiated for Cardiologists, Radio therapists, Medical Physicists, Nurses and Technicians, pretend to guarantee the safety and RP of both patient and staff in the procedures of ICB. The objectives are necessarily different because their RP formation and their role in the procedure are different. The general topics included in RP training programmes for ICB could be: general topics on RP (Interaction of radiation and matter, RP principles, radiobiology, etc), principles of operation of ICB and interventional X-ray equipment, quantification of radiation dose and risks, optimisation of protection of staff and patients, accidents and emergencies, regulations, responsibilities, quality assurance program, handling of ICB sources, installation and commissioning. Training programs based on the objectives presented in this paper would encourage positive safety culture in ICB and can also be used as a starting point by the Regulatory Authority for the authorization of new Installations and credentialing of professionals involved in this technique as well as for the continuous education of the staff involved. (Author) 10 refs

  3. A quality management program in intravascular brachytherapy.

    Science.gov (United States)

    Chakri, Abderrahim; Thomadsen, Bruce

    2002-12-01

    While simple, intravascular brachytherapy (IVB) presents a considerable potential for harm to the patient. The medical physicist maintains the responsibility to minimize the likelihood of operational problems or dosimetric errors. The principals for safe operation remain the same as with any radiotherapy treatment: to deliver the correct dose, to the correct location, safety. To develop an effective and comprehensive quality management (QM) program for IVB, a physicist should utilize proven risk assessment techniques rather than simply thinking of things to check, and follow guidances such as ISO9001:2000. The proposed QM program includes the following: Procedures designed to assure the safety of the patient. Identification of the patient; tests of the integrity and patency for the delivery catheter, operation of the source train, and patency of the catheter in the treatment position; a check for recovery preparations; and verification of source recovery. Procedures to assure positional accuracy of the treatment: Verification of the positioning the catheter in the artery and of the sources in the catheter. Procedures to assure dosimetry accuracy: Acceptance testing of the device, including verification of the source strength and uniformity, and of the treatment duration tables; verification of the treatment prescription and duration for each patient; and control measures that minimize the likelihood of errors removing the source at the correct time. PMID:12512720

  4. Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: Alternative to mastectomy? Results from a prospective trial

    International Nuclear Information System (INIS)

    Purpose: To assess the outcome of multi-catheter pulse dose rate (PDR) brachytherapy of re-irradiation for local ipsilateral breast tumour recurrence (IBTR) in regard to local control, survival, morbidity and quality of life (QoL). Patients and methods: Between 1999 and 2006, 39 patients were included with histologically confirmed IBTR, Karnofsky index ⩾80% and refusal of mastectomy. Exclusion criteria were multicentric invasive growth pattern, unclear surgical margins, distant metastasis and a postoperative breast not suitable for interstitial brachytherapy. Primary endpoint was local tumour control. Morbidity, cosmetic outcome and QoL were assessed in 24/39 patients. Results: The five year actuarial local control rate was 93% after a mean follow up of 57 (±30) months with two second local relapses. Overall survival and disease free survival, both at 5 years, were 87% and 77%, respectively. Late side effects Grade 1–2 were observed in 20/24 patients after a mean follow-up of 30 (±18) months. Late side effects ⩾Grade 3 occurred in 4/24 patients. Cosmetic outcome was excellent to fair in 76% of women. Overall QoL was comparable to a healthy control group. Mean scores of scales and items of QLQ-BR23 were comparable to primary breast conserving therapy. Conclusions: Accelerated PDR-brachytherapy following breast conserving surgery (BCS) for local IBTR results in local tumour control comparable to mastectomy. Morbidity is moderate; the cosmetic outcome is good and hardly any impairment on QoL is observed.

  5. Breast Cancer

    Science.gov (United States)

    ... I found something when I did my breast self-exam. What should I do now? How often should I have mammograms? I have breast cancer. What are my treatment options? How often should I do breast self-exams? I have breast cancer. Is my daughter ...

  6. Factors influencing outcome of I-125 prostate cancer brachytherapy

    NARCIS (Netherlands)

    Hinnen, K.A.

    2011-01-01

    Brachytherapy is becoming an increasingly popular prostate cancer treatment, probably due to the specific advantages of the procedure, such as the minimal invasiveness and the lower chance of impotence and incontinence. Nonetheless, because of the long follow-up that is required to obtain prostate c

  7. In vivo dosimetry: trends and prospects for brachytherapy

    DEFF Research Database (Denmark)

    Kertzscher, Gustavo; Rosenfeld, A.; Beddar, S.;

    2014-01-01

    The error types during brachytherapy (BT) treatments and their occurrence rates are not well known. The limited knowledge is partly attributed to the lack of independent verification systems of the treatment progression in the clinical workflow routine. Within the field of in vivo dosimetry (IVD)...

  8. Brachytherapy in Europe: philosophies, current practice and future directions

    International Nuclear Information System (INIS)

    Full text: Five months sabbatical leave provided an opportunity to visit six radiotherapy centres in France, Holland and England. While brachytherapy philosophies and practices within each country were similar, there were considerable differences in attitudes between countries. The Institute Gustave Roussy, home of the Paris System and host for the French sector confirmed that the Paris System is still very much the preferred dosimetry method in this part of the world. Though their preference for low dose rate brachytherapy is still evident, high dose rate brachytherapy has found some applications but the rules of the Paris System are never far away and the words 'what about the hyperdose sleeve' are firmly implanted into this visitor's brain. The use of real time dosimetry for I-125 prostate brachytherapy at the Institute Curie (Paris) provided an interesting contrast to the standard pre and post implant dosimetry techniques commonly employed elsewhere. The two Dutch centres on the itinerary, in stark contrast to the traditional techniques seen in France, have applied the power of computers to investigate optimisation of the classic dosimetry systems and called on the analysis techniques (DVH, NTCP, TCP etc) now familiar to us all in external beam therapy. The Cookridge Hospital in England fitted somewhere between the French and Dutch centres. This centre showed how both modern and traditional techniques could be applied in an efficient way for a large variety of treatment sites. Copyright (2000) Australasian College of Physical Scientists and Engineers in Medicine

  9. Initial application of digital tomosynthesis to improve brachytherapy treatment planning

    Science.gov (United States)

    Baydush, Alan H.; Mirzaei McKee, Mahta; King, June; Godfrey, Devon J.

    2007-03-01

    We present preliminary investigations that examine the feasibility of incorporating volumetric images generated using digital tomosynthesis into brachytherapy treatment planning. The Integrated Brachytherapy Unit (IBU) at our facility consists of an L-arm, C-arm isocentric motion system with an x-ray tube and fluoroscopic imager attached. Clinically, this unit is used to generate oblique, anterior-posterior, and lateral images for simple treatment planning and dose prescriptions. Oncologists would strongly prefer to have volumetric data to better determine three dimensional dose distributions (dose-volume histograms) to the target area and organs at risk. Moving the patient back and forth to CT causes undo stress on the patient, allows extensive motion of organs and treatment applicators, and adds additional time to patient treatment. We propose to use the IBU imaging system with digital tomosynthesis to generate volumetric patient data, which can be used for improving treatment planning and overall reducing treatment time. Initial image data sets will be acquired over a limited arc of a human-like phantom composed of real bones and tissue equivalent material. A brachytherapy applicator will be incorporated into one of the phantoms for visualization purposes. Digital tomosynthesis will be used to generate a volumetric image of this phantom setup. This volumetric image set will be visually inspected to determine the feasibility of future incorporation of these types of images into brachytherapy treatment planning. We conclude that initial images using the tomosynthesis reconstruction technique show much promise and bode well for future work.

  10. Verification of Oncentra brachytherapy planning using independent calculation

    Science.gov (United States)

    Safian, N. A. M.; Abdullah, N. H.; Abdullah, R.; Chiang, C. S.

    2016-03-01

    This study was done to investigate the verification technique of treatment plan quality assurance for brachytherapy. It is aimed to verify the point doses in 192Ir high dose rate (HDR) brachytherapy between Oncentra Masterplan brachytherapy treatment planning system and independent calculation software at a region of rectum, bladder and prescription points for both pair ovoids and full catheter set ups. The Oncentra TPS output text files were automatically loaded into the verification programme that has been developed based on spreadsheets. The output consists of source coordinates, desired calculation point coordinates and the dwell time of a patient plan. The source strength and reference dates were entered into the programme and then dose point calculations were independently performed. The programme shows its results in a comparison of its calculated point doses with the corresponding Oncentra TPS outcome. From the total of 40 clinical cases that consisted of two fractions for 20 patients, the results that were given in term of percentage difference, it shows an agreement between TPS and independent calculation are in the range of 2%. This programme only takes a few minutes to be used is preferably recommended to be implemented as the verification technique in clinical brachytherapy dosimetry.

  11. Hypothesize and Bound: A Computational Focus of Attention Mechanism for Simultaneous 3D Shape Reconstruction, Pose Estimation and Classification from a Single 2D Image

    OpenAIRE

    Rother, Diego; Mahendran, Siddharth; Vidal, René

    2011-01-01

    This article presents a mathematical framework to simultaneously tackle the problems of 3D reconstruction, pose estimation and object classification, from a single 2D image. In sharp contrast with state of the art methods that rely primarily on 2D information and solve each of these three problems separately or iteratively, we propose a mathematical framework that incorporates prior "knowledge" about the 3D shapes of different object classes and solves these problems jointly and simultaneousl...

  12. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Directory of Open Access Journals (Sweden)

    Samia de Freitas Brandao

    2013-07-01

    Full Text Available Objective Comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and Methods Simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results Intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h-1.p-1.s, respectively, on the healthy tissue, on the balloon periphery and on the I 1 and I 2 tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h-1.p-1.s, respectively on the healthy tissue, on the target tumor and on the I 1 and I 2 infiltration zones. Conclusion Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones.

  13. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    International Nuclear Information System (INIS)

    Objective: comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and methods: simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results: intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h-1.p-1.s, respectively, on the healthy tissue, on the balloon periphery and on the /1 and /2 tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h-1.p-1.s, respectively on the healthy tissue, on the target tumor and on the /1 and /2 infiltration zones. Conclusion: Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones. (author)

  14. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Samia de Freitas, E-mail: samiabrandao@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Campos, Tarcisio Passos Ribeiro de [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2013-06-15

    Objective: comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and methods: simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results: intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively, on the healthy tissue, on the balloon periphery and on the /{sub 1} and /{sub 2} tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively on the healthy tissue, on the target tumor and on the /{sub 1} and /{sub 2} infiltration zones. Conclusion: Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones. (author)

  15. Patient effective dose from endovascular brachytherapy with 192Ir sources.

    Science.gov (United States)

    Perma, L; Bianchi, C; Nicolini, G; Novario, R; Tanzi, F; Conte, L

    2002-01-01

    The growing use of endovascular brachytherapy has been accompanied by the publication of a large number of studies in several fields, but few studies on patient dose have been found in the literature. Moreover, these studies were carried out on the basis of Monte Carlo simulation. The aim of the present study was to estimate the effective dose to the patient undergoing endovascular brachytherapy treatment with 112Ir sources, by means of experimental measurements. Two standard treatments were taken into account: an endovascular brachytherapy of the coronary artery corresponding to the activity x time product of 184 GBq.min and an endovascular brachytherapy of the renal artery (898 GBq.min). Experimental assessment was accomplished by thermoluminescence dosemeters positioned in more than 300 measurement points in a properly adapted Rqndo phantom. A method has been developed to estimate the mean organ doses for all tissues and organs concerned in order to calculate the effective dose associated with intravascular brachytherapy. The normalised organ doses resulting from cronary treatment were 2.4 x 10(-2) mSv.GBq(-1).min(-1) for lung, 0.9 x 10(-2) mSv.GBSq(-1).min(-1) for oesophagus and 0.48 x 10(-2) mS.GBq(-1).min(-1) for bone marrow. During brachytherapy of the renal artery, the corresponding normalised doses were 4.2 x 10(-2) mS.GBq(-1).min(-1) for colon, 7.8 x 10(-2) mSv.GBq(-1).min(-1) for stomach and 1.7 x 10(-2) mSv.GBq(-1).min(-1) for liver. Coronary treatment iJnvlled an efl'fective dose of (0.046 mSv.GBq(-1).min(-1), whereas the treatment of the renal artery resulted in an effective dose of 0.15 mSv.GBq(-1).min(-1); there were many similarities with data from former studies. Based on these results it can be concluded that the dose level of patients exposed during brachytherapy treatment is low.

  16. Brachytherapy dose measurements in heterogeneous tissues

    Energy Technology Data Exchange (ETDEWEB)

    Paiva F, G.; Luvizotto, J.; Salles C, T.; Guimaraes A, P. C.; Dalledone S, P. de T.; Yoriyaz, H. [Instituto de Pesquisas Energeticas e Nucleares / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Rubo, R., E-mail: gabrielpaivafonseca@gmail.com [Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, 05403-900 Sao Paulo (Brazil)

    2014-08-15

    Recently, Beau lieu et al. published an article providing guidance for Model-Based Dose Calculation Algorithms (MBDCAs), where tissue heterogeneity considerations are addressed. It is well-known that T G-43 formalism which considers only water medium is limited and significant dose differences have been found comparing both methodologies. The aim of the present work is to experimentally quantify dose values in heterogeneous medium using different dose measurement methods and techniques and compare them with those obtained with Monte Carlo simulations. Experiments have been performed using a Nucletron micro Selectron-Hdr Ir-192 brachytherapy source and a heterogeneous phantom composed by PMMA and different tissue equivalent cylinders like bone, lungs and muscle. Several dose measurements were obtained using tissue equivalent materials with height 1.8 cm and 4.3 cm positioned between the radiation source and the detectors. Radiochromic films, TLDs and MOSFET S have been used for the dose measurements. Film dosimetry has been performed using two methodologies: a) linearization for dose-response curve based on calibration curves to create a functional form that linearize s the dose response and b) 177 multichannel analysis dosimetry where the multiple color channels are analyzed allowing to address not only disturbances in the measurements caused by thickness variation in the film layer, but also, separate other external influences in the film response. All experiments have been simulated using the MCNP5 Monte Carlo radiation transport code. Comparison of experimental results are in good agreement with calculated dose values with differences less than 6% for almost all cases. (Author)

  17. Medical physics aspects of ophthalmic brachytherapy

    International Nuclear Information System (INIS)

    Intraocular melanoma is the most common primary malignancy of the eye. Radiation therapy using ophthalmic plaque has proved successful in the management of various ocular lesions. Although a few centres were using 90Sr/90Y plaques for shallow turtlours some years ago, eye plaque therapy was not a common practice in India. A revived interest in the use of eye plaque therapy and very high cost of imported sources has led to the development and production of 125I seed sources by the Radiopharmaceuticals Division, BARC. This report presents a brief description on the clinical, dosimetry and radiation safety aspects of 90Sr/90Y and 106Ru/106Rh beta ray and 125I gamma ray eye plaque applicators. This report has been divided in five Sections. Section I presents general introduction of ophthalmic brachytherapy including the structure of a human eye, types of ophthalmic plaques and characteristics of radioisotopes commonly used in such applications. A brief review of sources, applicators and dosimetry of 90Sr/90Y and 106Ru/106Rh beta and 125I gamma ophthalmic plaques are given in Section II and Section III, respectively. Section IV contains the single seed dosimetry data of BARC OcuProsta 125I seed as well as dosimetry data of typical eye plaques loaded with BARC OcuProsta 125I seed. Quality assurance and radiation safety aspects of these eye applicators are described in Section V. A proforma of the application required to be filled in by the user institution for obtaining regulatory consent to start eye plaque therapy has also been appended to this report. (author)

  18. Epimacular brachytherapy for wet AMD: current perspectives

    Directory of Open Access Journals (Sweden)

    Casaroli-Marano RP

    2014-08-01

    Full Text Available Ricardo P Casaroli-Marano,1,2 Socorro Alforja,1 Joan Giralt,1 Michel E Farah2 1Instituto Clínic de Oftalmología (Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; 2Department of Ophthalmology and Visual Sciences, Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil Abstract: Age-related macular degeneration (AMD is considered the most common cause of blindness in the over-60 age group in developed countries. There are basically two forms of presentation: geographic (dry or atrophic and wet (neovascular or exudative. Geographic atrophy accounts for approximately 85%–90% of ophthalmic frames and leads to a progressive degeneration of the retinal pigment epithelium and the photoreceptors. Wet AMD causes the highest percentage of central vision loss secondary to disease. This neovascular form involves an angiogenic process in which newly formed choroidal vessels invade the macular area. Today, intravitreal anti-angiogenic drugs attempt to block the angiogenic events and represent a major advance in the treatment of wet AMD. Currently, combination therapy for wet AMD includes different forms of radiation delivery. Epimacular brachytherapy (EMBT seems to be a useful approach to be associated with current anti-vascular endothelial growth factor agents, presenting an acceptable efficacy and safety profile. However, at the present stage of research, the results of the clinical trials carried out to date are insufficient to justify extending routine use of EMBT for the treatment of wet AMD. Keywords: macular degeneration, radiation, vascular endothelial growth factor, combined therapy, intravitreal therapy, vitrectomy

  19. Evaluation of expansion algorithm of measurement range suited for 3D shape measurement using two pitches of projected grating with light source-stepping method

    Science.gov (United States)

    Sakaguchi, Toshimasa; Fujigaki, Motoharu; Murata, Yorinobu

    2015-03-01

    Accurate and wide-range shape measurement method is required in industrial field. The same technique is possible to be used for a shape measurement of a human body for the garment industry. Compact 3D shape measurement equipment is also required for embedding in the inspection system. A shape measurement by a phase shifting method can measure the shape with high spatial resolution because the coordinates can be obtained pixel by pixel. A key-device to develop compact equipment is a grating projector. Authors developed a linear LED projector and proposed a light source stepping method (LSSM) using the linear LED projector. The shape measurement euipment can be produced with low-cost and compact without any phase-shifting mechanical systems by using this method. Also it enables us to measure 3D shape in very short time by switching the light sources quickly. A phase unwrapping method is necessary to widen the measurement range with constant accuracy for phase shifting method. A general phase unwrapping method with difference grating pitches is often used. It is one of a simple phase unwrapping method. It is, however, difficult to apply the conventional phase unwrapping algorithm to the LSSM. Authors, therefore, developed an expansion unwrapping algorithm for the LSSM. In this paper, an expansion algorithm of measurement range suited for 3D shape measurement using two pitches of projected grating with the LSSM was evaluated.

  20. Multi-view stereophotogrammetry for post-mastectomy breast reconstruction.

    Science.gov (United States)

    Ju, Xiangyang; Henseler, Helga; Peng, Matthew Jian-Qiao; Khambay, Balvinder S; Ray, Arup K; Ayoub, Ashraf F

    2016-03-01

    A multi-view three-dimensional stereophotogrammetry system was developed to capture 3D shape of breasts for breast cancer patients. The patients had received immediate unilateral breast reconstruction after mastectomy by the extended latissimus dorsi flap and without contralateral surgery. In order to capture the whole breast shape including the inframammary fold, the patients were introduced to the imaging room and leaned over the imaging rig to open up the inframammary fold and to expose the entire area of each breast. The imaging system consisted of eight high-resolution ([Formula: see text] pixels) digital cameras and four flash units. The cameras were arranged in four stereo pairs from four different view angles to cover the whole surface of the breasts. The system calibration was carried out ahead of every capture session, and the stereo images were matched to generate four range images to be integrated using an elastic model proposed. A watertight breast mesh model was reconstructed to measure the volume of the breast captured. The accuracy of using the developed multi-view stereophotogrammetry system for breast volume measurement was 11.12cc with SEM 7.74cc, comparing to the measurements of the water displacement method. It was concluded that the 3D stereophotogrammetry image system developed was more reliable than the method of water displacement. PMID:26133282

  1. External beam irradiation plus 192Ir implant after breast-preserving surgery in women with early breast cancer

    International Nuclear Information System (INIS)

    Purpose: To provide more information for the clinician and to analyze the impact of the boost with brachytherapy on the local disease-free survival (LDFS), disease-free survival (DFS), specific overall survival (OS), and cosmesis, a retrospective study of external radiation therapy and 192Ir implantation in early breast cancer at Institut Catala d'Oncologia has been undertaken. Patients and Methods: From 1986 to 1996, 530 patients were selected for this study with a median follow-up period of 39.5 months (range, 10-115 months). External radiation therapy (combined with brachytherapy) was administered postoperatively to the breast in all patients. Mean given dose was 48.7 Gy (range, 42-52 Gy) with external radiation therapy to the breast, and 16.8 Gy (range, 10-27 Gy) was the mean dose with brachytherapy. Variables have been tested for cosmesis. Univariate and multivariate analysis have also been carried out. Results: Mean age of the patients was 54 years (range, 28-81 years). Stages were distributed as follows: 350 patients (66%) in Stage I, 173 in Stage II (32.8%), and 7 in Stage III (1.1%). Pathologic distribution was 445 patients with infiltrating ductal carcinoma (84%), 20 patients with infiltrating lobular carcinoma (4%), and 65 patients (12%) of a miscellaneous group. OS for the entire group was 89.4% and 85.9% at 5 and 7 years respectively. Probability of DFS was 81.7% and 70.1% at 5 and 7 years. The LDFS was 94.9% and 91.7% at 5 and 7 years. The MFS probability was 85.5% and 76.9% at 5 and 7 years, respectively. Univariate analysis demonstrated that age (older than 52 years), premenopausal status, moderate and high histologic grades (Grades II-III), and presence of intraductal comedocarcinoma were prognostic factors for local relapse. Multivariate analysis for local disease-free survival demonstrated that only perineural or muscular infiltration remain as prognostic factors. Tumor dose bed of 70 Gy or higher had a negative impact in breast subcutaneous

  2. Breast Gangrene

    Directory of Open Access Journals (Sweden)

    Husasin Irfan

    2011-08-01

    Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

  3. Breast lift

    Science.gov (United States)

    ... One breast that is larger than the other (asymmetry of the breasts) Uneven position of the nipples ... to achieve this important distinction for online health information and services. Learn more about A.D.A. ...

  4. Breast cancer

    Science.gov (United States)

    ... perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  5. Breast; Sein

    Energy Technology Data Exchange (ETDEWEB)

    Bourgier, C.; Garbay, J.R.; Pichenot, C.; Uzan, C.; Delaloge, S.; Andre, F.; Spielmann, M.; Arriagada, R.; Lefkopoulos, D.; Marsigli, H.; Bondiau, P.Y.; Courdi, A.; Lallemand, M.; Peyrotte, I.; Chapellier, C.; Ferrero, J.M.; Chiovati, P.; Baldissera, A.; Frezza, G.; Vicenzi, L.; Palombarini, M.; Martelli, O.; Degli Esposti, C.; Donini, E.; Romagna CDR, E.; Romagna CDF, E.; Benmensour, M.; Bouchbika, Z.; Benchakroun, N.; Jouhadi, H.; Tawfiq, N.; Sahraoui, S.; Benider, A.; Gilliot, O.; Achard, J.L.; Auvray, H.; Toledano, I.; Bourry, N.; Kwiatkowski, F.; Verrelle, P.; Lapeyre, M.; Tebra Mrad, S.; Braham, I.; Chaouache, K.; Bouaouin, N.; Ghorbel, L.; Siala, W.; Sallemi, T.; Guermazi, M.; Frikha, M.; Daou, J.; El Omrani, A.; Chekrine, T.; Mangoni, M.; Castaing, M.; Folino, E.; Livi, L.; Dunant, A.; Mathieu, M.C.; Bitib, G.P.; Arriagada, R.; Marsigli, H

    2007-11-15

    Nine articles treat the question of breast cancer. Three-dimensional conformal accelerated partial breast irradiation: dosimetric feasibility study; test of dose escalation neo-adjuvant radiotherapy focused by Cyberknife in breast cancer; Three dimensional conformal partial irradiation with the technique by the Irma protocol ( dummy run multi centers of the Emilie Romagne area Italy); Contribution of the neo-adjuvant chemotherapy in the treatment of locally evolved cancers of the uterine cervix; Post operative radiotherapy of breast cancers (N0, pN) after neo-adjuvant chemotherapy. Radiotherapy of one or two mammary glands and ganglions areas,The breast cancer at man; breast conservative treatment; breast cancers without histological ganglions invasion; the breast cancer at 70 years old and more women; borderline mammary phyllod tumors and malignant. (N.C.)

  6. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Murali V

    2010-01-01

    Full Text Available Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT and intensity modulated radiotherapy (IMRT are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR, namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  7. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer.

    Science.gov (United States)

    Murali, V; Kurup, P G G; Mahadev, P; Mahalakshmi, S

    2010-04-01

    Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR) with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR), namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  8. Clinical outcome and cosmetic results of conservative surgery plus radiation therapy in early stage breast cancer patients

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical outcome and cosmetic results in early stage breast cancer patients treated with conservative surgery plus radiation therapy. Methods: From May 1995 to December 2002, 109 such patients were so treated. The post-operative radiotherapy consisted of whole-breast 6 MV linear accelerator irradiation with two tangential half-fields to a total dose of 45-52 Gy (mean 48.6 Gy), followed by a boost irradiation to the tumor bed. Among them, 79 patients received 10-12 Gy (DB) boost by interstitial implantation brachytherapy (192Ir HDR, Nucletron), with single plane implantation for T1 and double plane implantation for T2 tumor. Thirty patients received 15 Gy boost by electron beam. Adjuvant/concurrent chemotherapy (CMF or CEF) and hormonotherapy were also used according to the patients' clinical characteristics. The cosmetic results were scored by both the doctor and the patients. Results: The overall actuarial 5-year survival was 93.8%, with local recurrence of 6.5%. No radiation-induced ulcer was observed in the breast except for acute inflammation at skin pinholes in 5 patients treated by interstitial implant brachytherapy. Among the 75 patients who had had breast examination, cosmetic result scored as good by patient and doctor were 81% and 87%, respectively. The good rate assessed by doctor in brachytherapy boost group and electron beam boost group were 81.2% (39/48) and 85.2% (23/27), There was no significant difference between these two boost techniques (P>0.05). Conclusions: Tumor bed boost irradiation by either brachytherapy or electron beam technique can provide satisfactory local control in early breast cancer treated with conservative surgery plus radiotherapy without increasing the side effects. There is no significant difference in cosmetic result between these two boost techniques. (authors)

  9. Accelerated partial breast irradiation:advances and controversies

    Institute of Scientific and Technical Information of China (English)

    Mani Akhtari; Bin S Teh

    2016-01-01

    The management of localized breast cancer has changed dramatically over the past three to four decades. Breast-conserving therapy, which involved lumpectomy followed by adjuvant irradiation, is now widely considered the standard of care in women with early-stage breast cancer. Accelerated partial breast irradiation (APBI), which involves focal irradiation of the lumpectomy cavity over a short period of time, has developed over the past two decades as an alternative to whole breast irradiation (WBI). Multiple APBI modalities have been developed including brachytherapy, external beam irradiation, and intraoperative irradiation. These new techniques have provided early-stage breast can-cer patients with shorter treatment duration and more focused irradiation, delivering very high biological doses to the region at a high risk of failures over a much shorter treatment course as compared with conventional radiotherapy. However, the advantages of APBI over conventional radiotherapy are controversial, including a higher risk of compli-cations reported in retrospective literature and shorter follow-up duration in the intraoperative APBI trials. Neverthe-less, APBI presents a valuable alternative to WBI for a selected population of women with early-stage breast cancer.

  10. 3T MR-Guided Brachytherapy for Gynecologic Malignancies

    CERN Document Server

    Kapur, Tina; Damato, Antonio; Schmidt, Ehud J; Viswanathan, Akila N; 10.1016/j.mri.2012.06.003

    2013-01-01

    Gynecologic malignancies are a leading cause of death in women worldwide. Standard treatment for many primary and recurrent gynecologic cancer cases includes a combination of external beam radiation, followed by brachytherapy. Magnetic Resonance Imaging (MRI) is benefitial in diagnostic evaluation, in mapping the tumor location to tailor radiation dose, and in monitoring the tumor response to treatment. Initial studies of MR-guidance in gynecologic brachtherapy demonstrate the ability to optimize tumor coverage and reduce radiation dose to normal tissues, resulting in improved outcomes for patients. In this article we describe a methodology to aid applicator placement and treatment planning for 3 Tesla (3T) MR-guided brachytherapy that was developed specifically for gynecologic cancers. This has been used in 18 cases to date in the Advanced Multimodality Image Guided Operating suite at Brigham and Women's Hospital. It is comprised of state of the art methods for MR imaging, image analysis, and treatment plann...

  11. Brachytherapy for prostate cancer: Comparative characteristics of procedures

    Directory of Open Access Journals (Sweden)

    S. V. Kanaev

    2015-01-01

    Full Text Available The introduction of interstitial radiation sources is the «youngest» of the radical method of treatment of patients with prostate cancer (PC. The high level of efficiency comparable to prostatectomy at a significantly lower rate of complications causes rapid growth of clinical use of brachytherapy (BT. Depending on the radiation source and the mode of administration into the prostate gland are two types BT – high-dose rate (temporary (HDR-BT and low-dose rate (permanent (LDR-BT brachytherapy. At the heart of these two methods are based on a single principle of direct effect of the quantum gamma radiation on the area of interest. However, the differences between the characteristics of isotopes used and technical aspects of the techniques cause the difference in performance and complication rates for expression HDR-BT and LDR-BT.

  12. Iodine-125 brachytherapy for brain tumours - a review

    International Nuclear Information System (INIS)

    Iodine-125 brachytherapy has been applied to brain tumours since 1979. Even though the physical and biological characteristics make these implants particularly attractive for minimal invasive treatment, the place for stereotactic brachytherapy is still poorly defined. An extensive review of the literature has been performed, especially concerning indications, results and complications. Iodine-125 seeds have been implanted in astrocytomas I-III, glioblastomas, metastases and several other tumour entities. Outcome data given in the literature are summarized. Complications are rare in carefully selected patients. All in all, for highly selected patients with newly diagnosed or recurrent primary or metastatic tumours, this method provides encouraging survival rates with relatively low complication rates and a good quality of life

  13. IMAGE-GUIDED RADIOTHERAPY AND -BRACHYTHERAPY FOR CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Suresh eDutta

    2015-03-01

    Full Text Available Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT, and 2-dimensional intracavitary brachytherapy.Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron emission tomography (PET and magnetic resonance imaging (MRI has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT, allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

  14. Distortions induced by radioactive seeds into interstitial brachytherapy dose distributions.

    Science.gov (United States)

    Zhou, Chuanyu; Inanc, Feyzi; Modrick, Joseph M

    2004-12-01

    In a previous article, we presented development and verification of an integral transport equation-based deterministic algorithm for computing three-dimensional brachytherapy dose distributions. Recently, we have included fluorescence radiation physics and parallel computation to the standing algorithms so that we can compute dose distributions for a large set of seeds without resorting to the superposition methods. The introduction of parallel computing capability provided a means to compute the dose distribution for multiple seeds in a simultaneous manner. This provided a way to study strong heterogeneity and shadow effects induced by the presence of multiple seeds in an interstitial brachytherapy implant. This article presents the algorithm for computing fluorescence radiation, algorithm for parallel computing, and display results for an 81-seed implant that has a perfect and imperfect lattice. The dosimetry data for a single model 6711 seeds is presented for verification and heterogeneity factor computations using simultaneous and superposition techniques are presented.

  15. Dose volume analysis in brachytherapy and stereotactic radiosurgery

    CERN Document Server

    Tozer-Loft, S M

    2000-01-01

    compared with a range of figures of merit which express different aspects of the quality of each dose distributions. The results are analysed in an attempt to answer the question: What are the important features of the dose distribution (conformality, uniformity, etc) which show a definite relationship with the outcome of the treatment? Initial results show positively that, when Gamma Knife radiosurgery is used to treat acoustic neuroma, some measures of conformality seem to have a surprising, but significant association with outcome. A brief introduction to three branches of radiotherapy is given: interstitial brachytherapy, external beam megavoltage radiotherapy, and stereotactic radiosurgery. The current interest in issues around conformity, uniformity and optimisation is explained in the light of technical developments in these fields. A novel method of displaying dose-volume information, which mathematically suppresses the inverse-square law, as first suggested by L.L. Anderson for use in brachytherapy i...

  16. Cataract extraction after brachytherapy for malignant melanoma of the choroid

    Energy Technology Data Exchange (ETDEWEB)

    Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G. (Texas Retina Associates, Dallas (USA))

    1991-05-01

    Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.

  17. Image-guided radiotherapy and -brachytherapy for cervical cancer.

    Science.gov (United States)

    Dutta, Suresh; Nguyen, Nam Phong; Vock, Jacqueline; Kerr, Christine; Godinez, Juan; Bose, Satya; Jang, Siyoung; Chi, Alexander; Almeida, Fabio; Woods, William; Desai, Anand; David, Rick; Karlsson, Ulf Lennart; Altdorfer, Gabor

    2015-01-01

    Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer. PMID:25853092

  18. Breast Cancer

    Science.gov (United States)

    Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks ... the risk. Women who have family members with breast or ovarian cancer may wish to be tested ...

  19. Ultrasound - Breast

    Science.gov (United States)

    ... Even so, mammograms do not detect all breast cancers. Some breast lesions and abnormalities are not visible or are difficult to interpret on mammograms. In breasts that are dense, meaning there is a lot ... and less fat, many cancers can be hard to see on mammography. Many ...

  20. The use of nomograms in LDR-HDR prostate brachytherapy

    OpenAIRE

    Pujades, Ma Carmen; Camacho, Cristina; Perez-Calatayud, Jose; Richart, José; Gimeno, Jose; Lliso, Françoise; Carmona, Vicente; Ballester, Facundo; Crispín, Vicente; Rodríguez, Silvia; Tormo, Alejandro

    2011-01-01

    Purpose The common use of nomograms in Low Dose Rate (LDR) permanent prostate brachytherapy (BT) allows to estimate the number of seeds required for an implant. Independent dosimetry verification is recommended for each clinical dosimetry in BT. Also, nomograms can be useful for dose calculation quality assurance and they could be adapted to High Dose Rate (HDR). This work sets nomograms for LDR and HDR prostate-BT implants, which are applied to three different institutions that use different...

  1. Brachytherapy in Lip Carcinoma: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Guibert, Mireille, E-mail: mireilleguib@voila.fr [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); David, Isabelle [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Vergez, Sebastien [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); Rives, Michel [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Filleron, Thomas [Department of Epidemiology, Claudius Regaud Institut, Toulouse (France); Bonnet, Jacques; Delannes, Martine [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France)

    2011-12-01

    Purpose: The aim of this study was to evaluate the effectiveness of low-dose-rate brachytherapy for local control and relapse-free survival in squamous cell and basal cell carcinomas of the lips. We compared two groups: one with tumors on the skin and the other with tumors on the lip. Patients and methods: All patients had been treated at Claudius Regaud Cancer Centre from 1990 to 2008 for squamous cell or basal cell carcinoma. Low-dose-rate brachytherapy was performed with iridium 192 wires according to the Paris system rules. On average, the dose delivered was 65 Gy. Results: 172 consecutive patients were included in our study; 69 had skin carcinoma (squamous cell or basal cell), and 92 had squamous cell mucosal carcinoma. The average follow-up time was 5.4 years. In the skin cancer group, there were five local recurrences and one lymph node recurrence. In the mucosal cancer group, there were ten local recurrences and five lymph node recurrences. The 8-year relapse-free survival for the entire population was 80%. The 8-year relapse-free survival was 85% for skin carcinoma 75% for mucosal carcinoma, with no significant difference between groups. The functional results were satisfactory for 99% of patients, and the cosmetic results were satisfactory for 92%. Maximal toxicity observed was Grade 2. Conclusions: Low-dose-rate brachytherapy can be used to treat lip carcinomas at Stages T1 and T2 as the only treatment with excellent results for local control and relapse-free survival. The benefits of brachytherapy are also cosmetic and functional, with 91% of patients having no side effects.

  2. Salvage robot-assisted radical prostatectomy after brachytherapy: our experience

    OpenAIRE

    A. V. Govorov; A. O. Vasilyev; E. A. Prilepskaya; K. B. Kоlоntaryov; D. Yu. Pushkar

    2014-01-01

    In case of recurrence of prostate cancer after radiation therapy patient may be offered salvage radical prostatectomy (both open and laparoscopic/robotic), hormone therapy, and a number of alternative techniques such as salvage cryoablation, HIFU-therapy and brachytherapy. Results of monitoring of patients for 10 years after salvage treatment of prostate cancer are known only after salvage prostatectomy. Technically radical prostatectomy after radiation therapy is associated with a large numb...

  3. Which modality for prostate brachytherapy; Quelle modalite de curietherapie prostatique?

    Energy Technology Data Exchange (ETDEWEB)

    Bossi, A. [Departement de radiotherapie, institut Gustave-Roussy, 94 - Villejuif (France)

    2010-10-15

    Brachytherapy techniques by permanent implant of radioactive sources or by temporary high-dose-rate (HDR) fractions are nowadays extensively used for the treatment of prostatic carcinoma. Long-term results (at 20 years) concerning large amount of patients have been published by major centers confirming both in terms of efficacy and toxicities that permanent implant of radioactive iodine-125 seeds yields at least the same good results of surgery and of external beam irradiation when proposed to patients affected by low-risk disease. For intermediate to high-risk tumors, HDR temporary implants are proposed as a boost for dose escalation. For both techniques, several topics still need to be clarified dealing with a recent enlargement of indications (HDR alone for low-risk, iodine-125 seeds boost for intermediate-high-risk cancers), or with technical aspects (loose seeds versus linked ones, number of fractions and dose for HDR protocols), while dosimetric issues have only recently been addressed by cooperatives groups. Last but not least, there is a real need to address and clearly characterize the correct definition of biochemical disease control both for iodine permanent implant and for HDR implant. New challenges are facing the prostate-brachytherapy community in the near future: local relapse after external beam radiotherapy are currently managed by several salvage treatments (prostatectomy, cryo, high intensity focused ultrasounds [HIFU]) but the role of reirradiation by brachytherapy is also actively investigated. Focal therapy has gained considerable interest in the last 5 years aiming at treating only the area of cancer foci inside the prostate and preserving nearby healthy tissues. Encouraging results have been obtained with the so-called 'minimally invasive' approaches and both permanent seed implantation and HDR brachytherapy techniques may be worthwhile testing in this setting because of their capability of exactly sculpting the dose inside the

  4. HDR neutron brachytherapy for cervix carcinoma in Lithuania

    International Nuclear Information System (INIS)

    Between 1988 and December 1995, a total of 285 patients with stage I-17, with stage II-157, with stage III-104 and stage IV-7 carcinoma of the cervix were treated with a combination of external beam radiation or surgery and HDR brachytherapy. The dose prescription for HDR brachytherapy was point A. The goals of combined radiation therapy were to deliver a total dose of 60.5-68.5 Gy to point A and 53-58 Gy to the pelvic lymph nodes (point B) or 14 Gy-eq to point A in case of preoperative brachytherapy. Dosimetric planning was performed in Gray- equivalents by the use of PC-based computer programme. Relative biological effectiveness of the Cf-252 neutrons was physical gamma and neutron dose rate dependent. Most of the insertions were performed weekly when dose per fraction was 8-10 Gy or 2 insertions were done in one week at lower fractions. The median follow-up for the various stages of disease ranged from 0.5 to 6.5 year. Treatment results, acute and late toxicity will be discussed

  5. Stereolithographic modelling as an aid to orbital brachytherapy

    International Nuclear Information System (INIS)

    Purpose: This paper describes the technique of stereolithographic biomodelling and its application to a patient who was treated using orbital brachytherapy. Methods and Materials: The process uses a moving laser beam, directed by a computer, to draw cross-sections of the model onto the surface of photo-curable liquid plastic. Using a stereolithographic apparatus (SLA), solid or surface data is sliced by software into very thin cross-sections. A helium cadmium (HeCd) laser then generates a small intense spot of ultraviolet (UV) light that is moved across the top of a vat of liquid photo monomer by a computerised optical scanning system. The laser polymerises the liquid into a solid where it touches, precisely printing each cross-section. A vertical elevator lowers the newly formed layer, and a recoating and levelling system establishes the next layer's thickness. Successive cross-sections (0.25 mm thick), each one adhering to the one below, are built one on top of the other, to form the part from the bottom up. The biomodel allowed the implant to be planned in detail prior to the surgery. The accurate placement of brachytherapy catheters was assured, and the dosimetry could be determined and optimised prior to the definitive procedure. Conclusions: Stereolithography is a useful technique in the area of orbital brachytherapy. It allows the implant to to be carried out with greater accuracy and confidence. For the patient, it minimises the risk to the eye and provides them with a greater understanding of the procedure

  6. Invited review, recent developments in brachytherapy source dosimetry

    International Nuclear Information System (INIS)

    Application of radioactive isotopes is the treatment of choice around the globe for many cancer sites. In this technique, the accuracy of the radiation delivery is highly dependent on the accuracy of radiation dosimetry around individual brachytherapy sources. Moreover, in order to have compatible clinical results, an identical method of source dosimetry must be employed across the world. This problem has been recently addressed by task group 43 from the American Association of Medical Physics with a protocol for dosimetric characterization of brachytherapy sources. This new protocol has been further updated using published data from international sources, by a new Task Group from the American Association of Medical Physics. This has resulted in an updated protocol known as TG43U1 that has been published in March 2004 issue of Medical Physics. The goal of this presentation is to review the original Task Group 43 protocol and associated algorithms for brachytherapy source dosimetry. In addition, the shortcomings of the original protocol that has been resolved in the updated recommendation will be highlighted. I am sure that this is not the end of the line and more work is needed to complete this task. I invite the scientists to join this task and complete the project, with the hope of much better clinical results for cancer patients

  7. Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

    International Nuclear Information System (INIS)

    Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium (192Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.)

  8. Criteria for the evaluation of brachytherapy for malignant brain tumors

    International Nuclear Information System (INIS)

    Thirty two patients with recurrent or unresectable malignant brain tumors were treated by interstitial brachytherapy with Ir-192 seeds. After-loading catheters were stereotactically implanted under local anesthesia using a Brown-Roberts-wells (BRW) CT guided stereotactic system. The response to the therapy was followed by serial CT and MRI scans and evaluated three months after implantation by the standard criteria for the evaluation of chemotherapy because there is no set of criteria available for radiation therapy. After interstitial brachytherapy, the most commonly observed CT and MRI finding was central low attenuation, that is, the central enhanced tumor replaced by the radiation necrosis. Three months after the treatment, these findings were observed in 23 patients out of 32 patients on the CT and MRI. We observed complete response (CR) in 6 of 32 patients, partial response (PR) in 9, no change (NC) in 7 and progressive disease (PD) in 9. In 6 CR patients, the tumor disappeared by three months after treatment. In 15 patients of 17 NC and PD patients, the central low attenuation was observed and their prognosis was better than those without central necrosis. The results suggested the standard criteria for the evaluation of chemotherapy, such as CR, PR etc, cannot be applicable to our series because the tumor mass replaced by necrotic tissue and remained as a mass lesion in most cases and new criteria in consideration of this low attenuation on CT and MRI will be needed for the evaluation of brachytherapy on neuroimagings. (author)

  9. Tomosynthesis-based localization of radioactive seeds in prostate brachytherapy

    International Nuclear Information System (INIS)

    Accurately assessing the quality of prostate brachytherapy intraoperatively would be valuable for improved clinical outcome by ensuring the delivery of a prescribed tumoricidal radiation dose to the entire prostate gland. One necessary step towards this goal is the robust and rapid localization of implanted seeds. Several methods have been developed to locate seeds from x-ray projection images, but they fail to detect completely-overlapping seeds, thus necessitating manual intervention. To overcome this limitation, we have developed a new method where (1) a three-dimensional volume is reconstructed from x-ray projection images using a brachytherapy-specific tomosynthesis reconstruction algorithm with built-in blur compensation and (2) the seeds are located in this reconstructed volume. In contrast to other projection-based methods, our method can detect completely overlapping seeds. Our simulation results indicate that we can locate all implanted seeds in the prostate using a tomosynthesis angle of 30 deg. and seven projection images. The mean localization error is 1.27 mm for a case with 100 seeds. We have also tested our method using a prostate phantom with 61 implanted seeds and succeeded in locating all seeds automatically. We believe this new method can be useful for the intraoperative quality assessment of prostate brachytherapy in the future

  10. Panoptes: Calibration of a dosimetry system for eye brachytherapy

    International Nuclear Information System (INIS)

    Intraocular cancer is a serious threat to the lives of those that suffer from it. Dosimetry for eye brachytherapy presents a significant challenge due to the inherently steep dose gradients that are needed to treat such small tumours in close proximity to sensitive normal structures. This issue is addressed by providing much needed quality assurance to eye brachytherapy, a novel volumetric dosimetry system, called PANOPTES was developed. This study focuses on the preliminary characterisation and calibration of the system. Using ion beam facilities, the custom, pixelated silicon detector of PANOPTES was shown to have good charge collection uniformity and a well defined sensitive volume. Flat-field calibration was conducted on the device using a 250 kVp orthovoltage beam. Finally, the detector and phantom were simulated with Monte Carlo in Geant4, to create water equivalent dose correction factors for each pixel across a range of angles. - Highlights: • Volumetric detector system produced for plaque brachytherapy. • Orthovoltage, flat-field calibration performed for detector pixels. • Monte Carlo simulation showed mostly little angular deviation across all angles. • Ion beam induced charge collection showed pixels uniform and fully depleted

  11. A compilation of current regulations, standards and guidelines in remote afterloading brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tortorelli, J.P.; Simion, G.P.; Kozlowski, S.D. [Idaho National Engineering Lab., Idaho Falls, ID (United States)

    1994-10-01

    Over a dozen government and professional organizations in the United States and Europe have issued regulations and guidance concerning quality management in the practice of remote afterloading brachytherapy. Information from the publications of these organizations was collected and collated for this report. This report provides the brachytherapy licensee access to a broad field of quality management information in a single, topically organized document.

  12. 10 CFR 35.67 - Requirements for possession of sealed sources and brachytherapy sources.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Requirements for possession of sealed sources and... MATERIAL General Technical Requirements § 35.67 Requirements for possession of sealed sources and brachytherapy sources. (a) A licensee in possession of any sealed source or brachytherapy source shall...

  13. Postoperative high-dose-rate brachytherapy in the prevention of keloids

    NARCIS (Netherlands)

    Veen, Ronald E.; Kal, Henk B.

    2007-01-01

    Background: The aim of this study is to show the efficiency of keloidectomy and postoperative interstitial high-dose-rate (HDR) brachytherapy in the prevention of keloids. Methods and Materials: Between 1998 and 2004, 35 patients with 54 keloids were treated postoperatively with HDR brachytherapy. T

  14. Fast patient-specific Monte Carlo brachytherapy dose calculations via the correlated sampling variance reduction technique

    Energy Technology Data Exchange (ETDEWEB)

    Sampson, Andrew; Le Yi; Williamson, Jeffrey F. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)

    2012-02-15

    Purpose: To demonstrate potential of correlated sampling Monte Carlo (CMC) simulation to improve the calculation efficiency for permanent seed brachytherapy (PSB) implants without loss of accuracy. Methods: CMC was implemented within an in-house MC code family (PTRAN) and used to compute 3D dose distributions for two patient cases: a clinical PSB postimplant prostate CT imaging study and a simulated post lumpectomy breast PSB implant planned on a screening dedicated breast cone-beam CT patient exam. CMC tallies the dose difference, {Delta}D, between highly correlated histories in homogeneous and heterogeneous geometries. The heterogeneous geometry histories were derived from photon collisions sampled in a geometrically identical but purely homogeneous medium geometry, by altering their particle weights to correct for bias. The prostate case consisted of 78 Model-6711 {sup 125}I seeds. The breast case consisted of 87 Model-200 {sup 103}Pd seeds embedded around a simulated lumpectomy cavity. Systematic and random errors in CMC were unfolded using low-uncertainty uncorrelated MC (UMC) as the benchmark. CMC efficiency gains, relative to UMC, were computed for all voxels, and the mean was classified in regions that received minimum doses greater than 20%, 50%, and 90% of D{sub 90}, as well as for various anatomical regions. Results: Systematic errors in CMC relative to UMC were less than 0.6% for 99% of the voxels and 0.04% for 100% of the voxels for the prostate and breast cases, respectively. For a 1 x 1 x 1 mm{sup 3} dose grid, efficiency gains were realized in all structures with 38.1- and 59.8-fold average gains within the prostate and breast clinical target volumes (CTVs), respectively. Greater than 99% of the voxels within the prostate and breast CTVs experienced an efficiency gain. Additionally, it was shown that efficiency losses were confined to low dose regions while the largest gains were located where little difference exists between the homogeneous and

  15. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy

    Directory of Open Access Journals (Sweden)

    Yasuhiro Yamada

    2015-01-01

    Full Text Available External beam radiotherapy (EBRT is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU] have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatment for low-risk and selected intermediate-risk prostate tumors. However, few studies have examined the use of brachytherapy to treat post-EBRT recurrent prostate cancer. The purpose of this paper is to analyze the current state of our knowledge about the effects of salvage brachytherapy in patients who develop locally recurrent prostate cancer after primary EBRT. This article also introduces our novel permanent brachytherapy salvage method.

  16. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy.

    Science.gov (United States)

    Yamada, Yasuhiro; Okihara, Koji; Iwata, Tsuyoshi; Masui, Koji; Kamoi, Kazumi; Yamada, Kei; Miki, Tsuneharu

    2015-01-01

    External beam radiotherapy (EBRT) is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU]) have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatment for low-risk and selected intermediate-risk prostate tumors. However, few studies have examined the use of brachytherapy to treat post-EBRT recurrent prostate cancer. The purpose of this paper is to analyze the current state of our knowledge about the effects of salvage brachytherapy in patients who develop locally recurrent prostate cancer after primary EBRT. This article also introduces our novel permanent brachytherapy salvage method. PMID:26112477

  17. 3DMADMAC|SPECTRAL: Hardware and Software Solution for Integrated Digitization of 3D Shape, Multispectral Color and BRDF for Cultural Heritage Documentation

    Directory of Open Access Journals (Sweden)

    Robert Sitnik

    2011-12-01

    Full Text Available In this article a new 3D measurement system along with the study on 3D printing technology is presented from the perspective of quality of reproduction. In the first part of the paper the 3DMADMAC|SPECTRAL system which integrates 3D shape with additional color and angular reflectance measurement capabilities is presented (see Figure 1. The shape measurement system is based on structured light projection with the use of a DLP projector. The 3D shape measurement method is based on sinusoidal fringes and Gray codes projection. Color is being measured using multispectral images with a set of interference filters to separate spectral channels. Additionally the set up includes an array of compact light sources for measuring angular reflectance based on image analysis and 3D data processing. All three components of the integrated system use the same greyscale camera as a detector. The purpose of the system is to obtain complete information about shape, color and reflectance characteristic of mea sured surface, especially for cultural heritage objects - in order to create high quality 3D documentation. In the second part of the paper the 3D printing technology will be tested on real measured cultural heritage objects. Tests allow to assess measurement and color accuracy of reproduction by selected 3D printing technology and shed some light on how current 3D printing technology can be applied into cultural heritage.

  18. Doses to internal organs for various breast radiation techniques - implications on the risk of secondary cancers and cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Keller Brian M

    2011-01-01

    Full Text Available Abstract Background Breast cancers are more frequently diagnosed at an early stage and currently have improved long term outcomes. Late normal tissue complications induced by adjuvant radiotherapy like secondary cancers or cardiomyopathy must now be avoided at all cost. Several new breast radiotherapy techniques have been developed and this work aims at comparing the scatter doses of internal organs for those techniques. Methods A CT-scan of a typical early stage left breast cancer patient was used to describe a realistic anthropomorphic phantom in the MCNP Monte Carlo code. Dose tally detectors were placed in breasts, the heart, the ipsilateral lung, and the spleen. Five irradiation techniques were simulated: whole breast radiotherapy 50 Gy in 25 fractions using physical wedge or breast IMRT, 3D-CRT partial breast radiotherapy 38.5 Gy in 10 fractions, HDR brachytherapy delivering 34 Gy in 10 treatments, or Permanent Breast 103Pd Seed Implant delivering 90 Gy. Results For external beam radiotherapy the wedge compensation technique yielded the largest doses to internal organs like the spleen or the heart, respectively 2,300 mSv and 2.7 Gy. Smaller scatter dose are induced using breast IMRT, respectively 810 mSv and 1.1 Gy, or 3D-CRT partial breast irradiation, respectively 130 mSv and 0.7 Gy. Dose to the lung is also smaller for IMRT and 3D-CRT compared to the wedge technique. For multicatheter HDR brachytherapy a large dose is delivered to the heart, 3.6 Gy, the spleen receives 1,171 mSv and the lung receives 2,471 mSv. These values are 44% higher in case of a balloon catheter. In contrast, breast seeds implant is associated with low dose to most internal organs. Conclusions The present data support the use of breast IMRT or virtual wedge technique instead of physical wedges for whole breast radiotherapy. Regarding partial breast irradiation techniques, low energy source brachytherapy and external beam 3D-CRT appear safer than 192Ir HDR

  19. Dosimetry Modeling for Focal Low-Dose-Rate Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: Focal brachytherapy targeted to an individual lesion(s) within the prostate may reduce side effects experienced with whole-gland brachytherapy. The outcomes of a consensus meeting on focal prostate brachytherapy were used to investigate optimal dosimetry of focal low-dose-rate (LDR) prostate brachytherapy targeted using multiparametric magnetic resonance imaging (mp-MRI) and transperineal template prostate mapping (TPM) biopsy, including the effects of random and systematic seed displacements and interseed attenuation (ISA). Methods and Materials: Nine patients were selected according to clinical characteristics and concordance of TPM and mp-MRI. Retrospectively, 3 treatment plans were analyzed for each case: whole-gland (WG), hemi-gland (hemi), and ultra-focal (UF) plans, with 145-Gy prescription dose and identical dose constraints for each plan. Plan robustness to seed displacement and ISA were assessed using Monte Carlo simulations. Results: WG plans used a mean 28 needles and 81 seeds, hemi plans used 17 needles and 56 seeds, and UF plans used 12 needles and 25 seeds. Mean D90 (minimum dose received by 90% of the target) and V100 (percentage of the target that receives 100% dose) values were 181.3 Gy and 99.8% for the prostate in WG plans, 195.7 Gy and 97.8% for the hemi-prostate in hemi plans, and 218.3 Gy and 99.8% for the focal target in UF plans. Mean urethra D10 was 205.9 Gy, 191.4 Gy, and 92.4 Gy in WG, hemi, and UF plans, respectively. Mean rectum D2 cm3 was 107.5 Gy, 77.0 Gy, and 42.7 Gy in WG, hemi, and UF plans, respectively. Focal plans were more sensitive to seed displacement errors: random shifts with a standard deviation of 4 mm reduced mean target D90 by 14.0%, 20.5%, and 32.0% for WG, hemi, and UF plans, respectively. ISA has a similar impact on dose-volume histogram parameters for all plan types. Conclusions: Treatment planning for focal LDR brachytherapy is feasible. Dose constraints are easily met with a notable reduction

  20. Dosimetry Modeling for Focal Low-Dose-Rate Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Al-Qaisieh, Bashar [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Mason, Josh, E-mail: joshua.mason@nhs.net [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Bownes, Peter; Henry, Ann [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Dickinson, Louise [Division of Surgery and Interventional Science, University College London, London (United Kingdom); Department of Radiology, Northwick Park Hospital, London North West NHS Trust, London (United Kingdom); Ahmed, Hashim U. [Division of Surgery and Interventional Science, University College London, London (United Kingdom); University College London Hospital, London (United Kingdom); Emberton, Mark [University College London Hospital, London (United Kingdom); Langley, Stephen [St Luke' s Cancer Centre, Guildford (United Kingdom)

    2015-07-15

    Purpose: Focal brachytherapy targeted to an individual lesion(s) within the prostate may reduce side effects experienced with whole-gland brachytherapy. The outcomes of a consensus meeting on focal prostate brachytherapy were used to investigate optimal dosimetry of focal low-dose-rate (LDR) prostate brachytherapy targeted using multiparametric magnetic resonance imaging (mp-MRI) and transperineal template prostate mapping (TPM) biopsy, including the effects of random and systematic seed displacements and interseed attenuation (ISA). Methods and Materials: Nine patients were selected according to clinical characteristics and concordance of TPM and mp-MRI. Retrospectively, 3 treatment plans were analyzed for each case: whole-gland (WG), hemi-gland (hemi), and ultra-focal (UF) plans, with 145-Gy prescription dose and identical dose constraints for each plan. Plan robustness to seed displacement and ISA were assessed using Monte Carlo simulations. Results: WG plans used a mean 28 needles and 81 seeds, hemi plans used 17 needles and 56 seeds, and UF plans used 12 needles and 25 seeds. Mean D90 (minimum dose received by 90% of the target) and V100 (percentage of the target that receives 100% dose) values were 181.3 Gy and 99.8% for the prostate in WG plans, 195.7 Gy and 97.8% for the hemi-prostate in hemi plans, and 218.3 Gy and 99.8% for the focal target in UF plans. Mean urethra D10 was 205.9 Gy, 191.4 Gy, and 92.4 Gy in WG, hemi, and UF plans, respectively. Mean rectum D2 cm{sup 3} was 107.5 Gy, 77.0 Gy, and 42.7 Gy in WG, hemi, and UF plans, respectively. Focal plans were more sensitive to seed displacement errors: random shifts with a standard deviation of 4 mm reduced mean target D90 by 14.0%, 20.5%, and 32.0% for WG, hemi, and UF plans, respectively. ISA has a similar impact on dose-volume histogram parameters for all plan types. Conclusions: Treatment planning for focal LDR brachytherapy is feasible. Dose constraints are easily met with a notable

  1. Ocular Response of Choroidal Melanoma With Monosomy 3 Versus Disomy 3 After Iodine-125 Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Marathe, Omkar S. [David Geffen School of Medicine, University of Los Angeles, Los Angeles, CA (United States); Wu, Jeffrey; Lee, Steve P. [Department of Radiation Oncology, University of Los Angeles, Los Angeles, CA (United States); Yu Fei; Burgess, Barry L. [Department of Ophthalmology, The Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); Leu Min [Department of Radiation Oncology, University of Los Angeles, Los Angeles, CA (United States); Straatsma, Bradley R. [Department of Ophthalmology, The Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); McCannel, Tara A., E-mail: TMcCannel@jsei.ucla.edu [Department of Ophthalmology, Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); Jonsson Comprehensive Cancer Center, University of Los Angeles, Los Angeles, CA (United States)

    2011-11-15

    Purpose: To report the ocular response of choroidal melanoma with monosomy 3 vs. disomy 3 after {sup 125}I brachytherapy. Methods and Materials: We evaluated patients with ciliochoroidal melanoma managed with fine needle aspiration biopsy immediately before plaque application for {sup 125}I brachytherapy between January 1, 2005 and December 31, 2008. Patients with (1) cytopathologic diagnosis of melanoma, (2) melanoma chromosome 3 status identified by fluorescence in situ hybridization, and (3) 6 or more months of follow-up after brachytherapy were sorted by monosomy 3 vs. disomy 3 and compared by Kruskal-Wallis test. Results: Among 40 ciliochoroidal melanomas (40 patients), 15 had monosomy 3 and 25 had disomy 3. Monosomy 3 melanomas had a median greatest basal diameter of 12.00 mm and a median tumor thickness of 6.69 mm before brachytherapy; at a median of 1.75 years after brachytherapy, median thickness was 3.10 mm. Median percentage decrease in tumor thickness was 48.3%. Disomy 3 melanomas had a median greatest basal diameter of 10.00 mm and median tumor thickness of 3.19 mm before brachytherapy; at a median of 2.00 years after brachytherapy, median tumor thickness was 2.37 mm. The median percentage decrease in tumor thickness was 22.7%. Monosomy 3 melanomas were statistically greater in size than disomy 3 melanomas (p < 0.001) and showed a greater decrease in tumor thickness after brachytherapy (p = 0.006). Conclusion: In this study, ciliochoroidal melanomas with monosomy 3 were significantly greater in size than disomy 3 melanoma and showed a significantly greater decrease in thickness at a median of 1.75 years after brachytherapy. The greater decrease in monosomy 3 melanoma thickness after brachytherapy is consistent with other malignancies in which more aggressive pathology has been shown to be associated with a greater initial response to radiotherapy.

  2. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR

    Energy Technology Data Exchange (ETDEWEB)

    Craciunescu, O [Duke University Medical Center, Durham, NC (United States); Todor, D [Virginia Commonwealth University, Richmond, VA (United States); Leeuw, A de

    2014-06-15

    In recent years, with the advent of high/pulsed dose rate afterloading technology, advanced treatment planning systems, CT/MRI compatible applicators, and advanced imaging platforms, image-guided adaptive brachytherapy treatments (IGABT) have started to play an ever increasing role in modern radiation therapy. The most accurate way to approach IGABT treatment is to provide the infrastructure that combines in a single setting an appropriate imaging device, a treatment planning system, and a treatment unit. The Brachytherapy Suite is not a new concept, yet the modern suites are incorporating state-of-the-art imaging (MRI, CBCT equipped simulators, CT, and /or US) that require correct integration with each other and with the treatment planning and delivery systems. Arguably, an MRI-equipped Brachytherapy Suite is the ideal setup for real-time adaptive brachytherapy treatments. The main impediment to MRI-IGABT adoption is access to MRI scanners. Very few radiation oncology departments currently house MRI scanners, and even fewer in a dedicated Brachytherapy Suite. CBCT equipped simulators are increasingly offered by manufacturers as part of a Brachytherapy Suite installation. If optimized, images acquired can be used for treatment planning, or can be registered with other imaging modalities. This infrastructure is relevant for all forms of brachytherapy, especially those utilizing multi-fractionated courses of treatment such as prostate and cervix. Moreover, for prostate brachytherapy, US imaging systems can be part of the suite to allow for real-time HDR/LDR treatments. Learning Objectives: Understand the adaptive workflow of MR-based IGBT for cervical cancer. Familiarize with commissioning aspects of a CBCT equipped simulator with emphasis on brachytherapy applications Learn about the current status and future developments in US-based prostate brachytherapy.

  3. SU-E-T-477: An Efficient Dose Correction Algorithm Accounting for Tissue Heterogeneities in LDR Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mashouf, S; Lai, P [University of Toronto, Medical Biophysics Dept., Toronto, ON (Canada); Karotki, A; Keller, B; Beachey, D; Pignol, J [Sunnybrook Health Sciences Centre, Toronto, ON (Canada)

    2014-06-01

    Purpose: Seed brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose surrounding the brachytherapy seeds is based on American Association of Physicist in Medicine Task Group No. 43 (TG-43 formalism) which generates the dose in homogeneous water medium. Recently, AAPM Task Group No. 186 emphasized the importance of accounting for tissue heterogeneities. This can be done using Monte Carlo (MC) methods, but it requires knowing the source structure and tissue atomic composition accurately. In this work we describe an efficient analytical dose inhomogeneity correction algorithm implemented using MIM Symphony treatment planning platform to calculate dose distributions in heterogeneous media. Methods: An Inhomogeneity Correction Factor (ICF) is introduced as the ratio of absorbed dose in tissue to that in water medium. ICF is a function of tissue properties and independent of source structure. The ICF is extracted using CT images and the absorbed dose in tissue can then be calculated by multiplying the dose as calculated by the TG-43 formalism times ICF. To evaluate the methodology, we compared our results with Monte Carlo simulations as well as experiments in phantoms with known density and atomic compositions. Results: The dose distributions obtained through applying ICF to TG-43 protocol agreed very well with those of Monte Carlo simulations as well as experiments in all phantoms. In all cases, the mean relative error was reduced by at least 50% when ICF correction factor was applied to the TG-43 protocol. Conclusion: We have developed a new analytical dose calculation method which enables personalized dose calculations in heterogeneous media. The advantages over stochastic methods are computational efficiency and the ease of integration into clinical setting as detailed source structure and tissue segmentation are not needed. University of Toronto, Natural Sciences and

  4. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... your stomach on a narrow table with your breasts hanging down into cushioned openings. The table slides ...

  5. Breast Cancer Treatment

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  6. Stages of Breast Cancer

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  7. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    Energy Technology Data Exchange (ETDEWEB)

    Ott, Oliver J.; Lotter, Michael; Fietkau, Rainer; Strnad, Vratislav [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2009-03-15

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p = 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven

  8. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    International Nuclear Information System (INIS)

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven that

  9. Patient Preferences and Physician Practice Patterns Regarding Breast Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: There are multiple current strategies for breast radiotherapy (RT). The alignment of physician practice patterns with best evidence and patient preferences will enhance patient autonomy and improve cancer care. However, there is little information describing patient preferences for breast RT and physician practice patterns. Methods and Materials: Using a reliable and valid instrument, we assessed the preferences of 5,000 randomly selected women (with or without cancer) undergoing mammography. To assess practice patterns, 2,150 randomly selected physician-members of American Society for Radiation Oncology were surveyed. Results: A total of 1,807 women (36%) and 363 physicians (17%) provided usable responses. The 95% confidence interval is < ±2.3% for patients and < ±5.3% for physicians. Patient preferences were hypofractionated whole breast irradiation (HF-WBI) 62%, partial breast irradiation (PBI) 28%, and conventionally fractionated whole breast irradiation (CF-WBI) 10%. By comparison, 82% of physicians use CF-WBI for more than 2/3 of women and 56% never use HF-WBI. With respect to PBI, 62% of women preferred three-dimensional (3D)-PBI and 38% favor brachytherapy-PBI, whereas 36% of physicians offer 3D-PBI and 66% offer brachytherapy-PBI. 70% of women prefer once-daily RT over 10 days vs. twice-daily RT over 5 days. 55% of physicians who use PBI do not offer PBI on clinical trial. Conclusions: HF-WBI, while preferred by patients and supported by evidence, falls behind the unproven and less preferred strategy of PBI in clinical practice. There is a discrepancy between women’s preferences for PBI modality and type of PBI offered by physicians. Further alignment is needed between practice patterns, patient preferences, and clinical evidence.

  10. Clinical outcome and cosmetics in breast cancer patients treated with conservative surgery and radiotherapy

    International Nuclear Information System (INIS)

    Objective: To evaluate the effectiveness and the cosmetics result of radiotherapy after conservative surgery for early breast cancer. Methods: Altogether 109 patients were treated by post-operative whole-breast irradiation and a tumor bed boost from May, 1995 to December, 2002. Among them 79 cases received a brachytherapy boost (192Ir HDR implant Nucletron ) of 10-12 Gy(DB) by single plan of implantation with 1.5 cm between the needles for T1 and double plan for T2-4 tumors, and 30 cases received an electron beam boost with 15 Gy. External beam irradiation was applied to the whole breast with 45-52 Gy(mean 48.6 Gy) in 25 fractions over 5 weeks followed or concurrently with chemotherapy (CMF or CEF) and hormonotherapy. The cosmetic result was scored by a doctor and patients via questionnaire. Results: The median follow-up time was 52 months. The actuarial 5-year overall survival rate was 93.8% using Kaplan-Meier method and the within breast recurrence rate was 6.5%. No radiation- induced ulcer in the breast occurred except acute inflammation of skin around the pinholes in 5 patients. Cosmetic results were scored to be good by patients and the doctor (81% and 87%, respectively) for 75 followed-up cases, and good cosmetic rate was reported by the doctor for 82% (39/48) of the cases treated with brachytherapy boost and 85.2%(23/27) for those treated with external beam boost. There was no difference in cosmetic results between these two groups(P>0.05). Conclusion: In patients at high risk for local recurrence, tumor-bed boost with brachytherapy or electron beam carried out after limited surgery and external radiotherapy can provide satisfactory local control without morbidity. Cosmetic result may not be influenced by the boost technique. (authors)

  11. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial

    International Nuclear Information System (INIS)

    Purpose: to evaluate perioperative morbidity, toxicity and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole radiation modality after breast conserving surgery. Materials and methods: from 11/2000 to 11/2004, 240 women with early stage breast cancer participated in a protocol of tumor bed irradiation alone using pulsed dose rate (PDR) or high dose rate (HDR) interstitial multi-catheter implants (partial breast irradiation). Perioperative morbidity, acute and late toxicity as well as cosmetic outcome were assessed. Of the first 51 patients treated in this multicenter trial, we present interim findings after a median follow-up of 36 months. Results: perioperative Morbidity: Bacterial infection of the implant: 2% (1/51). Acute toxicity: radiodermatitis grade 1: 4% (2/51). Late toxicity: breast pain grade 1: 8% (4/51), grade 2: 2% (1/51); dyspigmentation grade 1: 8% (4/51); fibrosis grade 1: 4% (2/51), grade 2: 8% (4/51); telangiectasia grade 1: 10% (5/51), grade 2: 4% (2/51). Cosmetic results: Excellent and good in 94% (48/51) of the patients. Conclusion: this analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter PDR-/HDR-implants (partial breast irradiation) is feasible with low perioperative morbidity, low acute and mild late toxicity at a median follow-up of 36 months. The cosmetic result is not significantly affected. (orig.)

  12. Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT. CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber. Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR 192Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT. The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR 192Ir brachytherapy

  13. Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

    Directory of Open Access Journals (Sweden)

    Kasper ME

    2015-11-01

    Full Text Available Michael E Kasper,1,2 Ahmed A Chaudhary3 1Department of Radiation Oncology, Lynn Cancer Institute at Boca Raton Regional Hospital, Boca Raton, 2Charles E. Schmidt College of Medicine, Florida Atlantic University, FL, 3North Main Radiation Oncology, Warren Alpert School of Medicine, Brown University, RI, USA Abstract: Nonmelanoma skin cancer (NMSC is an increasing health care issue in the United States, significantly affecting quality of life and impacting health care costs. Radiotherapy has a long history in the treatment of NMSC. Shortly after the discovery of X-rays and 226Radium, physicians cured patients with NMSC using these new treatments. Both X-ray therapy and brachytherapy have evolved over the years, ultimately delivering higher cure rates and lower toxicity. Electronic brachytherapy for NMSC is based on the technical and clinical data obtained from radionuclide skin surface brachytherapy and the small skin surface applicators developed over the past 25 years. The purpose of this review is to introduce electronic brachytherapy in the context of the history, data, and utilization of traditional radiotherapy and brachytherapy. Keywords: electronic brachytherapy, superficial radiotherapy, skin surface brachytherapy, electron beam therapy, nonmelanoma skin cancer, basal cell carcinoma, squamous cell carcinoma

  14. Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

    Energy Technology Data Exchange (ETDEWEB)

    Krengli, M.; Deantonio, L. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); University of ' ' Piemonte Orientale' ' , Department of Translational Medicine, Novara (Italy); Masini, L.; Filomeno, A.; Gambaro, G. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); Comoli, A.M. [University Hospital Maggiore della Carita, Ophthalmology, Novara (Italy); Negri, E. [University Hospital Maggiore della Carita, Medical Physics, Novara (Italy)

    2014-03-15

    Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium ({sup 192}Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.) [German] Das Karzinom des Augenlids stellt aufgrund der funktionellen und kosmetischen Beeintraechtigungen dieser anatomischen Region eine therapeutische Herausforderung dar. Ziele der Therapie sind sowohl die Tumorkontrolle als auch ein gutes funktionelles und kosmetisches Ergebnis. Lokale Kontrolle, Toxizitaet sowie funktionelle und kosmetische Ergebnisse bei Patienten mit Karzinom des Augenlids, die mit interstitieller Brachytherapie behandelt wurden, sollten analysiert werden. Sechzig Patienten mit Karzinom des Augenlids wurden mit interstitieller Brachytherapie mit Iridium-192-Draehten

  15. Prostate Brachytherapy in Men ≥75 Years of Age

    International Nuclear Information System (INIS)

    Purpose: To evaluate cause-specific survival (CSS), biochemical progression-free survival (bPFS), and overall survival (OS) in prostate cancer patients aged ≥75 years undergoing brachytherapy with or without supplemental therapies. Methods and Materials: Between April 1995 and August 2004, 145 consecutive patients aged ≥75 years underwent permanent prostate brachytherapy. Median follow-up was 5.8 years. Biochemical progression-free survival was defined by a prostate-specific antigen level ≤0.40 ng/mL after nadir. Patients with metastatic prostate cancer or hormone-refractory disease without obvious metastases who died of any cause were classified as dead of prostate cancer. All other deaths were attributed to the immediate cause of death. Multiple clinical, treatment, and dosimetric parameters were evaluated for impact on survival. Results: Nine-year CSS, bPFS, and OS rates for the entire cohort were 99.3%, 97.1%, and 64.5%, respectively. None of the evaluated parameters predicted for CSS, whereas bPFS was most closely predicted by percentage positive biopsies. Overall survival and non-cancer deaths were best predicted by tobacco status. Thirty-seven patients have died, with 83.8% of the deaths due to cardiovascular disease (22 patients) or second malignancies (9 patients). To date, only 1 patient (0.7%) has died of metastatic prostate cancer. Conclusions: After brachytherapy, high rates of CSS and bPFS are noted in elderly prostate cancer patients. Overall, approximately 65% of patients are alive at 9 years, with survival most closely related to tobacco status. We believe our results support an aggressive locoregional approach in appropriately selected elderly patients

  16. Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns

    International Nuclear Information System (INIS)

    Purpose: To determine whether alternative high dose rate prostate brachytherapy catheter patterns can result in similar or improved dose distributions while providing better access and reducing trauma. Materials and Methods: Standard prostate cancer high dose rate brachytherapy uses a regular grid of parallel needle positions to guide the catheter insertion. This geometry does not easily allow the physician to avoid piercing the critical structures near the penile bulb nor does it provide position flexibility in the case of pubic arch interference. This study used CT datasets with 3 mm slice spacing from ten previously treated patients and digitized new catheters following three hypothetical catheter patterns: conical, bi-conical, and fireworks. The conical patterns were used to accommodate a robotic delivery using a single entry point. The bi-conical and fireworks patterns were specifically designed to avoid the critical structures near the penile bulb. For each catheter distribution, a plan was optimized with the inverse planning algorithm, IPSA, and compared with the plan used for treatment. Irrelevant of catheter geometry, a plan must fulfill the RTOG-0321 dose criteria for target dose coverage (V100Prostate>90%) and organ-at-risk dose sparing (V75Bladder75Rectum125Urethra<<1 cc). Results: The three nonstandard catheter patterns used 16 nonparallel, straight divergent catheters, with entry points in the perineum. Thirty plans from ten patients with prostate sizes ranging from 26 to 89 cc were optimized. All nonstandard patterns fulfilled the RTOG criteria when the clinical plan did. In some cases, the dose distribution was improved by better sparing the organs-at-risk. Conclusion: Alternative catheter patterns can provide the physician with additional ways to treat patients previously considered unsuited for brachytherapy treatment (pubic arch interference) and facilitate robotic guidance of catheter insertion. In addition, alternative catheter patterns may

  17. Dose volume analysis in brachytherapy and stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Tozer-Loft, S.M

    2000-12-01

    A brief introduction to three branches of radiotherapy is given: interstitial brachytherapy, external beam megavoltage radiotherapy, and stereotactic radiosurgery. The current interest in issues around conformity, uniformity and optimisation is explained in the light of technical developments in these fields. A novel method of displaying dose-volume information, which mathematically suppresses the inverse-square law, as first suggested by L.L. Anderson for use in brachytherapy is explained in detail, and some improvements proposed. These 'natural' histograms are extended to show the effects of real point sources which do not exactly follow the inverse-square law, and to demonstrate the in-target dose-volume distribution, previously unpublished. The histograms are used as a way of mathematically analysing the properties of theoretical mono-energetic radionuclides, and for demonstrating the dosimetric properties of a potential new brachytherapy source (Ytterbium-169). A new modification of the Anderson formalism is then described for producing Anderson Inverse-Square Shifted (AISS) histograms for the Gamma Knife, which are shown to be useful for demonstrating the quality of stereotactic radiosurgery dose distributions. A study is performed analysing the results of Gamma Knife treatments on 44 patients suffering from a benign brain tumour (acoustic neuroma). Follow-up data is used to estimate the volume shrinkage or growth of each tumour, and this measure of outcome is compared with a range of figures of merit which express different aspects of the quality of each dose distributions. The results are analysed in an attempt to answer the question: What are the important features of the dose distribution (conformality, uniformity, etc) which show a definite relationship with the outcome of the treatment? Initial results show positively that, when Gamma Knife radiosurgery is used to treat acoustic neuroma, some measures of conformality seem to have a surprising

  18. Prosper: image and robot-guided prostate brachytherapy

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Descotes, Jean-Luc; Giraud, Jean-Yves; Hungr, Nikolai; Leroy, Antoine; Long, Jean-Alexandre; Martin, Sébastien; Troccaz, Jocelyne

    2011-01-01

    Brachytherapy for localized prostate cancer consists in destroying cancer by introducing iodine radioactive seeds into the gland through hollow needles. The planning of the position of the seeds and their introduction into the prostate is based on intra-operative ultrasound (US) imaging. We propose to optimize the global quality of the procedure by: i) using 3D US; ii) enhancing US data with MRI registration; iii) using a specially designed needle-insertion robot, connected to the imaging data. The imaging methods have been successfully tested on patient data while the robot accuracy has been evaluated on a realistic deformable phantom.

  19. Salvage robot-assisted radical prostatectomy after brachytherapy: our experience

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2014-11-01

    Full Text Available In case of recurrence of prostate cancer after radiation therapy patient may be offered salvage radical prostatectomy (both open and laparoscopic/robotic, hormone therapy, and a number of alternative techniques such as salvage cryoablation, HIFU-therapy and brachytherapy. Results of monitoring of patients for 10 years after salvage treatment of prostate cancer are known only after salvage prostatectomy. Technically radical prostatectomy after radiation therapy is associated with a large number of complications if compared with primary radical prostatectomy. The most frequent complications after salvage prostatectomy include incontinence, stricture formation of urethrovesical anastomosis, rectal injury, acute urinary retention and infectious complications.

  20. Salvage robot-assisted radical prostatectomy after brachytherapy: our experience

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2014-01-01

    Full Text Available In case of recurrence of prostate cancer after radiation therapy patient may be offered salvage radical prostatectomy (both open and laparoscopic/robotic, hormone therapy, and a number of alternative techniques such as salvage cryoablation, HIFU-therapy and brachytherapy. Results of monitoring of patients for 10 years after salvage treatment of prostate cancer are known only after salvage prostatectomy. Technically radical prostatectomy after radiation therapy is associated with a large number of complications if compared with primary radical prostatectomy. The most frequent complications after salvage prostatectomy include incontinence, stricture formation of urethrovesical anastomosis, rectal injury, acute urinary retention and infectious complications.

  1. A case of percutaneous high dose rate brachytherapy for superior pulmonary sulcus tumor

    Energy Technology Data Exchange (ETDEWEB)

    Asakura, Tamaki; Imamura, Masahiro; Murata, Takashi [Kansai Medical Univ., Moriguchi, Osaka (Japan)] [and others

    1996-07-01

    A 64-year-old man with advanced superior pulmonary sulcus tumor suffered severe unrelieved pain even after chemotherapy, external irradiation and hyperthermia. So we planned to introduce a percutaneous high dose rate brachytherapy using the microselectron HDR {sup 192}Ir. With the estimation using the Pain Score, satisfying pain relief was attainable with a combination of the percutaneous high dose rate brachytherapy and conventional treatment. So the percutaneous high dose rate brachytherapy had the possibility to contribute to the alleviation of the pain. (author)

  2. High dose brachytherapy in pediatric oncology; Braquiterapia com alta taxa de dose em oncologia pediatrica

    Energy Technology Data Exchange (ETDEWEB)

    Ferrigno, Robson; Codjaian, Osanna Esther; Novaes, Paulo Eduardo R.S.; Trippe, Nivaldo [Fundacao Antonio Prudente, Sao Paulo, SP (Brazil). Hospital A.C. Camargo. Dept. de Radioterapia

    1995-05-01

    Brachytherapy is a kind of radiotherapy that has been used in the multidisciplinary approach of some pediatric tumors, such as soft tissue sarcomas of the extremities, head and neck and urogenital tract. Recent technological advances in this area lead to development of computerized high dose rate remote afterloading brachytherapy. This type of treatment has some advantages compared to low dose rate brachytherapy traditionally used. This article describes not only the characteristics and advantages of this kind of treatment, but also the preliminary results of the first seven children treated with high dose rate at the Hospital A.C.Camargo. (author) 10 refs., 8 figs.

  3. Study of factors influencing dose distribution of brachytherapy in cervical cancer

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To study the factors which influence the dose distribution of brachytherapy in cervical cancer.Methods Ninety-five patients with cervical cancer Ⅱ-Ⅲb received fundamental radiation therapy including brachytherapy in our department from Aug.2004 to Nov.2005.The deviation of isodose curve of brachytherapy was based on A-B reference system,and the deviation of dose was defined by measuring in a practical standard body model.Results The factors influencing isodose offset significantly were parametrial...

  4. Use of Monte Carlo Methods in brachytherapy; Uso del metodo de Monte Carlo en braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    Granero Cabanero, D.

    2015-07-01

    The Monte Carlo method has become a fundamental tool for brachytherapy dosimetry mainly because no difficulties associated with experimental dosimetry. In brachytherapy the main handicap of experimental dosimetry is the high dose gradient near the present sources making small uncertainties in the positioning of the detectors lead to large uncertainties in the dose. This presentation will review mainly the procedure for calculating dose distributions around a fountain using the Monte Carlo method showing the difficulties inherent in these calculations. In addition we will briefly review other applications of the method of Monte Carlo in brachytherapy dosimetry, as its use in advanced calculation algorithms, calculating barriers or obtaining dose applicators around. (Author)

  5. Online gamma-camera imaging of 103Pd seeds (OGIPS) for permanent breast seed implantation

    Science.gov (United States)

    Ravi, Ananth; Caldwell, Curtis B.; Keller, Brian M.; Reznik, Alla; Pignol, Jean-Philippe

    2007-09-01

    Permanent brachytherapy seed implantation is being investigated as a mode of accelerated partial breast irradiation for early stage breast cancer patients. Currently, the seeds are poorly visualized during the procedure making it difficult to perform a real-time correction of the implantation if required. The objective was to determine if a customized gamma-camera can accurately localize the seeds during implantation. Monte Carlo simulations of a CZT based gamma-camera were used to assess whether images of suitable quality could be derived by detecting the 21 keV photons emitted from 74 MBq 103Pd brachytherapy seeds. A hexagonal parallel hole collimator with a hole length of 38 mm, hole diameter of 1.2 mm and 0.2 mm septa, was modeled. The design of the gamma-camera was evaluated on a realistic model of the breast and three layers of the seed distribution (55 seeds) based on a pre-implantation CT treatment plan. The Monte Carlo simulations showed that the gamma-camera was able to localize the seeds with a maximum error of 2.0 mm, using only two views and 20 s of imaging. A gamma-camera can potentially be used as an intra-procedural image guidance system for quality assurance for permanent breast seed implantation.

  6. Online gamma-camera imaging of {sup 103}Pd seeds (OGIPS) for permanent breast seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Ravi, Ananth [Department of Medical Biophysics, University of Toronto (Canada); Caldwell, Curtis B [Department of Medical Biophysics, University of Toronto (Canada); Keller, Brian M [Medical Physics, Sunnybrook Health Sciences Centre (Canada); Reznik, Alla [Department of Medical Biophysics, University of Toronto (Canada); Pignol, Jean-Philippe [Department of Medical Biophysics, University of Toronto (Canada)

    2007-09-21

    Permanent brachytherapy seed implantation is being investigated as a mode of accelerated partial breast irradiation for early stage breast cancer patients. Currently, the seeds are poorly visualized during the procedure making it difficult to perform a real-time correction of the implantation if required. The objective was to determine if a customized gamma-camera can accurately localize the seeds during implantation. Monte Carlo simulations of a CZT based gamma-camera were used to assess whether images of suitable quality could be derived by detecting the 21 keV photons emitted from 74 MBq {sup 103}Pd brachytherapy seeds. A hexagonal parallel hole collimator with a hole length of 38 mm, hole diameter of 1.2 mm and 0.2 mm septa, was modeled. The design of the gamma-camera was evaluated on a realistic model of the breast and three layers of the seed distribution (55 seeds) based on a pre-implantation CT treatment plan. The Monte Carlo simulations showed that the gamma-camera was able to localize the seeds with a maximum error of 2.0 mm, using only two views and 20 s of imaging. A gamma-camera can potentially be used as an intra-procedural image guidance system for quality assurance for permanent breast seed implantation.

  7. Observations on rotating needle insertions using a brachytherapy robot

    Energy Technology Data Exchange (ETDEWEB)

    Meltsner, M A [Department of Medical Physics, University of Wisconsin, Madison, WI 53706 (United States); Ferrier, N J [Department of Mechanical Engineering, University of Wisconsin, Madison, WI 53706 (United States); Thomadsen, B R [Department of Medical Physics, University of Wisconsin, Madison, WI 53706 (United States)

    2007-09-21

    A robot designed for prostate brachytherapy implantations has the potential to greatly improve treatment success. Much of the research in robotic surgery focuses on measuring accuracy. However, there exist many factors that must be optimized before an analysis of needle placement accuracy can be determined. Some of these parameters include choice of the needle type, insertion velocity, usefulness of the rotating needle and rotation speed. These parameters may affect the force at which the needle interacts with the tissue. A reduction in force has been shown to decrease the compression of the prostate and potentially increase the accuracy of seed position. Rotating the needle as it is inserted may reduce frictional forces while increasing accuracy. However, needle rotations are considered to increase tissue damage due to the drilling nature of the insertion. We explore many of the factors involved in optimizing a brachytherapy robot, and the potential effects each parameter may have on the procedure. We also investigate the interaction of rotating needles in gel and suggest the rotate-cannula-only method of conical needle insertion to minimize any tissue damage while still maintaining the benefits of reduced force and increased accuracy.

  8. Observations on rotating needle insertions using a brachytherapy robot

    Science.gov (United States)

    Meltsner, M. A.; Ferrier, N. J.; Thomadsen, B. R.

    2007-09-01

    A robot designed for prostate brachytherapy implantations has the potential to greatly improve treatment success. Much of the research in robotic surgery focuses on measuring accuracy. However, there exist many factors that must be optimized before an analysis of needle placement accuracy can be determined. Some of these parameters include choice of the needle type, insertion velocity, usefulness of the rotating needle and rotation speed. These parameters may affect the force at which the needle interacts with the tissue. A reduction in force has been shown to decrease the compression of the prostate and potentially increase the accuracy of seed position. Rotating the needle as it is inserted may reduce frictional forces while increasing accuracy. However, needle rotations are considered to increase tissue damage due to the drilling nature of the insertion. We explore many of the factors involved in optimizing a brachytherapy robot, and the potential effects each parameter may have on the procedure. We also investigate the interaction of rotating needles in gel and suggest the rotate-cannula-only method of conical needle insertion to minimize any tissue damage while still maintaining the benefits of reduced force and increased accuracy.

  9. Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

    International Nuclear Information System (INIS)

    Stereotactic body radiation therapy (SBRT) administered via a helical tomotherapy (HT) system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI) showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO) stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT) followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted

  10. Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

    Directory of Open Access Journals (Sweden)

    Chen Yu-Jen

    2010-11-01

    Full Text Available Abstract Background Stereotactic body radiation therapy (SBRT administered via a helical tomotherapy (HT system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. Case Presentation A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. Conclusions CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted.

  11. Iodine-125 orbital brachytherapy with a prosthetic implant in situ

    Energy Technology Data Exchange (ETDEWEB)

    Stannard, Clare [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Radiation Oncology; Maree, Gert; Munro, Roger [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Medical Physics; Lecuona, Karin [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Ophthalmology; Sauerwein, Wolfgang [Universitaetsklinikum Essen (Germany). Strahlenklinik, NCTeam

    2011-05-15

    Purpose: Brachytherapy is one method of irradiating the orbit after enucleation of an eye with a malignant tumor that has a potential to recur. It consists of 6 trains of I-125 seeds placed around the periphery of the orbit, a shorter central train, and a metal disc, loaded with seeds, placed beneath the eyelids. The presence of a prosthetic orbital implant requires omission of the central train and adjustment of the activity of the seeds in the anterior orbit around the prosthesis. Patients and Methods: This is a retrospective review of the technical modifications and outcome of 12 patients treated in this manner: 6 with retinoblastoma, 5 with malignant melanoma, and 1 with an intraocular rhabdomyosarcoma. The median dose was 35.5 Gy in 73 hours for retinoblastoma and 56 Gy in 141 hours for malignant melanoma. Patients with retinoblastoma and rhabdomyosarcoma also received chemotherapy. Results: The tubes can be placed satisfactorily around the prosthesis. The increased activity in the anterior half of the tubes produced comparable dose distributions. There have been no orbital recurrences, no extrusion of the prosthesis, and cosmesis is good. Conclusion: Insertion of a prosthetic implant at the time of enucleation greatly enhances the subsequent cosmetic appearance. This should be encouraged unless there is frank tumor in the orbit. Orbital brachytherapy without the central train continues to give excellent local control. The short treatment time and good cosmesis are added advantages. The patient is spared the expense and inconvenience of removing and replacing the prosthetic implant. (orig.)

  12. In vivo visualization of prostate brachytherapy seeds with photoacoustic imaging

    Science.gov (United States)

    Lediju Bell, Muyinatu A.; Kuo, Nathanael P.; Song, Danny Y.; Kang, Jin U.; Boctor, Emad M.

    2014-12-01

    We conducted a canine study to investigate the in vivo feasibility of photoacoustic imaging for intraoperative updates to brachytherapy treatment plans. A fiber coupled to a 1064-nm Nd:YAG laser was inserted into high-dose-rate brachytherapy needles, which diffused light spherically. These needles were inserted through the perineum into the prostate for interstitial light delivery and the resulting acoustic waves were detected with a transrectal ultrasound probe. Postoperative computed tomography images and ex vivo photoacoustic images confirmed seed locations. Limitations with insufficient light delivery were mitigated with short-lag spatial coherence (SLSC) beamforming, providing a 10-20 dB contrast improvement over delay-and-sum (DAS) beamforming for pulse energies ranging from 6.8 to 10.5 mJ with a fiber-seed distance as large as 9.5 mm. For the same distance and the same range of energy densities, signal-to-noise ratios (SNRs) were similar while the contrast-to-noise ratio (CNR) was higher in SLSC compared to DAS images. Challenges included visualization of signals associated with the interstitial fiber tip and acoustic reverberations between seeds separated by ≤2 mm. Results provide insights into the potential for clinical translation to humans.

  13. Methodology of quality control for brachytherapy {sup 125}I seeds

    Energy Technology Data Exchange (ETDEWEB)

    Moura, Eduardo S.; Zeituni, Carlos A.; Manzoli, Jose E.; Rostelato, Maria Elisa C.M. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)]. E-mail: esmoura@ipen.br

    2007-07-01

    This paper presents the methodology of quality control of {sup 125}I seeds used for brachytherapy. The {sup 125}I seeds are millimeter titanium capsules widely used in permanent implants of prostate cancer, allowing a high dose within the tumour and a low dose on the surrounding tissues, with very low harm to the other tissues. Besides, with this procedure, the patients have a low impotence rate and a small incidence of urinary incontinence. To meet the medical standards, an efficient quality control is necessary, showing values with the minimum uncertainness possible, concerning the seeds dimensions and their respective activities. The medical needles are used to insert the seeds inside the prostate. The needles used in brachytherapy have an internal diameter of 1.0 mm, so it is necessary {sup 125}I seeds with an external maximum diameter of 0.85 mm. For the seeds and the spacer positioning on the planning sheet, the seeds must have a length between 4.5 and 5.0 mm. The activities must not vary more than 5% in each batch of {sup 125}I seeds. For this methodology, we used two ionization chamber detectors and one caliper. In this paper, the methodology using one control batch with 75 seeds manufactured by GE Health care Ltd is presented. (author)

  14. Current status and perspectives of brachytherapy for cervical cancer.

    Science.gov (United States)

    Toita, Takafumi

    2009-02-01

    Standard definitive radiotherapy for cervical cancer consists of whole pelvic external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). In Japan, high-dose-rate ICBT (HDR-ICBT) has been utilized in clinical practice for more than 40 years. Several randomized clinical trials demonstrated that HDR-ICBT achieved comparative outcomes, both for pelvic control and incidences of late complications, to low-dose-rate (LDR) ICBT. In addition, HDR-ICBT has some potential advantages over LDR-ICBT, leading to further improvement in treatment results. Prior to the current computer planning systems, some excellent treatment planning concepts were established. At present, systems modified from these concepts, or novel approaches, such as image-guided brachytherapy (IGBT) are under investigation. One serious problem to be solved in HDR-ICBT for cervical cancer is that of the discrepancy in standard treatment schedules for combination HDR-ICBT and EBRT between the United States and Japan. Prospective studies are ongoing to assess the efficacy and toxicity of the Japanese schedule. PMID:19225920

  15. DEGRO practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences

    International Nuclear Information System (INIS)

    To update the practical guidelines for radiotherapy of patients with locoregional breast cancer recurrences based on the current German interdisciplinary S3 guidelines 2012. A comprehensive survey of the literature using the search phrases ''locoregional breast cancer recurrence'', ''chest wall recurrence'', ''local recurrence'', ''regional recurrence'', and ''breast cancer'' was performed, using the limits ''clinical trials'', ''randomized trials'', ''meta-analysis'', ''systematic review'', and ''guidelines''. Patients with isolated in-breast or regional breast cancer recurrences should be treated with curative intent. Mastectomy is the standard of care for patients with ipsilateral breast tumor recurrence. In a subset of patients, a second breast conservation followed by partial breast irradiation (PBI) is an appropriate alternative to mastectomy. If a second breast conservation is performed, additional irradiation should be mandatory. The largest reirradiation experience base exists for multicatheter brachytherapy; however, prospective clinical trials are needed to clearly define selection criteria, long-term local control, and toxicity. Following primary mastectomy, patients with resectable locoregional breast cancer recurrences should receive multimodality therapy including systemic therapy, surgery, and radiation +/- hyperthermia. This approach results in high local control rates and long-term survival is achieved in a subset of patients. In radiation-naive patients with unresectable locoregional recurrences, radiation therapy is mandatory. In previously irradiated patients with a high risk of a second local recurrence after surgical resection or in patients with unresectable recurrences, reirradiation should be strongly considered. Indication and dose concepts

  16. Treatment of localized prostate cancer with brachytherapy: six years experience

    International Nuclear Information System (INIS)

    The usage of ultrasound scan to perform prostate biopsy punctures, the new radiation therapies and the more accurate selection of patients has allowed brachytherapy to play an important role in the treatment of the localized pathology. The objective of this paper is to review the results obtained when treating the localized prostate cancer by using brachytherapy with mud 125. Materials and methods: Between December 1999 and July 2006, 100 prostate cancer patients were treated at the Hospital Italiano de Buenos Aires, using brachytherapy with mud 125. One of the patients was treated with a combined therapy (brachytherapy + external radiotherapy). For that reason, the patient was not taken into consideration for this paper. The average age was 65.95 (52-79). The tumoral stages were T1c in 81% of the patients and T2a in 19% of them. The PSA was always below 15 ng/ml, with an average of 8.92 ng/ml; inferior to 10 ng/ml in 72 patients and between 10 and 15 ng/m ml in 28 of them. The average prostate volume was 34.68 c.c. (18.70 c.c.-58.00 c.c.). The combined Gleason score was below 6 (except for three patients with Gleason 7 who had a PSA below 10, stage T1c). The dose used was 16,000 cGy as recommended by the TG43. The energy charge of each seed was between 0.28 and 0.40 mci. Thirty days later, a prostate axial computer tomography was carried out every 3 mm. with a scanning set every 5 mm. to perform a dosimetric control of the implant. Results: The average age was 65.95 (52-79). The control computer tomography showed an adequate dosimetric coverage for the entire prostate volume, with a maximum urethral dose not above 400 Gy and a maximum rectal dose below 100 Gy. The PSA of all patients decreased to a normal level 6 months after the treatment started. The average follow-up of the 71 patients able to be tested from an oncological perspective lasted 31.15 months, with a minimum of 18 and a maximum of 72 months. Currently, seven patients of those tested (9.86%) manifest

  17. Comparison of dose calculation methods for brachytherapy of intraocular tumors

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, Mark J.; Chiu-Tsao, Sou-Tung; Finger, Paul T.; Meigooni, Ali S.; Melhus, Christopher S.; Mourtada, Firas; Napolitano, Mary E.; Rogers, D. W. O.; Thomson, Rowan M.; Nath, Ravinder [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States); Quality MediPhys LLC, Denville, New Jersey 07834 (United States); New York Eye Cancer Center, New York, New York 10065 (United States); Department of Radiation Oncology, Comprehensive Cancer Center of Nevada, Las Vegas, Nevada 89169 (United States); Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States); Department of Radiation Physics, University of Texas, M.D. Anderson Cancer Center, Houston, Texas 77030 (United States) and Department of Experimental Diagnostic Imaging, University of Texas, M.D. Anderson Cancer Center, Houston, Texas 77030 (United States); Physics, Elekta Inc., Norcross, Georgia 30092 (United States); Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada); Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520 (United States)

    2011-01-15

    Purpose: To investigate dosimetric differences among several clinical treatment planning systems (TPS) and Monte Carlo (MC) codes for brachytherapy of intraocular tumors using {sup 125}I or {sup 103}Pd plaques, and to evaluate the impact on the prescription dose of the adoption of MC codes and certain versions of a TPS (Plaque Simulator with optional modules). Methods: Three clinical brachytherapy TPS capable of intraocular brachytherapy treatment planning and two MC codes were compared. The TPS investigated were Pinnacle v8.0dp1, BrachyVision v8.1, and Plaque Simulator v5.3.9, all of which use the AAPM TG-43 formalism in water. The Plaque Simulator software can also handle some correction factors from MC simulations. The MC codes used are MCNP5 v1.40 and BrachyDose/EGSnrc. Using these TPS and MC codes, three types of calculations were performed: homogeneous medium with point sources (for the TPS only, using the 1D TG-43 dose calculation formalism); homogeneous medium with line sources (TPS with 2D TG-43 dose calculation formalism and MC codes); and plaque heterogeneity-corrected line sources (Plaque Simulator with modified 2D TG-43 dose calculation formalism and MC codes). Comparisons were made of doses calculated at points-of-interest on the plaque central-axis and at off-axis points of clinical interest within a standardized model of the right eye. Results: For the homogeneous water medium case, agreement was within {approx}2% for the point- and line-source models when comparing between TPS and between TPS and MC codes, respectively. For the heterogeneous medium case, dose differences (as calculated using the MC codes and Plaque Simulator) differ by up to 37% on the central-axis in comparison to the homogeneous water calculations. A prescription dose of 85 Gy at 5 mm depth based on calculations in a homogeneous medium delivers 76 Gy and 67 Gy for specific {sup 125}I and {sup 103}Pd sources, respectively, when accounting for COMS-plaque heterogeneities. For off

  18. Systematic Review of Focal Prostate Brachytherapy and the Future Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion.

    Science.gov (United States)

    Peach, M Sean; Trifiletti, Daniel M; Libby, Bruce

    2016-01-01

    Prostate cancer is the most common malignancy found in North American and European men and the second most common cause of cancer related death. Since the practice of PSA screening has become common the disease is most often found early and can have a long indolent course. Current definitive therapy treats the whole gland but has considerable long-term side effects. Focal therapies may be able to target the cancer while decreasing dose to organs at risk. Our objective was to determine if focal prostate brachytherapy could meet target objectives while permitting a decrease in dose to organs at risk in a way that would allow future salvage treatments. Further, we wanted to determine if focal treatment results in less toxicity. Utilizing the Medline repository, dosimetric papers comparing whole gland to partial gland brachytherapy and clinical papers that reported toxicity of focal brachytherapy were selected. A total of 9 dosimetric and 6 clinical papers met these inclusion criteria. Together, these manuscripts suggest that focal brachytherapy may be employed to decrease dose to organs at risk with decreased toxicity. Of current technology, image-guided HDR brachytherapy using MRI registered to transrectal ultrasound offers the flexibility and efficiency to achieve such focal treatments. PMID:27293899

  19. Radiation Protection in Brachytherapy. Report of the SEFM Task Group on Brachytherapy; Proteccion radiologica en Braquiterapia. Informe del grupo de trabajo de Braquiterapia de la SEFM

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Calatayud, J.; Corredoira Silva, E.; Crispin Contreras, V.; Eudaldo Puell, T.; Frutos Baraja, J. de; Pino Sorroche, F.; Pujades Claumarchirant, M. C.; Richart Sancho, J.

    2015-07-01

    This document presents the report of the Brachytherapy Task Group of the Spanish Society of Medical Physics. It is dedicated to the radiation protection aspects involved in brachytherapy. The aim of this work is to include the more relevant aspects related to radiation protection issues that appear in clinical practice, and for the current equipment in Spain. Basically this report focuses on the typical contents associated with high dose rate brachytherapy with {sup 1}92Ir and {sup 6}0Co sources, and permanent seed implants with {sup 1}25I, {sup 1}03Pd and {sup 1}31Cs, which are the most current and widespread modalities. Ophthalmic brachytherapy (COMS with {sup 1}25I, {sup 1}06Ru, {sup 9}0Sr) is also included due to its availability in a significant number of spanish hospitals. The purpose of this report is to assist to the medical physicist community in establishing a radiation protection program for brachytherapy procedures, trying to solve some ambiguities in the application of legal requirements and recommendations in clinical practice. (Author)

  20. External radiotherapy plus intracavitary brachytherapy for recurrent chordoma of the nasopharynx

    Energy Technology Data Exchange (ETDEWEB)

    Orecchia, R. [Istituto Europeo di Oncologia, Milan (Italy). Div. of Radiotherapy]|[Milan Univ. (Italy); Leonardi, M.C. [Istituto Europeo di Oncologia, Milan (Italy). Div. of Radiotherapy; Krengli, M. [Istituto Europeo di Oncologia, Milan (Italy). Div. of Radiotherapy]|[Ospedale Maggiore, Novara (Italy). Radiotherapy Div.]|[Torino Univ. (Italy); Zurrida, S. [Istituto Europeo di Oncologia, Milan (Italy). Scientific Director`s Office; Brambilla, M.G. [Istituto Europeo di Oncologia, Milan (Italy). Physics Div.

    1998-09-01

    We report a case of recurrent nasopharyngeal chordoma treated by external beam radiotherapy plus brachytherapy, and discuss this technique in relation to treatment modalities reported in the literature. (orig.)

  1. Proceedings of the Second Congress of Radiochemotherapy and Brachytherapy and the Fifth Meeting of Medical Physics

    International Nuclear Information System (INIS)

    The Marie Curie Foundation in the city of Cordoba in Argentina, has organized the Second Congress of radiochemotherapy and brachytherapy and the Fifth Meeting of Medical Physics in order to collaborate with the scientific growth of radiation oncology and medical physics. The main topics covered were: patient's radioprotection, brachytherapy with iodine, radiation protection regulatory issues in Argentina, risk analysis in radiotherapy, medical radiation therapy, EPID dosimetry (Electronic Portal Image Device), accidents in radiotherapy, among others.

  2. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy

    OpenAIRE

    Yasuhiro Yamada; Koji Okihara; Tsuyoshi Iwata; Koji Masui; Kazumi Kamoi; Kei Yamada; Tsuneharu Miki

    2015-01-01

    External beam radiotherapy (EBRT) is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU]) have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatm...

  3. Filariasis of The Breast

    OpenAIRE

    Subhash Bhardwaj, Deepti Mahajan,MRAttri*

    2007-01-01

    Filariasis of the breast presenting as a breast lump and clinically simulating a breast cancer is an unusualpresentation. The present case is of a 42 year old female whose breast lump was excised and histopathologyrevealed filariasis.

  4. Premenstrual breast changes

    Science.gov (United States)

    Premenstrual tenderness and swelling of the breasts; Breast tenderness - premenstrual; Breast swelling - premenstrual ... Symptoms of premenstrual breast tenderness may range from mild to ... most severe just before each menstrual period Improve during ...

  5. Breast enlargement in males

    Science.gov (United States)

    Gynecomastia; Breast enlargement in a male ... The condition may occur in one or both breasts. It begins as a small lump beneath the nipple, which may be tender. One breast may be larger than the other. Enlarged breasts ...

  6. Fibrocystic breast disease

    Science.gov (United States)

    Fibrocystic breast disease; Mammary dysplasia; Diffuse cystic mastopathy; Benign breast disease; Glandular breast changes ... made in the ovaries may make a woman's breasts feel swollen, lumpy, or painful before or during ...

  7. Breast Cancer: Treatment Options

    Science.gov (United States)

    ... Breast Cancer > Breast Cancer - Treatment Options Request Permissions Breast Cancer - Treatment Options Approved by the Cancer.Net Editorial ... recommendations for ovarian ablation . Hormonal therapy for metastatic breast cancer Hormonal therapies are also commonly used to treat ...

  8. Surgery for Breast Cancer

    Science.gov (United States)

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  9. Learning about Breast Cancer

    Science.gov (United States)

    ... genetic terms used on this page Learning About Breast Cancer What do we know about heredity and breast ... Cancer What do we know about heredity and breast cancer? Breast cancer is a common disease. Each year, ...

  10. Brachytherapy in childhood rhabdomyosarcoma treatment; Braquiterapia no tratamento do rabdomiossarcoma da infancia

    Energy Technology Data Exchange (ETDEWEB)

    Novaes, Paulo Eduardo Ribeiro dos Santos

    1995-07-01

    A retrospective study of 21 children with rhabdomyosarcoma treated by brachytherapy to the primary site of the tumor at the Radiotherapy Department of the A.C.Camargo Hospital between january/1980 to june/1993 was undertaken. The main objectives were to comprove the utility of brachytherapy in childhood rhabdomyosarcoma, to evaluate the local control and survival, in association with chemotherapy, to analyze the late effects of the treatment and to determinate the preferential technique to each clinical situation. All patients received brachytherapy to the tumor site. The radioactive isotopes employed were Gold{sup 198}, Cesium{sup 137} and Iridium{sup 192}. The brachytherapy techniques depended on the tumor site, period of treatment, availability of the radioactive material and stage of the disease. Patients treated exclusively by brachytherapy received 40 Gy to 60 Gy. When brachytherapy was associated with external radiotherapy the dose ranged from 20 Gy to 40 Gy. Local control was achieved in 18 of 20 patients (90%). The global survival and local control survival rates were 61.9% (13/21 patients) and 72,2% (13/18 patients) respectively. (author)

  11. Palliative endobronchial HDR-brachytherapy in obstructing malignancies: influence on survival and pattern of failure

    International Nuclear Information System (INIS)

    To evaluate the influence of endobronchial HDR-brachytherapy on survival and pattern of failure 117 patients with central obstructing bronchial carcinoma with EBRT and endobronchial brachytherapy were prospectively investigated and retrospectively matched with a group of patients who received EBRT but no HDR-brachytherapy. The matching criteria were Sex, Age, Histology, TNM-status and EBRT dose. 94 pairs of patient could be evaluated. Taken the two groups as a whole, no difference in suvival could be detected in both groups. However, those patients in whom (by endoscopic findings) a complete remission could be achieved by HDR-brachytherapy, had a significant (p< 0,01) longer survival than the matched group. Patients with endobronchial HDR-brachytherapy died significantly more often by final hemorrhage (26 versus 10). However, survival in the combined modality group was significantly longer. 90 % of the patients in both groups who died by final hemorrhage had a squamous cell carcinoma. In conclusion palliative endobronchial HDR-brachytherapy offers not always benefit in survival to patients with a far advanced disease. However those patients who achieve a complete remission have a significant survival benefit, but with a consequence of a higher rate of final hemorrhage

  12. Intraluminal brachytherapy after metallic stent placement in primary bile duct carcinoma

    International Nuclear Information System (INIS)

    To determine the effect of intraluminal brachytherapy on stent patency and survival after metallic stent placement in patients with primary bile duct carcinoma. Twenty-seven patients with primary bile duct carcinoma underwent metallic stent placement; in 16 of the 27 intraluminal brachytherapy with an iridium-192 source (dose, 25 Gy) was the performed. Obstuction was due to either hilar (n=14) or non-hilar involvement (n=13). For statistical comparison of patients who underwent/did not undergo intraluminal brachytherapy, stent patency and survival were calculated using the Kaplan-Meier method and an independent t test. The mean durations of stent patency and survival were 9.1 and 10.0 months respectively in patients who underwent intraluminal brachytherapy, and 4.2 and 5.0 months in those who did not undergo this procedure (ρ<0.05). The mean durations of stent patency and survival among the 22 patients who died were 7.6 (range, 0.8-16.1) and 8.3 (range, 0.8-17.3) months, respectively, in the eleven patients who underwent intraluminal brachytherapy, and 4.2 (range, 0.9-8.0) and 5.0 (range, 0.9-8.4) months in those whom the procedure was not performed (ρ<0.05). Intraluminal brachytherapy after stent placement extended both stent patency and survival in patients with primary bile duct carcinoma

  13. HDR-192Ir intraluminal brachytherapy in treatment of malignant obstructive jaundice

    Institute of Scientific and Technical Information of China (English)

    Yi Chen; Xiao-Lin Wang; Zhi-Ping Yan; Jie-Min Cheng; Jian-Hua Wang; Gao-Quan Gong; Sheng Qian; Jian-Jun Luo; Qing-Xin Liu

    2004-01-01

    AIM: To determine the feasibility and safety of intraluminal brachytherapy in treatment of malignant obstructive jaundice (MOJ) and to evaluate the clinical effect of intraluminal brachytherapy on stent patency and patient survival.METHODS: Thirty-four patients with MOJ were included in this study. Having biliary stent placed, all patients were classified into intraluminal brachytherapy group (group A,n = 14) and control group (group B, n = 20) according to their own choice. Intraluminal brachytherapy regimen included: HDR-192Ir was used in the therapy, fractional doses of 4-7 Gy were given every 3-6 d for 3-4 times, and standard points were established at 0.5-1.0 cm. Some patients of both groups received transcatheter arterial chemoembolization (TACE) after stent placement.RESULTS: In group A, the success rate of intraluminal brachytherapy was 98.0%, RTOG grade 1 acute radiation morbidity occurred in 3 patients, RTOG/EORTC grade 1 late radiation morbidity occurred in 1 patient. Mean stent patency of group A (12.6 mo) was significantly longer than that of group B (8.3 mo) (P<0.05). There was no significant difference in the mean survival (9.4 mo vs6.0 mo) between the two groups.CONCLUSION: HDR-192Ir intraluminal brachytherapy is a safe palliative therapy in treating MOJ, and it may prolong stent patency and has the potentiality of extending survival of patients with MOJ.

  14. Breast-Conserving Treatment With Partial or Whole Breast Irradiation for Low-Risk Invasive Breast Carcinoma-5-Year Results of a Randomized Trial

    International Nuclear Information System (INIS)

    Purpose: To report the 5-year results of a randomized study comparing the survival and cosmetic results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Methods and Materials: Between 1998 and 2004, 258 selected patients with T1 N0-1mi, Grade 1-2, nonlobular breast cancer without presence of extensive intraductal component and resected with negative margins were randomized after breast-conserving surgery to receive 50 Gy/25 fractions WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy high-dose-rate (HDR) multicatheter brachytherapy (BT; n = 88) or 50 Gy/25 fractions electron beam (EB) irradiation (n = 40). Results: At a median follow-up of 66 months, the 5-year actuarial rate of local recurrence was 4.7% and 3.4% in the PBI and WBI arms, respectively (p = 0.50). There was no significant difference in the 5-year probability of overall survival (94.6% vs. 91.8%), cancer-specific survival (98.3% vs. 96.0%), and disease-free survival (88.3% vs. 90.3%). The rate of excellent to good cosmetic result was 77.6% in the PBI group (81.2% after HDR BT; 70.0% after EB) and 62.9% in the control group (52.2% after telecobalt; 65.6% after 6-9-MV photons; pWBI/PBI = 0.009). Conclusions: Partial breast irradiation using interstitial HDR implants or EB to deliver radiation to the tumor bed alone for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with carefully designed HDR multicatheter implants compared with the outcome after WBI

  15. Curative high dose rate vaginal apex brachytherapy in stage I papillary serous carcinoma of the endometrium

    International Nuclear Information System (INIS)

    Introduction: Uterine papillary serous carcinoma (UPSC) is a morphologically distinct variant of endometrial carcinoma that is associated with a poor prognosis, high recurrence rate, clinical understaging, and poor response to salvage treatment. We describe the presentation, local and distant control, survival, salvage rate, and complications for patients undergoing whole abdominal radiation therapy (WART), low dose rate (LDR) intracavitary brachytherapy, or high dose rate (HDR) vaginal brachytherapy in patients with stage I UPSC. Methods: Between 1976 and 1994 more than 1700 patients with endometrial carcinoma were treated with radiation therapy, 30 patients with stage I UPSC (1.8%) were treated with radiation before or following TAH/BSO. All patients underwent either preoperative Simon's packing or tandem and plaque which delivered 30-40 Gy to the serosa, WART, or HDR Ir-192 vaginal apex brachytherapy to a total dose of 21 Gy in 3 fractions at 0.5 cm from the vaginal mucosa. A total of 14 patients received HDR vaginal brachytherapy and (5(14)) patients received systemic chemotherapy. All patients presented with vaginal bleeding at a median age of 67 years (range 34-88). The group of 30 patients underwent TAH/BSO, 17 patients were completely staged pathologically (pelvic and para-aortic lymph nodes, omentectomy, and pelvic washings), and 2 patients underwent omental biopsy and pelvic washings only. All specimens revealed UPSC, nuclear grade 3, and lymphovascular invasion (23%). The pathologic stage was IA: 23% (7), IB: 67% (20), and IC: 10% (3). The median follow-up for all patients was 49 months (range 13-187 months). For the patients receiving postoperative HDR vaginal brachytherapy the median time from surgery to radiation was 42 days (range 29-91). Results: The 5-year actuarial disease free survival for Figo stage I UPSC patients treated with postoperative HDR vaginal brachytherapy and systemic chemotherapy was 100% compared to 74% for stage I UPSC patient

  16. Breast Cancer

    Science.gov (United States)

    ... click the brackets in the lower right-hand corner of the video screen. To reduce the videos, ... with breast cancer are under way. With early detection, and prompt and appropriate treatment, the outlook for ...

  17. Breast cancer

    International Nuclear Information System (INIS)

    This article is about the diagnosis, treatment and monitoring of breast cancer. Positive diagnosis is based on clinical mammary exam, mammography, mammary ultrasonography, and histological study. Before the chemotherapy and radiotherapy treatment are evaluated the risks

  18. Breast ultrasound

    Science.gov (United States)

    Hacker NF, Friedland ML. Breast disease. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 30. Harvey ...

  19. Breast Density and Your Breast Mammogram Report

    Science.gov (United States)

    Breast Density and Your Mammogram Report Regular mammograms are the best way to find breast cancer early. But if ... But in some women, there’s little change. Breast density is very common, and is not abnormal. How ...

  20. Screening for Breast Problems

    Science.gov (United States)

    ... a clinical breast exam done? • What is breast self-awareness? • How is breast self-awareness different from the traditional breast self-exam? •Glossary ... problems includes mammography , clinical breast exams, and breast self-awareness. What is mammography? Mammography is an X-ray ...

  1. Passively mode-locked erbium-doped fiber laser via a D-shape-fiber-based MoS2 saturable absorber with a very low nonsaturable loss

    Science.gov (United States)

    Li-Na, Duan; Yu-Long, Su; Yong-Gang, Wang; Lu, Li; Xi, Wang; Yi-Shan, Wang

    2016-02-01

    We report on the generation of conventional and dissipative solitons in erbium-doped fiber lasers by the evanescent field interaction between the propagating light and a multilayer molybdenum disulfide (MoS2) thin film. The MoS2 film is fabricated by depositing the MoS2 water-ethanol mixture on a D-shape-fiber (DF) repetitively. The measured nonsaturable loss, saturable optical intensity, and the modulation depth of this device are 13.3%, 110 MW/cm2, and 3.4% respectively. Owing to the very low nonsaturable loss, the laser threshold of conventional soliton is as low as 4.8 mW. The further increase of net cavity dispersion to normal regime, stable dissipation soliton pulse trains with a spectral bandwidth of 11.7 nm and pulse duration of 116 ps are successfully generated. Our experiment demonstrates that the MoS2-DF device can indeed be used as a high performance saturable absorber for further applications in ultrafast photonics. Project supported by the National Natural Science Foundation of China (Grant No. 61378024).

  2. HDR intralumenal brachytherapy in bronchial cancer: review of our experience

    International Nuclear Information System (INIS)

    The main indications for brachytherapy in the treatment of endobronchial cancer are dyspnea. postobstructive pneumonia and atelectasis, cough and hemoptysis resulting from broncus obstruction by exophytic intralumenal tumor growth. High Dose Rate intralumenal brachytherapy (HDRBT) may be combined with external beam radiotherapy (EBRT), in particular as almost all tumors are too large for HDRBT alone. From January 1992 to September 1995 we treated 268 patients affected by bronchial cancer, with EBRT combined with HDRBT. All patients were staged as IIIa-IIIb-IV but KPS was >60 and expectancy of life > than 3 months. After bronchoscopy and Tc simulation we found that almost 10% of patients were downstaged. Treatment was always realized delivering 60 Gy to the tumour volume and 50 Gy to the mediastinal structures with EBRT. Brachytherapy was performed during the radiotherapy course. In 38 patients HDRBT was realized just one time, at the beginning of EBRT, with a dose of 10 Gy calculated at 1cm from the central axis of the catheter. In 47 HDRBT was performed twice (at the beginning and at the end of EBRT) with a dose of 7 Gy calculated at 1 cm from the central axis. From 1994 we started a 3 fractions protocol (Timing: days 1.15.30) with a dose of 5 Gy calculated at 0.5 cm from the axis. Of the 183 patients introduced in the protocol 170 received the three fractions of HDRBT and 13 were excluded from the study for personal or clinical reasons. In 97% of cases the application did not need general anesthesia; local anesthesia has been sufficient supplemented by some drug for sedation and coughing. Anyway both bronchoscopy and HDRBT (with anterior-posterior and lateral chest X-ray) are performed in the same shielded room without the necessity of displacing the patient. In almost 60% of treatments we used just one endobronchial applicator. In case of tumor involvement of the carina, two applicators were introduced. By this a larger tumor volume can be treated with adequate

  3. Primary Causes of Death After Permanent Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate the primary causes of death in low-risk (low-risk), intermediate-risk (intermediate-risk), and high-risk (high-risk) patients undergoing permanent prostate brachytherapy with or without supplemental therapies. Methods and Materials: From April 1995 through November 2004, a total of 1,354 consecutive patients underwent prostate brachytherapy. All patients underwent brachytherapy >3 years before analysis. Of the patients, 532 (39.3%) received androgen deprivation therapy and 703 (51.9%) received supplemental radiation therapy. The median follow-up was 5.4 years. Multiple parameters were evaluated as predictors of cause-specific, biochemical progression-free, and overall survival. Results: The 10-year cause-specific survival was 97.0% (99.7%, 99.0%, and 90.1% for low-risk, intermediate-risk, and high-risk patients). Overall survival was 76.7% (82.5%, 78.3%, and 67.6% for low-, intermediate-, and high-risk patients, respectively). The cumulative death rate for cardiovascular disease was 11.5% (8.7%, 9.3%, and 19.8% for low-, intermediate-, and high-risk patients). The death rate from second malignancies (nonprostate cancer) was 7.2% and was not substantially different when stratified by risk group. Death from all other causes was 6.5% for the entire cohort but 1.3%, 5.0%, and 10.8% for low-, intermediate-, and high-risk patients. In multivariate analysis, death from prostate cancer was best predicted by Gleason score and risk group, whereas death from cardiovascular disease, nonprostate cancer, and all other causes were most closely related to patient age and tobacco use. Conclusions: Although cardiovascular mortality was the predominant cause of death, prostate cancer was responsible for approximately 10% of all deaths. In particular, overall survival was poorest in the high-risk group. Although high-risk patients were most likely to die of prostate cancer, the divergence in overall survival between high-risk and lower-risk patients primarily

  4. Effectiveness of brachytherapy in treating carcinoma of the vulva

    International Nuclear Information System (INIS)

    Purpose: Radical radiotherapeutic management of vulvar cancer often incorporates brachytherapy as a portion of the treatment regimen. However, few studies using this modality alone to manage vulvar cancer have been published. Methods and Materials: Thirty four patients were treated with iridium-192 (192Ir) brachytherapy for vulvar cancer between 1975 and 1993 at Centre Alexis Vautrin. Twenty-one patients were treated at first presentation when surgery was contraindicated or declined. Of these patients, 12 had International Federation of Gynecology and Obstetrics Classification Stage III or IV disease, 8 were Stage II, 1 was Stage I, and 1 was Stage 0. Thirteen patients were treated for recurrent disease. Paris system rules for implantation and dose prescription were followed. The median reference dose was 60 Gy (range 53 to 88 Gy). At the time of analysis, 10 of 34 patients were alive. Median follow-up in these 10 patients was 31 months (range: 21 months to 107 months). Fourteen of the 24 deaths were from causes other than vulvar cancer. Results: Kaplan-Meier actuarial 5-year local control was 47% (95% confidence interval (CI) = 23 to 73%) and 5-year actuarial loco-regional control was 45% (95% CI = 21 to 70%). Kaplan-Meier actuarial 5-year disease-specific survival was 56% (95% CI = 33 to 76%) and actuarial 5-year survival was 29% (95% CI = 15 to 49%). Median time to death was 14 months. Subset analysis revealed a higher actuarial 5-year local control in patients treated at first presentation than those treated for recurrence (80 vs. 19%, log rank, p = 0.04). Similarly, actuarial 5-year loco-regional control was higher in patients treated at first presentation (80 vs. 16%, log rank, p 0.01). The two groups did not differ significantly in disease-specific or overall survival. The actuarial 5-year disease specific survival of 56% is somewhat less than the expected 5-year disease-specific survival after surgery in a group having a similar proportion of early stage

  5. Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns

    Energy Technology Data Exchange (ETDEWEB)

    Cunha, J. A. M.; Hsu, I-C.; Pouliot, J. [University of California, San Francisco, California 94115 (United States)

    2009-01-15

    Purpose: To determine whether alternative high dose rate prostate brachytherapy catheter patterns can result in similar or improved dose distributions while providing better access and reducing trauma. Materials and Methods: Standard prostate cancer high dose rate brachytherapy uses a regular grid of parallel needle positions to guide the catheter insertion. This geometry does not easily allow the physician to avoid piercing the critical structures near the penile bulb nor does it provide position flexibility in the case of pubic arch interference. This study used CT datasets with 3 mm slice spacing from ten previously treated patients and digitized new catheters following three hypothetical catheter patterns: conical, bi-conical, and fireworks. The conical patterns were used to accommodate a robotic delivery using a single entry point. The bi-conical and fireworks patterns were specifically designed to avoid the critical structures near the penile bulb. For each catheter distribution, a plan was optimized with the inverse planning algorithm, IPSA, and compared with the plan used for treatment. Irrelevant of catheter geometry, a plan must fulfill the RTOG-0321 dose criteria for target dose coverage (V{sub 100}{sup Prostate}>90%) and organ-at-risk dose sparing (V{sub 75}{sup Bladder}<1 cc, V{sub 75}{sup Rectum}<1 cc, V{sub 125}{sup Urethra}<<1 cc). Results: The three nonstandard catheter patterns used 16 nonparallel, straight divergent catheters, with entry points in the perineum. Thirty plans from ten patients with prostate sizes ranging from 26 to 89 cc were optimized. All nonstandard patterns fulfilled the RTOG criteria when the clinical plan did. In some cases, the dose distribution was improved by better sparing the organs-at-risk. Conclusion: Alternative catheter patterns can provide the physician with additional ways to treat patients previously considered unsuited for brachytherapy treatment (pubic arch interference) and facilitate robotic guidance of

  6. Dosimetry TL 'in vivo' for the quality control in radiotherapy with Co-60 and brachytherapy of low dose rate

    International Nuclear Information System (INIS)

    Full text: The dosimetry 'in vivo' is used frequently as a valuable tool for the quality control in radiotherapy. Measurements of the entry and exit doses provide us of information on the precision of the technique or the procedure of used treatment; the measurement of the doses in rectal or bladder in gynecological implants contribute to perfect or to adjust the procedures in brachytherapy. Also systematic errors can be identified in particular situations that allow to optimize the treatment and to minimize errors. A study in the service of Radiotherapy of the San Roque Hospital, was realized for to control the procedures used in the treatment of different cancer therapy. Patients were selected, to which were carried out a routine planning with the system of planning of on line treatment Prowess 3000 that then were controlled with thermoluminescent dosemeters 'in vivo' using the Ceprocor Services. Skin doses were measurement in treatment of breast, pelvis, thorax, head and neck, and doses was measured in cavities of the body as oral cavity, rectal, esophagus, etc., placing the TLD inside special catheters. In the case of doses in skin, the dosimeters was placed in acrylic badges. A very good agreement was found between the measurements 'in vivo' and the plans of the planner. In some cases the control allowed to modify the doses to avoid organs damage for the radiation fields. (author)

  7. Breast fibromatosis associated with breast implants.

    Science.gov (United States)

    Seo, Yoon Nae; Park, Young Mi; Yoon, Hye Kyoung; Lee, Sun Joo; Choo, Hye Jung; Ryu, Ji Hwa

    2015-09-01

    Fibromatosis refers to an extra-abdominal desmoid tumor or aggressive fibromatosis. Breast fibromatosis can develop in association with the capsule around a breast implant, although reports of cases of fibromatosis associated with breast implants are rare. As the demand for breast augmentation has increased, it is important to understand the diseases associated with breast implants. In the present report, we describe a case of breast fibromatosis that developed adjacent to a breast implant and demonstrated a relatively well-defined border even though it invaded the surrounding structures. We also explore the specific imaging features for diagnosing breast fibromatosis in association with implants by reviewing previous literature.

  8. Synthesis of phosphosilicate matrix for application to brachytherapy sources

    International Nuclear Information System (INIS)

    Brachytherapy with beta sources can be useful for in situ radiotherapy of cancers where tiny radioactive seeds are injected directly into the tumor. Phosphorus 31P can be activated to b-emitter 32P by neutron activation with a half-life of 14.3 days. In this work, phosphosilicate matrices were synthesized through sol-gel process by hydrolysis and condensation of the tetraethylorthosilicate (TEOS) under two different conditions of synthesis. In both conditions the phosphoric acid and drying control chemical additives (DCCA's) were the same. Three drying control chemical additives were utilized: propylene carbonate, N,N-dimethylformamide and ethylene glycol. The casting solutions were prepared with phosphorus content of 3.2 wt.% and xerogels were thermally treated at 900 deg C. Different microstructures were observed under different conditions of synthesis. The microstructures of phosphosilicate matrices obtained with ethylene glycol and without DCCA's have shown the presence of a globular structure regions with large amount of phosphorous. (author)

  9. Evaluating the cost of therapy for restenosis: considerations for brachytherapy.

    Science.gov (United States)

    Weintraub, W S

    1996-11-01

    Costs have become increasingly important in medicine in recent years as demand for services has outstripped readily available resources. Clinical microeconomics offers an approach to understanding cost and outcomes in an environment of economic scarcity. In this article the types of costs and methods for determining cost are presented. In addition, methods for assessing outcome and outcome in relation to cost are developed. Restenosis after coronary angioplasty is a prime example of a clinical problem requiring economic evaluation. This is because it results in little serious morbidity except for recurrent chest pain, but it has serious economic consequences which occur some time after the original angioplasty. This makes the economic assessment of restenosis complicated. The application of health care microeconomic principles to brachytherapy for restenosis in the coronary arteries is presented. PMID:8960526

  10. Evaluating the cost of therapy for restenosis: considerations for brachytherapy

    International Nuclear Information System (INIS)

    Costs have become increasingly important in medicine in recent years as demand for services has outstripped readily available resources. Clinical microeconomics offers an approach to understanding cost and outcomes in an environment of economic scarcity. In this article the types of costs and methods for determining cost are presented. In addition, methods for assessing outcome and outcome in relation to cost are developed. Restenosis after coronary angioplasty is a prime example of a clinical problem requiring economic evaluation. This is because it results in little serious morbidity except for recurrent chest pain, but it has serious economic consequences which occur some time after the original angioplasty. This makes the economic assessment of restenosis complicated. The application of health care microeconomic principles to brachytherapy for restenosis in the coronary arteries is presented

  11. Design and implementation of an intravascular brachytherapy installation in cardiology

    International Nuclear Information System (INIS)

    Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

  12. Cs-137 brachytherapy sources calibration with well chamber

    International Nuclear Information System (INIS)

    This work describes the procedures and actions developed for the identification and reference air kerma rate (Sk) verification of Cs-137 sources used in gynecological brachytherapy practices. Following the IAEA TECDOC 1151 recommendations, the first stage consisted in designing the documentation required for the inventory and shipping registry of sources, along with the digital spreadsheets for calculating the decay and Sk of the sources at the moment of implantation. As a second stage, the Sk of sources was measured, following the low dose rate sources protocol advise, with a Standard Imaging HDR 1000 Plus well chamber calibrated at the University of Wisconsin SSDL. The documentation generated through this procedure allows identify each source clearly and uni-vocally. No significant differences were found between the Sk values obtained from the well chamber calibration procedure and those reported by the manufacturer in the corresponding certificates. The highest percent difference found was 2.3%. (author)

  13. Optimization in brachytherapy with the implementation of Radiobiology

    International Nuclear Information System (INIS)

    In the brachytherapy planning treatments with High dose rates (HDR), the optimization algorithms used are based in dosimetric considerations and/or geometric ones, ignoring the radiobiological response of the tissue treated. In this work we wish to show the implementation of radiobiological concepts in the optimization. Assuming that the subtiles differences that result in the dose distribution among the different optimization models which are not visible in an isodose plane, it is studied how is classically make it , the quality implant through natural histograms about dose volumes and the resulting parameters. Also is studied the necrosis probability which may be caused by the choice of some optimization model, allowing with this the choice of the best implant. (Author)

  14. A new human eye model for ophthalmic brachytherapy dosimetry

    International Nuclear Information System (INIS)

    The present work proposes a new mathematical eye model for ophthalmic brachytherapy dosimetry. This new model includes detailed description of internal structures that were not treated in previous works, allowing dose determination in different regions of the eye for a more adequate clinical analysis. Dose calculations were determined with the MCNP-4C Monte Carlo particle transport code running n parallel environment using PVM. The Amersham CKA4 ophthalmic applicator has been chosen and the depth dose distribution has been determined and compared to those provide by the manufacturer. The results have shown excellent agreement. Besides, absorbed dose values due to both 125I seeds and 60Co plaques were obtained for each one of the different structures which compose the eye model and can give relevant information in eventual clinical analyses. (authors)

  15. Dosimetry of the 198Au Source used in Interstitial Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dauffy, L; Braby, L; Berner, B

    2004-05-18

    The American Association of Physicists in Medicine Task Group 43 report, AAPM TG-43, provides an analytical model and a dosimetry protocol for brachytherapy dose calculations, as well as documentation and results for some sealed sources. The radionuclide {sup 198}Au (T{sub 1/2} = 2.70 days, E{gamma} = 412 keV) has been used in the form of seeds for brachytherapy treatments including brain, eye, and prostate tumors. However, the TG-43 report has no data for {sup 198}Au seeds, and none have previously been obtained. For that reason, and because of the conversion of most treatment planning systems to TG-43 based methods, both Monte Carlo calculations (MCNP 4C) and thermoluminescent dosimeters (TLDs) are used in this work to determine these data. The geometric variation in dose is measured using an array of TLDs in a solid water phantom, and the seed activity is determined using both a well ion chamber and a High Purity Germanium detector (HPGe). The results for air kerma strength, S{sub k}, per unit apparent activity, are 2.06 (MCNP) and 2.09 (measured) U mCi{sup -1}. The former is identical to what was published in 1991 in the AAPM Task Group 32 report. The dose rate constant results, {Lambda}, are 1.12 (MCNP) and 1.10 (measured), cGy h{sup -1} U{sup -1}. The radial dose function, g(r), anisotropy function, F(r,{theta}), and anisotropy factor, {psi}{sub an}(r), are given. The anisotropy constant values are 0.973 (MCNP) and 0.994 (measured) and are consistent with both source geometry and the emitted photon energy.

  16. Physics and quality assurance of low dose rate brachytherapy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this course is to review the physical principles underlying design, clinical application and execution of interstitial and intracavitary implants in the classical low dose-rate (LDR) range. This year, the course will focus on quality assurance of sources, applicators and treatment planning software. In addition, development of procedures and QA checks designed optimize treatment delivery accuracy and patient safety during each individual procedure will be reviewed. The level of presentation will be designed to accommodate both physicists and physicians. Implementation of recently published AAPM Task Group reports (no. 40, 'Comprehensive Quality Assurance' and No. 43, 'Dosimetry of Interstitial Brachytherapy Sources') will be reviewed. Outline: (A) General Principles (1) QA endpoints: temporal accuracy, positional accuracy, dose delivery accuracy, and safety of the patient, personnel, and the institution (2) QA procedure development: forms, checklists, test development and design of treatment delivery procedures (B) QA of treatment delivery devices (1) Source acceptance testing and QA a) calibration and source strength specification standards b) leakage tests and source geometry verification (2) Applicator acceptance testing and QA (3) Remote afterloading devices (4) Treatment planning systems a) graphic input/output devices, implant geometry reconstruction, and graphical display b) dose calculation accuracy i) review of brachytherapy dose calculation algorithms ii) dosimetric benchmarks available: Task Group 43 report (C) Procedure-specific QA 1) Organization of treatment delivery team 2) Preplanning and preparation 3) Applicator insertion 4) Radiographic examination of the implant, prescription, and treatment calculation 5) Source insertion 6) Treatment planning and physicist review of treatment plans 7) QA during patient treatment and removal of sources and applicators

  17. A Monte Carlo investigation of lung brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Iodine-125 (125I) and Caesium-131 (131Cs) brachytherapy have been used in conjunction with sublobar resection to reduce the local recurrence of stage I non-small cell lung cancer compared with resection alone. Treatment planning for this procedure is typically performed using only a seed activity nomogram or look-up table to determine seed strand spacing for the implanted mesh. Since the post-implant seed geometry is difficult to predict, the nomogram is calculated using the TG-43 formalism for seeds in a planar geometry. In this work, the EGSnrc user-code BrachyDose is used to recalculate nomograms using a variety of tissue models for 125I and 131Cs seeds. Calculated prescription doses are compared to those calculated using TG-43. Additionally, patient CT and contour data are used to generate virtual implants to study the effects that post-implant deformation and patient-specific tissue heterogeneity have on perturbing nomogram-derived dose distributions. Differences of up to 25% in calculated prescription dose are found between TG-43 and Monte Carlo calculations with the TG-43 formalism underestimating prescription doses in general. Differences between the TG-43 formalism and Monte Carlo calculated prescription doses are greater for 125I than for 131Cs seeds. Dose distributions are found to change significantly based on implant deformation and tissues surrounding implants for patient-specific virtual implants. Results suggest that accounting for seed grid deformation and the effects of non-water media, at least approximately, are likely required to reliably predict dose distributions in lung brachytherapy patients. (paper)

  18. Urethral stricture following high dose rate brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the incidence, timing, nature and outcome of urethral strictures following high dose rate brachytherapy (HDRB) for prostate carcinoma. Methods and materials: Data from 474 patients with clinically localised prostate cancer treated with HDRB were analysed. Ninety percent received HDRB as a boost to external beam radiotherapy (HDRBB) and the remainder as monotherapy (HDRBM). Urethral strictures were graded according to the Common Terminology Criteria for Adverse Events v3.0. Results: At a median follow-up of 41 months, 38 patients (8%) were diagnosed with a urethral stricture (6-year actuarial risk 12%). Stricture location was bulbo-membranous (BM) urethra in 92.1%. The overall actuarial rate of grade 2 or more BM urethral stricture was estimated at 10.8% (95% CI 7.0-14.9%), with a median time to diagnosis of 22 months (range 10-68 months). All strictures were initially managed with either dilatation (n = 15) or optical urethrotomy (n = 20). Second line therapy was required in 17 cases (49%), third line in three cases (9%) and 1 patient open urethroplasty (grade 3 toxicity). Predictive factors on multivariate analysis were prior trans-urethral resection of prostate (hazard ratio (HR) 2.81, 95% CI 1.15-6.85, p = 0.023); hypertension (HR 2.83, 95% CI 1.37-5.85, p = 0.005); and dose per fraction used in HDR (HR for 1 Gy increase per fraction 1.33, 95% CI 1.08-1.64, p = 0.008). Conclusions: BM urethral strictures are the most common late grade 2 or more urinary toxicity following HDR brachytherapy for prostate cancer. Most are manageable with minimally invasive procedures. Both clinical and dosimetric factors appear to influence the risk of stricture formation.

  19. Brachytherapy as sole treatment modality in initial cervix carcinoma

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate brachytherapy as the only treatment modality in inoperable early cervix carcinoma patients (carcinoma in situ, IA and IBocc). In a retrospective analysis 36 patients were treated with intracavitary irradiation between 1984 and 1988 in the Radiotherapy Department of the National Institute of Neoplasmic Diseases. Distribution by stage was; carcinoma in situ: one patient (2,47%), IA: six patients (16,6%), IBooc: twenty-nine patients (80,7%). Histology revealed epidermoid carcinoma in all cases. Mean age 55 years (range: 32-78). Treatment consisted in: two intracavitary applications of Radium, for 120 hours each, with a month interval, in 30 patients (carcinoma in situ: one, IA: four, IBocc: twenty-five patients), two applications of 72 hours each, with 15 days interval in four patients (IA: one, IBocc: 3) and one single intracavitary radium application in two patients (IA and IBocc). Local control was complete in all carcinoma in situ and IA patients. Only 1 of 29 patients with IBocc stage failed to respond, in spite of having received two applications, this shows that local response is independent of the number of insertions. Incidence of complications was low, and resolved with medical treatment. One patient had rectal adenocarcinoma 3 years after treatment -it was considered as radio induced neoplasm, since time of appearance was more than two years and localization was within irradiated area. Two patients died form intercurrent diseases, one (IBocc) from persistent diseases. Two patients were lost to follow-up. Three years survival was: 100% for carcinoma in situ and IA 86,2% for IBocc. Five years survival was 80% for IA and IBocc. Brachytherapy as unique modality of treatment is highly effective in initial cervix carcinoma stages. (author). 41 refs., 14 tabs., 2 figs., 1 ill

  20. CT use for nasopharingeal molds realization in endocavitary brachytherapy

    International Nuclear Information System (INIS)

    Purpose: We present the following procedure for the making of individual molds with dental silicone for endocavitary brachytherapy of nasopharingeal cancer aided by CT scan. Procedure: Head immobilization during the realization of nasopharynx CT. Planification of treatment using these CT images, to determine the optimum position of radioactive sources. Printing on paper CT images with the nasopharynx contoured walls and the radioactive sources position. Realization of the mold in plastiline with the aid of the cuts of printer paper cut out with the nasopharynx form. Obtaining of the negative of the mold of plastiline by means of the use of alginate. Placement of two number 20 rectal rigid catheters with metal malleable bars inside them, in order to give them an adequate form in relation to the previous carried out planning. Filling in of alginato negative, where rectal catheters were placed, with Provil MCD Bayer Dental, a silicone based material for precision impression. We recommend to crossing the catheters' end with a number 2 silk thread to secure the catheter. An end of the silk thread is left outside the mold in order to help the extraction at the end of application. We advise to carry out a neuroleptic anaesthesia for its insertion, for the purpose of achieving a soft palate suitable relaxation. It makes the insertion easier. Repeat CT with the mold and phantoms in position to know a definitive dose distribution calculation. Conclusion: This method avoids the necessity of general anaesthesia in the realization of individual molds of nasopharyx for endocavitary brachytherapy and it improves the implant dosimetry

  1. Iodine-125 interstitial brachytherapy for experimental liver cancer

    Institute of Scientific and Technical Information of China (English)

    ZHOU Fei-guo; YAN Jian-jun; HUANG Liang; LIU Cai-feng; ZHANG Xiang-hua; ZHOU Wei-ping; YAN Yi-qun

    2007-01-01

    Objective:To study the effect of iodine-125 interstitial brachytherapy on liver cancer.Methods:Animal model of human liver cancer was established by injecting SMMC-7721 cells cultivated in vitro subcutaneously into the flank of BALB/c nude mice.Nude mice with tumor of 5 mm in diameter were randomly divided into 2 groups(n=10).One iodine-125 seed of apparent activity 0.8 mCi was implanted into the center of tumor in treatment group,whereas an inactive seed was implanted in control group.The other 20 nude mice with tumor reaching 10 mm in diameter were also treated as above.The size of tumor was determined weekly after implantation,and pathological examination and blood routine were taken on the 28th day.Results:Tumor growth was obviously inhibited in treatment group of tumor of 5 mm in diameter,and there was statistically significant difference in tumor volume between treatment and control groups(P<0.01).Around iodine-125 seed,apparent necrosis of tumor was shown in treatment group,accompanied by karyopyknosis and reduced plasma in residual tumor cells microscopically.Tumor growth was not inhibited in either treatment or control group of tumor of 10 mm in diameter.There was no obvious adverse effect except for decreased white blood cells in treatment groups.Conclusion:There is certain effect of iodine-125 interstitial brachytherapy on liver cancer,which is associated with the size of tumor.

  2. Deterministic calculations of radiation doses from brachytherapy seeds

    International Nuclear Information System (INIS)

    Brachytherapy is used for treating certain types of cancer by inserting radioactive sources into tumours. CDTN/CNEN is developing brachytherapy seeds to be used mainly in prostate cancer treatment. Dose calculations play a very significant role in the characterization of the developed seeds. The current state-of-the-art of computation dosimetry relies on Monte Carlo methods using, for instance, MCNP codes. However, deterministic calculations have some advantages, as, for example, short computer time to find solutions. This paper presents a software developed to calculate doses in a two-dimensional space surrounding the seed, using a deterministic algorithm. The analysed seeds consist of capsules similar to IMC6711 (OncoSeed), that are commercially available. The exposure rates and absorbed doses are computed using the Sievert integral and the Meisberger third order polynomial, respectively. The software also allows the isodose visualization at the surface plan. The user can choose between four different radionuclides (192Ir, 198Au, 137Cs and 60Co). He also have to enter as input data: the exposure rate constant; the source activity; the active length of the source; the number of segments in which the source will be divided; the total source length; the source diameter; and the actual and effective source thickness. The computed results were benchmarked against results from literature and developed software will be used to support the characterization process of the source that is being developed at CDTN. The software was implemented using Borland Delphi in Windows environment and is an alternative to Monte Carlo based codes. (author)

  3. Development of prostate voxel models for brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Adriano M.; Reis, Lucas P.; Grynberg, Suely E., E-mail: amsantos@cdtn.b [Center for Development of Nuclear Technology (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    The tools developed recently in the areas of computer graphics and animation movies to computer games allow the creation of new voxel anthropomorphic phantoms with better resolution and thus, more anatomical details. These phantoms can be used in nuclear applications, especially in radiation protection for estimating doses in cases of occupational or accidental radioactive incidents, and in medical and biological applications. For dose estimates, the phantoms are coupled to a Monte Carlo code, which will be responsible for the transport of radiation in this environment. This study aimed to develop a computational tool to estimate the isodose curves in the prostate after brachytherapy seed implants. For this, we have created a model called FANTPROST in the shape of a 48 mm side cube, with a standard prostate inserted in the center of this cube with different distributions of brachytherapy seeds in this volume. The prostate, according to this model, was obtained from the phantom voxels MASH2 developed by Numerical Dosimetry Group, Department of Nuclear Energy - Federal University of Pernambuco. The modeling of the seeds, added to FANTPROST, was done through the use of geometric information of Iodine-125 Amersham 6711 commercial seed. The simulations were performed by the code MCNP5 for spatial distributions containing different amounts of seeds within the FANTPROST. The obtained curves allowed an estimation of the behavior of the maximum dose that decreases with distance, showing that this tool can be used for a more accurate analysis of the effects produced by the presence of such seeds in the prostate and its vicinity. (author)

  4. 早期乳腺癌部分乳腺加速放疗%Accelerated partial breast irradiation for early breast cancer

    Institute of Scientific and Technical Information of China (English)

    张秋宁; 王小虎

    2011-01-01

    随着乳腺癌术后复发模式的研究进展,部分乳腺照射方法 成为乳腺癌放疗的热点.组织间插植、球囊近距离治疗、术中放疗及三维适形放疗和调强放疗等部分乳腺加速放疗已进入临床研究.其局部控制率和安全性与全乳腺照射比较相当,同时具有治疗周期短、方便患者等优势.部分乳腺加速放疗在部分患者有望代替全乳腺放疗,成为早期乳腺癌保乳术后放疗的标准治疗之一.%With a view to patterns of local recurrence after breast conserving surgery, whole breast irradiation(WBI) after surgery is controversial and partial-breast irradiation(PBI) came up. Many clinical trials related with accelerated partial-breast irradiation using a variety of radiotherapeutic techniques such as interstitial brachytherapy (IBT), MammoSite Radiation Therapy System, intraoperative radiotherapy(IORT), threedimensional conformal radiotherapy(3-DCRT)and intensity modulated radiation therapy(IMRT) in selected patients have been carried out. Accelerated partial-breast irradiation that provides faster, more convenient treat-ment demonstrates local control rate and safety comparable to that of whole breast irradiation. Partial breast irradiation may be an alternative way to whole breast radiotherapy and will be one of the standard treatments in women with early breast cancer seeking breast conservation.

  5. GGEMS-Brachy: GPU GEant4-based Monte Carlo simulation for brachytherapy applications

    International Nuclear Information System (INIS)

    In brachytherapy, plans are routinely calculated using the AAPM TG43 formalism which considers the patient as a simple water object. An accurate modeling of the physical processes considering patient heterogeneity using Monte Carlo simulation (MCS) methods is currently too time-consuming and computationally demanding to be routinely used. In this work we implemented and evaluated an accurate and fast MCS on Graphics Processing Units (GPU) for brachytherapy low dose rate (LDR) applications. A previously proposed Geant4 based MCS framework implemented on GPU (GGEMS) was extended to include a hybrid GPU navigator, allowing navigation within voxelized patient specific images and analytically modeled 125I seeds used in LDR brachytherapy. In addition, dose scoring based on track length estimator including uncertainty calculations was incorporated. The implemented GGEMS-brachy platform was validated using a comparison with Geant4 simulations and reference datasets. Finally, a comparative dosimetry study based on the current clinical standard (TG43) and the proposed platform was performed on twelve prostate cancer patients undergoing LDR brachytherapy. Considering patient 3D CT volumes of 400  × 250  × 65 voxels and an average of 58 implanted seeds, the mean patient dosimetry study run time for a 2% dose uncertainty was 9.35 s (≈500 ms 10−6 simulated particles) and 2.5 s when using one and four GPUs, respectively. The performance of the proposed GGEMS-brachy platform allows envisaging the use of Monte Carlo simulation based dosimetry studies in brachytherapy compatible with clinical practice. Although the proposed platform was evaluated for prostate cancer, it is equally applicable to other LDR brachytherapy clinical applications. Future extensions will allow its application in high dose rate brachytherapy applications. (paper)

  6. Radiation risk to patient and intervention personell from intracoronary brachytherapy; Die Dosisbelastung von Patienten und Interventionspersonal in der intravaskulaeren Brachytherapie

    Energy Technology Data Exchange (ETDEWEB)

    Hefner, A. [Austrian Research Centers Seibersdorf (Austria); Kirisits, C.; Georg, D.; Poetter, R. [Universitaetsklinik fuer Strahlentherapie und Strahlenbiologie, Wien (Austria); Aiginger, H. [Atominstitut der Oesterreichischen Universitaeten, Wien (Austria)

    2001-07-01

    During the last years coronary brachytherapy has been extensively explored as a new treatment to prevent restenosis after percutaneous coronary interventions. While clinical and physical aspects of such treatments are addressed in literature, there is little information available on radiation protection and radiation safety aspects. In this paper we estimate the radiation risk for the patient using analytical methods and Monte Carlo calculations for three delivering systems currently used in clinics. Additionally, radiation risk to personell involved in such treatments is investigated. For gamma emitting sources the radiation exposure to patients is in the order of magnitude of the exposure due to diagnostic angiography. Doses to organs at risk when applying beta emitting sources are significantly lower. Measured doses for intervention personell are consistent with the estimated whole body dose. They are smaller than 7,5 {mu} {mu}Sv per intervention, which is a dose much less than 0,1 permille of the annual radiation workers maximum permissible dose (MPD) recommended by EC regulations. (orig.) [German] Intrakoronaere Brachytherapie ist in den letzten Jahren zu einer vielversprechenden Methode der Strahlenbehandlung geworden, um die Rate an Wiederverschluessen von Gefaessen nach revaskularisierenden Eingriffen zu verringern. Waehrend ueber die klinischen Behandlungsmethoden ausreichend Literatur vorhanden ist, stehen auf dem Gebiete des Strahlenschutzes fast keine Veroeffentlichungen zur Verfuegung. In dieser Veroeffentlichung gehen wir insbesondere auf die Abschaetzung des Strahlenrisikos des Patienten durch analytische Methoden und Monte Carlo-Rechnung fuer die drei derzeit in den Kliniken verwendeten Systeme ein. Ausserdem geben wir eine Abschaetzung des Strahlenrisikos des mit der Behandlung betrauten Personals. Die Strahlenbelastung des Patienten mit Systemen mit Gammastrahlern lieht in der Groessenordnung der Dosisbelastung bei der diagnostischen Angiographie

  7. A case report on bilateral partial breast irradiation using SAVI

    Energy Technology Data Exchange (ETDEWEB)

    Gloi, Aime M., E-mail: agloi@stvgb.org [Radiation Oncology, St. Vincent Hospital, Green Bay, WI (United States); Buchanan, Robert [Southeast Alabama Medical Center, Radiation Oncology Department, Dothan, AL 36301 (United States); Nuskind, Jeff; Zuge, Corrie; Goettler, Anndrea [Radiation Oncology, St. Vincent Hospital, Green Bay, WI (United States)

    2012-07-01

    To assess dosimetric parameters in a case study where bilateral accelerated partial breast irradiation (APBI) is delivered using a strut-adjusted volume implant (SAVI) device. A 59-year-old female received APBI in both breasts over 5 days, with fractions of 3.4 Gy twice daily. A Vac-lok system was used for immobilization, and a C-arm was used for daily imaging. We generated dose-volume histograms (DVHs) for the brachytherapy plans to derive several important biologic factors. We calculated the normal tissue complication probability (NTCP), equivalent uniform dose (EUD), and tumor control probability (TCP) using the Lyman-Kutcher-Burman model parameters {alpha} = 0.3 Gy{sup -1}, {alpha}/{beta} = 4 Gy, n = 0.1, and m = 0.3. In addition, we assessed the dose homogeneity index (DHI), overdose index, and dose nonuniformity ratio. D95 was >95% and V150 was <50 mL for both breasts. The DHIs were 0.469 and 0.512 for the left and right breasts, respectively. The EUDs (normalized to 3.4 Gy b.i.d.) were 33.53 and 29.10 Gy. The TCPs were estimated at 99.2% and 99.9%, whereas the NTCP values were 4.2% and 2.57%. In this clinical case, we were able to quantify the dosimetric parameters of an APBI treatment performed with a SAVI device.

  8. Calculations radiobiological using the quadratic lineal model in the use of the medium dose rate absorbed in brachytherapy. Pt. 3

    International Nuclear Information System (INIS)

    Calculations with the quadratic lineal model for medium rate using the equation dose-effect. Several calculations for system of low dose rate brachytherapy plus teletherapy, calculations for brachytherapy with medium dose rate together with teletherapy, dose for fraction and the one numbers of fractions in medium rate

  9. Size Effects of Gold and Iron Nanoparticles on Radiation Dose Enhancement in Brachytherapy and Teletherapy: A Monte Carlo Study

    Directory of Open Access Journals (Sweden)

    Ahad Ollah Ezzati

    2014-08-01

    Full Text Available Introduction In this study, we aimed to calculate dose enhancement factor (DEF for gold (Au and iron (Fe nanoparticles (NPs in brachytherapy and teletherapy, using Monte Carlo (MC method. Materials and Methods In this study, a new algorithm was introduced to calculate dose enhancement by AuNPs and FeNPs for Iridium-192 (Ir-192 brachytherapy and Cobalt-60 (Co-60 teletherapy sources, using the MC method. In this algorithm, the semi-random distribution of NPs was used instead of the regular distribution. Diameters were assumed to be 15, 30, and 100 nm in brachytherapy and 15 and 30 nm in teletherapy. Monte Carlo MCNP4C code was used for simulations, and NP density values were 0.107 mg/ml and 0.112 mg/ml in brachytherapy and teletherapy, respectively. Results AuNPs significantly enhanced the radiation dose in brachytherapy (approximately 60%, and 100 nm diameter NPs showed the most uniform dose distribution. AuNPs had an insignificant effect on teletherapy radiation field, with a dose enhancement ratio of 3% (about the calculation uncertainty or less. In addition, FeNPs had an insignificant effect on both brachytherapy and teletherapy radiation fields. FeNPs dose enhancement was 3% in brachytherapy and 6% (about the calculation uncertainty or less in teletherapy. Conclusion It can be concluded that AuNPs can significantly increase the absorbed dose in brachytherapy; however, FeNPs do not have a noticeable effect on the absorbed dose

  10. Accelerated Partial Breast Irradiation With Interstitial Implants: Risk Factors Associated With Increased Local Recurrence

    International Nuclear Information System (INIS)

    Purpose: To analyze patient, disease, and treatment-related factors regarding their impact on local control after interstitial multicatheter accelerated partial breast irradiation (APBI). Methods and Materials: Between November 2000 and April 2005, 274 patients with early breast cancer were recruited for the German-Austrian APBI Phase II trial ( (ClinicalTrials.gov) identifier: NCT00392184). In all, 64% (175/274) of the patients received pulsed-dose-rate (PDR) brachytherapy and 36% (99/274) received high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3 to 4 days. Results: The median follow-up time was 64 months (range, 9-110). The actuarial 5-year local recurrence free survival rate (5-year LRFS) was 97.7%. Comparing patients with an age <50 years (49/274) vs. ≥50 years (225/274), the 5-year LRFS resulted in 92.5% and 98.9% (exact p = 0.030; 99% confidence interval, 0.029-0.032), respectively. Antihormonal treatment (AHT) was not applied in 9% (24/274) of the study population. The 5-year LRFS was 99% and 84.9% (exact p = 0.0087; 99% confidence interval, 0.0079-0.0094) in favor of the patients who received AHT. Lobular histology (45/274) was not associated with worse local control compared with all other histologies (229/274). The 5-year LRFS rates were 97.6% and 97.8%, respectively. Conclusions: Local control at 5 years is excellent and comparable to therapeutic successes reported from corresponding whole-breast irradiation trials. Our data indicate that patients <50 years of age ought to be excluded from APBI protocols, and that patients with hormone-sensitive breast cancer should definitely receive adjuvant AHT when interstitial multicatheter APBI is performed. Lobular histology need not be an exclusion criterion for future APBI trials.

  11. Conceptual source design and dosimetric feasibility study for intravascular treatment: a proposal for intensity modulated brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Si Yong; Han, Eun Young; Palta, Jatinder R. [College of Medicine, Florida Univ., Florida (United States); Ha, Sung W. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2003-06-01

    To propose a conceptual design of a novel source for intensity modulated brachytherapy. The source design incorporates both radioactive and shielding materials (stainless steel or tungsten), to provide an asymmetric dose intensity in the azimuthal direction. The intensity modulated intravascular brachytherapy was performed by combining a series of dwell positions and times, distributed along the azimuthal coordinates. Two simple designs for the beta-emitting sources, with similar physical dimensions to a {sub 90}Sr/Y Novoste Beat-Cath source, were considered in the dosimetric feasibility study. In the first design, the radioactive and materials each occupy half of the cylinder and in the second, the radioactive material occupies only a quarter of the cylinder. The radial and azimuthal dose distributions around each source were calculated using the MCNP Monte Carlo code. The preliminary hypothetical simulation and optimization results demonstrated the 87% difference between the maximum and minimum doses to the lumen wall, due to off-centering of the radiation source, could be reduced to less than 7% by optimizing the azimuthal dwell positions and times of the partially shielded intravascular brachytherapy sources. The novel brachytherapy source design, and conceptual source delivery system, proposed in this study show promising dosimetric characteristics for the realization of intensity modulated brachytherapy in intravascular treatment. Further development of this concept will center on building a delivery system that can precisely control the angular motion of a radiation source in a small-diameter catheter.

  12. Tolerance of the carotid-sheath contents to brachytherapy: an experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Werber, J.L.; Sood, B.; Alfieri, A.; McCormick, S.A.; Vikram, B. (Department of Otolaryngology--Head and Neck Surgery, New York Medical College, Beth Israel (USA))

    1991-06-01

    Tumor invasion of the carotid artery is a potential indication for brachytherapy, which delivers a high dose of irradiation to residual tumor while limiting the dose to adjacent healthy tissues. The tolerance of carotid-sheath contents to varying doses of brachytherapy, however, has not been clearly established. In order to evaluate brachytherapy effects on carotid-sheath contents, after-loading catheters were implanted bilaterally in 3 groups of 6 rabbits each (18 rabbits). Iridium 192 brachytherapy doses of either 5000 cGy (rad), 9000 cGy, or 13,000 cGy were delivered unilaterally, with the contralateral neck serving as a nonirradiated control in each animal. There were no carotid ruptures and wound healing was normal. Two animals from each group were killed at 6, 20, and 48 weeks. Even at the highest dose (13,000 cGy), nerve conduction studies performed on the vagus nerve prior to sacrifice revealed no increased latency, histologic changes were minimal, and carotid arteries were patent. These observations suggest that the carotid-sheath contents in healthy rabbits could tolerate high doses (up to 13,000 cGy) of low-dose-rate interstitial brachytherapy without complications.

  13. Time, dose and volume factors in interstitial brachytherapy combined with external irradiation for oral tongue carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yorozu, Atsunori [National Tokyo Second Hospital (Japan)

    1996-04-01

    This is a retrospective analysis of 136 patients with squamous cell carcinoma of stages I and II of the oral tongue who were treated with interstitial brachytherapy alone or in combination with external irradiation between 1976 and 1991. Control of the primary lesion and the occurrence of late complications were analyzed with respect to dose, time and tumor size with the Cox hazard model. The 5-year survival rates for stages I and II were 84.5% and 75.6%. The 5-year primary control rate was 91.3% for stage I and 77.3% for stage II (p<0.05). Local control and survival rates were comparable with those of other modalities. The significant factor in local control was stage. For lesions more than 30 mm in diameter, local control was rather poor in the group given only brachytherapy compared with the group given combined therapy. After 30 Gy of external irradiation, local control was better at a brachytherapy dose >50 Gy compared with a brachytherapy dose <=50 Gy. Mucosal ulcer occurred frequently with increasing total dose and tumor volume. Bone necrosis increased significantly with increasing external irradiation dose. We suggest that external irradiation of 30 Gy followed by brachytherapy of 52 Gy is a better choice for T2 lesions >30 mm. Late complications should be reduced by using a spacer, improvements in dental and oral hygiene, and a sophisticated implant method. (author).

  14. Breast self-exam

    Science.gov (United States)

    Self-examination of the breast; BSE; Breast cancer - BSE; Breast cancer screening - self exam ... The best time to do a monthly self-breast exam is about 3 to 5 days after your period starts. Do it at the same time every month. Your breasts are ...

  15. Breast cancer

    CERN Multimedia

    2002-01-01

    "Cancer specialists will soon be able to compare mammograms with computerized images of breast cancer from across Europe, in a bid to improve diagnosis and treatment....The new project, known as MammoGrid, brings together computer and medical imaging experts, cancer specialists, radiologists and epidemiologists from Bristol, Oxford, Cambridge, France and Italy" (1 page).

  16. The Preliminary Prototype of Medium Dose Rate Brachytherapy Equipment

    Directory of Open Access Journals (Sweden)

    A. Satmoko

    2013-08-01

    Full Text Available A preliminary prototype of a brachytherapy equipment has been constructed. The work started by developing conceptual design, followed by basic design and detailed design. In the conceptual design, design requirements are stated. In the basic design, technical specifications for main components are determined. In detailed design, general drawings are discussed. The prototype consists of three main systems: a mechanical system, an instrumentation system, and a safety system. The mechanical system assures the movement mechanism of the isotope source position beginning from the standby position until the applicators. It consists of three main modules: a position handling module, a container module, and a channel distribution module. The position handling module serves to move the isotope source position. As shielding, the second module is to store the source when the equipment is in standby position. The prototype provides 12 output channels. The channel selection is performed by the third module. The instrumentation system controls the movement of source position by handling motor operations. It consists of several modules. A microcontroller module serves as a control center whose task includes both controlling motors and communicating with computer. A motor module serves to handle motors. 10 sensors, including their signal conditionings, are introduced to read the environment conditions of the equipment. LEDs are used to display these conditions. In order to facilitate the operators’ duty, communication via RS232 is provided. The brachytherapy equipment can therefore be operated by using computer. Interface software is developed using C# language. To complete both mechanical and instrumentation systems performance, a safety system is developed to make sure that the safety for operator and patients from receiving excessive radiation. An interlock system is introduced to guard against abnormal conditions. In the worst case, a manual intervention

  17. Water equivalent phantom materials for 192Ir brachytherapy

    Science.gov (United States)

    Schoenfeld, Andreas A.; Harder, Dietrich; Poppe, Björn; Chofor, Ndimofor

    2015-12-01

    Several solid phantom materials have been tested regarding their suitability as water substitutes for dosimetric measurements in brachytherapy with 192Ir as a typical high energy photon emitter. The radial variations of the spectral photon fluence, of the total, primary and scattered photon fluence and of the absorbed dose to water in the transversal plane of the tested cylindrical phantoms surrounding a centric and coaxially arranged Varian GammaMed afterloading 192Ir brachytherapy source were Monte-Carlo simulated in EGSnrc. The degree of water equivalence of a phantom material was evaluated by comparing the radial dose-to-water profile in the phantom material with that in water. The phantom size was varied over a large range since it influences the dose contribution by scattered photons with energies diminished by single and multiple Compton scattering. Phantom axis distances up to 10 cm were considered as clinically relevant. Scattered photons with energies reaching down into the 25 keV region dominate the photon fluence at source distances exceeding 3.5 cm. The tested phantom materials showed significant differences in the degree of water equivalence. In phantoms with radii up to 10 cm, RW1, RW3, Solid Water, HE Solid Water, Virtual Water, Plastic Water DT, and Plastic Water LR phantoms show excellent water equivalence with dose deviations from a water phantom not exceeding 0.8%, while Original Plastic Water (as of 2015), Plastic Water (1995), Blue Water, polyethylene, and polystyrene show deviations up to 2.6%. For larger phantom radii up to 30 cm, the deviations for RW1, RW3, Solid Water, HE Solid Water, Virtual Water, Plastic Water DT, and Plastic Water LR remain below 1.4%, while Original Plastic Water (as of 2015), Plastic Water (1995), Blue Water, polyethylene, and polystyrene produce deviations up to 8.1%. PMMA plays a separate role, with deviations up to 4.3% for radii not exceeding 10 cm, but below 1% for radii up to 30 cm. As suggested by

  18. Occupational exposure of professionals during interstitial permanent prostate brachytherapy implants

    International Nuclear Information System (INIS)

    Full text of publication follows: Introduction: In this study we present dose measurements for professionals exposed during interstitial 125 I permanent prostate brachytherapy implants. Methods and Materials: The implant technique used was intra operative real time using strand and loose seeds. The professionals inside the operating room are an oncologist, a radiologist, a physicist, a nurse and an anesthesiologist. The oncologist and the physicist contact directly the loaded needle with radioactive seeds and two types of measurements were taken: total body and extremities (finger) dose. The rest of the team operates at long distances, but measurements were made. To measure total body equivalent dose we use a Berthold Umo LB 123 coupled with a LB 1236-H10 detector, and we recorded dose, time and distance from implant location. Finger dosemeters are thermo -luminescent dosimeter (TLD) rings that were controlled over one month. Results: 50 cases (average number of applications per year) were analysed for extremities measurements and 9 cases for total body measurements (in this case, the results were extrapolated for 50 cases), with an average of 26.1 mCi total activity per implant (in a range of 17.4 - 40.3 mCi). The finger dose was 1.8 mSv for the oncologist and 1.9 mSv for the physicist. The interpolation of total body equivalent dose for the oncologist was 24 mSv, for the radiologist 6 mSv and 9 mSv for the physicist. The rest of the team did not receive anything but background radiation. The annual national limit dose for workers is 20 mSv for total body irradiation, and 500 mSv for extremities. Conclusion: In conclusion we may say that during interstitial permanent prostate brachytherapy implants, total doses received for all groups are not significant when compared to annual limits for Portuguese laws 1. Even so, our main goal is always to get the less possible dose (ALARA principle). References: 1. Decreto Lei n. 180/2002 de 8 de Agosto. (authors)

  19. Water equivalent phantom materials for (192)Ir brachytherapy.

    Science.gov (United States)

    Schoenfeld, Andreas A; Harder, Dietrich; Poppe, Björn; Chofor, Ndimofor

    2015-12-21

    Several solid phantom materials have been tested regarding their suitability as water substitutes for dosimetric measurements in brachytherapy with (192)Ir as a typical high energy photon emitter. The radial variations of the spectral photon fluence, of the total, primary and scattered photon fluence and of the absorbed dose to water in the transversal plane of the tested cylindrical phantoms surrounding a centric and coaxially arranged Varian GammaMed afterloading (192)Ir brachytherapy source were Monte-Carlo simulated in EGSnrc. The degree of water equivalence of a phantom material was evaluated by comparing the radial dose-to-water profile in the phantom material with that in water. The phantom size was varied over a large range since it influences the dose contribution by scattered photons with energies diminished by single and multiple Compton scattering. Phantom axis distances up to 10 cm were considered as clinically relevant. Scattered photons with energies reaching down into the 25 keV region dominate the photon fluence at source distances exceeding 3.5 cm.The tested phantom materials showed significant differences in the degree of water equivalence. In phantoms with radii up to 10 cm, RW1, RW3, Solid Water, HE Solid Water, Virtual Water, Plastic Water DT, and Plastic Water LR phantoms show excellent water equivalence with dose deviations from a water phantom not exceeding 0.8%, while Original Plastic Water (as of 2015), Plastic Water (1995), Blue Water, polyethylene, and polystyrene show deviations up to 2.6%. For larger phantom radii up to 30 cm, the deviations for RW1, RW3, Solid Water, HE Solid Water, Virtual Water, Plastic Water DT, and Plastic Water LR remain below 1.4%, while Original Plastic Water (as of 2015), Plastic Water (1995), Blue Water, polyethylene, and polystyrene produce deviations up to 8.1%. PMMA plays a separate role, with deviations up to 4.3% for radii not exceeding 10 cm, but below 1% for radii up to 30 cm.As suggested

  20. Rapid emission angle selection for rotating-shield brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yunlong [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 (United States); Flynn, Ryan T.; Kim, Yusung; Bhatia, Sudershan K.; Sun, Wenqing [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Yang Wenjun [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States); Wu Xiaodong [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 and Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)

    2013-05-15

    Purpose: The authors present a rapid emission angle selection (REAS) method that enables the efficient selection of the azimuthal shield angle for rotating shield brachytherapy (RSBT). The REAS method produces a Pareto curve from which a potential RSBT user can select a treatment plan that balances the tradeoff between delivery time and tumor dose conformity. Methods: Two cervical cancer patients were considered as test cases for the REAS method. The RSBT source considered was a Xoft Axxent{sup TM} electronic brachytherapy source, partially shielded with 0.5 mm of tungsten, which traveled inside a tandem intrauterine applicator. Three anchor RSBT plans were generated for each case using dose-volume optimization, with azimuthal shield emission angles of 90 Degree-Sign , 180 Degree-Sign , and 270 Degree-Sign . The REAS method converts the anchor plans to treatment plans for all possible emission angles by combining neighboring beamlets to form beamlets for larger emission angles. Treatment plans based on exhaustive dose-volume optimization (ERVO) and exhaustive surface optimization (ERSO) were also generated for both cases. Uniform dwell-time scaling was applied to all plans such that that high-risk clinical target volume D{sub 90} was maximized without violating the D{sub 2cc} tolerances of the rectum, bladder, and sigmoid colon. Results: By choosing three azimuthal emission angles out of 32 potential angles, the REAS method performs about 10 times faster than the ERVO method. By setting D{sub 90} to 85-100 Gy{sub 10}, the delivery times used by REAS generated plans are 21.0% and 19.5% less than exhaustive surface optimized plans used by the two clinical cases. By setting the delivery time budget to 5-25 and 10-30 min/fx, respectively, for two the cases, the D{sub 90} contributions for REAS are improved by 5.8% and 5.1% compared to the ERSO plans. The ranges used in this comparison were selected in order to keep both D{sub 90} and the delivery time within acceptable

  1. Plaque Brachytherapy for Uveal Melanoma: A Vision Prognostication Model

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Niloufer [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio (United States); Khan, Mohammad K. [Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia (United States); Bena, James [Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (United States); Macklis, Roger [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio (United States); Singh, Arun D., E-mail: singha@ccf.org [Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2012-11-01

    Purpose: To generate a vision prognostication model after plaque brachytherapy for uveal melanoma. Methods and Materials: All patients with primary single ciliary body or choroidal melanoma treated with iodine-125 or ruthenium-106 plaque brachytherapy between January 1, 2005, and June 30, 2010, were included. The primary endpoint was loss of visual acuity. Only patients with initial visual acuity better than or equal to 20/50 were used to evaluate visual acuity worse than 20/50 at the end of the study, and only patients with initial visual acuity better than or equal to 20/200 were used to evaluate visual acuity worse than 20/200 at the end of the study. Factors analyzed were sex, age, cataracts, diabetes, tumor size (basal dimension and apical height), tumor location, and radiation dose to the tumor apex, fovea, and optic disc. Univariate and multivariable Cox proportional hazards were used to determine the influence of baseline patient factors on vision loss. Kaplan-Meier curves (log rank analysis) were used to estimate freedom from vision loss. Results: Of 189 patients, 92% (174) were alive as of February 1, 2011. At presentation, visual acuity was better than or equal to 20/50 and better than or equal to 20/200 in 108 and 173 patients, respectively. Of these patients, 44.4% (48) had post-treatment visual acuity of worse than 20/50 and 25.4% (44) had post-treatment visual acuity worse than 20/200. By multivariable analysis, increased age (hazard ratio [HR] of 1.01 [1.00-1.03], P=.05), increase in tumor height (HR of 1.35 [1.22-1.48], P<.001), and a greater total dose to the fovea (HR of 1.01 [1.00-1.01], P<.001) were predictive of vision loss. This information was used to develop a nomogram predictive of vision loss. Conclusions: By providing a means to predict vision loss at 3 years after treatment, our vision prognostication model can be an important tool for patient selection and treatment counseling.

  2. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses sound waves ... Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast are often ...

  3. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  4. High dose rate endovascular brachytherapy in aorto-iliac lesion for the prevention of restenosis

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Hideya [Toyonaka Municipal Hospital, Osaka (Japan); Tomoda, Kaname; Shiomi, Hiroya [Osaka Univ., Suita (Japan). Graduate School of Medicine] [and others

    2002-02-01

    This study examined the applicability of endovascular brachytherapy to larger del arteries such as the abdominal aorta and iliac artery. Endovascular brachytherapy using an Ir-192 HDR source was administered 11 times to nine patients who had undergone percutaneous transluminal angioplasty (PTA) between 1995 and 1999. The follow-up lasted 13 to 55 months after treatment (median, 24 months). Eight of the 11 lesions have been controlled so far. Although one case developed thrombus inside the stent five months later, recanalization was achieved by means of retreatment. One patient who underwent low-dose irradiation (6 Gy) without stent implantation showed restenosis five months after treatment. We used a centering catheter that did not block the blood stream for exact centering of the radiation source in larger vessels such as the abdominal aorta. Although endovascular brachytherapy is a promising and safe procedure, careful follow-up is needed to detect untoward reactions such as thrombosis. (author)

  5. Magnetic resonance imaging for planning intracavitary brachytherapy for the treatment of locally advanced cervical cancer.

    Science.gov (United States)

    Oñate Miranda, M; Pinho, D F; Wardak, Z; Albuquerque, K; Pedrosa, I

    2016-01-01

    Cervical cancer is the third most common gynecological cancer. Its treatment depends on tumor staging at the time of diagnosis, and a combination of chemotherapy and radiotherapy is the treatment of choice in locally advanced cervical cancers. The combined use of external beam radiotherapy and brachytherapy increases survival in these patients. Brachytherapy enables a larger dose of radiation to be delivered to the tumor with less toxicity for neighboring tissues with less toxicity for neighboring tissues compared to the use of external beam radiotherapy alone. For years, brachytherapy was planned exclusively using computed tomography (CT). The recent incorporation of magnetic resonance imaging (MRI) provides essential information about the tumor and neighboring structures making possible to better define the target volumes. Nevertheless, MRI has limitations, some of which can be compensated for by fusing CT and MRI. Fusing the images from the two techniques ensures optimal planning by combining the advantages of each technique.

  6. Simulation of dose distribution for iridium-192 brachytherapy source type-H01 using MCNPX

    Energy Technology Data Exchange (ETDEWEB)

    Purwaningsih, Anik [Center for development of nuclear informatics, National Nuclear Energy Agency, PUSPIPTEK, Serpong, Banten 15310 (Indonesia)

    2014-09-30

    Dosimetric data for a brachytherapy source should be known before it used for clinical treatment. Iridium-192 source type H01 was manufactured by PRR-BATAN aimed to brachytherapy is not yet known its dosimetric data. Radial dose function and anisotropic dose distribution are some primary keys in brachytherapy source. Dose distribution for Iridium-192 source type H01 was obtained from the dose calculation formalism recommended in the AAPM TG-43U1 report using MCNPX 2.6.0 Monte Carlo simulation code. To know the effect of cavity on Iridium-192 type H01 caused by manufacturing process, also calculated on Iridium-192 type H01 if without cavity. The result of calculation of radial dose function and anisotropic dose distribution for Iridium-192 source type H01 were compared with another model of Iridium-192 source.

  7. Treatment of keloids by high-dose-rate brachytherapy: A seven-year study

    International Nuclear Information System (INIS)

    Purpose: To analyze the results obtained in a prospective group of patients with keloid scars treated by high-dose-rate (HDR) brachytherapy with or without surgery. Methods and Materials: One hundred and sixty-nine patients with keloid scars were treated with HDR brachytherapy between December 1991 and December 1998. One hundred and thirty-four patients were females, and 35 were males. The distribution of keloid scars was as follows: face, 77; trunk, 73; and extremities, 19. The mean length was 4.2 cm (range 2-22 cm), and the mean width 1.8 cm (range 1.0-2.8 cm). In 147 patients keloid tissues were removed before HDR brachytherapy treatment, and in 22 HDR brachytherapy was used as definitive treatment. In patients who underwent prior surgery, a flexible plastic tube was put in place during the surgical procedure. Bottoms were used to fix the plastic tubes, and the surgical wound was repaired by absorbable suture. HDR brachytherapy was administered within 30-60 min of surgery. A total dose of 12 Gy (at 1 cm from the center of the catheter) was given in four fractions of 300 cGy in 24 h (at 09.00 am, 15.00 pm, 21.00 pm, and 09.00 am next day). Treatment was optimized using standard geometric optimization. In patients who did not undergo surgery, standard brachytherapy was performed, and plastic tubes were placed through the skin to cover the whole scar. Local anesthesia was used in all procedures. In these patients a total dose of 18 Gy was given in 6 fractions of 300 cGy in one and a half days (at 9.00 am, 3.00 pm, and 9.00 pm; and at 9.00 am, 3.00 pm, and 9.00 pm next day). No further treatment was given to any patient. Patients were seen in follow-up visits every 3 months during the first year, every 6 months in the second year, and yearly thereafter. No patient was lost to follow-up. Particular attention was paid to keloid recurrence, late skin effects, and cosmetic results. Results: All patients completed the treatment. After a follow-up of seven years, 8

  8. IPIP: A New Approach to Inverse Planning for HDR Brachytherapy by Directly Optimizing Dosimetric Indices

    CERN Document Server

    Siauw, Timmy; Atamturk, Alper; Hsu, I-Chow; Pouliot, Jean; Goldberg, Ken

    2010-01-01

    Purpose: Many planning methods for high dose rate (HDR) brachytherapy treatment planning require an iterative approach. A set of computational parameters are hypothesized that will give a dose plan that meets dosimetric criteria. A dose plan is computed using these parameters, and if any dosimetric criteria are not met, the process is iterated until a suitable dose plan is found. In this way, the dose distribution is controlled by abstract parameters. The purpose of this study is to improve HDR brachytherapy planning by developing a new approach that directly optimizes the dose distribution based on dosimetric criteria. Method: We develop Inverse Planning by Integer Program (IPIP), an optimization model for computing HDR brachytherapy dose plans and a fast heuristic for it. We used our heuristic to compute dose plans for 20 anonymized prostate cancer patient image data sets from our clinic database. Dosimetry was evaluated and compared to dosimetric criteria. Results: Dose plans computed from IPIP satis?ed al...

  9. HDR brachytherapy. An option for preventing nonmalignant obstruction in patients after lung transplantation

    International Nuclear Information System (INIS)

    Purpose: Interventional bronchoscopy is the main treatment modality in managing benign airway obstructions following lung transplantation. We analyzed the effect of intraluminal brachytherapy on preventing recurrence of hyperplastic tissue. Patients and methods: From September 2002 to September 2004, a total of 24 intraluminal brachytherapy applications were carried out on 12 lung transplant patients in 15 different locations. A single dose of 3 Gy was calculated at a 5-mm distance from the catheter surface; the target volume included a stenosis plus safety interval of 0.5-1.0 cm. Results: All patients had a mean 10.6 local interventions (Argon plasma coagulation, balloon dilatations, stenting) over 4.4 months before the first application of endobronchial brachytherapy, with a mean amount of 2.4 applications per month. The mean forced expiratory volume in 1 s (FEV1) was 2,219 ml in the 3 months before application of brachytherapy. After endobronchial brachytherapy, all patients experienced improvement in clinical status and respiratory function. The mean level of FEV1 in the 3 months after application was 2,435 ml (p = 0.02), and the number of invasive interventions dropped to a mean rate of 5.2 interventions in the 5.1 months after the first intervention, with an amount of 1 application per month. No treatment-related complications were seen. Four patients were treated twice, 1 patient three times, and 1 patient four times at the same localization. Conclusions: Recurrent symptomatic benign airway obstruction from hyperplastic tissue in the bronchus after lung transplantation can be successfully treated with intraluminal high-dose-rate brachytherapy with a dose of 3 Gy at a 5-mm distance from the catheter surface and a longitudinal safety margin of 1 cm. (orig.)

  10. HDR brachytherapy. An option for preventing nonmalignant obstruction in patients after lung transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, A.; Karstens, J.H.; Christiansen, H. [Medical School Hannover (Germany). Dept. of Radiation Oncology; Warszawski-Baumann, A.; Baumann, R. [Medical School Hannover (Germany). Dept. of Radiation Oncology; Medical Practice for Radiotherapy and Radiation Oncology, Hannover (Germany); Gottlieb, J.; Welte, T. [Medical School Hannover (Germany). Dept. of Respiratory Medicine

    2012-12-15

    Purpose: Interventional bronchoscopy is the main treatment modality in managing benign airway obstructions following lung transplantation. We analyzed the effect of intraluminal brachytherapy on preventing recurrence of hyperplastic tissue. Patients and methods: From September 2002 to September 2004, a total of 24 intraluminal brachytherapy applications were carried out on 12 lung transplant patients in 15 different locations. A single dose of 3 Gy was calculated at a 5-mm distance from the catheter surface; the target volume included a stenosis plus safety interval of 0.5-1.0 cm. Results: All patients had a mean 10.6 local interventions (Argon plasma coagulation, balloon dilatations, stenting) over 4.4 months before the first application of endobronchial brachytherapy, with a mean amount of 2.4 applications per month. The mean forced expiratory volume in 1 s (FEV1) was 2,219 ml in the 3 months before application of brachytherapy. After endobronchial brachytherapy, all patients experienced improvement in clinical status and respiratory function. The mean level of FEV1 in the 3 months after application was 2,435 ml (p = 0.02), and the number of invasive interventions dropped to a mean rate of 5.2 interventions in the 5.1 months after the first intervention, with an amount of 1 application per month. No treatment-related complications were seen. Four patients were treated twice, 1 patient three times, and 1 patient four times at the same localization. Conclusions: Recurrent symptomatic benign airway obstruction from hyperplastic tissue in the bronchus after lung transplantation can be successfully treated with intraluminal high-dose-rate brachytherapy with a dose of 3 Gy at a 5-mm distance from the catheter surface and a longitudinal safety margin of 1 cm. (orig.)

  11. Interstitial high-dose rate brachytherapy as boost for anal canal cancer

    International Nuclear Information System (INIS)

    To assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC). From August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed. Median age was 60.6 years [34 – 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 – 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation. High-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time

  12. Brachytherapy for early oral tongue cancer. Low dose rate to high dose rate

    International Nuclear Information System (INIS)

    To examine the compatibility of low dose rate (LDR) with high dose rate (HDR) brachytherapy, we reviewed 399 patients with early oral tongue cancer (T1-2N0M0) treated solely by brachytherapy at Osaka University Hospital between 1967 and 1999. For patients in the LDR group (n=341), the treatment sources consisted of Ir-192 pin for 227 patients (1973-1996; irradiated dose, 61-85 Gy; median, 70 Gy), Ra-226 needle for 113 patients (1967-1986; 55-93 Gy; median, 70 Gy). Ra-226 and Ir-192 were combined for one patient. Ir-192 HDR (microSelectron-HDR) was used for 58 patients in the HDR group (1991-present; 48-60 Gy; median, 60 Gy). LDR implantations were performed via oral and HDR via a submental/submandibular approach. The dose rates at the reference point for the LDR group were 0.30 to 0.8 Gy/h, and for the HDR group 1.0 to 3.4 Gy/min. The patients in the HDR group received a total dose of 48-60 Gy (8-10 fractions) during one week. Two fractions were administered per day (at least a 6-h interval). The 3- and 5-year local control rates for patients in the LDR group were 85% and 80%, respectively, and those in the HDR group were both 84%. HDR brachytherapy showed the same lymph-node control rate as did LDR brachytherapy (67% at 5 years). HDR brachytherapy achieved the same locoregional result as did LDR brachytherapy. A converting factor of 0.86 is applicable for HDR in the treatment of early oral tongue cancer. (author)

  13. The changing landscape of brachytherapy for cervical cancer: a Canadian practice survey

    Science.gov (United States)

    Phan, T.; Mula-Hussain, L.; Pavamani, S.; Pearce, A.; D’Souza, D.; Patil, N.G.; Traptow, L.; Doll, C.M.

    2015-01-01

    Background We documented changes in practice from 2009 to 2012 for cervical cancer brachytherapy in Canada. Methods Centres with gynecologic brachytherapy services were sent an e-mail questionnaire querying their 2012 practice. Responses are reported and compared with practice patterns identified in a similar survey for 2009. Results The response rate was 77% (24 of 31 centres). Almost all use high-dose-rate brachytherapy (92%); low-dose-rate brachytherapy has been completely phased out. Most continue to move patients from the site of applicator insertion to the radiation treatment simulation suite (75%) or to a diagnostic imaging department (29%), or both. In 2012, the imaging modalities used for dose specification were computed tomography [ct (75%)], magnetic resonance imaging [mri (38%)], plain radiography (21%), and cone-beam ct (8%). The number of institutions using mri guidance has markedly increased during the period of interest (9 vs. 1). Most respondents (58% vs. 14%) prescribed using guidelines from the Groupe Européen de Curiethérapie and the European Society for Therapeutic Radiology and Oncology, but they also used point A as a reference. Commonly used high-dose radiation regimens included 30 Gy in 5 fractions and 24 Gy in 3 fractions. Conclusions In Canada, image-guided brachytherapy for cervical cancer continues to evolve. Although ct-based imaging remains the most commonly used modality, many centres have adopted mri for at least 1 brachytherapy treatment. More centres are using fewer fractions and a slightly lower biologically effective dose, but are still achieving EQD2 (2-Gy equivalent) doses of 80–90 Gy in combination with external-beam radiation therapy. PMID:26628868

  14. Brachytherapy for early oral tongue cancer: low dose rate to high dose rate.

    Science.gov (United States)

    Yamazaki, Hideya; Inoue, Takehiro; Yoshida, Ken; Yoshioka, Yasuo; Furukawa, Souhei; Kakimoto, Naoya; Shimizutani, Kimishige; Inoue, Toshihiko

    2003-03-01

    To examine the compatibility of low dose rate (LDR) with high dose rate (HDR) brachytherapy, we reviewed 399 patients with early oral tongue cancer (T1-2N0M0) treated solely by brachytherapy at Osaka University Hospital between 1967 and 1999. For patients in the LDR group (n = 341), the treatment sources consisted of Ir-192 pin for 227 patients (1973-1996; irradiated dose, 61-85 Gy; median, 70 Gy), Ra-226 needle for 113 patients (1967-1986; 55-93 Gy; median, 70 Gy). Ra-226 and Ir-192 were combined for one patient. Ir-192 HDR (microSelectron-HDR) was used for 58 patients in the HDR group (1991-present; 48-60 Gy; median, 60 Gy). LDR implantations were performed via oral and HDR via a submental/submandibular approach. The dose rates at the reference point for the LDR group were 0.30 to 0.8 Gy/h, and for the HDR group 1.0 to 3.4 Gy/min. The patients in the HDR group received a total dose of 48-60 Gy (8-10 fractions) during one week. Two fractions were administered per day (at least a 6-h interval). The 3- and 5-year local control rates for patients in the LDR group were 85% and 80%, respectively, and those in the HDR group were both 84%. HDR brachytherapy showed the same lymph-node control rate as did LDR brachytherapy (67% at 5 years). HDR brachytherapy achieved the same locoregional result as did LDR brachytherapy. A converting factor of 0.86 is applicable for HDR in the treatment of early oral tongue cancer.

  15. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery ... wait 1 to 3 months before the permanent breast implant is placed during the second stage. In the ... from your chest and replaces it with a breast implant. This surgery takes 1 to 2 hours. Before ...

  16. Breast lump removal

    Science.gov (United States)

    Lumpectomy; Wide local excision; Breast conservation surgery; Breast-sparing surgery; Partial mastectomy ... If the breast cancer can be seen on imaging tests but the doctor cannot feel it when examining you, a wire ...

  17. Breast Cancer Disparities

    Science.gov (United States)

    ... 2.65 MB] Read the MMWR Science Clips Breast Cancer Black Women Have Higher Death Rates from Breast ... of Page U.S. State Info Number of Additional Breast Cancer Deaths Among Black Women, By State SOURCE: National ...

  18. Breast cancer screenings

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000837.htm Breast cancer screenings To use the sharing features on this page, please enable JavaScript. Breast cancer screenings can help find breast cancer early, before ...

  19. Male Breast Cancer

    Science.gov (United States)

    Although breast cancer is much more common in women, men can get it too. It happens most often to men between ... 60 and 70. Breast lumps usually aren't cancer. However, most men with breast cancer have lumps. ...

  20. Breast-conserving therapy with partial or whole breast irradiation: Ten-year results of the Budapest randomized trial

    International Nuclear Information System (INIS)

    Background and purpose: To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Patients and methods: Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1–2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 × 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n = 88) or 50 Gy electron beam (EB) irradiation (n = 40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. Results: After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p = 0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p < 0.01). Conclusions: Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI

  1. In vivo dosimetry thermoluminescence dosimeters during brachytherapy with a 370 GBq {sup 192}Ir source

    Energy Technology Data Exchange (ETDEWEB)

    Cuepers, S.; Piessens, M.; Verbeke, L.; Roelstraete, A. [Onze-Lieve-Vrouw Hospitaal, Aalst (Belgium). Dept. of Radiotherapy and Oncology

    1995-12-01

    When using LiF thermoluminescence dosimeters in brachytherapy, we have to take into account the properties of a high dose rate {sup 192}Ir source (energy spectrum ranging form 9 to 885 keV, steep dose gradient in the vicinity of the source) and these of the dosimeters themselves (supralinearity, reproducibility, size). All these characteristics combine into a set of correction factors which have been determined during in phantom measurements. These results have then been used to measure the dose delivered to organs at risk (e.g. rectum, bladder, etc.) during high dose rate brachytherapy with a 370 GBq {sup 192}Ir source for patients with gynaecological tumors.

  2. Evaluation of sexual functions and sexual behaviors after penile brachytherapy in men treated for penile carcinoma

    OpenAIRE

    Soh, Patrice Njomnang; Delaunay, Boris; Nasr, Elie Bou; Delannes, Martine; Soulie, Michel; Huyghe, Eric

    2014-01-01

    Purpose To assess sexual functions and behaviors of men treated by penile brachytherapy for a cancer of the penis. Materials and methods Thirty eight men (19 patients treated by penile brachytherapy for a cancer of the penis and 19 age paired-matched controls) participated in a survey about sexuality. The mean age of patients and controls were 73.2 +/- 11.7 and 70.0 +/- 10.5 years, respectively (NS). Controls were men without penile pathology, without history of cancer and no evidence of cogn...

  3. Magnetic resonance spectroscopy-guided transperineal prostate biopsy and brachytherapy for recurrent prostate cancer.

    Science.gov (United States)

    Barnes, Agnieszka Szot; Haker, Steven J; Mulkern, Robert V; So, Minna; D'Amico, Anthony V; Tempany, Clare M

    2005-12-01

    Brachytherapy targeted to the peripheral zone with magnetic resonance imaging (MRI) guidance is a prostate cancer treatment option with potentially fewer complications than other treatments. Follow-up MRI when failure is suspected is, however, difficult because of radiation-induced changes. Furthermore, MR spectroscopy (MRS) is compromised by susceptibility artifacts from radioactive seeds in the peripheral zone. We report a case in which combined MRI/MRS was useful for the detection of prostate cancer in the transitional zone in patients previously treated with MR-guided brachytherapy. We propose that MRI/MRS can help detect recurrent prostate cancer, guide prostate biopsy, and help manage salvage treatment decisions. PMID:16360468

  4. Endovascular brachytherapy to prevent restenosis after angioplasty; Endovaskulaere Brachytherapie in der Restenoseprophylaxe nach Angioplastie und Stentimplantation: Eine Uebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, W.A.; Bohndorf, K. [Klinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie

    2003-02-01

    Endovascular radiotherapy is the first effective prophylaxis of restenosis after percutaneous transluminal angioplasty (PTA) and stenting. The FDA recently approved two devices for the delivery of intracoronary radiation following coronary artery stenting. Published multicenter, double-blind, randomized trials of intracoronary radiation therapy report good results for preventing in-stent restenosis, while the data for the peripheral circulation are still inconclusive. Beta-emitters are easier applicable and probably also safer, whereas gamma-emitters have been more extensively evaluated clinically so far. Primary indication for endovascular brachytherapy are patients at high risk for restenosis, such as previous restenoses, in-stent hyperplasia, long stented segment, long PTA lesion, narrow residual vascular lumen and diabetes. Data from coronary circulation suggest a safety margin of at least 4 to 10 mm at both ends of the angioplastic segment to avoid edge restenosis. To prevent late thrombosis of the treated coronary segment, antiplatelet therapy with clopidogrel and aspirin are recommended for at least 6 months after PTA and for 12 months after a newly implanted stent. An established medication regimen after radiotherapy of peripheral arteries is still lacking. (orig.) [German] Die endovaskulaere Radiotherapie stellt das erste erfolgreiche Therapiekonzept in der Restenoseprophylaxe nach PTA und Stentimplantation dar. Am 3.11.2000 hat die amerikanische Food and Drug Administration erstmalig zwei Brachytherapiegeraete zur Restenoseprophylaxe nach Koronararterien-Stenting zugelassen. Grosse multizentrische, kontrollierte Studien wurden fuer das koronare Stromgebiet mit positiven Ergebnissen publiziert, die Datenlage im peripheren Stromgebiet ist noch ungenuegend. Beta-Strahler bieten Vorteile in der Anwendung, moeglicherweise auch in der Sicherheit, Gamma-Strahler dagegen sind besser klinisch evaluiert. Die primaere Indikation zur endovaskulaeren Brachytherapie

  5. Pedicle versus free flap reconstruction in patients receiving intraoperative brachytherapy.

    Science.gov (United States)

    Geiger, Erik J; Basques, Bryce A; Chang, Christopher C; Son, Yung; Sasaki, Clarence T; McGregor, Andrew; Ariyan, Stephan; Narayan, Deepak

    2016-08-01

    Introduction This study compared complication rates between pedicle flaps and free flaps used for resurfacing of intraoperative brachytherapy (IOBT) implants placed following head and neck tumour extirpation to help clarify the ideal reconstructive procedure for this scenario. Patients and methods A retrospective review of reconstructions with IOBT at our institution was conducted. Patient and treatment details were recorded, as were the number and type of flap complications, including re-operations. Logistic regressions compared complications between flap groups. Results Fifty free flaps and 55 pedicle flaps were included. On multivariate analysis, free flap reconstruction with IOBT was significantly associated with both an increased risk of having any flap complication (OR = 2.9, p = 0.037) and with need for operative revision (OR = 3.5, p = 0.048) compared to pedicle flap reconstruction. Conclusions In the setting of IOBT, free flaps are associated with an increased risk of having complications and requiring operative revisions. PMID:26983038

  6. Dose optimization in simulated permanent interstitial implant of prostate brachytherapy

    International Nuclear Information System (INIS)

    Any treatment of cancer that uses some modality of radiotherapy is planned before being executed. In general the goal in radiotherapy is to irradiate the target to be treated minimizing the incidence of radiation in healthy surrounding tissues. The planning differ among themselves according to the modality of radiotherapy, the type of cancer and where it is located. This work approaches the problem of dose optimization for the planning of prostate cancer treatment through the modality of low dose-rate brachytherapy with Iodine 125 or Palladium 103 seeds. An algorithm for dose calculation and optimization was constructed to find the seeds configuration that better fits the relevant clinical criteria such as as the tolerated dose by the urethra and rectum and the desired dose for prostate. The algorithm automatically finds this configuration from the prostate geometry established in two or three dimensions by using images of ultrasound, magnetic resonance or tomography and from the establishment of minimum restrictions to the positions of the seeds in the prostate and needles in a template. Six patterns of seeds distribution based on clinical criteria were suggested and tested in this work. Each one of these patterns generated a space of possible seeds configurations for the prostate tested by the dose calculation and optimization algorithm. The configurations that satisfied the clinical criteria were submitted to a test according to an optimization function suggested in this work. The configuration that produced maximum value for this function was considered the optimized one. (author)

  7. Study of isodose curves of an eye brachytherapy plaque

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Marcos R.O.; Mourao, Arnaldo P., E-mail: marcos.robertto@hotmail.com, E-mail: seg@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Grynberg, Suely E., E-mail: aprata@des.cefetmg.br [Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET-MG), Belo Horizonte, MG (Brazil). Nucleo de Engenharia Hospitalar

    2015-07-01

    The use eye plaque brachytherapy for intraocular tumors treatment is a process designed to protect healthy eye structures, as well as visual functions. It replaces enucleation when possible. The knowledge of the dose spatial distribution inside the eyeball and adjacent structures is very important to obtain the therapeutic dose, minimize the side effects and ensure efficiency in the process. Small variations in positioning the plaque on the ocular surface may generate a less effective treatment. Thus, in this work an eyeball phantom and a seed accommodation system similar to a commercially eye plaque model ROPES with diameter of 15 mm, were developed both in solid water Gammex 457 to conduct the study of the possible variation in the dose deposition inside the eye phantom. Radiochromic films were used to record isodose curves of two orthogonal plans within the simulator. The results showed that there is a difference in the dose deposition for the two orthogonal plans studied. This difference is 8.33% higher for the maximum dose value. Thus, a difference in dose that occurs due to the asymmetrical distribution of seeds on the eye plaque may interfere with the treatment, making it less effective. (author)

  8. Development of irradiation support devices for production of brachytherapy seeds

    Energy Technology Data Exchange (ETDEWEB)

    Mattos, Fabio R.; Rostelato, Maria Elisa C.M.; Zeituni, Carlos A.; Souza, Carla D.; Moura, Joao A.; Peleias Junior, Fernando S.; Karan Junior, Dib; Feher, Anselmo; Oliveira, Tiago B.; Benega, Marcos A.G., E-mail: tiagooliveira298@gmail.com, E-mail: mattos.fr@gmail.com, E-mail: elisaros@ipen.br, E-mail: czeituni@ipen.br, E-mail: carladdsouza@yahoo.com.br, E-mail: jamoura@ipen.br, E-mail: ernandopeleias@gmail.com, E-mail: s, E-mail: dib.karan@usp.br, E-mail: afeher@ipen.br, E-mail: marcosagbenega@gmail.com [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    Ophthalmic tumors treatment with brachytherapy sources has been widely used as a primary or secondary therapy for non-malignant or malignant tumors, for example, choroid melanoma, and retinoblastoma. Ruthenium-106, Iodine-125, Palladium -103, Gold-198 and Iridium-192, are some radionuclides that can be applied for treatment of ocular tumors. These sources are in small sizes (a few millimeters) and different shapes (rods, wires, disks). To ensure high accuracy during treatment, they are positioned in eye applicators, specially designed to fit on the surface of tumor. The Nuclear and Energy Research Institute (IPEN/CNEN) in a partnership with Paulista Medicine School (UNIFESP) created a project that aims to develop a prototype of Iridium-192 seeds for treatment of eye cancer. This seed consists in a core of Ir -Pt alloy (20%-80%) with a length of 3 mm, to be activated in IPEN's IEA-R1 Reactor, and a titanium capsule sealing the core. It was imperative to develop a sustainer device for irradiation. This piece is used to avoid overlapping of one cores and, therefore, avoiding the 'shadow effect' that does not allow full activation of each core due to the high density. (author)

  9. MRI/TRUS data fusion for prostate brachytherapy. Preliminary results

    CERN Document Server

    Reynier, Christophe; Fourneret, Philippe; Dusserre, André; Gay-Jeune, Cécile; Descotes, Jean-Luc; Bolla, Michel; Giraud, Jean-Yves

    2008-01-01

    Prostate brachytherapy involves implanting radioactive seeds (I125 for instance) permanently in the gland for the treatment of localized prostate cancers, e.g., cT1c-T2a N0 M0 with good prognostic factors. Treatment planning and seed implanting are most often based on the intensive use of transrectal ultrasound (TRUS) imaging. This is not easy because prostate visualization is difficult in this imaging modality particularly as regards the apex of the gland and from an intra- and interobserver variability standpoint. Radioactive seeds are implanted inside open interventional MR machines in some centers. Since MRI was shown to be sensitive and specific for prostate imaging whilst open MR is prohibitive for most centers and makes surgical procedures very complex, this work suggests bringing the MR virtually in the operating room with MRI/TRUS data fusion. This involves providing the physician with bi-modality images (TRUS plus MRI) intended to improve treatment planning from the data registration stage. The pape...

  10. Simultaneous radiochemotherapy and endoluminal HDR brachytherapy in esophageal cancer; Simultane Radiochemotherapie mit intraluminaler HDR-Brachytherapie des Oesophaguskarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Patonay, P.; Naszaly, A.; Mayer, A. [Hauptstaedtisches Zentrum fuer Radioonkologie und Strahlentherapie, Budapest (Hungary)

    2007-02-15

    Purpose: to study efficacy and toxicity of radiochemotherapy in esophageal cancer including initial endoluminal high-dose-rate brachytherapy (HDR-BT). Patients and methods: between 01/1995 and 06/2005, 61 patients with esophageal cancer were treated preoperatively with definitive and palliative intent. Treatment started with intraluminal HDR-BT for recanalization of the esophagus (single fraction size of 8 Gy in 0.5 cm depth, three times, q7d) followed by external-beam radiation therapy (50 Gy total dose, 5 x 2 Gy/week, 25 fractions in 5 weeks). Chemotherapy was started simultaneously with external irradiation (three courses of cisplatin and 5-fluorouracil, q21d). Results: swallowing function improved in 55/61 patients (dysphagia classification according to the RTOG), and worsened in 6/61 patients, respectively. Median duration of symptomatic improvement was 11 months, median follow-up 12 months (range 3-68 months). Following simultaneous radiochemotherapy, tumor resectability was achieved in 7/25 patients of the neoadjuvant group, and the histological specimen showed complete remission in 6/7 patients. Conclusion: these results indicate a favorable effect of simultaneous radiochemotherapy starting with endoluminal HDR-after-loading-(AL-)BT in esophageal cancer. (orig.)

  11. Breast Milk Best from the Breast?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_159054.html Breast Milk Best From the Breast? Babies were more likely ... get ear infections if they were fed pumped milk, study found To use the sharing features on ...

  12. CT-guided brachytherapy. A novel percutaneous technique for interstitial ablation of liver malignancies; CT-gesteuerte Brachytherapie. Eine neue perkutane Technik zur interstitiellen Ablation von Lebermetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Ricke, J.; Wust, P.; Stohlmann, A.; Beck, A.; Cho, C.H.; Pech, M.; Wieners, G.; Spors, B.; Werk, M.; Rosner, C.; Haenninen, E.L.; Felix, R. [Klinik fuer Strahlenheilkunde, Charite Virchow-Klinikum, Humboldt-Univ. zu Berlin (Germany)

    2004-05-01

    Purpose: to assess safety and efficacy of CT-guided brachytherapy of liver malignancies. Patients and methods: 21 patients with 21 liver malignancies (19 metastases, two primary liver tumors) were treated with interstitial CT-guided brachytherapy applying a {sup 192}Ir source. In all patients, the use of image-guided thermal tumor ablation such as by radiofrequency or laser-induced thermotherapy (LITT) was impeded either by tumor size {>=} 5 cm in seven, adjacent portal or hepatic vein in ten, or adjacent bile duct bifurcation in four patients. Dosimetry was performed using three-dimensional CT data sets acquired after CT-guided positioning of the brachytherapy catheters. Results: the mean tumor diameter was 4.6 cm (2.5-11 cm). The mean minimal tumor dose inside the tumor margin amounted to 17 Gy (12-20 Gy). The proportion of the liver parenchyma exposed to > 5 gy was 18% (5-39%) of total liver parenchyma minus tumor volume. Nausea and vomiting were observed in six patients after brachytherapy (28%). One patient demonstrated obstructive jaundice due to tumor edema after irradiation of a metastasis adjacent to the bile duct bifurcation. We commonly encountered asymptomatic increases of liver enzymes. Local control rates after 6 and 12 months were 87% and 70%, respectively. Conclusion: CT-guided brachytherapy is safe and effective. This technique displays broader indications compared to image-guided thermal ablation by radiofrequency or LITT with respect to tumor size or localization. (orig.) [German] Ziel: Analyse der Sicherheit und Effektivitaet CT-gesteuerter Brachytherapie zur Ablation von Lebermalignomen. Patienten und Methodik: 21 Patienten mit 21 Lebermalignomen (19 Metastasen, zwei primaere Lebermalignome) wurden mit perkutaner, CT-gesteuerter interstitieller Brachytherapie mit {sup 192}Ir behandelt. Alle Patienten wiesen Umstaende auf, die eine bildgefuehrte thermische Ablation mit Radiofrequenz oder laserinduzierter Thermotherapie (LITT) einschraenkten

  13. In-phantom dosimetric measurements as quality control for brachytherapy. System check and constancy check; Messungen im Festkoerperphantom als Qualitaetskontrolle in der Brachytherapie. Systempruefung und Konstanzpruefung

    Energy Technology Data Exchange (ETDEWEB)

    Kollefrath, Michael; Bruggmoser, Gregor; Nanko, Norbert; Gainey, Mark [Universitaetsklinik Freiburg (Germany). Klinik fuer Strahlenheilkunde

    2015-09-01

    In brachytherapy dosimetric measurements are difficult due to the inherent dose-inhomogeneities. Typically in routine clinical practice only the nominal dose rate is determined for computer controlled afterloading systems. The region of interest lies close to the source when measuring the spatial dose distribution. In this region small errors in the positioning of the detector, and its finite size, lead to large measurement uncertainties that exacerbate the routine dosimetric control of the system in the clinic. The size of the measurement chamber, its energy dependence, and the directional dependence of the measurement apparatus are the factors which have a significant influence on dosimetry. Although ionisation chambers are relatively large, they are employed since similar chambers are commonly found on clinical brachytherapy units. The dose is determined using DIN 6800 [11] since DIN 6809-2 [12], which deals with dosimetry in brachytherapy, is antiquated and is currently in the process of revision. Further information regarding dosimetry for brachytherapy can be found in textbooks [1] and [2]. The measurements for this work were performed with a HDR (High-Dose-Rate) {sup 192}Ir source, type mHDR V2, and a Microselectron Afterloader V2 both from Nucletron/Elekta. In this work two dosimetric procedures are presented which, despite the aforemention difficulties, should assist in performing checks of the proper operation of the system. The first is a system check that measures the dose distribution along a line and is to be performed when first bringing the afterloader into operation, or after significant changes to the system. The other is a dosimetric constancy check, which with little effort can be performed monthly or weekly. It simultaneously verifies the positioning of the source at two positions, the functionality of the system clock and the automatic re-calculation of the source activity.

  14. Absorbed dose simulations in near-surface regions using high dose rate Iridium-192 sources applied for brachytherapy

    International Nuclear Information System (INIS)

    Brachytherapy treatment with Iridium-192 high dose rate (HDR) sources is widely used for various tumours and it could be developed in many anatomic regions. Iridium-192 sources are inserted inside or close to the region that will be treated. Usually, the treatment is performed in prostate, gynaecological, lung, breast and oral cavity regions for a better clinical dose coverage compared with other techniques, such as, high energy photons and Cobalt-60 machines. This work will evaluate absorbed dose distributions in near-surface regions around Ir-192 HDR sources. Near-surface dose measurements are a complex task, due to the contribution of beta particles in the near-surface regions. These dose distributions should be useful for non-tumour treatments, such as keloids, and other non-intracavitary technique. For the absorbed dose distribution simulations the Monte Carlo code PENELOPE with the general code penEasy was used. Ir-192 source geometry and a Polymethylmethacrylate (PMMA) tube, for beta particles shield were modelled to yield the percentage depth dose (PDD) on a cubic water phantom. Absorbed dose simulations were realized at the central axis to yield the Ir-192 dose fall-off along central axis. The results showed that more than 99.2% of the absorbed doses (relative to the surface) are deposited in 5 cm depth but with slower rate at higher distances. Near-surface treatments with Ir-192 HDR sources yields achievable measurements and with proper clinical technique and accessories should apply as an alternative for treatment of lesions where only beta sources were used. - Highlights: ► A PMMA (polymethylmethacrylate) tube was used to surround the HDR Ir-192 to shield the beta particles. ► 99.2% of the absorbed doses (relative to the surface) are deposited in 5 cm depth. ► Near-surface treatments with Ir-192 HDR sources yields achievable measurements

  15. Construction of a anthropomorphic phantom for dose measurement in hands in brachytherapy procedures

    International Nuclear Information System (INIS)

    The main objective of this work was to show the differences between the dose value measured by dosimeter endpoint and the values measured in different points inside the hand during brachytherapy procedures. For this, the procedures involved in the handling of sources were analyzed and the simulated using an anthropomorphic phantom hand

  16. Interactive multiobjective optimization for anatomy-based three-dimensional HDR brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ruotsalainen, Henri [Department of Physics and Mathematics, University of Eastern Finland, PO Box 1627, FI-70211 Kuopio (Finland); Miettinen, Kaisa [Department of Mathematical Information Technology, PO Box 35 (Agora), FI-40014 University of Jyvaeskylae (Finland); Palmgren, Jan-Erik; Lahtinen, Tapani, E-mail: henrimatias.ruotsalainen@gmail.co [Department of Oncology, Kuopio University Hospital, PO Box 1777, FI-70211 Kuopio (Finland)

    2010-08-21

    In this paper, we present an anatomy-based three-dimensional dose optimization approach for HDR brachytherapy using interactive multiobjective optimization (IMOO). In brachytherapy, the goals are to irradiate a tumor without causing damage to healthy tissue. These goals are often conflicting, i.e. when one target is optimized the other will suffer, and the solution is a compromise between them. IMOO is capable of handling multiple and strongly conflicting objectives in a convenient way. With the IMOO approach, a treatment planner's knowledge is used to direct the optimization process. Thus, the weaknesses of widely used optimization techniques (e.g. defining weights, computational burden and trial-and-error planning) can be avoided, planning times can be shortened and the number of solutions to be calculated is small. Further, plan quality can be improved by finding advantageous trade-offs between the solutions. In addition, our approach offers an easy way to navigate among the obtained Pareto optimal solutions (i.e. different treatment plans). When considering a simulation model of clinical 3D HDR brachytherapy, the number of variables is significantly smaller compared to IMRT, for example. Thus, when solving the model, the CPU time is relatively short. This makes it possible to exploit IMOO to solve a 3D HDR brachytherapy optimization problem. To demonstrate the advantages of IMOO, two clinical examples of optimizing a gynecologic cervix cancer treatment plan are presented.

  17. Current situation of high-dose-rate brachytherapy for cervical cancer in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Rogerio Matias Vidal da; Souza, Divanizia do Nascimento, E-mail: rmv.fisica@gmail.com [Universidade Federal de Sergipe (UFS), Sao Cristovao, SE (Brazil); Pinezi, Juliana Castro Dourado [Pontificia Universidade Catolica de Goias (PUC-Goias), Goiania, GO (Brazil); Macedo, Luiz Eduardo Andrade [Hospital Chama, Arapiraca, AL (Brazil)

    2014-05-15

    To assess the current situation of high-dose-rate (HDR) brachytherapy for cancer of the cervix in Brazil, regarding apparatuses, planning methods, prescription, fractionation schedule and evaluation of dose in organs at risk. Materials and methods: in the period between March/2012 and May/2013, a multiple choice questionnaire was developed and sent to 89 Brazilian hospitals which perform HDR brachytherapy. Results: sixty-one services answered the questionnaire. All regions of the country experienced a sharp increase in the number of HDR brachytherapy services in the period from 2001 to 2013. As regards planning, although a three-dimensional planning software was available in 91% of the centers, conventional radiography was mentioned by 92% of the respondents as their routine imaging method for such a purpose. Approximately 35% of respondents said that brachytherapy sessions are performed after teletherapy. The scheme of four 7 Gy intracavitary insertions was mentioned as the most frequently practiced. Conclusion: the authors observed that professionals have difficulty accessing adjuvant three-dimensional planning tools such as computed tomography and magnetic resonance imaging. (author)

  18. Mold brachytherapy in Bowen's disease: a case report and review of the literature

    OpenAIRE

    HÜRMÜZ, Pervin; EVANS, Sibel Ersoy; YAPICI, Bülent; GÜRDALLI, Salih; SAĞLAM, Yücel; ŞAHİN, Sedef; ÖZYAR, Enis

    2006-01-01

    Bowen's disease is a disease that must be treated because of its potential to progress to squamous cell carcinoma. There are many treatment options including radiotherapy. Radiotherapy is an effective in the treatment with a variety of application procedures. Here, we present a patient with Bowen disease who was treated with mold brachytherapy in our department and a review of the literature was made.

  19. Investigation of palladium-103 production and IR07-103Pd brachytherapy seed preparation

    International Nuclear Information System (INIS)

    Highlights: → We report the cyclotron production of 103-palladium via 103Rh(p,n)103Pd reaction. → 103Pd was absorbed on resin beads for brachytherapy seed preparation. → The optimum absorption of 103Pd in resin was achieved at 0.5 M HCl. → Version 5 of MCNP code was employed to model a new 103Pd brachytherapy seed. - Abstract: In this study, design and fabrication of 103Pd brachytherapy seed was investigated. The excitation functions of 103Rh(p,n)103Pd and 103Rh(d,2n)103Pd reactions were calculated using EMPIRE (version 3.1 Rivoli), ALICE/ASH and TALYS-1.2 codes, the TENDL-2010 database and compared with the published data. Production of 103Pd was done via 103Rh(p,n)103Pd nuclear reaction. The target was bombarded with 18 MeV protons at 200 μA beam current for 15 h. After irradiation and radiochemical separation of the electroplated rhodium target, the optimum condition for absorption of 103Pd into Amberlite (registered) IR-93 resin was achieved at 0.5 M HCl. Version 5 of the (MCNP) Monte Carlo radiation transport code was employed to calculate the dosimetric parameters around the 103Pd brachytherapy seed. Finally the calculated results were compared with published results for other commercial sources.

  20. Staff dose of hospitalization in the treatment of patients in ophthalmic brachytherapy with 125 I

    International Nuclear Information System (INIS)

    The objective of this work, therefore, has been the evaluation of the dose levels which nursing staff can receive in care for ophthalmic brachytherapy patients treated with 125 I from measurements made on the same, evaluating, in an experimental way, job security following the PR rules laid down for these treatments. (Author)

  1. Salvage/Adjuvant Brachytherapy After Ophthalmic Artery Chemosurgery for Intraocular Retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Francis, Jasmine H., E-mail: francij1@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Barker, Christopher A.; Wolden, Suzanne L.; McCormick, Beryl; Segal, Kira; Cohen, Gil [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Gobin, Y. Pierre; Marr, Brian P. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States); Brodie, Scott E. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Mount Sinai School of Medicine, New York, New York (United States); Dunkel, Ira J.; Abramson, David H. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States)

    2013-11-01

    Purpose: To evaluate the efficacy and toxicity of brachytherapy after ophthalmic artery chemosurgery (OAC) for retinoblastoma. Methods and Materials: This was a single-arm, retrospective study of 15 eyes in 15 patients treated with OAC followed by brachytherapy at (blinded institution) between May 1, 2006, and December 31, 2012, with a median 19 months' follow-up from plaque insertion. Outcome measurements included patient and ocular survival, visual function, and retinal toxicity measured by electroretinogram (ERG). Results: Brachytherapy was used as adjuvant treatment in 2 eyes and as salvage therapy in 13 eyes of which 12 had localized vitreous seeding. No patients developed metastasis or died of retinoblastoma. The Kaplan-Meier estimate of ocular survival was 79.4% (95% confidence interval 48.7%-92.8%) at 18 months. Three eyes were enucleated, and an additional 6 eyes developed out-of-target volume recurrences, which were controlled with additional treatments. Patients with an ocular complication had a mean interval between last OAC and plaque of 2.5 months (SD 2.3 months), which was statistically less (P=.045) than patients without ocular complication who had a mean interval between last OAC and plaque of 6.5 months (SD 4.4 months). ERG responses from pre- versus postplaque were unchanged or improved in more than half the eyes. Conclusions: Brachytherapy following OAC is effective, even in the presence of vitreous seeding; the majority of eyes maintained stable or improved retinal function following treatment, as assessed by ERG.

  2. A gEUD-based inverse planning technique for HDR prostate brachytherapy: Feasibility study

    International Nuclear Information System (INIS)

    Purpose: The purpose of this work was to study the feasibility of a new inverse planning technique based on the generalized equivalent uniform dose for image-guided high dose rate (HDR) prostate cancer brachytherapy in comparison to conventional dose-volume based optimization. Methods: The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO (Hybrid Inverse Planning Optimization) is compared with alternative plans, which were produced through inverse planning using the generalized equivalent uniform dose (gEUD). All the common dose-volume indices for the prostate and the organs at risk were considered together with radiobiological measures. The clinical effectiveness of the different dose distributions was investigated by comparing dose volume histogram and gEUD evaluators. Results: Our results demonstrate the feasibility of gEUD-based inverse planning in HDR brachytherapy implants for prostate. A statistically significant decrease in D10 or/and final gEUD values for the organs at risk (urethra, bladder, and rectum) was found while improving dose homogeneity or dose conformity of the target volume. Conclusions: Following the promising results of gEUD-based optimization in intensity modulated radiation therapy treatment optimization, as reported in the literature, the implementation of a similar model in HDR brachytherapy treatment plan optimization is suggested by this study. The potential of improved sparing of organs at risk was shown for various gEUD-based optimization parameter protocols, which indicates the ability of this method to adapt to the user's preferences.

  3. Dwell time modulation restrictions do not necessarily improve treatment plan quality for prostate HDR brachytherapy

    NARCIS (Netherlands)

    Balvert, M.; Gorissen, B.L.; den Hertog, D.; Hoffmann, A.L.

    2015-01-01

    Inverse planning algorithms for dwell time optimisation in interstitial high-dose-rate (HDR) brachytherapy may produce solutions with large dwell time variations within catheters, which may result in undesirable selective high-dose subvolumes. Extending the dwell time optimisation model with a dwell

  4. Intra-fraction uncertainties of MRI guided brachytherapy in patients with cervical cancer

    International Nuclear Information System (INIS)

    Dosimetric intra-fraction uncertainties in MRI-guided brachytherapy were analysed for HR-CTV and OARs. While dose differences were generally small, individual outliers occurred. In contrast to HDR, patients treated with PDR show increased mean rectal dose over time. Re-imaging prior to dose delivery helps to detect unfavorable anatomical changes, and allows for intervention

  5. A Monte Carlo dosimetry study using Henschke applicator for cervical brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Pei-Chieh [Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101 Sec. 2, Kung Fu Road, Hsinchu 30013, Taiwan (China); Department of Radiation Oncology, Cathay General Hospital, 280 Renai Rd. Sec.4, Taipei 106, Taiwan (China); Chao, Tsi-Chian [Department of Medical Imaging and Radiological Science, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China); Lee, Chung-Chi [Department of Medical Imaging and Radiological Science, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan 333, Taiwan (China); Wu, Ching-Jung [Department of Radiation Oncology, Cathay General Hospital, 280 Renai Rd. Sec.4, Taipei 106, Taiwan (China); Tung, Chuan-Jong, E-mail: cjtung@mail.cgu.edu.t [Department of Medical Imaging and Radiological Science, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China)

    2010-07-21

    In recent years the Henschke applicator has been widely used for gynecologic patients treated by brachytherapy in Taiwan. However, the commercial brachytherapy planning system did not properly evaluate the dose perturbation caused by the Henschke applicator. Since the European Society for Therapeutic Radiology and Oncology advised that the effect of source shielding should be incorporated into the brachytherapy planning system, it required calculation and comparison of the dose distribution around the applicator. This study used the Monte Carlo MCNP code to simulate the dose distribution in a water phantom that contained the Henschke applicator with one tandem and two ovoids. Three dwell positions of a high dose rate {sup 192}Ir source were simulated by including and excluding the applicator. The mesh tally option of the MCNP was applied to facilitate the calculation of a large number of tallies in the phantom. The voxel size effect and the charge particle equilibrium were studied by comparing the results calculated with different tally options. The calculated results showed that the brachytherapy planning system overestimated the rectal dose and that the shielding material in the applicator contributed more than 40% to the rectal dose.

  6. Impact of delineation uncertainties on dose to organs at risk in CT-guided intracavitary brachytherapy.

    LENUS (Irish Health Repository)

    Duane, Frances K

    2014-08-07

    This study quantifies the inter- and intraobserver variations in contouring the organs at risk (OARs) in CT-guided brachytherapy (BT) for the treatment of cervical carcinoma. The dosimetric consequences are reported in accordance with the current Gynecological Groupe Européen de Curiethérapie\\/European Society for Therapeutic Radiology and Oncology guidelines.

  7. Changes in the micromorphology of the corneal subbasal nerve plexus in patients after plaque brachytherapy

    International Nuclear Information System (INIS)

    To quantify the development of radiation neuropathy in corneal subbasal nerve plexus (SNP) after plaque brachytherapy, and the subsequent regeneration of SNP micromorphology and corneal sensation. Nine eyes of 9 melanoma patients (ciliary body: 3, iris: 2, conjunctiva: 4) underwent brachytherapy (ruthenium-106 plaque, dose to tumour base: 523 ± 231 Gy). SNP micromorphology was assessed by in-vivo confocal microscopy. Using software developed in–house, pre-irradiation findings were compared with those obtained after 3 days, 1, 4 and 7 months, and related to radiation dose and corneal sensation. After 3 days nerve fibres were absent from the applicator zone and central cornea, and corneal sensation was abolished. The earliest regenerating fibres were seen at the one-month follow-up. By 4 months SNP structures had increased to one-third of pre-treatment status (based on nerve fibre density and nerve fibre count), and corneal sensation had returned to approximately two-thirds of pre-irradiation values. Regeneration of SNP and corneal sensation was nearly complete 7 months after plaque brachytherapy. The evaluation of SNP micromorphology and corneal sensation is a reliable and clinically useful method for assessing neuropathy after plaque brachytherapy. Radiation-induced neuropathy of corneal nerves develops quickly and is partly reversible within 7 months. The clinical impact of radiation-induced SNP damage is moderate

  8. Surface membrane based bladder registration for evaluation of accumulated dose during brachytherapy in cervical cancer

    DEFF Research Database (Denmark)

    Noe, Karsten Østergaard; Tanderup, Kari; Sørensen, Thomas Sangild

    2011-01-01

    of the fixed surface. Optional landmark based matches can be included in the suggested iterative solver. The technique is demonstrated for bladder registration in brachytherapy treatment evaluation of cervical cancer. It holds promise to better estimate the accumulated but unintentional dose delivered...

  9. COMS eye plaque brachytherapy dosimetric sensitivity to source photon energy and seed design

    International Nuclear Information System (INIS)

    This study explores the influence of source photon energy on eye plaque brachytherapy dose distributions for a 16 mm COMS plaque filled with 103Pd, 125I, or 131Cs sources or monoenergetic photon emissions ranging from 12 keV to 100 keV. Dose distributions were similarly created for all permutations of three common brachytherapy seed designs. Within this range, sources with average energy ≤22 keV may reduce dose to the opposite eye wall by more than a factor of 2 while maintaining tolerable proximal sclera doses when prescribing to depths of 9 mm or less. Current commercially-available brachytherapy sources can exhibit up to 15% relative dosimetric sensitivity to seed design at regions within the eye. - Highlights: • Episcleral eye plaque brachytherapy utilizes low-energy photon-emitting sources. • Dose distribution sensitivity to source photon energy and seed design was examined. • Tumor dose conformity and critical structure sparing from ≤22 keV photons is preferred. • Ocular dose distributions varied by up to 15% with seed design permutations

  10. Doses of radiation in the environment of patients undergoing treatment of ophthalmic brachytherapy

    International Nuclear Information System (INIS)

    This paper presents results for measures of dose made to different patient undergoing treatment with ophthalmic brachytherapy. The aim of these measures has been, on the one hand, verify assessments relating to radiation protection in the memory of the installation and, on the other hand, experimental measures that can serve to reduce the perception of the radiological risk professionals have. (Author)

  11. Salvage/Adjuvant Brachytherapy After Ophthalmic Artery Chemosurgery for Intraocular Retinoblastoma

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy and toxicity of brachytherapy after ophthalmic artery chemosurgery (OAC) for retinoblastoma. Methods and Materials: This was a single-arm, retrospective study of 15 eyes in 15 patients treated with OAC followed by brachytherapy at (blinded institution) between May 1, 2006, and December 31, 2012, with a median 19 months' follow-up from plaque insertion. Outcome measurements included patient and ocular survival, visual function, and retinal toxicity measured by electroretinogram (ERG). Results: Brachytherapy was used as adjuvant treatment in 2 eyes and as salvage therapy in 13 eyes of which 12 had localized vitreous seeding. No patients developed metastasis or died of retinoblastoma. The Kaplan-Meier estimate of ocular survival was 79.4% (95% confidence interval 48.7%-92.8%) at 18 months. Three eyes were enucleated, and an additional 6 eyes developed out-of-target volume recurrences, which were controlled with additional treatments. Patients with an ocular complication had a mean interval between last OAC and plaque of 2.5 months (SD 2.3 months), which was statistically less (P=.045) than patients without ocular complication who had a mean interval between last OAC and plaque of 6.5 months (SD 4.4 months). ERG responses from pre- versus postplaque were unchanged or improved in more than half the eyes. Conclusions: Brachytherapy following OAC is effective, even in the presence of vitreous seeding; the majority of eyes maintained stable or improved retinal function following treatment, as assessed by ERG

  12. A single session of intraluminal brachytherapy in palliation of oesophageal cancer

    NARCIS (Netherlands)

    Jager, J; Langendijk, H; Pannebakker, M; Rijken, J; deJong, J

    1995-01-01

    Between September 1987 and September 1993, 88 patients with oesophageal cancer were treated by a single session of intraluminal brachytherapy of 15 Gy prescribed at 1 cm distance from the central axis, using MDR Cs-137 (n = 51) during the first part of the study and HDR Ir-192 (n = 37) during the se

  13. Determination of the tissue inhomogeneity correction in high dose rate Brachytherapy for Iridium-192 source

    Directory of Open Access Journals (Sweden)

    Barlanka Ravikumar

    2012-01-01

    Full Text Available In Brachytherapy treatment planning, the effects of tissue heterogeneities are commonly neglected due to lack of accurate, general and fast three-dimensional (3D dose-computational algorithms. In performing dose calculations, it is assumed that the tumor and surrounding tissues constitute a uniform, homogeneous medium equivalent to water. In the recent past, three-dimensional computed tomography (3D-CT based treatment planning for Brachytherapy applications has been popularly adopted. However, most of the current commercially available planning systems do not provide the heterogeneity corrections for Brachytherapy dosimetry. In the present study, we have measured and quantified the impact of inhomogeneity caused by different tissues with a 0.015 cc ion chamber. Measurements were carried out in wax phantom which was employed to measure the heterogeneity. Iridium-192 (192 Ir source from high dose rate (HDR Brachytherapy machine was used as the radiation source. The reduction of dose due to tissue inhomogeneity was measured as the ratio of dose measured with different types of inhomogeneity (bone, spleen, liver, muscle and lung to dose measured with homogeneous medium for different distances. It was observed that different tissues attenuate differently, with bone tissue showing maximum attenuation value and lung tissue resulting minimum value and rest of the tissues giving values lying in between those of bone and lung. It was also found that inhomogeneity at short distance is considerably more than that at larger distances.

  14. Stereotactic interstitial brachytherapy for the treatment of oligodendroglial brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    El Majdoub, Faycal; Neudorfer, Clemens; Maarouf, Mohammad [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University of Witten/Herdecke, Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Cologne-Merheim Medical Center (CMMC), Cologne (Germany); Blau, Tobias; Deckert, Martina [University Hospital of Cologne, Department of Neuropathology, Cologne (Germany); Hellmich, Martin [University Hospital of Cologne, Institute of Statistics, Informatics and Epidemiology, Cologne (Germany); Buehrle, Christian [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); Sturm, Volker [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University Hospital of Wurzburg, Department of Neurosurgery, Wuerzburg (Germany)

    2015-12-15

    We evaluated the treatment of oligodendroglial brain tumors with interstitial brachytherapy (IBT) using {sup 125}iodine seeds ({sup 125}I) and analyzed prognostic factors. Between January 1991 and December 2010, 63 patients (median age 43.3 years, range 20.8-63.4 years) suffering from oligodendroglial brain tumors were treated with {sup 125}I IBT either as primary, adjuvantly after incomplete resection, or as salvage therapy after tumor recurrence. Possible prognostic factors influencing disease progression and survival were retrospectively investigated. The actuarial 2-, 5-, and 10-year overall and progression-free survival rates after IBT for WHO II tumors were 96.9, 96.9, 89.8 % and 96.9, 93.8, 47.3 %; for WHO III tumors 90.3, 77, 54.9 % and 80.6, 58.4, 45.9 %, respectively. Magnetic resonance imaging demonstrated complete remission in 2 patients, partial remission in 13 patients, stable disease in 17 patients and tumor progression in 31 patients. Median time to progression for WHO II tumors was 87.6 months and for WHO III tumors 27.8 months. Neurological status improved in 10 patients and remained stable in 20 patients, while 9 patients deteriorated. There was no treatment-related mortality. Treatment-related morbidity was transient in 11 patients. WHO II, KPS ≥ 90 %, frontal location, and tumor surface dose > 50 Gy were associated with increased overall survival (p ≤ 0.05). Oligodendroglioma and frontal location were associated with a prolonged progression-free survival (p ≤ 0.05). Our study indicates that IBT achieves local control rates comparable to surgery and radio-/chemotherapy treatment, is minimally invasive, and safe. Due to the low rate of side effects, IBT may represent an attractive option as part of a multimodal treatment schedule, being supplementary to microsurgery or as a salvage therapy after chemotherapy and conventional irradiation. (orig.) [German] Die Behandlung oligodendroglialer Hirntumoren durch die interstitielle Brachytherapie

  15. Brachytherapy on restenosis. {sup 32}P radioisotope in animal model

    Energy Technology Data Exchange (ETDEWEB)

    Bergoc, R.; Rivera, E.; Cocca, C.; Martin, G.; Cricco, G. [Buenos Aires Univ. (Argentina). School of Pharmacy and Biochemistry; Croci, M.; Guzman, L.

    2000-05-01

    Despite a notorious decline in age-adjusted death rates for cardiovascular pathologies, coronary artery disease still remains as the main cause of mortality above the age of 40 in men and 60 in women. More than 25% of death in persons over the age of 35 are due to coronary disease. In about 50% of men and 30% of women, the first manifestation of the disease is an acute myocardial infarction and 10% a sudden cardiac death. In Argentina it is estimated that in 1998 about 100.000-115.000 people suffered as first manifestation of coronary illness a myocardial acute infarct. Angioplasty has an important and well established site in the treatment of the coronary illness and restenosis represents the principal complication of this method for myocardial re-vascularization. About a 35-40% of treated arteries present restenosis within the first six month the intervention with the concomitant need of re-interventions, re-hospitalizations, by-pass surgery, work discontinuity and the high cost for the health system. A number of drugs were tested as anti-restenosis: anticoagulants, aspirin, antispasmodics and lipid-lowering agents but none was clearly efficient; also, experimental studies in which intravascular irradiation with different source types and energies, radiation doses and doses rate to prevent restenosis was utilized; however, there is no consensus in many aspects of this intravascular brachytherapy. The first step in this work was to induce the experimental model in rabbits. Afterwards, by means of the balloon methodology and stent implantation, brachytherapy experiments were carried out to evaluate the biological effect on different layers of arteries, with different Doses using a beta particle emitting radioisotope ({sup 32}P). The arteriosclerotic lesions were induced in New Zealand rabbits through the administration of a diet with high cholesterol content. Angioplastic interventions on femoral arteries were done with balloon methodology and controlled by

  16. A reappraisal of local anesthesia for prostate brachytherapy

    International Nuclear Information System (INIS)

    Purpose: Faced with rapidly increasing patient numbers, the authors adopted and modified a technique to perform prostate implants under local anesthesia in a radiation oncology facility. Our reasons for assembling the current report detailing 20 consecutive, unselected patients are to show how patients tolerate brachytherapy without the use of sedatives, to provide more technical detail regarding the procedure's practical aspects, and to summarize the time needed to complete its components. Materials and methods: No pre-operative medication is given. The patient is placed in the lithotomy position, using stirrups mounted on the end of the simulator table. A 5-cmx5-cm patch of perineal skin and subcutaneous tissue is anesthetized by local infiltration of 3--5 cm3 of 0.5% lidocaine, using a 25-gauge 1.5-inch needle. Immediately following injection into the subcutaneous tissues, the deeper tissues, of the pelvic floor are anesthetized by injecting 5 cm3 lidocaine solution with approximately 16 passes of a 25-gauge 1.5-inch needle entering perpendicular to the skin surface. The transrectal ultrasound (TRUS) probe of a Siemens SONOLINE Prima ultrasound machine (6.0 MHz) and a Winston-Barzell stepper unit is next positioned to reproduce the planning images and a 3.5-inch, 22-gauge spinal needle is inserted into the peripheral and a few central tracks. About 0.5 cm3 of lidocaine solution is injected into each intraprostatic track, as the needle is slowly advanced. Finally, a 7-inch 22-gauge spinal needle inserted through the skin via a 3.5-inch 18-gauge needle, is used to anesthetize to the base of the prostate under TRUS and fluoroscopic guidance. Seed placement is done with a Mick ApplicatorTM, inserting and loading one needle at a time. The number of seeds placed ranged from 60 to 118 (average: 87) and the number of needles used ranged from 14 to 20 (average: 18). For the purpose of this study, prior to walking to the simulator suite, patients were asked to rate the

  17. Brachytherapy on restenosis. 32P radioisotope in animal model

    International Nuclear Information System (INIS)

    Despite a notorious decline in age-adjusted death rates for cardiovascular pathologies, coronary artery disease still remains as the main cause of mortality above the age of 40 in men and 60 in women. More than 25% of death in persons over the age of 35 are due to coronary disease. In about 50% of men and 30% of women, the first manifestation of the disease is an acute myocardial infarction and 10% a sudden cardiac death. In Argentina it is estimated that in 1998 about 100.000-115.000 people suffered as first manifestation of coronary illness a myocardial acute infarct. Angioplasty has an important and well established site in the treatment of the coronary illness and restenosis represents the principal complication of this method for myocardial re-vascularization. About a 35-40% of treated arteries present restenosis within the first six month the intervention with the concomitant need of re-interventions, re-hospitalizations, by-pass surgery, work discontinuity and the high cost for the health system. A number of drugs were tested as anti-restenosis: anticoagulants, aspirin, antispasmodics and lipid-lowering agents but none was clearly efficient; also, experimental studies in which intravascular irradiation with different source types and energies, radiation doses and doses rate to prevent restenosis was utilized; however, there is no consensus in many aspects of this intravascular brachytherapy. The first step in this work was to induce the experimental model in rabbits. Afterwards, by means of the balloon methodology and stent implantation, brachytherapy experiments were carried out to evaluate the biological effect on different layers of arteries, with different Doses using a beta particle emitting radioisotope (32P). The arteriosclerotic lesions were induced in New Zealand rabbits through the administration of a diet with high cholesterol content. Angioplastic interventions on femoral arteries were done with balloon methodology and controlled by fluoroscopy

  18. Breast Cancer Overview

    Science.gov (United States)

    ... Other less common types of breast cancer include: Medullary Mucinous Tubular Metaplastic Papillary breast cancer Inflammatory breast cancer is a faster-growing type of cancer that accounts for about 1% to 5% of all breast cancers. Paget’s disease is a type of cancer that begins in ...

  19. Breast Cancer -- Male

    Science.gov (United States)

    ... Home > Types of Cancer > Breast Cancer in Men Breast Cancer in Men This is Cancer.Net’s Guide to Breast Cancer in Men. Use the menu below to choose ... social workers, and patient advocates. Cancer.Net Guide Breast Cancer in Men Overview Statistics Risk Factors and Prevention ...

  20. Breast cancer in men

    Science.gov (United States)

    ... in situ-male; Intraductal carcinoma-male; Inflammatory breast cancer-male; Paget disease of the nipple-male; Breast cancer-male ... The cause of breast cancer is not clear. But there are risk ... breast cancer more likely in men: Exposure to radiation Higher ...

  1. Brachytherapy Application With In Situ Dose Painting Administered by Gold Nanoparticle Eluters

    International Nuclear Information System (INIS)

    Purpose: Recent studies show promise that administering gold nanoparticles (GNP) to tumor cells during brachytherapy could significantly enhance radiation damage to the tumor. A new strategy proposed for sustained administration of the GNP in prostate tumors is to load them into routinely used brachytherapy spacers for customizable in situ release after implantation. This in silico study investigated the intratumor biodistribution and corresponding dose enhancement over time due to GNP released from such GNP-loaded brachytherapy spacers (GBS). Method and Materials: An experimentally determined intratumoral diffusion coefficient (D) for 10-nm nanoparticles was used to estimate D for other sizes by using the Stokes-Einstein equation. GNP concentration profiles, obtained using D, were then used to calculate the corresponding dose enhancement factor (DEF) for each tumor voxel, using dose painting-by-numbers approach, for times relevant to the considered brachytherapy sources' lifetimes. The investigation was carried out as a function of GNP size for the clinically applicable low-dose-rate brachytherapy sources iodine-125 (I-125), palladium-103 (Pd-103), and cesium-131 (Cs-131). Results: Results showed that dose enhancement to tumor voxels and subvolumes during brachytherapy can be customized by varying the size of GNP released or eluted from the GBS. For example, using a concentration of 7 mg/g GNP, significant DEF (>20%) could be achieved 5 mm from a GBS after 5, 12, 25, 46, 72, 120, and 195 days, respectively, for GNP sizes of 2, 5, 10, 20, 30, and 50 nm and for 80 nm when treating with I-125. Conclusions: Analyses showed that using Cs-131 provides the highest dose enhancement to tumor voxels. However, given its relatively longer half-life, I-125 presents the most flexibility for customizing the dose enhancement as a function of GNP size. These findings provide a useful reference for further work toward development of potential new brachytherapy application

  2. The first manchester clinical trial of endobronchial brachytherapy

    International Nuclear Information System (INIS)

    Introduction: A randomised trial in advanced lung cancer was completed in 1993. The aims were to compare high dose-rate endobronchial brachytherapy (EBT) with conventional x-ray therapy (XRT) for (1) symptom relief, (2) side-effects, (3) survival and to perform a Quality of Life Analysis. Material and Methods: 99 patients with inoperable stage III non-small cell endobronchial tumours (thoracic symptoms limited to cough, haemoptysis and breathlessness) were treated. Their mean age was 68 years, 79 were male and 92 had and ECOG score of 0-2. 49 received EBT as a single treatment, prescribing 15Gy at 1cm. 50 were given XRT, 30Gy in 8 fractions over 10 days. Results and Discussion: Symptom relief was the same in both arms for haemoptysis (86%) and breathlessness (64%). There was a significant difference in favour of XRT (67 v 42%) for cough. Cross-over retreatment for persistent, recurrent or new thoracic symptoms was required in 51% of the EBT and 28% of XRT group. Acute morbidity was greater with XRT reaching statistical significance for dysphagia (55 v 10%). Late morbidity was the same. The incidence of massive fatal haemoptysis was only 7%. The median survival was better with XRT (287 v 250 days). The survival difference at 2 years was 10 v 2%. The Q of L Analysis revealed no differences for functional status, anxiety or depression but the symptom scores confirmed the excess acute morbidity and better symptom control for cough, tiredness and lack of energy in the XRT group. Conclusion: In this particular patient population XRT is slightly superior to EBT. EBT may provide additional benefit when combined with XRT

  3. Brachytherapy of carcinoma of vulva with 252Cf

    International Nuclear Information System (INIS)

    Thirty patients with carcinoma of vulva were treated with interstitial neutron radiotherapy with 252Cf. Age of patients was from 32 to 83 years. Stage I was in I patient, stage II - in 12, stage III was in 10 patients. The diagnosis of vulvar cancer was made for the first time in 11 cases, 19 patients had recurrences after the initial treatment. Most of these patients also received external irradiation for cancer of vulva and bilateral inguinal sites with a single fraction dose of 2 Gy to a total dose 30-50 Gy. Enlarged inguinal lymph nodes were irradiated additionally to 60 Gy with reduced field of irradiation. When radiotherapy was used repeatedly interstitial brachytherapy comprised the major part of irradiation dose or the therapy was used alone delivering 35-55 iGy. We used 252Cf sources with increased activity at the ends 20-30 mm long. A number of inserted sources varied from 2 to 10, irradiation dose rate from 20.3 to 236.7 cGy/h, time of irradiation from 10.2 to 12. hours, RBE from 4.6 to 6.33. Special template device made it possible to implant sources in strictly pre-set geometry. Analysis of survival of patients showed that 2 years survival was 66%, 3 years - 60%, and 5 years survival was 49%. In two cases necrotic epithelitis developed with following radiation ulcer which were cured in 3-4 months. Clinical data showed great effectiveness of interstitial neutron therapy having in mind that 19 patients were treated for recurrences of vulvar cancer after previuos treatment

  4. Stereotactic interstitial brachytherapy for the treatment of oligodendroglial brain tumors

    International Nuclear Information System (INIS)

    We evaluated the treatment of oligodendroglial brain tumors with interstitial brachytherapy (IBT) using 125iodine seeds (125I) and analyzed prognostic factors. Between January 1991 and December 2010, 63 patients (median age 43.3 years, range 20.8-63.4 years) suffering from oligodendroglial brain tumors were treated with 125I IBT either as primary, adjuvantly after incomplete resection, or as salvage therapy after tumor recurrence. Possible prognostic factors influencing disease progression and survival were retrospectively investigated. The actuarial 2-, 5-, and 10-year overall and progression-free survival rates after IBT for WHO II tumors were 96.9, 96.9, 89.8 % and 96.9, 93.8, 47.3 %; for WHO III tumors 90.3, 77, 54.9 % and 80.6, 58.4, 45.9 %, respectively. Magnetic resonance imaging demonstrated complete remission in 2 patients, partial remission in 13 patients, stable disease in 17 patients and tumor progression in 31 patients. Median time to progression for WHO II tumors was 87.6 months and for WHO III tumors 27.8 months. Neurological status improved in 10 patients and remained stable in 20 patients, while 9 patients deteriorated. There was no treatment-related mortality. Treatment-related morbidity was transient in 11 patients. WHO II, KPS ≥ 90 %, frontal location, and tumor surface dose > 50 Gy were associated with increased overall survival (p ≤ 0.05). Oligodendroglioma and frontal location were associated with a prolonged progression-free survival (p ≤ 0.05). Our study indicates that IBT achieves local control rates comparable to surgery and radio-/chemotherapy treatment, is minimally invasive, and safe. Due to the low rate of side effects, IBT may represent an attractive option as part of a multimodal treatment schedule, being supplementary to microsurgery or as a salvage therapy after chemotherapy and conventional irradiation. (orig.)

  5. Dosimetric study in iodine-125 seeds for brachytherapy application

    International Nuclear Information System (INIS)

    The demand for iodine-125 seeds for use in brachytherapy treatments has experienced an increase along recent years in Brazil and all over the world. All iodine-125 seed must have its operational parameters measured and/or calculated every time changes in the production process are carried out. A complete dosimetric measurement is very expensive, and it is recommended that this procedure must be repeated at least once a year. Thus, this work developed a methodology for the entire dosimetric process. This methodology is based on the scarce information available in the literature, once almost all the methodology used in large industrial laboratories is commercial secret. The proposed methodology was tested using seeds of Amersham-Oncura-Ge Healthcare, which is the largest seed manufactory in the world. In this new methodology, an automatic reader was employed in order to reduce the time required in the selection process of the TLD-100 dosimeters used and a postprocessing of the obtained spectra was carried out. A total of 142 dosimeters were used and only 29 have been selected using the new methodology. Measurements were performed using slabs of Solid Water RW1 to simulate measuring in the 'water', using three different experimental apparatus and each measurement was repeated at least three times. The TLD-100 calibration was performed using a Dermopan II - Siemens. The measured values showed a good agreement with the ones available in the literature. Finally, these measured values were compared with calculated ones obtained by a semiempirical simulation program, showing a good agreement and, therefore, demonstrating the validity of the proposed methodology regarding dosimetric calculations. (author)

  6. Production of 125I seed sources for brachytherapy uses

    International Nuclear Information System (INIS)

    The production of radioactive sources of 125I, used mainly for the brachytherapy of prostate and ocular cancer, is a work that is being carried out in the plant of production of radioisotopes (PPR) of the Nuclear Center Racso of the IPEN. The employed methodology is based on the 125I physical-chemistry adsorption at silver wires coated with palladium. In the realization of the tests, it has been considered the procedure used by India and Iran participants of this CRP. In the execution of this work, the 131I radioisotope is been used simulating the 125I, because in the PPR-IPEN we produce the 131I. In total 50 samples were used, they were divided in ten groups. In first place with nine working groups, the optimum conditions for work for the coating of the silver wires with palladium were obtained, these being the following: simple method, employing PdCl2 0.1 m, pH of 5.5 to 6.5 and a temperature of 100 deg. C. Later on, a series of tests were carried out to determine the appropriate parameters for the adsorption of 131I in the previously treated wires, these being the following: carrier concentration of Ki 0.03 m, time of adsorption of 6 hours, and temperature of 70 deg. C. Finally, the percentage of 131I adsorption was obtained in the silver wires tried previously with palladium chloride solution of 98.24%. The control of leachability was made, having very good results. To confirm these previously mentioned parameters, a test was made with ten pieces of silver wires, corresponding to the group 10, giving the confirmation as a result of these. Also, samples of the titanium tube have been sent for test with microplasma welding to a French company: air welding liquidates export. With these results obtained, subsequently the production of these radioactive sources will be carried out employing 125I as a radioisotope. (author)

  7. Localization of brachytherapy seeds in ultrasound by registration to fluoroscopy

    Science.gov (United States)

    Fallavollita, P.; KarimAghaloo, Z.; Burdette, E. C.; Song, D. Y.; Abolmaesumi, P.; Fichtinger, G.

    2010-02-01

    Motivation: In prostate brachytherapy, transrectal ultrasound (TRUS) is used to visualize the anatomy, while implanted seeds can be seen in C-arm fluoroscopy or CT. Intra-operative dosimetry optimization requires localization of the implants in TRUS relative to the anatomy. This could be achieved by registration of TRUS images and the implants reconstructed from fluoroscopy or CT. Methods: TRUS images are filtered, compounded, and registered on the reconstructed implants by using an intensity-based metric based on a 3D point-to-volume registration scheme. A phantom was implanted with 48 seeds, imaged with TRUS and CT/X-ray. Ground-truth registration was established between the two. Seeds were reconstructed from CT/X-ray. Seven TRUS filtering techniques and two image similarity metrics were analyzed as well. Results: For point-to-volume registration, noise reduction combined with beam profile filter and mean squares metrics yielded the best result: an average of 0.38 +/- 0.19 mm seed localization error relative to the ground-truth. In human patient data C-arm fluoroscopy images showed 81 radioactive seeds implanted inside the prostate. A qualitative analysis showed clinically correct agreement between the seeds visible in TRUS and reconstructed from intra-operative fluoroscopy imaging. The measured registration error compared to the manually selected seed locations by the clinician was 2.86 +/- 1.26 mm. Conclusion: Fully automated seed localization in TRUS performed excellently on ground-truth phantom, adequate in clinical data and was time efficient having an average runtime of 90 seconds.

  8. Automated treatment planning engine for prostate seed implant brachytherapy

    International Nuclear Information System (INIS)

    brachytherapy

  9. Aktuelle Entwicklungen in der Strahlentherapie des Prostatakarzinoms: HDR-Brachytherapie

    Directory of Open Access Journals (Sweden)

    Knocke-Abulesz TH

    2004-01-01

    Full Text Available In der primären Therapie des Prostatakarzinoms ist die Seed-Implantation neben der radikalen Prostatektomie und der konformalen 3D-geplanten Teletherapie in den letzten Jahren insbesondere bei den lokal begrenzten Tumoren die dritte etablierte Behandlungstechnik geworden. In den USA werden bereits fast ein Drittel der Patienten mit dieser Technik behandelt. Im Gegensatz hierzu wurde in der Strahlentherapie in den letzten beiden Jahrzehnten die Langzeit-Implantation von Nukliden bei den meisten Tumoren zugunsten der fraktionierten Afterloading-Bestrahlung in "high dose rate" (HDR- Technik ersetzt – wobei partiell für HNO- und gynäkologische Tumoren die HDR-Technik als "pulse-dose-rate" (PDR- Verfahren modifiziert wird, um die biologischen Vorteile der LDR- und die technologischen Vorteile der HDR-Anwendung zu vereinen. Vorteile der Methode im Vergleich zur Seed-Implantation sind: – Niedrigere Kosten, allgemeine Verfügbarkeit, – Idealer Strahlenschutz, – Zuverlässige Dosisverteilung, – Keine Migration von Seeds, – Durchführbar auch nach TURP, – Durchführbar bei manifesten Lokalrezidiven. Allerdings liegen bisher nur vereinzelte klinische Ergebnisse beim Prostatakarzinom vor, die zeigen, daß eine lokale Dosiserhöhung in Kombination mit der Teletherapie eine Verbesserung der lokalen Kontrolle bei kapselüberschreitenden Tumoren ermöglicht. Inwieweit der Einsatz der Technik bei Lokalrezidiven zu langandauernden Remissionen führen kann, ist Gegenstand von laufenden Untersuchungen. Der Ersatz der Seed-Implantation durch eine 2-tägige fraktionierte Brachytherapie mit vier Bestrahlungen ist derzeit Gegenstand einer prospektiven Studie, deren erste Langzeitergebnisse in diesem Jahr erwartet werden.

  10. Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  11. EM-navigated catheter placement for gynecologic brachytherapy: an accuracy study

    Science.gov (United States)

    Mehrtash, Alireza; Damato, Antonio; Pernelle, Guillaume; Barber, Lauren; Farhat, Nabgha; Viswanathan, Akila; Cormack, Robert; Kapur, Tina

    2014-03-01

    Gynecologic malignancies, including cervical, endometrial, ovarian, vaginal and vulvar cancers, cause significant mortality in women worldwide. The standard care for many primary and recurrent gynecologic cancers consists of chemoradiation followed by brachytherapy. In high dose rate (HDR) brachytherapy, intracavitary applicators and /or interstitial needles are placed directly inside the cancerous tissue so as to provide catheters to deliver high doses of radiation. Although technology for the navigation of catheters and needles is well developed for procedures such as prostate biopsy, brain biopsy, and cardiac ablation, it is notably lacking for gynecologic HDR brachytherapy. Using a benchtop study that closely mimics the clinical interstitial gynecologic brachytherapy procedure, we developed a method for evaluating the accuracy of image-guided catheter placement. Future bedside translation of this technology offers the potential benefit of maximizing tumor coverage during catheter placement while avoiding damage to the adjacent organs, for example bladder, rectum and bowel. In the study, two independent experiments were performed on a phantom model to evaluate the targeting accuracy of an electromagnetic (EM) tracking system. The procedure was carried out using a laptop computer (2.1GHz Intel Core i7 computer, 8GB RAM, Windows 7 64-bit), an EM Aurora tracking system with a 1.3mm diameter 6 DOF sensor, and 6F (2 mm) brachytherapy catheters inserted through a Syed-Neblett applicator. The 3D Slicer and PLUS open source software were used to develop the system. The mean of the targeting error was less than 2.9mm, which is comparable to the targeting errors in commercial clinical navigation systems.

  12. On the Development of a Miniature Neutron Generator for the Brachytherapy Treatment of Cancer

    Science.gov (United States)

    Forman, L.

    2009-03-01

    Brachytherapy refers to application of an irradiation source within a tumor. 252Cf needles used in brachytherapy have been successfully applied to treatment of some of the most virulent cancers but it is doubtful that it will be widely used because of difficulty in dealing with unwanted dose (source cannot be turned off) and in adhering to stringent NRC regulations that have been exacerbated in our post 911 environment. We have been working on the development of a miniature neutron generator with the reaction target placed at the end of a needle (tube) for brachytherapy applications. Orifice geometries are most amenable, e.g. rectum and cervix, but interstitial use is possible with microsurgery. This paper dicusses the results of a 30 watt DD neutron generator SBU project that demonstrates that sufficient hydrogen isotope current can be delivered down a small diameter needle required for a DT neutron treatment device, and, will summarize the progress of building a commercial device pursued by the All Russian Institute for Automatics (VNIIA) supported by the DOE's Industrial Proliferation Prevention Program (IPP). It is known that most of the fast neutron (FN) beam cancer treatment facilities have been closed down. It appears that the major limitation in the use of FN beams has been damage to healthy tissue, which is relatively insensitive to photons, but this problem is alleviated by brachytherapy. Moreover, recent clinical results indicate that fast neutrons in the boost mode are most highly effective in treating large, hypoxic, and rapidly repopulating diseases. It appears that early boost application of FN may halt angiogenesis (development and repair of tumor vascular system) and shrink the tumor resulting in lower hypoxia. The boost brachytherapy application of a small, low cost neutron generator holds promise of significant contribution to the treatment of cancer.

  13. Imaging male breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, S., E-mail: sdoyle2@nhs.net [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom); Steel, J.; Porter, G. [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom)

    2011-11-15

    Male breast cancer is rare, with some pathological and radiological differences from female breast cancer. There is less familiarity with the imaging appearances of male breast cancer, due to its rarity and the more variable use of preoperative imaging. This review will illustrate the commonest imaging appearances of male breast cancer, with emphasis on differences from female breast cancer and potential pitfalls in diagnosis, based on a 10 year experience in our institution.

  14. BREAST IMPLANT SURFACE DEVELOPMENT

    OpenAIRE

    Valencia Lazenco, Anai Alicia

    2015-01-01

    Bilateral breast augmentation is one of the most common cosmetic surgical procedures carried out on women in the western world. Breast augmentation involves increasing the volume of a woman‘s breasts through surgery by placing a silicone implant in the subglandular or subpectoral cavity. Although a capsule forms inevitably around breast implants as a natural part of healing, it can cause significant morbidity if the capsule becomes firm and contracted, a condition known as breast capsular con...

  15. American Brachytherapy Society survey regarding practice patterns of postoperative irradiation for endometrial cancer: Current status of vaginal brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To survey the current postoperative recommendations for radiotherapy (RT) in patients with endometrial cancer, with an emphasis on vaginal brachytherapy (VBT). Methods and Materials: In August 2003, a 32-item questionnaire was mailed to a random sample of 2396 members of the American Society for Therapeutic Radiology and Oncology and the American Brachytherapy Society. The sample excluded members-in-training, physicists, and non-U.S. members. A follow-up mailing was conducted in November 2003. Those who had not treated any patient in the previous year for endometrial carcinoma were instructed to indicate so at the beginning of the questionnaire and return it without responding to any other item. Responses were tabulated to determine the relative frequency distribution. Results: of the 2396 surveys sent out, 757 were returned, for a response rate of 31.6%. Of those who responded, 551 (72.8%) had performed postoperative irradiation for endometrial cancer and were included in this study. Of the 551 respondents, 99.8% had delivered external beam RT to some endometrial cancer patients. An increasing trend was found toward referrals for VBT; 91.5% of those who treated endometrial cancer performed VBT. The vaginal target most often irradiated was the upper vagina in 40.7%, upper 4-5 cm in 54.5%, and the entire vagina in 4.9%; 21.3% placed clips at the vaginal apex for applicator verification. The maximal dose to the bladder and rectum was recorded in 78.3% and 80.2% of patients, respectively. Of the respondents, 40% did not use low-dose-rate (LDR) VBT. The two most common LDR applicators were Delclos cylinders (29.7%) and Fletcher colpostats (29.3%). The mean boost dose delivered with LDR VBT when prescribed to the surface was 29.9 Gy and when prescribed to 0.5 cm was 23.8 Gy. When LDR therapy was used without external beam RT, the mean dose when prescribed to the surface was 56.8 Gy and when prescribed to 0.5 cm was 47.9 Gy. In 2002, 69.1% of respondents treated

  16. Iodine-125 prostate seed brachytherapy in renal transplant recipients: an analysis of oncological outcomes and toxicity profile

    OpenAIRE

    Beydoun, Nadine; Bucci, Joseph; Malouf, David

    2014-01-01

    Purpose Prostate cancer is among the most common non-cutaneous neoplasms affecting renal transplant recipients (RTRs). Available treatments including radical prostatectomy and external beam radiotherapy carry a risk of damage to the transplanted kidney, ureters, or bladder. We assessed the safety and efficacy of Iodine-125 (125I) prostate seed brachytherapy as an alternative to surgery and radiotherapy in these individuals. Material and methods We retrospectively reviewed our brachytherapy da...

  17. Retrospective study of the local control and the cosmetic result of 147 face carcinomas after interstitial brachytherapy

    International Nuclear Information System (INIS)

    The purpose was to evaluate retrospectively the local control rate and the cosmetic results for patients that received an interstitial brachytherapy for a base or spino-cellular carcinoma of face orifices areas. The interstitial brachytherapy by iridium 192 is an excellent alternative to surgery in the skin carcinomas of the face, as well at the level of local control as the cosmetic and functional results. (N.C.)

  18. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis

    OpenAIRE

    Fouad Aoun; Ksenija Limani; Alexandre Peltier; Quentin Marcelis; Marc Zanaty; Alexandre Chamoun; Marc Vanden Bossche; Thierry Roumeguère; Roland van Velthoven

    2015-01-01

    Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU) compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon's rank-sum or χ 2 test. Kaplan-Meier curves, log-rank tests, and Cox regression mod...

  19. Nordic group on X-ray diagnostics: Intravascular brachytherapy - what it is and what the Nordic authorities demand

    International Nuclear Information System (INIS)

    Intravascular brachytherapy is radiotherapy of the blood vessel to prevent it from re-narrowing after angioplasty. Angioplasty is a treatment for coronary artery disease where the artery that supplies the heart muscle with blood is blocked or narrowed. The radiotherapy is performed to decrease the growth of normal tissue and thus prevent the risk of restenosis, i.e. prevent it from renarrowing. Intravascular brachytherapy after angioplasty has decreased the restenosis with more than 60%. (orig.)

  20. Accelerated partial-breast irradiation with interstitial implants. The clinical relevance of the calculation of skin doses

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2007-08-15

    Purpose: To describe relative skin dose estimations and their impact on cosmetic outcome in interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 105 consecutive patients with early breast cancer were recruited in Erlangen, Germany, for this substudy of the German-Austrian APBI phase II trial. 51% (54/105) received pulsed-dose-rate (PDR), and 49% (51/105) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy every hour. Total treatment time was 3-4 days. With a wire cross on the skin surface during the brachytherapy-planning procedure the minimal, mean and maximal relative skin doses (SD{sub min%}, SD{sub max%}, SD{sub mean%}) were recorded. Endpoint of this evaluation was the cosmetic outcome in relation to the relative skin doses. Results: Median follow-up time was 38 months (range, 19-65 months). Cosmetic results for all patients were excellent in 57% (60/105), good in 36% (38/105), and fair in 7% (7/105). The SD{sub min%} (27.0% vs. 31.7%; p = 0.032), SD{sub mean%} (34.2% vs. 38.1%; p = 0.008), and SD{sub max%} (38.2% vs. 46.4%; p = 0.003) were significantly lower for patients with excellent cosmetic outcome compared to patients with a suboptimal outcome. SD{sub mean%} (37.6% vs. 34.2%; p = 0.026) and SD{sub max%} (45.4% vs. 38.2%; p = 0.008) were significantly higher for patients with good cosmetic outcome compared with the patients with excellent results. Conclusion: The appraisal of skin doses has been shown to be relevant to the achievement of excellent cosmetic outcome. Further investigations are necessary, especially on the basis of CT-based brachytherapy planning, to further improve the treatment results of multicatheter APBI. (orig.)

  1. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon’s rank-sum or χ2 test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p<0.05. Median oncologic follow-up was 83 months (13–123 months in the HIFU cohort and 44 months (13–89 months in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p<0.05. No statistically si