Extracranial stereotactic radiotherapy: preliminary results with the CyberKnife.

Science.gov (United States)

Lartigau, Eric; Mirabel, Xavier; Prevost, Bernard; Lacornerie, Thomas; Dubus, Francois; Sarrazin, Thierry

2009-04-01

In the field of radiation oncology, equipment for fractionated radiotherapy and single-dose radiosurgery has become increasingly accurate, together with the introduction of robotized treatments. A robot is a device that can be programmed to carry out accurate, repeated and adjusted tasks in a given environment. Treatment of extracranial lesions involves taking into account organ mobility (tumor and healthy tissue) whilst retaining the ability to stereotactically locate the target. New imaging techniques (single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), positron emission tomography (PET)) provide further relevant information to slice images (computed tomography (CT) scans, MRI) for target definition. Hypo-fractionated treatments can only be used for curative treatment if the target is accurately defined and tracked during treatment. The CyberKnife is a non-invasive system of radiosurgery and fractionated stereotactic radiotherapy. For intracranial lesions treated by single-dose radiosurgery, it has been used to treat meningioma, acoustic neuromas, pituitary adenoma, metastases, arteriovenous malformations and refractory pain (trigeminal neuralgia). More than 10,000 patients have been treated worldwide. Currently, the most significant developments are in the field of extracranial stereotactic radiotherapy (lung, liver, reirradiation, prostate, etc.). Clinical results obtained in the CyberKnife Nord-Ouest program after 1 year of experience are presented. Copyright 2009 S. Karger AG, Basel.

Clinical experience with image-guided robotic radiosurgery (the Cyberknife) in the treatment of brain and spinal cord tumors

International Nuclear Information System (INIS)

Chang, S.D.; Murphy, M.; Geis, P.; Martin, D.P.; Hancock, S.L.; Doty, J.R.; Adler, J.R. Jr.

1998-01-01

The Cyberknife is an image-guided ''frameless'' dedicated radiosurgical device. This instrument has several distinct advantages over frame-based systems, including improved patient comfort, increased treatment degrees of freedom, and the potential to target extracranial lesions. Clinical results thus far with respect to the treatment of malignant intracranial tumors has been promising. Additionally, the Cyberknife will likely revolutionize the application of radiosurgery to extracranial sites. A description of the components, treatment planning, and clinical results of the Cyberknife will be reviewed. (author)

Real time tracking in liver SBRT: comparison of CyberKnife and Vero by planning structure-based γ-evaluation and dose-area-histograms.

Science.gov (United States)

Sothmann, T; Blanck, O; Poels, K; Werner, R; Gauer, T

2016-02-21

The purpose of this study was to evaluate and compare two clinical tracking systems for radiosurgery with regard to their dosimetric and geometrical accuracy in liver SBRT: the robot-based CyberKnife and the gimbal-based Vero. Both systems perform real-time tumour tracking by correlating internal tumour and external surrogate motion. CyberKnife treatment plans were delivered to a high resolution 2D detector array mounted on a 4D motion platform, with the platform simulating (a) tumour motion trajectories extracted from the corresponding CyberKnife predictor log files and (b) the tumour motion trajectories with superimposed baseline-drift. Static reference and tracked dose measurements were compared and dosimetric as well as geometrical uncertainties analyzed by a planning structure-based evaluation. For (a), γ-passing rates inside the CTV (γ-criteria of 1% / 1 mm) ranged from 95% to 100% (CyberKnife) and 98% to 100% (Vero). However, dosimetric accuracy decreases in the presence of the baseline-drift. γ-passing rates for (b) ranged from 26% to 92% and 94% to 99%, respectively; i.e. the effect was more pronounced for CyberKnife. In contrast, the Vero system led to maximum dose deviations in the OAR between  +1.5 Gy to +6.0 Gy (CyberKnife: +0.5 Gy to +3.5 Gy). Potential dose shifts were interpreted as motion-induced geometrical tracking errors. Maximum observed shift ranges were  -1.0 mm to  +0.7 mm (lateral) /-0.6 mm to +0.1 mm (superior-inferior) for CyberKnife and  -0.8 mm to +0.2 mm /-0.8 mm to +0.4 mm for Vero. These values illustrate that CyberKnife and Vero provide high precision tracking of regular breathing patterns. Even for the modified motion trajectory, the obtained dose distributions appear to be clinical acceptable with regard to literature QA γ-criteria of 3% / 3 mm.

SU-E-T-453: A Novel Daily QA System for Robotic Image Guided Radiosurgery with Variable Aperture Collimator

International Nuclear Information System (INIS)

Wang, L; Nelson, B

2014-01-01

Purpose: A novel end-to-end system using a CCD camera and a scintillator based phantom that is capable of measuring the beam-by-beam delivery accuracy of Robotic Radiosurgery has been developed and reported in our previous work. This work investigates its application to end-to-end type daily QA for Robotic Radiosurgery (Cyberknife) with Variable Aperture Collimator (Iris). Methods: The phantom was first scanned with a CT scanner at 0.625 slice thickness and exported to the Cyberknife Muliplan (v4.6) treatment planning system. An isocentric treatment plan was created consisting of ten beams of 25 Monitor Units each using Iris apertures of 7.5, 10, 15, 20, and 25 mm. The plan was delivered six times in two days on the Cyberknife G4 system with fiducial tracking on the four metal fiducials embedded in phantom with re-positioning between the measurements. The beam vectors (X, Y, Z) are measured and compared with the plan from the machine delivery file (XML file). The Iris apertures (FWHM) were measured from the beam flux map and compared with the commissioning data. Results: The average beam positioning accuracies of the six deliveries are 0.71 ± 0.40 mm, 0.72 ± 0.44 mm, 0.74 ± 0.42 mm, 0.70 ± 0.40 mm, 0.79 ± 0.44 mm and 0.69 ± 0.41 mm respectively. Radiation beam width (FWHM) variations are within ±0.05 mm, and they agree with the commissioning data within 0.22 mm. The delivery time for the plan is about 7 minutes and the results are given instantly. Conclusion: The experimental results agree with stated sub-millimeter delivery accuracy of Cyberknife system. Beam FWHM variations comply with the 0.2 mm accuracy of the Iris collimator at SAD. The XRV-100 system has proven to be a powerful tool in performing end-to-end type tests for Robotic Image Guided Radiosurgery Daily QA

Robotic radiosurgery. Treating tumors that move with respiration

International Nuclear Information System (INIS)

Urschel, Harold C. Jr.; Kresl, John J.; Luketich, James D.; Papiez, Lech; Timmerman, Robert D.; Schulz, Raymond A.

2007-01-01

Addresses in detail all aspects of the use of robotic radiosurgery to treat tumors of the lung, liver, and pancreas Includes full consideration of tumor tracking techniques, dosimetry, radiobiology, and fiducial placement strategies Written by leading experts Includes many high quality illustrations Stereotactic radiosurgery continues to evolve in ways that allow this powerful technology to reach and treat more tumors in more patients. This volume in the Robotic Radiosurgery series is devoted to theory and practice in the emerging field of stereotactic radiosurgery (also called stereotactic body radiation therapy) for extracranial tumors, particularly those that move as patients breathe. The book is divided into six sections. The first three sections address tumor motion due to respiration and tumor tracking techniques; dosimetry, radiobiology, and imaging; and fiducial placement systems. The fourth and fifth sections then discuss in depth the use of robotic radiosurgery to treat lung and abdominal tumors, respectively, and a final section explains emerging concepts and techniques. Within this framework, detailed information is provided on the technology and methodology for delivery of high doses of radiation to moving targets, radiobiological and radiological principles, and the challenges faced by clinicians performing extracranial stereotactic radiosurgery. Furthermore, there are thorough reviews of the general clinical literature on stereotactic radiation treatment of tumors of the lungs, liver, and pancreas, and the latest clinical data from clinicians conducting clinical studies using the CyberKnife registered Robotic Radiosurgery System. Special attention is given to the frameless robotic radiosurgery device known as the CyberKnife, the only image-guided radiosurgery system that utilizes intelligent robotics to track, detect, and correct for changes in tumor position during treatments. Tumors that move with respiration are treated with the CyberKnife using a

Robotic radiosurgery. Treating tumors that move with respiration

Energy Technology Data Exchange (ETDEWEB)

Urschel, Harold C. Jr. [Baylor University Medical Center, Dallas, TX (United States). Chair of Cardiovascular and Thoracic Surgical Research, Education and Clinical Excellence; Kresl, John J. [Arizona Oncology Services at St. Joseph' s Hospital and Medical Center, Phoenix, AZ (United States). Dept. of Radiation Oncology; Luketich, James D. [University of Pittsburgh Medical Center PUH, Pittsburgh, PA (United States). The Heart, Lung and Esophageal Surgery Inst.; Papiez, Lech; Timmerman, Robert D. [University of Texas Southwestern Medical Center, Dallas, TX (United States). Dept. of Radiation Oncology; Schulz, Raymond A. (eds.)

2007-07-01

Addresses in detail all aspects of the use of robotic radiosurgery to treat tumors of the lung, liver, and pancreas Includes full consideration of tumor tracking techniques, dosimetry, radiobiology, and fiducial placement strategies Written by leading experts Includes many high quality illustrations Stereotactic radiosurgery continues to evolve in ways that allow this powerful technology to reach and treat more tumors in more patients. This volume in the Robotic Radiosurgery series is devoted to theory and practice in the emerging field of stereotactic radiosurgery (also called stereotactic body radiation therapy) for extracranial tumors, particularly those that move as patients breathe. The book is divided into six sections. The first three sections address tumor motion due to respiration and tumor tracking techniques; dosimetry, radiobiology, and imaging; and fiducial placement systems. The fourth and fifth sections then discuss in depth the use of robotic radiosurgery to treat lung and abdominal tumors, respectively, and a final section explains emerging concepts and techniques. Within this framework, detailed information is provided on the technology and methodology for delivery of high doses of radiation to moving targets, radiobiological and radiological principles, and the challenges faced by clinicians performing extracranial stereotactic radiosurgery. Furthermore, there are thorough reviews of the general clinical literature on stereotactic radiation treatment of tumors of the lungs, liver, and pancreas, and the latest clinical data from clinicians conducting clinical studies using the CyberKnife {sup registered} Robotic Radiosurgery System. Special attention is given to the frameless robotic radiosurgery device known as the CyberKnife, the only image-guided radiosurgery system that utilizes intelligent robotics to track, detect, and correct for changes in tumor position during treatments. Tumors that move with respiration are treated with the CyberKnife

Determination of acquisition frequency for intrafractional motion of pancreas in CyberKnife radiotherapy.

Science.gov (United States)

Zhang, Huailing; Zhao, Guoru; Djajaputra, David; Xie, Yaoqin

2014-01-01

To report the characteristics of pancreas motion as tracked using implanted fiducials during radiotherapy treatments with CyberKnife. Twenty-nine patients with pancreas cancer treated using CyberKnife system were retrospectively selected for this study. During the treatment, the deviation is examined every 3-4 nodes (~45 s interval) and compensated by the robot. The pancreas displacement calculated from X-ray images acquired within the time interval between two consecutive couch motions constitute a data set. A total of 498 data sets and 4302 time stamps of X-ray images were analyzed in this study. The average duration for each data set is 634 s. The location of the pancreas becomes more dispersed as the time elapses. The acquisition frequency depends on the prespecified movement distance threshold of pancreas. If the threshold between two consecutive images is 1 mm, the acquisition frequency should be less than 30 s, while if the threshold is 2 mm, the acquisition frequency can be around 1 min. The pancreas target moves significantly and unpredictably during treatment. Effective means of compensating the intrafractional movement is critical to ensure adequate dose coverage of the tumor target.

Cyberknife fractionated radiotherapy for adrenal metastases: Preliminary report from a multispecialty Indian cancer care center

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Trinanjan Basu

2015-03-01

Full Text Available Purpose: Metastasis to adrenal gland from lung, breast, and kidney malignancies are quite common. Historically radiotherapy was intended for pain palliation. Recent studies with stereotactic body radiotherapy (SBRT including Cyberknife robotic radiosurgery aiming at disease control brings about encouraging results. Here we represent the early clinical experience with Cyberknife stereotactic system from an Indian cancer care center. The main purpose of this retrospective review is to serve as a stepping stone for future prospective studies with non- invasive yet effective technique compared to surgery. Methods: We retrospectively reviewed four cases of adrenal metastases (three: lung and one: renal cell carcinoma treated with Cyberknife SBRT. X sight spine tracking was employed for planning and treatment delivery. Patients were evaluated for local response clinically as well as with PETCT based response criteria.Results: With a median gross tumor volume of 20.5 cc and median dose per fraction of 10 Gy, two patients had complete response (CR and two had partial response (PR when assessed 8-12 weeks post treatment as per RECIST. There was no RTOG grade 2 or more acute adverse events and organs at risk dosage were acceptable. Till last follow up all the patients were locally controlled and alive. Conclusion: Cyberknife SBRT with its unique advantages like non- invasive, short duration outpatient treatment technique culminating in similar local control rates in comparison to surgery is an attractive option. World literature of linear accelerator based SBRT and our data with Cyberknife SBRT with small sample size and early follow up are similar in terms of local control in adrenal metastases. Future prospective data would reveal more information on the management of adrenal metastases.

The development of quality assurance program for cyberknife

International Nuclear Information System (INIS)

Jang, Ji Sun; Lee, Dong Han; Kang, Young Nam

2006-01-01

Standardization quality assurance (QA)program of Cyberknife for suitable circumstances in Korea has not been established. In this research, we investigated the development of QA program for Cyberknife and evaluation of the feasibility under applications. Considering the feature of constitution for systems and the therapeutic methodology of Cyberknife, the list of quality control (QC) was established and divided dependent on the each period of operations. And then all these developed QC lists were categorized into three groups such as basic QC, delivery specific QC, and patient specific QC based on the each purpose of QA. In order to verify the validity of the established QA program, this QC lists was applied to two Cyberknife centers. The acceptable tolerance was based on the undertaking inspection list from the Cyberknife manufacturer and the QC results during last three years of two Cyberknife centers in Korea. The acquired measurement results were evaluated for the analysis of the current QA status and the verification of the propriety for the developed QA program. The current QA status of two Cyberknife centers was evaluated from the accuracy of all measurements in relation with application of the established QA program. Each measurement result was verified having a good agreement within the acceptable tolerance limit of the developed QA program. It is considered that the developed QA program in this research could be established the standardization of QC methods for Cyberknife and confirmed the accuracy and stability for the image-guided stereotactic radiotherapy

SU-G-TeP4-12: Individual Beam QA for a Robotic Radiosurgery System Using a Scintillator Cone

Energy Technology Data Exchange (ETDEWEB)

McGuinness, C; Descovich, M; Sudhyadhom, A [University of California San Francisco, San Francisco, CA (United States)

2016-06-15

Purpose: The targeting accuracy of the Cyberknife system is measured by end-to-end tests delivering multiple isocentric beams to a point in space. While the targeting accuracy of two representative beams can be determined by a Winston-Lutz-type test, no test is available today to determine the targeting accuracy of each clinical beam. We used a scintillator cone to measure the accuracy of each individual beam. Methods: The XRV-124 from Logos Systems Int’l is a scintillator cone with an imaging system that is able to measure individual beam vectors and a resulting error between planned and measured beam coordinates. We measured the targeting accuracy of isocentric and non-isocentric beams for a number of test cases using the Iris and the fixed collimator. The average difference between plan and measured beam position was 0.8–1.2mm across the collimator sizes and plans considered here. The max error for a single beam was 2.5mm for the isocentric plans, and 1.67mm for the non-isocentric plans. The standard deviation of the differences was 0.5mm or less. Conclusion: The CyberKnife System is specified to have an overall targeting accuracy for static targets of less than 0.95mm. In E2E tests using the XRV124 system we measure average beam accuracy between 0.8 to 1.23mm, with maximum of 2.5mm. We plan to investigate correlations between beam position error and robot position, and to quantify the effect of beam position errors on patient specific plans. Martina Descovich has received research support and speaker honoraria from Accuray.

SU-G-TeP4-12: Individual Beam QA for a Robotic Radiosurgery System Using a Scintillator Cone

International Nuclear Information System (INIS)

McGuinness, C; Descovich, M; Sudhyadhom, A

2016-01-01

Purpose: The targeting accuracy of the Cyberknife system is measured by end-to-end tests delivering multiple isocentric beams to a point in space. While the targeting accuracy of two representative beams can be determined by a Winston-Lutz-type test, no test is available today to determine the targeting accuracy of each clinical beam. We used a scintillator cone to measure the accuracy of each individual beam. Methods: The XRV-124 from Logos Systems Int’l is a scintillator cone with an imaging system that is able to measure individual beam vectors and a resulting error between planned and measured beam coordinates. We measured the targeting accuracy of isocentric and non-isocentric beams for a number of test cases using the Iris and the fixed collimator. The average difference between plan and measured beam position was 0.8–1.2mm across the collimator sizes and plans considered here. The max error for a single beam was 2.5mm for the isocentric plans, and 1.67mm for the non-isocentric plans. The standard deviation of the differences was 0.5mm or less. Conclusion: The CyberKnife System is specified to have an overall targeting accuracy for static targets of less than 0.95mm. In E2E tests using the XRV124 system we measure average beam accuracy between 0.8 to 1.23mm, with maximum of 2.5mm. We plan to investigate correlations between beam position error and robot position, and to quantify the effect of beam position errors on patient specific plans. Martina Descovich has received research support and speaker honoraria from Accuray

Cyberknife: A double edged sword?

International Nuclear Information System (INIS)

Joseph, B.; Ramachandra, A.; Supeb, S. S.

2010-01-01

The Cyberknife represents a new, frame less stereotactic radiosurgery system which efficiently incorporates advance robotics with computerized image reconstruction to allow highly conformal image guided radiation delivery. This review focus is on the pros and cons of this new radiotherapy tool, its current indications, safety profile and future directions. A literature search of Medline, Pubmed, Biomed, Medscape and Cancer lit database were referred to retrieve relevant data/information. The authors conclude that the use of this system offers an invaluable solution to the treatment of selective tumours/lesions located close to critical structures, salvage of recurrent and metastatic lesions and potential of treatment of selective early stage malignancies like the carcinoma prostate and lung. However, it is still too premature, with insufficient follow up data to advocate it as the treatment of choice in any set up. There are several radiobiological issues that also remain in the grey zone. (authors)

Determination of Acquisition Frequency for Intrafractional Motion of Pancreas in CyberKnife Radiotherapy

Directory of Open Access Journals (Sweden)

Huailing Zhang

2014-01-01

Full Text Available Purpose. To report the characteristics of pancreas motion as tracked using implanted fiducials during radiotherapy treatments with CyberKnife. Methods and Materials. Twenty-nine patients with pancreas cancer treated using CyberKnife system were retrospectively selected for this study. During the treatment, the deviation is examined every 3-4 nodes (~45 s interval and compensated by the robot. The pancreas displacement calculated from X-ray images acquired within the time interval between two consecutive couch motions constitute a data set. Results. A total of 498 data sets and 4302 time stamps of X-ray images were analyzed in this study. The average duration for each data set is 634 s. The location of the pancreas becomes more dispersed as the time elapses. The acquisition frequency depends on the prespecified movement distance threshold of pancreas. If the threshold between two consecutive images is 1 mm, the acquisition frequency should be less than 30 s, while if the threshold is 2 mm, the acquisition frequency can be around 1 min. Conclusions. The pancreas target moves significantly and unpredictably during treatment. Effective means of compensating the intrafractional movement is critical to ensure adequate dose coverage of the tumor target.

Spinal and para spinal tumors treated by Cyberknife: feasibility and efficacy

International Nuclear Information System (INIS)

Castelli, J.; Thariat, J.; Benezery, K.; Courdi, A.; Doyen, J.; Mammar, H.; Bondiau, P.Y.; Chanalet, S.; Paquis, P.; Frenay, M.

2010-01-01

Purpose Stereotactic radiotherapy using the Cyberknife has become a key treatment in the multidisciplinary management of secondary tumours, as well as primary benign or malignant tumours located within or adjacent to vertebral bodies and the spinal cord. The aim of this treatment is to improve local control and clinical response, including previously irradiated cases. Patients and methods In this study, we present the first patients treated with Cyberknife between December 2006 and December 2007 for spinal or para spinal tumours. The primary aim was to assess the feasibility and tolerance of stereotactic radiotherapy using the Cyberknife. Secondary aims were to establish the short-term local control, to calculate the local progression-free survival and overall survival. Clinical examination and imaging procedures were performed every three months. Response was assessed according to RECIST criteria. Results During that period, 16 patients were treated with Cyberknife. Thirteen patients had been pre-treated, three of whom had received spinal cord doses considered to be maximal. Three patients did not receive previous irradiation. The median age was 59 (36-74). The most frequent symptoms were pain (n = 8) and motor weakness (n = 4). The median dose was 30 Gy (16-50). The median number of fractions was 3 (1-5). No patient developed acute myelitis. Three patients developed acute reaction. Overall survival at 18 months was 72.4%, with a mean survival of 18.2 months (95% CI: 15.4-20.9). Local progression-free survival at 18 months was 58.4%, with a mean value of 16.9 months (95% CI: 13.6-20.2). Conclusion The use of stereotactic radiotherapy with Cyberknife represents a major progress in the management of para spinal tumours. The main advantages are better sparing of the spinal cord and the possibility of increasing the dose to the tumour target volume. (authors)

CyberKnife SRS: new technologies that enhance the treatment of cancer

International Nuclear Information System (INIS)

Cohen, A.

2008-01-01

The CyberKnife Robotic Radiosurgery System (Accuracy Incorporated, Sunnyvale, CA, USA) is used worldwide to treat tumors and neurological disorders anywhere in the body with sub-millimetre beam delivery accuracy. Accuracy has developed a number of new technologies in recent years to enhance the treatment of cancer patients. Such new technologies include a fast Monte Carlo Dose Calculation algorithm, Sequential Optimization dose planning, the Iris TM Variable Aperture Collimator, an 800 MU/min Linear Accelerator, and Optimized Path Traversal. These technologies enable physicists and physicians to plan treatments quickly and easily and deliver them with unrivalled accuracy and precision

Treat high cervical spinal arteriovenous malformation with Cyberknife radiosurgery

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Yu-Fen Huang

2014-01-01

Full Text Available This paper describes the use of CyberKnife radiosurgery in the treatment of accidentally found cervical spinal arteriovenous malformation (AVM. We present the case of a patient with cervical spinal AVM, who developed progressive neck pain, gait disturbance, urine and stool incontinence 2 weeks after the fell down accident. The patient underwent CyberKnife radiosurgery. After CyberKnife radiosurgery for 2 years, the patient′s neck pain diminished and was able to keep the walk without any assistance. The management of cervical spinal AVM varies. This patient demonstrated a successful treatment of cervical spinal AVM with CyberKnife radiosurgery.

SU-E-T-228: Liquid Ionisation Chamber Array and MicroDiamond Measurements with the CyberKnife System

International Nuclear Information System (INIS)

Poppinga, D; Looe, H; Stelljes, T; Poppe, B; Blanck, O; Harder, D

2014-01-01

Purpose: The aim of this study was to measure the dose profile and output factors with a CyberKnife accelerator using a TM60019 microDiamond detector and a 1000SRS liquid chamber array (both PTW Freiburg, Germany). Methods: An MP3 water phantom (PTW, Freiburg) was positioned along the robotic world coordinate system. The TM60019 detector was adjusted to the center of the according fields and the semiconductor axis was aligned with the beam direction. Profiles at 5cm water depth and SSD = 80 cm were measured along the robotic x axis and y axis for the cylindrical collimators of the CyberKnife (diameter 60, 50, 40, 30, 20, 15, 12.5, 10, 7.5 and 5mm). To determine the output factors the dose profile was measured at 0.1 mm steps around the field center to find the maximum dose value. The liquid chamber array (1000SRS) measurement was performed with the same setup, but with RW3 buildup. Results: The 1000SRS measurements closely conform with the TM60019 profile measurement in all profile regions and for all collimator sizes. The profile measurement is influenced by the almost equal spatial resolution of the TM60019 detector (radius of the sensitive area 1.1mm) and of the 1000SRS liquid chamber array (single chamber width 2.3mm). The measured dose profiles have not been corrected for this limited spatial resolution. Rather we purpose to consider that spatial dose averaging over 2 mm wide regions might be justified in view of patient positioning inaccuracies and of the spaces in tissue participating in the biological radiation responses. Conclusion: The 1000SRS data points conform with the TM60019 profile measurements at all profile regions showing the applicability of liquid ion chamber arrays with the CyberKnife system

SU-E-T-228: Liquid Ionisation Chamber Array and MicroDiamond Measurements with the CyberKnife System

Energy Technology Data Exchange (ETDEWEB)

Poppinga, D; Looe, H; Stelljes, T; Poppe, B [University of Oldenburg, Oldenburg, Lower Saxony (Germany); Blanck, O [CyberKnife Zentrum Norddeutschland, Guestrow (Germany); Harder, D [Georg August University, Goettingen, Niedersachsen (Germany)

2014-06-01

Purpose: The aim of this study was to measure the dose profile and output factors with a CyberKnife accelerator using a TM60019 microDiamond detector and a 1000SRS liquid chamber array (both PTW Freiburg, Germany). Methods: An MP3 water phantom (PTW, Freiburg) was positioned along the robotic world coordinate system. The TM60019 detector was adjusted to the center of the according fields and the semiconductor axis was aligned with the beam direction. Profiles at 5cm water depth and SSD = 80 cm were measured along the robotic x axis and y axis for the cylindrical collimators of the CyberKnife (diameter 60, 50, 40, 30, 20, 15, 12.5, 10, 7.5 and 5mm). To determine the output factors the dose profile was measured at 0.1 mm steps around the field center to find the maximum dose value. The liquid chamber array (1000SRS) measurement was performed with the same setup, but with RW3 buildup. Results: The 1000SRS measurements closely conform with the TM60019 profile measurement in all profile regions and for all collimator sizes. The profile measurement is influenced by the almost equal spatial resolution of the TM60019 detector (radius of the sensitive area 1.1mm) and of the 1000SRS liquid chamber array (single chamber width 2.3mm). The measured dose profiles have not been corrected for this limited spatial resolution. Rather we purpose to consider that spatial dose averaging over 2 mm wide regions might be justified in view of patient positioning inaccuracies and of the spaces in tissue participating in the biological radiation responses. Conclusion: The 1000SRS data points conform with the TM60019 profile measurements at all profile regions showing the applicability of liquid ion chamber arrays with the CyberKnife system.

TH-AB-201-01: A Feasibility Study of Independent Dose Verification for CyberKnife

International Nuclear Information System (INIS)

Sato, A; Noda, T; Keduka, Y; Kawajiri, T; Itano, M; Yamazaki, T; Tachibana, H

2016-01-01

Purpose: CyberKnife irradiation is composed of tiny-size, multiple and intensity-modulated beams compared to conventional linacs. Few of the publications for Independent dose calculation verification for CyberKnife have been reported. In this study, we evaluated the feasibility of independent dose verification for CyberKnife treatment as Secondary check. Methods: The followings were measured: test plans using some static and single beams, clinical plans in a phantom and using patient’s CT. 75 patient plans were collected from several treatment sites of brain, lung, liver and bone. In the test plans and the phantom plans, a pinpoint ion-chamber measurement was performed to assess dose deviation for a treatment planning system (TPS) and an independent verification program of Simple MU Analysis (SMU). In the clinical plans, dose deviation between the SMU and the TPS was performed. Results: In test plan, the dose deviations were 3.3±4.5%, and 4.1±4.4% for the TPS and the SMU, respectively. In the phantom measurements for the clinical plans, the dose deviations were −0.2±3.6% for the TPS and −2.3±4.8% for the SMU. In the clinical plans using the patient’s CT, the dose deviations were −3.0±2.1% (Mean±1SD). The systematic difference was partially derived from inverse square law and penumbra calculation. Conclusion: The independent dose calculation for CyberKnife shows −3.0±4.2% (Mean±2SD) and our study, the confidence limit was achieved within 5% of the tolerance level from AAPM task group 114 for non-IMRT treatment. Thus, it may be feasible to use independent dose calculation verification for CyberKnife treatment as the secondary check. This research is partially supported by Japan Agency for Medical Research and Development (AMED)

Initial treatment results using cyberknife for head and neck tumor

International Nuclear Information System (INIS)

Himei, Kengo; Katsui, Kuniaki; Yoshida, Atsushi; Takemoto, Mitsuhiro; Kobayashi, Mitsuru; Kuroda, Masahiro; Hiraki, Yoshio

2002-01-01

The CyberKnife, a medical device for stereotactic radiotherapy, is composed of a combination of a robot manipulator and LINAC. For the treatment of head and neck tumors, this system has been applied. Between June 2000 and January 2001, 18 patients with head and neck tumor were treated with this system because of tumor recurrence, difficulty in surgery or additional increase after external radiotherapy. The median age was 64 years. Primary lesions were skull base (4), nasopharynx (3), paranasal sinus (3), nasal cavity (2), lacrimal gland (1), oropharynx (1), oral floor (1), and buccul mucosa (1), metastatic lymph nodes were found in three. The prescribed dose was 12-38 Gy as for marginal dose. The response rate (CR+PR) was 44.4% and local control rate (CR+PR+NC) was 77.8%. The adverse effects were assessed by the NCI-CTC Version 2.0 and observed grade 3 in two cases. Our early experience indicates that this system could to be feasible for the treatment of locally advanced or recurrent head and neck tumor, and for the reduction of adverse effect and maintenance of useful QOL of patients. (author)

CyberKnife radiosurgery: Precision without incision

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Enja Siva Prasad Reddy

2015-01-01

Full Text Available CyberKnife stereotactic radiosurgery system is an innovative, effective, frameless, non-invasive substitute for conventional surgical treatment of cancer. It works on the principle of stereotaxy. It is used for the treatment of both cancerous and non-cancerous tumors, intracranial lesions, tumors of lung, spine, prostate, and kidney, recurrent cases of oral squamous cell carcinoma, arteriovenous malformation, and trigeminal neuralgia. It has an advantage over other systems like Gamma knife radiosurgery and linear accelerator (LINAC-based systems, as it is frameless, has submillimeter accuracy, does not affect the normal cells adjacent to the lesion, and tracks the lesion in synchronization with the patient′s respiratory rate. The future of CyberKnife encompasses possibilities such as incremental improvements in accuracy and better shaping of the field of radiation and would certainly allow extension of radiosurgery as an effective substitute for chemotherapy. This paper aims to review and highlight the immense potential that CyberKnife holds in the field of dentistry in treating disorders of the head and neck region, thereby ensuring enhanced longevity for the patients.

Patient-reported quality of life progression in men with prostate cancer following primary cryotherapy, cyberknife, or active holistic surveillance.

Science.gov (United States)

Werneburg, Glenn T; Kongnyuy, Michael; Halpern, Daniel M; Salcedo, Jose M; Kosinski, Kaitlin E; Haas, Jonathan A; Schiff, Jeffrey T; Corcoran, Anthony T; Katz, Aaron E

2017-12-07

Technological advancements have led to the success of minimally invasive treatment modalities for prostate cancer such as CyberKnife and Cryotherapy. Here, we investigate patient-reported urinary function, bowel habits, and sexual function in patients following CyberKnife (CK) or Cryotherapy treatment, and compare them with active holistic surveillance (AHS) patients. An IRB-approved institutional database was retrospectively reviewed for patients who underwent CK, Cryotherapy, or AHS. Quality of life (QoL) survey responses were collected every three months and the mean function scores were analyzed in yearly intervals over the 4 years post-treatment. 279 patients (767 survey sets) were included in the study. There was no difference among groups in urinary function scores. The CyberKnife group had significantly lower bowel habit scores in the early years following treatment (year 2 mean difference: -5.4, P treatment. A history of hormonal therapy was associated with a lower sexual function scores relative to those patients who did not receive hormones in both CyberKnife (-18.45, P < 0.01) and Cryotherapy patients (-14.6, P < 0.05). After initial lower bowel habits and sexual function scores, CyberKnife or Cryotherapy-treated patients had no significant difference in QoL relative to AHS patients. These results highlight the benefit of CyberKnife and Cryotherapy in the management of organ-confined prostate cancer.

SU-F-T-554: Dark Current Effect On CyberKnife Beam Dosimetry

Energy Technology Data Exchange (ETDEWEB)

Kim, H; Chang, A [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

2016-06-15

Purpose: All RF linear accelerators produce dark current to varying degrees when an accelerating voltage and RF input is applied in the absence of electron gun injection. This study is to evaluate how dark current from the linear accelerator of CyberKnife affect the dose in the reference dosimetry. Methods: The G4 CyberKnife system with 6MV photon beam was used in this study. Using the ion chamber and the diode detector, the dose was measured in water with varying time delay between acquiring charges and staring beam-on after applying high-voltage into the linear accelerator. The dose was measured after the time delay with over the range of 0 to 120 seconds in the accelerating high-voltage mode without beam-on, applying 0, 10, 50, 100, and 200 MUs. For the measurements, the collimator of 60 mm was used and the detectors were placed at the depths of 10 cm with the source-to-surface distance of 80 cm. Results: The dark current was constant over time regardless of MU. The dose due to the dark current increased over time linearly with the R-squared value of 0.9983 up to 4.4 cGy for the time 120 seconds. In the dose rate setting of 720 MU/min, the relative dose when applying the accelerating voltage without beam-on was increased over time up to 0.6% but it was less than the leakage radiation resulted from the accelerated head. As the reference dosimetry condition, when 100 MU was delivered after 10 seconds time delay, the relative dose increased by 0.7% but 6.7% for the low MU (10 MU). Conclusion: In the dosimetry using CyberKnife system, the constant dark current affected to the dose. Although the time delay in the accelerating high-voltage mode without beam-on is within 10 seconds, the dose less than 100 cGy can be overestimated more than 1%.

Initial results of CyberKnife treatment for recurrent previously irradiated head and neck cancer

International Nuclear Information System (INIS)

Himei, Kengo; Katsui, Kuniaki; Yoshida, Atsushi

2003-01-01

The purpose of this study was to evaluate the efficacy of CyberKnife for recurrent previously irradiated head and neck cancer. Thirty-one patients with recurrent previously irradiated head and neck cancer were treated with a CyberKnife from July 1999 to March 2002 at Okayama Kyokuto Hospital were retrospectively studied. The accumulated dose was 28-80 Gy (median 60 Gy). The interval between CyberKnife treatment and previous radiotherapy was 0.4-429.5 months (median 16.3 months). Primary lesions were nasopharynx: 7, maxillary sinus: 6, tongue: 5, ethmoid sinus: 3, and others: 1. The pathology was squamous cell carcinoma: 25, adenoid cystic carcinoma: 4, and others: 2. Symptoms were pain: 8, and nasal bleeding: 2. The prescribed dose was 15.0-40.3 Gy (median 32.3 Gy) as for the marginal dose. The response rate (complete response (CR)+partial response (PR)) and local control rate (CR+PR+no change (NC)) was 74% and 94% respectively. Pain disappeared for 4 cases, relief was obtained for 4 cases and no change for 2 cases and nasal bleeding disappeared for 2 cases for an improvement of symptoms. An adverse effects were observed as mucositis in 5 cases and neck swelling in one case. Prognosis of recurrent previously irradiated head and neck cancer was estimated as poor. Our early experience shows that CyberKnife is expected to be feasible treatment for recurrent previously irradiated head and neck cancer, and for the reduction adverse effects and maintenance of useful quality of life (QOL) for patients. (author)

Image-guided robotic radiosurgery for spinal metastases

International Nuclear Information System (INIS)

Gibbs, Iris C.; Kamnerdsupaphon, Pimkhuan; Ryu, Mi-Ryeong; Dodd, Robert; Kiernan, Michaela; Chang, Steven D.; Adler, John R.

2007-01-01

Background and Purpose: To determine the effectiveness and safety of image-guided robotic radiosurgery for spinal metastases. Materials/Methods: From 1996 to 2005, 74 patients with 102 spinal metastases were treated using the CyberKnife TM at Stanford University. Sixty-two (84%) patients were symptomatic. Seventy-four percent (50/68) of previously treated patients had prior radiation. Using the CyberKnife TM , 16-25 Gy in 1-5 fractions was delivered. Patients were followed clinically and radiographically for at least 3 months or until death. Results: With mean follow-up of 9 months (range 0-33 months), 36 patients were alive and 38 were dead at last follow-up. No death was treatment related. Eighty-four (84%) percent of symptomatic patients experienced improvement or resolution of symptoms after treatment. Three patients developed treatment-related spinal injury. Analysis of dose-volume parameters and clinical parameters failed to identify predictors of spinal cord injury. Conclusions: Robotic radiosurgery is effective and generally safe for spinal metastases even in previously irradiated patients

Fractionated stereotactic irradiation by Cyberknife of choroid melanomas: repositioning validation, closed eyelids; Irradiation stereotaxique fractionnee par Cyberknife des melanomes choroidiens: validation du repositionnement, paupieres fermees

Energy Technology Data Exchange (ETDEWEB)

Horn, S.; Rezvoy, N.; Lacornerie, T.; Mirabel, X.; Labalette, P.; Lartigau, E. [Centre Oscar-Lambret, Service de Radiotherapie, 59 - Lille (France)

2009-10-15

The fractionated stereotactic radiotherapy by Cyberknife is an option in the treatment of eyes tumors. The advantages of the Cyberknife in the choroid melanomas are in its infra-millimetric precision, to the automated repositioning on the skull bones and to the conformity brought by the stereotaxy. The objective of this study was to validate the quality of repositioning and the immobility of the eyes with closed eyelids. Conclusion: the reproducibility of the eye positioning with closed eyelids seems enough to consider the conservative treatment of choroid melanomas by fractionated stereotactic radiotherapy by Cyberknife without implementation of fiducials nor retrobulbar anaesthesia. (N.C.)

CyberKnife robotic image-guided stereotactic radiotherapy for oligometastic cancer. A prospective evaluation of 95 patients/118 lesions

Energy Technology Data Exchange (ETDEWEB)

Jereczek-Fossa, B.A.; Bossi-Zanetti, I.; Mauro, R. [European Institute of Oncology, Milan (Italy). Dept. of Radiotherapy; Milan Univ. (Italy); Beltramo, G.; Bianchi, L.C. [CyberKnife Center CDI, Milan (Italy); Fariselli, L. [Carlo Besta Neurological Institute Foundation, Milan (Italy). Radiotherapy Unit; Fodor, C. [European Institute of Oncology, Milan (Italy). Dept. of Radiotherapy; Fossati, P.; Orecchia, R. [European Institute of Oncology, Milan (Italy). Dept. of Radiotherapy; National Center for Oncological Hadrontherapy (CNAO) Foundation, Pavia, Milan (Italy); Milan Univ. (Italy); Baroni, G. [National Center for Oncological Hadrontherapy (CNAO) Foundation, Pavia, Milan (Italy); Politecnico di Milano (Italy). Dept. of Bioengineering

2013-06-15

Purpose: To evaluate the outcome of robotic CyberKnife (Accuray Inc. Sunnyvale, USA)-based stereotactic radiotherapy (CBK-SRT) for oligometastic cancer patients. Patients and methods: Between May 2007 and December 2009, 95 patients with a total of 118 lesions underwent CBK-SRT (median dose 24 Gy in 3 fractions). Inclusion criteria: adult patients with limited volume cancer; suitability for SRT but not for other local therapies. Primary diagnoses included breast, lung, head and neck, gastrointestinal and other malignancies. Prostate cancer patients were excluded. Concomitant systemic therapy was given in 40 % of cases and median follow-up was 12 months. Toxicity and tumor response were evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) Scale and Response Evaluation Criteria in Solid Tumors RECIST. Results: Toxicity was rare and observed mainly in patients with comorbidities or uncontrolled cancer. Out of 87 evaluable lesions, complete radiological response, partial response, stabilization and progressive disease were observed in 15 (17 %), 25 (29 %), 34 (39 %) and 13 (15 %) lesions, respectively. Upon restricting the analysis to lesions treated with CBK-SRT alone (no concomitant therapy), response- and local control (LC) rates remained similar. Actuarial 3-year in-field progression-free survival- (i.e. LC), progression-free survival- (PFS) and overall-survival (OS) rates were 67.6, 18.4, and 31.2 %, respectively. LC was reduced in cases of early recurrence. OS- and cause-specific survival (CSS) rates were significantly lower in patients treated for visceral lesions. Failures were predominantly out-field. Conclusion: CBK-SRT is a feasible therapeutic approach for oligometastastic cancer patients that provides long-term in-field tumor control with a low toxicity profile. Further investigations should focus on dose escalation and optimization of the combination with systemic therapies. (orig.)

Analysis of the model of pulmonary lesions of the cyberknife system tracking

International Nuclear Information System (INIS)

Floriano Pardal, A.; Santa-Olalla, I.; Sanchez-Reyes, A.

2013-01-01

The CyberKnife VSI system has the ability to carry out treatments for injuries that move with respiration through tracking Synchrony system, compensating for the breathing of the patient through the robotic arm, and thus allowing the reduction of the volume of treatment PTV margins. Tumor tracking is based on a model of correspondence between the positions of internal fiduciales brands previously introduced in the patient, and the external positions of infrared transmitters placed on the patient. This model is associated with a few errors that should be taken into account. The objective of the study is twofold: on the one hand to study the movement of the PTV based on location, and on the other analyze errors associated with this respiratory model. (Author)

Robots cut maintenance costs at PSE and G

International Nuclear Information System (INIS)

Roman, H.T.

1992-01-01

This paper reports that teleoperated robots are routinely used for cleaning, sampling, and remote inspections at PSE and G's nuclear and fossil power plants. Robots are rapidly becoming a strategic technology in the electric utility industry. Since 1983, more than 200 applications of these devices have been documented, often resulting in significant time and manpower savings. In nuclear plants, these devices have reduced radiation exposure to human workers. Public Service Electric and Gas Co. (PSE and G) has been evaluating, testing, and applying robotic technology since 1984. The work has been characterized by a two-step approach - interdepartmental task forces identify and assess potential applications, then five-year plans are developed to introduce the technology, apply it, and measure cost effectiveness. Throughout this effort, PSE and G has maintained a strong partnership with robot vendors/developers, making them an integral part of the program. Work on robotics at PSE and G's Salem and Hope Creek plants has been a pioneering effort. From 1987 through 1991, in the company's first five-year plan, it spent $1.6 million on robotic applications. Savings to date exceed $5 million, Figure 1. It is projected that by 1993 the savings will increase to $6-7 million. Applications for the next five-year plan, 1992-1996, are being finalized. These will concentrate on the development of robots for operation and maintenance applications. The first five-year plan concentrated on inspection, surveillance, and monitoring tasks

Robotics at PSE ampersand G: The cutting edge

International Nuclear Information System (INIS)

Taylor, G.M.

1992-01-01

Public Service Electric ampersand Gas Company's robotics program, which started its momentum in the mid-1980s, has demonstrated a cost-benefit ratio of 1:3 from use of the technology at the utility's three nuclear power units, Salem-1 and-1, and Hope Creek. During PSE ampersand G's first five-year nuclear robotics plan, from April 1986 through December 1991, open-quotes we spent R1.6 million, but we saved $5.3 million,close quotes declared Harry T. Roman, principal engineer/PSE ampersand G robotics and artificial intelligence program manager. open-quotes That's one buck in, three bucks out.close quotes A third of the savings came from reduced dose, a third from fewer person-hours, and a third from decreased plant down-time. This report discusses the development and nuclear/applications of robots at PSE ampersand G

Split-Volume Treatment Planning of Multiple Consecutive Vertebral Body Metastases for Cyberknife Image-Guided Robotic Radiosurgery

International Nuclear Information System (INIS)

Sahgal, Arjun; Chuang, Cynthia; Larson, David; Huang, Kim; Petti, Paula; Weinstein, Phil; Ma Lijun

2008-01-01

Cyberknife treatment planning of multiple consecutive vertebral body metastases is challenging due to large target volumes adjacent to critical normal tissues. A split-volume treatment planning technique was developed to improve the treatment plan quality of such lesions. Treatment plans were generated for 1 to 5 consecutive thoracic vertebral bodies (CVBM) prescribing a total dose of 24 Gy in 3 fractions. The planning target volume (PTV) consisted of the entire vertebral body(ies). Treatment plans were generated considering both the de novo clinical scenario (no prior radiation), imposing a dose limit of 8 Gy to 1 cc of spinal cord, and the retreatment scenario (prior radiation) with a dose limit of 3 Gy to 1 cc of spinal cord. The split-volume planning technique was compared with the standard full-volume technique only for targets ranging from 2 to 5 CVBM in length. The primary endpoint was to obtain best PTV coverage by the 24 Gy prescription isodose line. A total of 18 treatment plans were generated (10 standard and 8 split-volume). PTV coverage by the 24-Gy isodose line worsened consistently as the number of CVBM increased for both the de novo and retreatment scenario. Split-volume planning was achieved by introducing a 0.5-cm gap, splitting the standard full-volume PTV into 2 equal length PTVs. In every case, split-volume planning resulted in improved PTV coverage by the 24-Gy isodose line ranging from 4% to 12% for the de novo scenario and, 8% to 17% for the retreatment scenario. We did not observe a significant trend for increased monitor units required, or higher doses to spinal cord or esophagus, with split-volume planning. Split-volume treatment planning significantly improves Cyberknife treatment plan quality for CVBM, as compared to the standard technique. This technique may be of particular importance in clinical situations where stringent spinal cord dose limits are required

Establishing a process of irradiating small animal brain using a CyberKnife and a microCT scanner

International Nuclear Information System (INIS)

Kim, Haksoo; Welford, Scott; Fabien, Jeffrey; Zheng, Yiran; Yuan, Jake; Brindle, James; Yao, Min; Lo, Simon; Wessels, Barry; Machtay, Mitchell; Sohn, Jason W.; Sloan, Andrew

2014-01-01

Purpose: Establish and validate a process of accurately irradiating small animals using the CyberKnife G4 System (version 8.5) with treatment plans designed to irradiate a hemisphere of a mouse brain based on microCT scanner images. Methods: These experiments consisted of four parts: (1) building a mouse phantom for intensity modulated radiotherapy (IMRT) quality assurance (QA), (2) proving usability of a microCT for treatment planning, (3) fabricating a small animal positioning system for use with the CyberKnife's image guided radiotherapy (IGRT) system, and (4)in vivo verification of targeting accuracy. A set of solid water mouse phantoms was designed and fabricated, with radiochromic films (RCF) positioned in selected planes to measure delivered doses. After down-sampling for treatment planning compatibility, a CT image set of a phantom was imported into the CyberKnife treatment planning system—MultiPlan (ver. 3.5.2). A 0.5 cm diameter sphere was contoured within the phantom to represent a hemispherical section of a mouse brain. A nude mouse was scanned in an alpha cradle using a microCT scanner (cone-beam, 157 × 149 pixels slices, 0.2 mm longitudinal slice thickness). Based on the results of our positional accuracy study, a planning treatment volume (PTV) was created. A stereotactic body mold of the mouse was “printed” using a 3D printer laying UV curable acrylic plastic. Printer instructions were based on exported contours of the mouse's skin. Positional reproducibility in the mold was checked by measuring ten CT scans. To verify accurate dose delivery in vivo, six mice were irradiated in the mold with a 4 mm target contour and a 2 mm PTV margin to 3 Gy and sacrificed within 20 min to avoid DNA repair. The brain was sliced and stained for analysis. Results: For the IMRT QA using a set of phantoms, the planned dose (6 Gy to the calculation point) was compared to the delivered dose measured via film and analyzed using Gamma analysis (3% and 3 mm). A

Fractionated stereotactic irradiation by Cyberknife of choroid melanomas: repositioning validation, closed eyelids

International Nuclear Information System (INIS)

Horn, S.; Rezvoy, N.; Lacornerie, T.; Mirabel, X.; Labalette, P.; Lartigau, E.

2009-01-01

The fractionated stereotactic radiotherapy by Cyberknife is an option in the treatment of eyes tumors. The advantages of the Cyberknife in the choroid melanomas are in its infra-millimetric precision, to the automated repositioning on the skull bones and to the conformity brought by the stereotaxy. The objective of this study was to validate the quality of repositioning and the immobility of the eyes with closed eyelids. Conclusion: the reproducibility of the eye positioning with closed eyelids seems enough to consider the conservative treatment of choroid melanomas by fractionated stereotactic radiotherapy by Cyberknife without implementation of fiducials nor retrobulbar anaesthesia. (N.C.)

Extracranial Facial Nerve Schwannoma Treated by Hypo-fractionated CyberKnife Radiosurgery.

Science.gov (United States)

Sasaki, Ayaka; Miyazaki, Shinichiro; Hori, Tomokatsu

2016-09-21

Facial nerve schwannoma is a rare intracranial tumor. Treatment for this benign tumor has been controversial. Here, we report a case of extracranial facial nerve schwannoma treated successfully by hypo-fractionated CyberKnife (Accuray, Sunnyvale, CA) radiosurgery and discuss the efficacy of this treatment. A 34-year-old female noticed a swelling in her right mastoid process. The lesion enlarged over a seven-month period, and she experienced facial spasm on the right side. She was diagnosed with a facial schwannoma via a magnetic resonance imaging (MRI) scan of the head and neck and was told to wait until the facial nerve palsy subsides. She was referred to our hospital for radiation therapy. We planned a fractionated CyberKnife radiosurgery for three consecutive days. After CyberKnife radiosurgery, the mass in the right parotid gradually decreased in size, and the facial nerve palsy disappeared. At her eight-month follow-up, her facial spasm had completely disappeared. There has been no recurrence and the facial nerve function has been normal. We successfully demonstrated the efficacy of CyberKnife radiosurgery as an alternative treatment that also preserves neurofunction for facial nerve schwannomas.

Continuous versus step-by-step scanning mode of a novel 3D scanner for CyberKnife measurements

International Nuclear Information System (INIS)

Al Kafi, M Abdullah; Mwidu, Umar; Moftah, Belal

2015-01-01

The purpose of the study is to investigate the continuous versus step-by-step scanning mode of a commercial circular 3D scanner for commissioning measurements of a robotic stereotactic radiosurgery system. The 3D scanner was used for profile measurements in step-by-step and continuous modes with the intent of comparing the two scanning modes for consistency. The profile measurements of in-plane, cross-plane, 15 degree, and 105 degree were performed for both fixed cones and Iris collimators at depth of maximum dose and at 10 cm depth. For CyberKnife field size, penumbra, flatness and symmetry analysis, it was observed that the measurements with continuous mode, which can be up to 6 times faster than step-by-step mode, are comparable and produce scans nearly identical to step-by-step mode. When compared with centered step-by-step mode data, a fully processed continuous mode data gives rise to maximum of 0.50% and 0.60% symmetry and flatness difference respectfully for all the fixed cones and Iris collimators studied. - Highlights: • D scanner for CyberKnife beam data measurements. • Beam data analysis for continuous and step-by-step scan modes. • Faster continuous scanning data are comparable to step-by-step mode scan data.

Peripheral dose measurement for CyberKnife radiosurgery with upgraded linac shielding

International Nuclear Information System (INIS)

Chuang, Cynthia F.; Larson, David A.; Zytkovicz, Andrea; Smith, Vernon; Petti, Paula L.

2008-01-01

The authors investigated the peripheral dose reduction for CyberKnife radiosurgery treatments after the installation of a linac shielding upgrade. As in a previous investigation, the authors considered two treatment plans, one for a hypothetical target in the brain and another for a target in the thorax, delivered to an anthropomorphic phantom. The results of the prior investigation showed that the CyberKnife delivered significantly higher peripheral doses than comparable model C Gamma Knife or IMRT treatments. Current measurements, after the linac shielding upgrade, demonstrate that the additional shielding decreased the peripheral dose, expressed as a percentage of the delivered monitor units (MU), by a maximum of 59%. The dose reduction was greatest for cranial-caudal distances from the field edge less than 30 cm, and at these distances, the CyberKnife peripheral dose, expressed as a percentage of the delivered MU, is now comparable to that measured for the other treatment modalities in our previous investigation. For distances between 30 and 70 cm from the field edge, the additional shielding reduced the peripheral dose by between 20% and 55%. At these distances, the CyberKnife peripheral dose remains higher than doses measured in our previous study for the model C Gamma Knife and IMRT

Poster - 49: Assessment of Synchrony respiratory compensation error for CyberKnife liver treatment

International Nuclear Information System (INIS)

Liu, Ming; Cygler, Joanna; Vandervoort, Eric

2016-01-01

The goal of this work is to quantify respiratory motion compensation errors for liver tumor patients treated by the CyberKnife system with Synchrony tracking, to identify patients with the smallest tracking errors and to eventually help coach patient’s breathing patterns to minimize dose delivery errors. The accuracy of CyberKnife Synchrony respiratory motion compensation was assessed for 37 patients treated for liver lesions by analyzing data from system logfiles. A predictive model is used to modulate the direction of individual beams during dose delivery based on the positions of internally implanted fiducials determined using an orthogonal x-ray imaging system and the current location of LED external markers. For each x-ray pair acquired, system logfiles report the prediction error, the difference between the measured and predicted fiducial positions, and the delivery error, which is an estimate of the statistical error in the model overcoming the latency between x-ray acquisition and robotic repositioning. The total error was calculated at the time of each x-ray pair, for the number of treatment fractions and the number of patients, giving the average respiratory motion compensation error in three dimensions. The 99 th percentile for the total radial error is 3.85 mm, with the highest contribution of 2.79 mm in superior/inferior (S/I) direction. The absolute mean compensation error is 1.78 mm radially with a 1.27 mm contribution in the S/I direction. Regions of high total error may provide insight into features predicting groups of patients with larger or smaller total errors.

Poster - 49: Assessment of Synchrony respiratory compensation error for CyberKnife liver treatment

Energy Technology Data Exchange (ETDEWEB)

Liu, Ming [Carleton University (Canada); Cygler, Joanna [The Ottawa Hospital Cancer Centre, Carleton University, Ottawa University (Canada); Vandervoort, Eric [The Ottawa Hospital Cancer Centre, Ottawa University (Canada)

2016-08-15

The goal of this work is to quantify respiratory motion compensation errors for liver tumor patients treated by the CyberKnife system with Synchrony tracking, to identify patients with the smallest tracking errors and to eventually help coach patient’s breathing patterns to minimize dose delivery errors. The accuracy of CyberKnife Synchrony respiratory motion compensation was assessed for 37 patients treated for liver lesions by analyzing data from system logfiles. A predictive model is used to modulate the direction of individual beams during dose delivery based on the positions of internally implanted fiducials determined using an orthogonal x-ray imaging system and the current location of LED external markers. For each x-ray pair acquired, system logfiles report the prediction error, the difference between the measured and predicted fiducial positions, and the delivery error, which is an estimate of the statistical error in the model overcoming the latency between x-ray acquisition and robotic repositioning. The total error was calculated at the time of each x-ray pair, for the number of treatment fractions and the number of patients, giving the average respiratory motion compensation error in three dimensions. The 99{sup th} percentile for the total radial error is 3.85 mm, with the highest contribution of 2.79 mm in superior/inferior (S/I) direction. The absolute mean compensation error is 1.78 mm radially with a 1.27 mm contribution in the S/I direction. Regions of high total error may provide insight into features predicting groups of patients with larger or smaller total errors.

An initial report of cyberknife radiosurgery treatment in early stage lung cancer

International Nuclear Information System (INIS)

Yuan Zhiyong; Song Yongchun; Li Fengtong; Dong Yang; Wang Jingsheng; Wang Jun; Wang Changli; Wang Ping

2008-01-01

Objective: To study the efficacy and toxicity of the cyberknife in the treatment of medically inoperable patients with early stage lung cancer. Methods: From September 2006 to July 2007,17 patients with clinical stage I a-I b lung cancer were treated with cyberknife at Tianjin Cancer Hospital. Of the 11 patients receiving CT guided biopsy, 3 were squamous cell cancer and 8 were adenocarcinoma. Six patients refused intrusive operation and were diagnosed by PET-CT scan. All patients were medically inoperable evaluated by a thoracic surgeon. The PTV=GTV + 3-5 mm, and the median volume of PTV was 36 cm 3 (6-82 cm 3 ). The median total prescription dose was 50 Gy(45-60 Gy) at 3-5 fractions. Results: The median follow-up time was 7 months(3-11 months). All the patients finished the treatment and were alive by the last follow-up. Slight fatigue was the most common complain. Evaluated by CT scan, 13 were complete response and 4 were partial response. No recurrence, progression or distant metastasis occurred. There were 3 patients with grade I granulocytopenia, 3 grade I pneumonitis and 1 grade II pneumonitis. Conclusions: The cyberknife radiosurgery treatment in early stage lung cancer shows a high rate of local control and minimal toxicity. Long time follow-up is necessary to evaluate the survival data and late toxicity. (authors)

Establishing a process of irradiating small animal brain using a CyberKnife and a microCT scanner

Energy Technology Data Exchange (ETDEWEB)

Kim, Haksoo; Welford, Scott [Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 (United States); Fabien, Jeffrey; Zheng, Yiran; Yuan, Jake; Brindle, James; Yao, Min; Lo, Simon; Wessels, Barry; Machtay, Mitchell; Sohn, Jason W., E-mail: jason.sohn@case.edu [Department of Radiation Oncology, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106 (United States); Sloan, Andrew [Department of Neurosurgery, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106 (United States)

2014-02-15

Purpose: Establish and validate a process of accurately irradiating small animals using the CyberKnife G4 System (version 8.5) with treatment plans designed to irradiate a hemisphere of a mouse brain based on microCT scanner images. Methods: These experiments consisted of four parts: (1) building a mouse phantom for intensity modulated radiotherapy (IMRT) quality assurance (QA), (2) proving usability of a microCT for treatment planning, (3) fabricating a small animal positioning system for use with the CyberKnife's image guided radiotherapy (IGRT) system, and (4)in vivo verification of targeting accuracy. A set of solid water mouse phantoms was designed and fabricated, with radiochromic films (RCF) positioned in selected planes to measure delivered doses. After down-sampling for treatment planning compatibility, a CT image set of a phantom was imported into the CyberKnife treatment planning system—MultiPlan (ver. 3.5.2). A 0.5 cm diameter sphere was contoured within the phantom to represent a hemispherical section of a mouse brain. A nude mouse was scanned in an alpha cradle using a microCT scanner (cone-beam, 157 × 149 pixels slices, 0.2 mm longitudinal slice thickness). Based on the results of our positional accuracy study, a planning treatment volume (PTV) was created. A stereotactic body mold of the mouse was “printed” using a 3D printer laying UV curable acrylic plastic. Printer instructions were based on exported contours of the mouse's skin. Positional reproducibility in the mold was checked by measuring ten CT scans. To verify accurate dose delivery in vivo, six mice were irradiated in the mold with a 4 mm target contour and a 2 mm PTV margin to 3 Gy and sacrificed within 20 min to avoid DNA repair. The brain was sliced and stained for analysis. Results: For the IMRT QA using a set of phantoms, the planned dose (6 Gy to the calculation point) was compared to the delivered dose measured via film and analyzed using Gamma analysis (3% and 3 mm

SU-G-JeP1-10: Feasibility of CyberKnife Tracking Using the Previously-Implanted Permanent Brachytherapy Seed Cloud

International Nuclear Information System (INIS)

Cheung, J; Cunha, J; Sudhyadhom, A; McGuinness, C; Roach, M; Descovich, M

2016-01-01

Purpose: Robotic radiosurgery is a salvage treatment option for patients with recurrent prostate cancer. We explored the feasibility of tracking the bolus of permanent prostate implants (PPI) using image recognition software optimized to track spinal anatomy. Methods: Forty-five inert iodine seeds were implanted into a gelatin-based prostate phantom. Four superficial gold seeds were inserted to provide ground-truth alignment. A CT scan of the phantom (120 kVp, 1 mm slice thickness) was acquired and a single-energy iterative metal artifact reduction (MAR) algorithm was used to enhance the quality of the DRR used for tracking. CyberKnife treatment plans were generated from the MAR CT and regular CT (no-MAR) using spine tracking. The spine-tracking grid was centered on the bolus of seeds and resized to encompass the full seed cloud. A third plan was created from the regular CT scan, using fiducial tracking based on the 4 superficial gold seeds with identical align-center coordinates. The phantom was initially aligned using the fiducial-tracking plan. Then the MAR and no-MAR spine-tracking plans were loaded without moving the phantom. Differences in couch correction parameters were recorded in the case of perfect alignment and after the application of known rotations and translations (roll/pitch of 2 degrees; translations XYZ of 2 cm). Results: The spine tracking software was able to lock on to the bolus of seeds and provide couch corrections both in the MAR and no-MAR plans. In all cases, differences in the couch correction parameters from fiducial alignment were <0.5 mm in translations and <1 degree in rotations. Conclusion: We were able to successfully track the bolus of seeds with the spine-tracking grid in phantom experiments. For clinical applications, further investigation and developments to adapt the spine-tracking algorithm to optimize for PPI seed cloud tracking is needed to provide reliable tracking in patients. One of the authors (MD) has received research

SU-G-JeP1-10: Feasibility of CyberKnife Tracking Using the Previously-Implanted Permanent Brachytherapy Seed Cloud

Energy Technology Data Exchange (ETDEWEB)

Cheung, J; Cunha, J; Sudhyadhom, A; McGuinness, C; Roach, M; Descovich, M [University of California San Francisco, San Francisco, CA (United States)

2016-06-15

Purpose: Robotic radiosurgery is a salvage treatment option for patients with recurrent prostate cancer. We explored the feasibility of tracking the bolus of permanent prostate implants (PPI) using image recognition software optimized to track spinal anatomy. Methods: Forty-five inert iodine seeds were implanted into a gelatin-based prostate phantom. Four superficial gold seeds were inserted to provide ground-truth alignment. A CT scan of the phantom (120 kVp, 1 mm slice thickness) was acquired and a single-energy iterative metal artifact reduction (MAR) algorithm was used to enhance the quality of the DRR used for tracking. CyberKnife treatment plans were generated from the MAR CT and regular CT (no-MAR) using spine tracking. The spine-tracking grid was centered on the bolus of seeds and resized to encompass the full seed cloud. A third plan was created from the regular CT scan, using fiducial tracking based on the 4 superficial gold seeds with identical align-center coordinates. The phantom was initially aligned using the fiducial-tracking plan. Then the MAR and no-MAR spine-tracking plans were loaded without moving the phantom. Differences in couch correction parameters were recorded in the case of perfect alignment and after the application of known rotations and translations (roll/pitch of 2 degrees; translations XYZ of 2 cm). Results: The spine tracking software was able to lock on to the bolus of seeds and provide couch corrections both in the MAR and no-MAR plans. In all cases, differences in the couch correction parameters from fiducial alignment were <0.5 mm in translations and <1 degree in rotations. Conclusion: We were able to successfully track the bolus of seeds with the spine-tracking grid in phantom experiments. For clinical applications, further investigation and developments to adapt the spine-tracking algorithm to optimize for PPI seed cloud tracking is needed to provide reliable tracking in patients. One of the authors (MD) has received research

CyberKnife Boost for Patients with Cervical Cancer Unable to Undergo Brachytherapy

International Nuclear Information System (INIS)

Haas, Jonathan Andrew; Witten, Matthew R.; Clancey, Owen; Episcopia, Karen; Accordino, Diane; Chalas, Eva

2012-01-01

Standard radiation therapy for patients undergoing primary chemosensitized radiation for carcinomas of the cervix usually consists of external beam radiation followed by an intracavitary brachytherapy boost. On occasion, the brachytherapy boost cannot be performed due to unfavorable anatomy or because of coexisting medical conditions. We examined the safety and efficacy of using CyberKnife stereotactic body radiotherapy (SBRT) as a boost to the cervix after external beam radiation in those patients unable to have brachytherapy to give a more effective dose to the cervix than with conventional external beam radiation alone. Six consecutive patients with anatomic or medical conditions precluding a tandem and ovoid boost were treated with combined external beam radiation and CyberKnife boost to the cervix. Five patients received 45 Gy to the pelvis with serial intensity-modulated radiation therapy boost to the uterus and cervix to a dose of 61.2 Gy. These five patients received an SBRT boost to the cervix to a dose of 20 Gy in five fractions of 4 Gy each. One patient was treated to the pelvis to a dose of 45 Gy with an external beam boost to the uterus and cervix to a dose of 50.4 Gy. This patient received an SBRT boost to the cervix to a dose of 19.5 Gy in three fractions of 6.5 Gy. Five percent volumes of the bladder and rectum were kept to ≤75 Gy in all patients (i.e., V75 Gy ≤ 5%). All of the patients remain locally controlled with no evidence of disease following treatment. Grade 1 diarrhea occurred in 4/6 patients during the conventional external beam radiation. There has been no grade 3 or 4 rectal or bladder toxicity. There were no toxicities observed following SBRT boost. At a median follow-up of 14 months, CyberKnife radiosurgical boost is well tolerated and efficacious in providing a boost to patients with cervix cancer who are unable to undergo brachytherapy boost. Further follow-up is required to see if these results remain durable.

SU-E-T-797: Variations of Cardiac Dose at Different Respiratory Status in CyberKnife M6â„¢ Treatment Plans for Accelerated Partial Breast Irradiation (APBI)

Energy Technology Data Exchange (ETDEWEB)

Long, S [Florida Atlantic University, Boca Raton, FL (United States); Shang, C [Boca Raton Regional Hospital, Boca Raton, FL (United States); Evans, G [Boca Raton, FL (United States); Leventouri, T [FAU, Boca Raton, FL (United States)

2015-06-15

Purpose: Cyberknife robotic assisted radiation delivery has become a choice for accelerated breast RT, while a slightly increased cardiac dose has been reported. The dose dynamics throughout the respiration cycle has scarcely been explored. This study was designed to investigate the dose changes at each respiratory phase or status during respiration cycle. Methods: Six patients with 4DCT studies and six patients with a pair of free-breathing and deep breath-hold CT sets were used for dosimetry comparisons. 4DCT sets were obtained by Siemens™ CT and its respiratory gating system, comprising of 8 phases. Standard APBI plan at 340 cGy was done per fraction per NSABP B-39/RTOG 0413 and modulated with Cyberknife M6™ on MultiPlan™5.1.2. For the purpose of this study, the tumor volume was outlined in the media-lower quadrant of the left breast. Results: Except for D5cc in plans with 4DCT, cardiac doses are significantly different between respiratory phases in well inhaled breathing phases, and more significantly in plans with BH CT. Mean cardiac doses in 100% inhalation phase were often found to be 5–15% (p< 0.02) less than those in other phases. Conclusion: Although ineligible cardiac doses are noted in APBI plans using 4D free-breathing CT and instantaneous free breathing CT series, a reduction in cardiac dose was seen for the well-inhaled phases. This provides practical guidance for cardiac dose reduction applicable with CK M6 APBR.

SU-E-T-797: Variations of Cardiac Dose at Different Respiratory Status in CyberKnife M6â„¢ Treatment Plans for Accelerated Partial Breast Irradiation (APBI)

International Nuclear Information System (INIS)

Long, S; Shang, C; Evans, G; Leventouri, T

2015-01-01

Purpose: Cyberknife robotic assisted radiation delivery has become a choice for accelerated breast RT, while a slightly increased cardiac dose has been reported. The dose dynamics throughout the respiration cycle has scarcely been explored. This study was designed to investigate the dose changes at each respiratory phase or status during respiration cycle. Methods: Six patients with 4DCT studies and six patients with a pair of free-breathing and deep breath-hold CT sets were used for dosimetry comparisons. 4DCT sets were obtained by Siemens™ CT and its respiratory gating system, comprising of 8 phases. Standard APBI plan at 340 cGy was done per fraction per NSABP B-39/RTOG 0413 and modulated with Cyberknife M6™ on MultiPlan™5.1.2. For the purpose of this study, the tumor volume was outlined in the media-lower quadrant of the left breast. Results: Except for D5cc in plans with 4DCT, cardiac doses are significantly different between respiratory phases in well inhaled breathing phases, and more significantly in plans with BH CT. Mean cardiac doses in 100% inhalation phase were often found to be 5–15% (p< 0.02) less than those in other phases. Conclusion: Although ineligible cardiac doses are noted in APBI plans using 4D free-breathing CT and instantaneous free breathing CT series, a reduction in cardiac dose was seen for the well-inhaled phases. This provides practical guidance for cardiac dose reduction applicable with CK M6 APBR

St. Joseph's Hospital Barrow Neurological Institute stereitatic radiotherapy experience comparison of Gamma Knife and CyberKnife

International Nuclear Information System (INIS)

Kresl, J.J.

2006-01-01

The clinical utilisation stereotactic radiotherapy continues to increase in breadth and scope within the medical community. However, no single standard treatment platform exists for the delivery of stereotactic radiotherapy treatments. This is because although there are several commercially available platforms capable of delivering stereotactic radiotherapy treatments, each platform has unique abilities and limitations. The most widely used stereotactic radiotherapy system for intracranial treatments is the Gamma Knife. The first image guided robotic stereotactic radiotherapy system enabling body stereotactic radiotherapy is the CyberKnife. Both are available at the Barrow Neurological Institute. We describe our experience with the complementary use of these two distinct treatment platforms. This permits us to make a meaningful comparison and to detail their contrasting advantages and disadvantages for state of the art for stereotactic radiotherapy. (author)

Accuracy of out-of-field dose calculation of tomotherapy and Cyberknife treatment planning systems. A dosimetric study

International Nuclear Information System (INIS)

Schneider, Uwe; Hirslanden Medical Center, Aarau; Haelg, Roger A.; Hartmann, Matthias; Mack, Andreas; Storelli, Fabrizio; Besserer, Juergen; Joosten, Andreas; Moeckli, Raphael

2014-01-01

Purpose: Late toxicities such as second cancer induction become more important as treatment outcome improves. Often the dose distribution calculated with a commercial treatment planning system (TPS) is used to estimate radiation carcinogenesis for the radiotherapy patient. However, for locations beyond the treatment field borders, the accuracy is not well known. The aim of this study was to perform detailed out-of-field-measurements for a typical radiotherapy treatment plan administered with a Cyberknife and a Tomotherapy machine and to compare the measurements to the predictions of the TPS. Materials and methods: Individually calibrated thermoluminescent dosimeters were used to measure absorbed dose in an anthropomorphic phantom at 184 locations. The measured dose distributions from 6 MV intensity-modulated treatment beams for CyberKnife and TomoTherapy machines were compared to the dose calculations from the TPS. Results: The TPS are underestimating the dose far away from the target volume. Quantitatively the Cyberknife underestimates the dose at 40 cm from the PTV border by a factor of 60, the Tomotherapy TPS by a factor of two. If a 50% dose uncertainty is accepted, the Cyberknife TPS can predict doses down to approximately 10 mGy/treatment Gy, the Tomotherapy-TPS down to 0.75 mGy/treatment Gy. The Cyberknife TPS can then be used up to 10 cm from the PTV border the Tomotherapy up to 35 cm. Conclusions: We determined that the Cyberknife and Tomotherapy TPS underestimate substantially the doses far away from the treated volume. It is recommended not to use out-of-field doses from the Cyberknife TPS for applications like modeling of second cancer induction. The Tomotherapy TPS can be used up to 35 cm from the PTV border (for a 390 cm 3 large PTV). (orig.)

CyberKnife with Tumor Tracking: An Effective Treatment for High-Risk Surgical Patients with Single Peripheral Lung Metastases

Energy Technology Data Exchange (ETDEWEB)

Snider, James W.; Oermann, Eric K.; Chen, Viola; Rabin, Jennifer; Suy, Simeng; Yu, Xia [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); Vahdat, Saloomeh [Department of Pathology, Georgetown University Hospital, Washington, DC (United States); Collins, Sean P. [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); Banovac, Filip [Department of Radiology, Georgetown University Hospital, Washington, DC (United States); Anderson, Eric [Division of Pulmonary, Critical Care and Sleep Medicine, Georgetown University Hospital, Washington, DC (United States); Collins, Brian T., E-mail: collinsb@gunet.georgetown.edu [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States)

2012-06-29

Standard treatment for operable patients with single peripheral lung metastases is metastasectomy. We report mature CyberKnife outcomes for high-risk surgical patients with biopsy proven single peripheral lung metastases. Twenty-four patients (median age 73 years) with a mean maximum tumor diameter of 2.5 cm (range, 0.8–4.5 cm) were treated over a 6-year period extending from September 2004 to September 2010 and followed for a minimum of 1 year or until death. A mean dose of 52 Gy (range, 45–60 Gy) was delivered to the prescription isodose line in three fractions over a 3–11 day period (mean, 7 days). At a median follow-up of 20 months, the 2-year Kaplan–Meier local control and overall survival rates were 87 and 50%, respectively. CyberKnife with fiducial tracking is an effective treatment for high-risk surgical patients with single small peripheral lung metastases. Trials comparing CyberKnife with metastasectomy for operable patients are necessary to confirm equivalence.

Poster — Thur Eve — 23: Dose and Position Quality Assurance using the RADPOS System for 4D Radiotherapy with CyberKnife

Energy Technology Data Exchange (ETDEWEB)

Marants, R [Department of Medical Physics, Carleton University (Canada); Vandervoort, E [Department of Medical Physics, The Ottawa Hospital Cancer Centre (Canada); Cygler, J E [Department of Medical Physics, Carleton University, Department of Medical Physics, The Ottawa Hospital Cancer Centre (Canada)

2014-08-15

Introduction: RADPOS 4D dosimetry system consists of a microMOSFET dosimeter combined with an electromagnetic positioning sensor, which allows for performing real-time dose and position measurements simultaneously. In this report the use of RADPOS as an independent quality assurance (QA) tool during CyberKnife 4D radiotherapy treatment is described. In addition to RADPOS, GAFCHROMIC® films were used for simultaneous dose measurement. Methods: RADPOS and films were calibrated in a Solid Water® phantom at 1.5 cm depth, SAD= 80 cm, using 60 mm cone. CT based treatment plan was created for a Solid Water® breast phantom containing metal fiducials and RADPOS probe. Dose calculations were performed using iPlan pencil beam algorithm. Before the treatment delivery, GAFCHROMIC® film was inserted inside the breast phantom, next to the RADPOS probe. Then the phantom was positioned on the chest platform of the QUASAR, to which Synchrony LED optical markers were also attached. Position logging began for RADPOS and the Synchrony tracking system, the QUASAR motion was initiated and the treatment was delivered. Results: RADPOS position measurements very closely matched the LED marker positions recorded by the Synchrony camera tracking system. The RADPOS measured dose was 2.5% higher than the average film measured dose, which is within the experimental uncertainties. Treatment plan calculated dose was 4.1 and 1.6% lower than measured by RADPOS and film, respectively. This is most likely due to the inferior nature of the dose calculation algorithm. Conclusions: Our study demonstrates that RADPOS system is a useful tool for independent QA of CyberKnife treatments.

A new strategy of CyberKnife treatment system based radiosurgery followed by early use of adjuvant bevacizumab treatment for brain metastasis with extensive cerebral edema.

Science.gov (United States)

Wang, Yang; Wang, Enmin; Pan, Li; Dai, Jiazhong; Zhang, Nan; Wang, Xin; Liu, Xiaoxia; Mei, Guanghai; Sheng, Xiaofang

2014-09-01

Bevacizumab blocks the effects of vascular endothelial growth factor in leakage-prone capillaries and has been suggested as a new treatment for cerebral radiation edema and necrosis. CyberKnife is a new, frameless stereotactic radiosurgery system. This work investigated the safety and efficacy of CyberKnife followed by early bevacizumab treatment for brain metastasis with extensive cerebral edema. The eligibility criteria of the patients selected for radiosurgery followed by early use of adjuvant bevacizumab treatment were: (1) brain tumors from metastasis with one solitary brain lesion and symptomatic extensive cerebral edema; (2) >18 years of age; (3) the patient refused surgery due to the physical conditions and the risk of surgery; (4) no contraindications for bevacizumab. (5) bevacizumab was applied for a minimum of 2 injections and a maximum of 6 injections with a 2-week interval between treatments, beginning within 2 weeks of the CyberKnife therapy; (6) Karnofsky performance status (KPS) ≥30. Tumor size and edema were monitored by magnetic resonance imaging (MRI). Dexamethasone dosage, KPS, adverse event occurrence and associated clinical outcomes were also recorded. Eight patients were accrued for this new treatment. Radiation dose ranged from 20 to 33 Gy in one to five sessions, prescribed to the 61-71 % isodose line. Bevacizumab therapy was administered 3-10 days after completion of CyberKnife treatment for a minimum of two cycles (5 mg/kg, at 2-week intervals). MRI revealed average reductions of 55.8 % (post-gadolinium) and 63.4 % (T2/FLAIR). Seven patients showed significant clinical neurological improvements. Dexamethasone was reduced in all patients, with five successfully discontinuing dexamethasone treatment 4 weeks after bevacizumab initiation. Hypertension, a bevacizumab-related adverse event, occurred in one patient. After 3-8 months, all patients studied were alive and primary brain metastases were under control, 2 developed new brain

SU-G-JeP3-03: Effect of Robot Pose On Beam Blocking for Ultrasound Guided SBRT of the Prostate

Energy Technology Data Exchange (ETDEWEB)

Gerlach, S; Schlaefer, A [Hamburg University of Technology, Hamburg (Germany); Kuhlemann, I; Ernst, F [Universitaet zu Luebeck, Luebeck (Germany); Fuerweger, C [European Cyberknife Center Munich, Munich (Germany)

2016-06-15

Purpose: Ultrasound presents a fast, volumetric image modality for real-time tracking of abdominal organ motion. How-ever, ultrasound transducer placement during radiation therapy is challenging. Recently, approaches using robotic arms for intra-treatment ultrasound imaging have been proposed. Good and reliable imaging requires placing the transducer close to the PTV. We studied the effect of a seven degrees of freedom robot on the fea-sible beam directions. Methods: For five CyberKnife prostate treatment plans we established viewports for the transducer, i.e., points on the patient surface with a soft tissue view towards the PTV. Choosing a feasible transducer pose and using the kinematic redundancy of the KUKA LBR iiwa robot, we considered three robot poses. Poses 1 to 3 had the elbow point anterior, superior, and inferior, respectively. For each pose and each beam starting point, the pro-jections of robot and PTV were computed. We added a 20 mm margin accounting for organ / beam motion. The number of nodes for which the PTV was partially of fully blocked were established. Moreover, the cumula-tive overlap for each of the poses and the minimum overlap over all poses were computed. Results: The fully and partially blocked nodes ranged from 12% to 20% and 13% to 27%, respectively. Typically, pose 3 caused the fewest blocked nodes. The cumulative overlap ranged from 19% to 29%. Taking the minimum overlap, i.e., considering moving the robot’s elbow while maintaining the transducer pose, the cumulative over-lap was reduced to 16% to 18% and was 3% to 6% lower than for the best individual pose. Conclusion: Our results indicate that it is possible to identify feasible ultrasound transducer poses and to use the kinematic redundancy of a 7 DOF robot to minimize the impact of the imaging subsystem on the feasible beam directions for ultrasound guided and motion compensated SBRT. Research partially funded by DFG grants ER 817/1-1 and SCHL 1844/3-1.

SU-G-JeP3-03: Effect of Robot Pose On Beam Blocking for Ultrasound Guided SBRT of the Prostate

International Nuclear Information System (INIS)

Gerlach, S; Schlaefer, A; Kuhlemann, I; Ernst, F; Fuerweger, C

2016-01-01

Purpose: Ultrasound presents a fast, volumetric image modality for real-time tracking of abdominal organ motion. How-ever, ultrasound transducer placement during radiation therapy is challenging. Recently, approaches using robotic arms for intra-treatment ultrasound imaging have been proposed. Good and reliable imaging requires placing the transducer close to the PTV. We studied the effect of a seven degrees of freedom robot on the fea-sible beam directions. Methods: For five CyberKnife prostate treatment plans we established viewports for the transducer, i.e., points on the patient surface with a soft tissue view towards the PTV. Choosing a feasible transducer pose and using the kinematic redundancy of the KUKA LBR iiwa robot, we considered three robot poses. Poses 1 to 3 had the elbow point anterior, superior, and inferior, respectively. For each pose and each beam starting point, the pro-jections of robot and PTV were computed. We added a 20 mm margin accounting for organ / beam motion. The number of nodes for which the PTV was partially of fully blocked were established. Moreover, the cumula-tive overlap for each of the poses and the minimum overlap over all poses were computed. Results: The fully and partially blocked nodes ranged from 12% to 20% and 13% to 27%, respectively. Typically, pose 3 caused the fewest blocked nodes. The cumulative overlap ranged from 19% to 29%. Taking the minimum overlap, i.e., considering moving the robot’s elbow while maintaining the transducer pose, the cumulative over-lap was reduced to 16% to 18% and was 3% to 6% lower than for the best individual pose. Conclusion: Our results indicate that it is possible to identify feasible ultrasound transducer poses and to use the kinematic redundancy of a 7 DOF robot to minimize the impact of the imaging subsystem on the feasible beam directions for ultrasound guided and motion compensated SBRT. Research partially funded by DFG grants ER 817/1-1 and SCHL 1844/3-1.

A pencil beam dose calculation model for CyberKnife system

Energy Technology Data Exchange (ETDEWEB)

Liang, Bin; Li, Yongbao; Liu, Bo; Zhou, Fugen [Image Processing Center, Beihang University, Beijing 100191 (China); Xu, Shouping [Department of Radiation Oncology, PLA General Hospital, Beijing 100853 (China); Wu, Qiuwen, E-mail: Qiuwen.Wu@Duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 (United States)

2016-10-15

Purpose: CyberKnife system is initially equipped with fixed circular cones for stereotactic radiosurgery. Two dose calculation algorithms, Ray-Tracing and Monte Carlo, are available in the supplied treatment planning system. A multileaf collimator system was recently introduced in the latest generation of system, capable of arbitrarily shaped treatment field. The purpose of this study is to develop a model based dose calculation algorithm to better handle the lateral scatter in an irregularly shaped small field for the CyberKnife system. Methods: A pencil beam dose calculation algorithm widely used in linac based treatment planning system was modified. The kernel parameters and intensity profile were systematically determined by fitting to the commissioning data. The model was tuned using only a subset of measured data (4 out of 12 cones) and applied to all fixed circular cones for evaluation. The root mean square (RMS) of the difference between the measured and calculated tissue-phantom-ratios (TPRs) and off-center-ratio (OCR) was compared. Three cone size correction techniques were developed to better fit the OCRs at the penumbra region, which are further evaluated by the output factors (OFs). The pencil beam model was further validated against measurement data on the variable dodecagon-shaped Iris collimators and a half-beam blocked field. Comparison with Ray-Tracing and Monte Carlo methods was also performed on a lung SBRT case. Results: The RMS between the measured and calculated TPRs is 0.7% averaged for all cones, with the descending region at 0.5%. The RMSs of OCR at infield and outfield regions are both at 0.5%. The distance to agreement (DTA) at the OCR penumbra region is 0.2 mm. All three cone size correction models achieve the same improvement in OCR agreement, with the effective source shift model (SSM) preferred, due to their ability to predict more accurately the OF variations with the source to axis distance (SAD). In noncircular field validation

Robots deliver real benefits for PSE and G

International Nuclear Information System (INIS)

Anon.

1990-01-01

The US utility PSE and G has found that using robots in the nuclear industry can bring real rewards in terms of reduced exposures, improved maintenance, and cost savings. Their experience is described. (author)

SU-C-BRB-04: Characteristics and Performance Evaluation of the First Commercial MLC for a Robotic Delivery System

International Nuclear Information System (INIS)

Fuerweger, C; Prins, P; Coskan, H; Heijmen, B

2015-01-01

Purpose: To assess characteristics and performance of the “Incise™” MLC (41 leaf pairs, 2.5mm width, FFF linac) mounted on the robotic SRS/SBRT platform “CyberKnife M6™” in a pre-clinical 5 months (11/2014–03/2015) test period. Methods: Beam properties were measured with unshielded diodes and EBT3 film. The CyberKnife workspace for MLC was analyzed by transforming robot node coordinates (cranial / body paths) into Euler geometry. Bayouth tests for leaf / bank position accuracy were performed in standard (A/P) and clinically relevant non-standard positions, before and after exercising the MLC for 10+ minutes. Total system and delivery accuracy were assessed in End-to-End tests and dosimetric verification of exemplary plans. Stability over time was evaluated in Picket-Fence-and adapted Winston-Lutz-tests (AQA) for different collimator angles. Results: Penumbrae (80–20%, with 100%=2*dose at inflection point; SAD 80cm; 10cm depth) parallel / perpendicular to leaf motion were 2.87/2.64mm for the smallest (0×76×0.75cm 2 ) and 5.34/4.94mm for the largest (9.76×9.75cm 2 ) square field. MLC circular field penumbrae exceeded fixed cones by 10–20% (e.g. 60mm: 4.0 vs. 3.6mm; 20mm: 3.6 vs. 2.9mm). Interleaf leakage was <0.5%. Clinically accessible workspace with MLC covered (non-coplanar) gantry angles of [-113°;+112°] (cranial) and [-108°;+102°] (body), and collimator angles of [-100°;+107°] (cranial) and [-91°;+100°] (body). Average leaf position offsets were ≤0.2mm in 14 standard A/P Bayouth tests and ≤0.6mm in 8 non-standard direction tests. Pre-test MLC exercise increased jaggedness (range ±0.3mm vs. ±0.5mm) and allowed to identify one malfunctioning leaf motor. Total system accuracy with MLC was 0.39±0.06mm in 6 End-to-End tests. Picket-Fence and AQA showed no adverse trends during the test period. Conclusion: The Incise™ MLC for CyberKnife M6™ displayed high accuracy and mechanical stability over the test period. The specific CyberKnife

SU-C-BRB-04: Characteristics and Performance Evaluation of the First Commercial MLC for a Robotic Delivery System

Energy Technology Data Exchange (ETDEWEB)

Fuerweger, C [Erasmus MC Cancer Institute, Rotterdam (Netherlands); European Cyberknife Center Munich, Munich, DE (Germany); Prins, P; Coskan, H; Heijmen, B [Erasmus MC Cancer Institute, Rotterdam (Netherlands)

2015-06-15

Purpose: To assess characteristics and performance of the “Incise™” MLC (41 leaf pairs, 2.5mm width, FFF linac) mounted on the robotic SRS/SBRT platform “CyberKnife M6™” in a pre-clinical 5 months (11/2014–03/2015) test period. Methods: Beam properties were measured with unshielded diodes and EBT3 film. The CyberKnife workspace for MLC was analyzed by transforming robot node coordinates (cranial / body paths) into Euler geometry. Bayouth tests for leaf / bank position accuracy were performed in standard (A/P) and clinically relevant non-standard positions, before and after exercising the MLC for 10+ minutes. Total system and delivery accuracy were assessed in End-to-End tests and dosimetric verification of exemplary plans. Stability over time was evaluated in Picket-Fence-and adapted Winston-Lutz-tests (AQA) for different collimator angles. Results: Penumbrae (80–20%, with 100%=2*dose at inflection point; SAD 80cm; 10cm depth) parallel / perpendicular to leaf motion were 2.87/2.64mm for the smallest (0×76×0.75cm{sup 2}) and 5.34/4.94mm for the largest (9.76×9.75cm{sup 2}) square field. MLC circular field penumbrae exceeded fixed cones by 10–20% (e.g. 60mm: 4.0 vs. 3.6mm; 20mm: 3.6 vs. 2.9mm). Interleaf leakage was <0.5%. Clinically accessible workspace with MLC covered (non-coplanar) gantry angles of [-113°;+112°] (cranial) and [-108°;+102°] (body), and collimator angles of [-100°;+107°] (cranial) and [-91°;+100°] (body). Average leaf position offsets were ≤0.2mm in 14 standard A/P Bayouth tests and ≤0.6mm in 8 non-standard direction tests. Pre-test MLC exercise increased jaggedness (range ±0.3mm vs. ±0.5mm) and allowed to identify one malfunctioning leaf motor. Total system accuracy with MLC was 0.39±0.06mm in 6 End-to-End tests. Picket-Fence and AQA showed no adverse trends during the test period. Conclusion: The Incise™ MLC for CyberKnife M6™ displayed high accuracy and mechanical stability over the test period. The

SU-F-T-620: Development of a Convolution/Superposition Dose Engine for CyberKnife System

Energy Technology Data Exchange (ETDEWEB)

Li, Y; Liu, B; Liang, B; Xu, X; Guo, B; Wei, R; Zhou, F [Beihang University, Beijing, Beijing (China); Song, T [Southern Medical University, Guangzhou, Guangdong (China); Xu, S [PLA General Hospital, Beijing, Beijing (China); Piao, J [302 Military Hospital, Beijing, Beijing (China)

2016-06-15

Purpose: Current CyberKnife treatment planning system (TPS) provided two dose calculation algorithms: Ray-tracing and Monte Carlo. Ray-tracing algorithm is fast, but less accurate, and also can’t handle irregular fields since a multi-leaf collimator system was recently introduced to CyberKnife M6 system. Monte Carlo method has well-known accuracy, but the current version still takes a long time to finish dose calculations. The purpose of this paper is to develop a GPU-based fast C/S dose engine for CyberKnife system to achieve both accuracy and efficiency. Methods: The TERMA distribution from a poly-energetic source was calculated based on beam’s eye view coordinate system, which is GPU friendly and has linear complexity. The dose distribution was then computed by inversely collecting the energy depositions from all TERMA points along 192 collapsed-cone directions. EGSnrc user code was used to pre-calculate energy deposition kernels (EDKs) for a series of mono-energy photons The energy spectrum was reconstructed based on measured tissue maximum ratio (TMR) curve, the TERMA averaged cumulative kernels was then calculated. Beam hardening parameters and intensity profiles were optimized based on measurement data from CyberKnife system. Results: The difference between measured and calculated TMR are less than 1% for all collimators except in the build-up regions. The calculated profiles also showed good agreements with the measured doses within 1% except in the penumbra regions. The developed C/S dose engine was also used to evaluate four clinical CyberKnife treatment plans, the results showed a better dose calculation accuracy than Ray-tracing algorithm compared with Monte Carlo method for heterogeneous cases. For the dose calculation time, it takes about several seconds for one beam depends on collimator size and dose calculation grids. Conclusion: A GPU-based C/S dose engine has been developed for CyberKnife system, which was proven to be efficient and accurate

SU-E-T-125: Dosimetric Comparison of Intensity Modulated Radiation Therapy Using Robotic Versus Traditional Linac Platform in Prostate Cancer

International Nuclear Information System (INIS)

Hayes, T; Rella, J; Yang, J; Sims, C; Fung, C

2014-01-01

Purpose: Recent development of an MLC for robotic external beam radiotherapy has the potential of new clinical application in conventionally fractionated radiation therapy. This study offers a dosimetric comparison of IMRT plans using Cyberknife with MLC versus conventional linac plans. Methods: Ten prostate cancer patients treated on a traditional linac with IMRT to 7920cGy at 180cGy/fraction were randomly selected. GTVs were defined as prostate plus proximal seminal vesicles. PTVs were defined as GTV+8mm in all directions except 5mm posteriorly. Conventional IMRT planning was performed on Philips Pinnacle and delivered on a standard linac with CBCT and 10mm collimator leaf width. For each case a Cyberknife plan was created using Accuray Multiplan with same CT data set, contours, and dose constraints. All dosimetric data was transferred to third party software for independent computation of contour volumes and DVH. Delivery efficiency was evaluated using total MU, treatment time, number of beams, and number of segments. Results: Evaluation criteria including percent target coverage, homogeneity index, and conformity index were found to be comparable. All dose constraints from QUANTEC were found to be statistically similar except rectum V50Gy and bladder V65Gy. Average rectum V50Gy was lower for robotic IMRT (30.07%±6.57) versus traditional (34.73%±3.62, p=0.0130). Average bladder V65Gy was lower for robotic (17.87%±12.74) versus traditional (21.03%±11.93, p=0.0405). Linac plans utilized 9 coplanar beams, 48.9±3.8 segments, and 19381±2399MU. Robotic plans utilized 38.4±9.0 non-coplanar beams, 85.5±21.0 segments and 42554.71±16381.54 MU. The average treatment was 15.02±0.60 minutes for traditional versus 20.90±2.51 for robotic. Conclusion: The robotic IMRT plans were comparable to the traditional IMRT plans in meeting the target volume dose objectives. Critical structure dose constraints were largely comparable although statistically significant

Quality level of a treatment by Cyberknife with Synchrony; Niveau de qualite d'un traitement par le CyberKnife avec Synchrony

Energy Technology Data Exchange (ETDEWEB)

Khawaja, M.S.A.; Noel, A. [CRAN UMR 7039, CNRS, 54 - Vandoeuvre-les-Nancy (France); Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Nancy-1 Univ., 54 (France); Marchesi, V. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Wolf, D. [INPL CRAN UMR 7039, CNRS, 54 - Vandoeuvre-les-Nancy (France)

2009-10-15

The Cyberknife and its Synchrony associated subsystem represent a very reliable mean to treat the tumors of soft tissues moving with respiration. It allows to guarantee a high quality of treatment because of sub-millimetric accuracy whatever be the complexity degree of the patient respiration cycle. (N.C.)

Evaluation of clinically applied treatment beams with respect to bunker shielding parameters for a Cyberknife M6.

Science.gov (United States)

Henzen, Dominik; Schmidhalter, Daniel; Zanella, Claudia Christina; Volken, Werner; Mackeprang, Paul-Henry; Malthaner, Marco; Fix, Michael Karl; Manser, Peter

2018-01-01

Compared to a conventional linear accelerator, the Cyberknife (CK) is a unique system with respect to radiation protection shielding and the variety and number of non-coplanar beams are two key components regarding this aspect. In this work, a framework to assess the direction distribution and modulation factor (MF) of clinically applied treatment beams of a CyberKnife M6 is developed. Database filtering options allow studying the influence of different parameters such as collimator types, treatment sites or different bunker sizes. A distribution of monitor units (MU) is generated by projecting treatment beams onto the walls, floor and ceiling of the CyberKnife bunker. This distribution is found to be highly heterogeneous and depending, among other parameters, on the bunker size. For our bunker design, 10%-13% of the MUs are delivered to the right and left wall, each. The floor receives more than 64% of the applied MUs, while the wall behind the patient's head is not hit by primary treatment beams. Between 0% and 5% of the total MUs are delivered to the wall at the patient's feet. This number highly depends on the treatment site, e.g., for extracranial patients no beams hit that wall. Collimator choice was found to have minor influence on the distribution of MUs. On the other hand, the MF depends on the collimator type as well as on the treatment site. The MFs (delivered MU/prescribed dose) for all treatments, all MLC treatments, cranial and extracranial treatments are 8.3, 6.4, 7.7, and 9.9 MU/cGy, respectively. The developed framework allows assessing and monitoring important parameters regarding radiation protection of a CK-M6 using the actually applied treatment beams. Furthermore, it enables evaluating different clinical and constructional situations using the filtering options. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Clinical observation on the therapeutic efficacy of CyberKnife for primary or metastatic retroperitoneal tumors

International Nuclear Information System (INIS)

Zhuang Hongqing; Yuan Zhiyong; Wang Ping

2012-01-01

Objective: To evaluate the early response rate and radiation toxicity of CyberKnife in the treatment of primary or metastatic retroperitoneal tumors. Methods: Twenty-eight patients with retroperitoneal tumors were treated with CyberKnife. The total doses were 2000-6000 cGy (median 4500 cGy) and biological effective doses were 3750-10080 cGy (median 7680 cGy) in 2-10 fractions (median 5). Of all patients, 3 received three dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT) boost, 1 was treated as second-course radiotherapy, and others were treated with CyberKnife only. The survival rates were calculated by Kaplan-Meier method and compared with Logrank test. Results: The complete response, stable disease and progression disease rates were 43% (12/28), 6% (10/28), 18% (5/28), 4%, (1/28), respectively. The overall response rate was 96%. The number of patients who were followed up more than 1, 2, 3 years were 17, 9, 7, respectively. The 1-, 2- and 3-year local control rates were 92%, 86%, and 86%, respectively. The 1-, 2- and 3-year overall survival rates were 60%, 49% and 49%, respectively. The difference between local progression-free survival and overall survival was not significant (median 9.5 and 12.0 months, χ 2 =0.17, P=0.680), Moreover, if the patients did not have metastasis elsewhere and local treatment was effective, there was no significant difference between local progression-free survival and progression free survival (median 17 and 11 months, χ 2 =0.13, P=0.720), Acute radiation-induced side effects (≥ 2 grade) such as fatigue, anorexia, nausea, vomiting and epigastric discomfort occurred in 9, 9, 7, 7 and 2 patients, respectively. Intestinal stenosis of 1 grade occurred in 1 patients. Conclusions: Radiotherapy for retroperitoneal tumors with CyberKnife has provided a high response rate with minimal side effects. It is a safe and effective local treatment method for retroperitoneal tumors. (authors)

R4SA for Controlling Robots

Science.gov (United States)

Aghazarian, Hrand

2009-01-01

The R4SA GUI mentioned in the immediately preceding article is a userfriendly interface for controlling one or more robot(s). This GUI makes it possible to perform meaningful real-time field experiments and research in robotics at an unmatched level of fidelity, within minutes of setup. It provides such powerful graphing modes as that of a digitizing oscilloscope that displays up to 250 variables at rates between 1 and 200 Hz. This GUI can be configured as multiple intuitive interfaces for acquisition of data, command, and control to enable rapid testing of subsystems or an entire robot system while simultaneously performing analysis of data. The R4SA software establishes an intuitive component-based design environment that can be easily reconfigured for any robotic platform by creating or editing setup configuration files. The R4SA GUI enables event-driven and conditional sequencing similar to those of Mars Exploration Rover (MER) operations. It has been certified as part of the MER ground support equipment and, therefore, is allowed to be utilized in conjunction with MER flight hardware. The R4SA GUI could also be adapted to use in embedded computing systems, other than that of the MER, for commanding and real-time analysis of data.

Six-dimensional correction of intra-fractional prostate motion with CyberKnife stereotactic body radiation therapy

Directory of Open Access Journals (Sweden)

Sean eCollins

2011-12-01

Full Text Available AbstractLarge fraction radiation therapy offers a shorter course of treatment and radiobiological advantages for prostate cancer treatment. The CyberKnife is an attractive technology for delivering large fraction doses based on the ability to deliver highly conformal radiation therapy to moving targets. In addition to intra-fractional translational motion (left-right, superior-inferior and anterior-posterior, prostate rotation (pitch, roll and yaw can increase geographical miss risk. We describe our experience with six-dimensional (6D intrafraction prostate motion correction using CyberKnife stereotactic body radiation therapy (SBRT. Eighty-eight patients were treated by SBRT alone or with supplemental external radiation therapy. Trans-perineal placement of four gold fiducials within the prostate accommodated X-ray guided prostate localization and beam adjustment. Fiducial separation and non-overlapping positioning permitted the orthogonal imaging required for 6D tracking. Fiducial placement accuracy was assessed using the CyberKnife fiducial extraction algorithm. Acute toxicities were assessed using Common Toxicity Criteria (CTC v3. There were no Grade 3, or higher, complications and acute morbidity was minimal. Ninety-eight percent of patients completed treatment employing 6D prostate motion tracking with intrafractional beam correction. Suboptimal fiducial placement limited treatment to 3D tracking in 2 patients. Our experience may guide others in performing 6D correction of prostate motion with CyberKnife SBRT.

Report of AAPM TG 135: quality assurance for robotic radiosurgery.

Science.gov (United States)

Dieterich, Sonja; Cavedon, Carlo; Chuang, Cynthia F; Cohen, Alan B; Garrett, Jeffrey A; Lee, Charles L; Lowenstein, Jessica R; d'Souza, Maximian F; Taylor, David D; Wu, Xiaodong; Yu, Cheng

2011-06-01

The task group (TG) for quality assurance for robotic radiosurgery was formed by the American Association of Physicists in Medicine's Science Council under the direction of the Radiation Therapy Committee and the Quality Assurance (QA) Subcommittee. The task group (TG-135) had three main charges: (1) To make recommendations on a code of practice for Robotic Radiosurgery QA; (2) To make recommendations on quality assurance and dosimetric verification techniques, especially in regard to real-time respiratory motion tracking software; (3) To make recommendations on issues which require further research and development. This report provides a general functional overview of the only clinically implemented robotic radiosurgery device, the CyberKnife. This report includes sections on device components and their individual component QA recommendations, followed by a section on the QA requirements for integrated systems. Examples of checklists for daily, monthly, annual, and upgrade QA are given as guidance for medical physicists. Areas in which QA procedures are still under development are discussed.

SU-F-T-611: Critical Analysis and Efficacy of Linac Based (Beam Modulator) and Cyberknife Treatment Plans for Acoustic Neuroma/schwannoma

International Nuclear Information System (INIS)

KP, Karrthick; Kataria, T; Thiyagarajan, R; Selvan, T; Abhishek, A

2016-01-01

Purpose: To study the critical analysis and efficacy of Linac and Cyberknife (CK) treatment plans for acoustic neuroma/schwannoma. Methods: Twelve of acoustic neuroma/schwannoma patients were taken for these study that. Treatment plans were generated in Multiplan treatment planning system (TPS) for CK using 5,7.5 and 10mm diameter collimators. Target volumes were in the range of 0.280 cc to 9.256 cc. Prescription dose (Rx) ranges from 1150cGy to 1950cGy delivered over 1 to 3 Fractions. For same patients stereotactic Volumetric modulated arc plans were generated using Elekta Linac with MLC thickness of 4mm in Monaco TPS. Appropriate calculation algorithms and grid size were used with same Rx and organ at risk (OAR) constrains for both Linac and CK plans. Treatment plans were developed to achieve at least 95% of the target volume to receive the Rx. The dosimetric indices such as conformity index (CI), coverage, OAR dose and volume receiving 50% of Rx (V50%) were used to evaluate the plans. Results: Target volumes ranges from 0.280 cc to 3.5cc shows the CI of 1.16±0.109 and 1.53±0.360 for cyberknife and Linac plans respectively. For small volume targets, the OARs were well spared in CK plans. There are no significant differences in CI and OAR doses were observed between CK and Linac plans that have the target volume >3.5 cc. Perhaps the V50% were lesser in CK plans, and found to be 12.8± 8.4 and 22.8 ± 15.0 for CK and Linac respectively. Conclusion: The analysis shows the importance of collimator size for small volume targets. The target volumes >3.5 cc can be treated in Linac as comparable with CK. For targets <3.5cc CK plans showed superior plan quality with better CI and OAR sparing than the Linac based plans. Further studies may require evaluating the clinical advantage of CK robotic system.

The Perfect Mindstorm: 4-H Robotics in Afterschool Settings

Directory of Open Access Journals (Sweden)

Dave Francis

2009-12-01

Full Text Available As the 4-H Science, Engineering and Technology (SET Mission Mandate unfolds, robotics provides an opportunity to involve youth in SET activities. Utah 4-H utilized Lego Mindstorms Robotics kits to teach youth about robotics. Evaluations demonstrated that robots increase youth’s interest in science, engineering and technology.

Variable Circular Collimator in Robotic Radiosurgery: A Time-Efficient Alternative to a Mini-Multileaf Collimator?

International Nuclear Information System (INIS)

Water, Steven van de; Hoogeman, Mischa S.; Breedveld, Sebastiaan; Nuyttens, Joost J.M.E.; Schaart, Dennis R.; Heijmen, Ben J.M.

2011-01-01

Purpose: Compared with many small circular beams used in CyberKnife treatments, beam's eye view-shaped fields are generally more time-efficient for dose delivery. However, beam's eye view-shaping devices, such as a mini-multileaf collimator (mMLC), are not presently available for CyberKnife, although a variable-aperture collimator (Iris, 12 field diameters; 5-60 mm) is available. We investigated whether the Iris can mimic noncoplanar mMLC treatments using a limited set of principal beam orientations (nodes) to produce time-efficient treatment plans. Methods and Materials: The data from 10 lung cancer patients and the beam-orientation optimization algorithm 'Cycle' were used to generate stereotactic treatment plans (3 x 20 Gy) for a CyberKnife virtually equipped with a mMLC. Typically, 10-16 favorable beam orientations were selected from 117 available robot node positions using beam's eye view-shaped fields with uniform fluence. Second, intensity-modulated Iris plans were generated by inverse optimization of nonisocentric circular candidate beams targeted from the same nodes selected in the mMLC plans. The plans were evaluated using the mean lung dose, lung volume receiving ≥20 Gy, conformality index, number of nodes, beams, and monitor units, and estimated treatment time. Results: The mMLC plans contained an average of 12 nodes and 11,690 monitor units. For a comparable mean lung dose, the Iris plans contained 12 nodes, 64 beams, and 21,990 monitor units. The estimated fraction duration was 12.2 min (range, 10.8-13.5) for the mMLC plans and 18.4 min (range, 12.9-28.5) for the Iris plans. In contrast to the mMLC plans, the treatment time for the Iris plans increased with an increasing target volume. The Iris plans were, on average, 40% longer than the corresponding mMLC plans for small targets ( 3 ) and ≤121% longer for larger targets. For a comparable conformality index, similar results were obtained. Conclusion: For stereotactic lung irradiation, time

WE-DE-BRA-11: A Study of Motion Tracking Accuracy of Robotic Radiosurgery Using a Novel CCD Camera Based End-To-End Test System

Energy Technology Data Exchange (ETDEWEB)

Wang, L; M Yang, Y [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Nelson, B [Logos Systems Intl, Scotts Valley, CA (United States)

2016-06-15

Purpose: A novel end-to-end test system using a CCD camera and a scintillator based phantom (XRV-124, Logos Systems Int’l) capable of measuring the beam-by-beam delivery accuracy of Robotic Radiosurgery (CyberKnife) was developed and reported in our previous work. This work investigates its application in assessing the motion tracking (Synchrony) accuracy for CyberKnife. Methods: A QA plan with Anterior and Lateral beams (with 4 different collimator sizes) was created (Multiplan v5.3) for the XRV-124 phantom. The phantom was placed on a motion platform (superior and inferior movement), and the plans were delivered on the CyberKnife M6 system using four motion patterns: static, Sine- wave, Sine with 15° phase shift, and a patient breathing pattern composed of 2cm maximum motion with 4 second breathing cycle. Under integral recording mode, the time-averaged beam vectors (X, Y, Z) were measured by the phantom and compared with static delivery. In dynamic recording mode, the beam spots were recorded at a rate of 10 frames/second. The beam vector deviation from average position was evaluated against the various breathing patterns. Results: The average beam position of the six deliveries with no motion and three deliveries with Synchrony tracking on ideal motion (sinewave without phase shift) all agree within −0.03±0.00 mm, 0.10±0.04, and 0.04±0.03 in the X, Y, and X directions. Radiation beam width (FWHM) variations are within ±0.03 mm. Dynamic video record showed submillimeter tracking stability for both regular and irregular breathing pattern; however the tracking error up to 3.5 mm was observed when a 15 degree phase shift was introduced. Conclusion: The XRV-124 system is able to provide 3D and 4D targeting accuracy for CyberKnife delivery with Synchrony. The experimental results showed sub-millimeter delivery in phantom with excellent correlation in target to breathing motion. The accuracy was degraded when irregular motion and phase shift was introduced.

SU-E-J-64: Feasibility Study of Surgical Clips for Fiducial Tracking in CyberKnife System

International Nuclear Information System (INIS)

Lee, H; Yoon, J; Lee, E; Cho, S; Park, K; Choi, W; Baek, J; Keum, K; Koom, W

2015-01-01

Purpose: To investigate the ability of CyberKnife to track surgical clips used as fiducial markers. Methods: The Octavius 1000SRS detector and solid water (RW3) slab phantom were used with motion platform to evaluate the study. The RW3 slab phantom was set up to measure the dose distribution from coronal plane. It consists of 9 plates and the thickness of each plate is 10mm. Among them, one plate was attached with 3 surgical clips, which are orthogonally positioned on outer region of array. The length of attached clip was represented as 1cm on planning CT. The clip plate was placed on the 1000SRS detector and 3 slabs were stacked up on the plate to build the measuring depth. Below the detector, 5 slabs were set. The two-axis motion platform was programmed with 1D sinusoidal movement (20mm peak-to-peak, 3s period) toward superior/inferior and left/right directions to simulate target motion. During delivery, two clips were extracted by two X-ray imagers, which led to translational error correction only. Synchrony was also used for dynamic tracking. After the irradiation, the measured dose distribution of coronal plane was compared with the planar dose distribution calculated by the CyberKnife treatment planning system (Multiplan) for cross verification. The results were assessed by comparing the absolute Gamma (γ) index. Results: The dose distributions measured by the 1000SRS detector were in good agreements with those calculated by Multiplan. In the dosimetric comparison using γ-function criteria based on the distance-to-agreement of 3mm and the local dose difference of 3%, the passing rate with γ- parameter ≤1 was 91% in coronal plane. Conclusion: The surgical clips can be considered as new fiducials for robotic radiosurgery delivery by considering the target margin with less than 5mm

SU-F-T-633: Cyberknife Boost Versus Conventional Tandem and Ovoid Treatment for Cervical Cancer

Energy Technology Data Exchange (ETDEWEB)

Santoro, J; Witten, M; Haas, J [Winthrop University Hospital, Lynbrook, NY (United States)

2016-06-15

Purpose: Brachytherapy has been the standard of care for cervical cancer for 100 years. The treatment can be administered using an HDR (high dose rate) remote afterloader with a {sup 192}Ir source in an outpatient setting, a PDR afterloader with a {sup 192}Ir source, or with LDR manually loaded or a remote afterloader utilizing {sup 192}Ir or {sup 137}Cs sources in an inpatient setting. The procedure involves the placement of a tandem and ovoid, tandem and ring, or tandem and cylinder applicator in an operating room setting with the patient under general anesthesia. Inaccuracies introduced into the process occurring between placement of the applicator and actual delivery can introduce uncertainty into the actual dose delivered to the tumor and critical organs. In this study we seek to investigate the dosimetric difference between an SBRT-based radiotherapy boost and conventional Brachytherapy in treating cervical cancer. Methods: Five HDR tandem and ovoid patients were planned using the Brachyvision treatment planning system and treated in four fractions using the Varian Varisource afterloader (Varian Medical Systems). For the same cohort, the patient planning CTs were imported into Multiplan (Accuray Inc) and a dose/fractionation-equivalent CyberKnife SBRT plan was retrospectively generated. Dosimetric quantities such as target/CTV D90, V90, D2cc for rectum, bladder, and bowel were measured and compared between the two modalities. Results: The CTV D90 for the tandem and ovoid was 2540cGy (90.7%) and 3009cGy (107.5%) for the CyberKnife plan. The D2cc for the rectum, bladder, and bowel were 1576cGy, 1641cGy, and 996cGy for the tandem and ovoid and 1374cGy, 1564cGy, and 1547cGy for CyberKnife. Conclusion: The D2cc doses to critical structures are comparable in both modalities. The CTV coverage is far superior for the CyberKnife plan. The dose distribution for CyberKnife has the advantage of increased conformality and lower maximum CTV dose.

Kinematics, dynamics and control design of 4WIS4WID mobile robots

Directory of Open Access Journals (Sweden)

Ming-Han Lee

2015-01-01

Full Text Available Kinematic and dynamic modelling and corresponding control design of a four-wheel-independent steering and four-wheel-independent driving (4WIS4WID mobile robot are presented in this study. Different from the differential or car-like mobile robot, the 4WIS4WID mobile robot is controlled by four steering and four driving motors, so the control scheme should possess the ability to integrate and manipulate the four independent wheels. A trajectory tracking control scheme is developed for the 4WIS4WID mobile robot, where both non-linear kinematic control and dynamic sliding-mode control are designed. All of the stabilities of the kinematic and dynamic control laws are proved by Lyapunov stability analysis. Finally, the feasibility and validity of the proposed trajectory tracking control scheme are confirmed through computer simulations.

SU-E-J-06: Additional Imaging Guidance Dose to Patient Organs Resulting From X-Ray Tubes Used in CyberKnife Image Guidance System

Energy Technology Data Exchange (ETDEWEB)

Sullivan, A; Ding, G [Vanderbilt University, Nashville, TN (United States)

2015-06-15

Purpose: The use of image-guided radiation therapy (IGRT) has become increasingly common, but the additional radiation exposure resulting from repeated image guidance procedures raises concerns. Although there are many studies reporting imaging dose from different image guidance devices, imaging dose for the CyberKnife Robotic Radiosurgery System is not available. This study provides estimated organ doses resulting from image guidance procedures on the CyberKnife system. Methods: Commercially available Monte Carlo software, PCXMC, was used to calculate average organ doses resulting from x-ray tubes used in the CyberKnife system. There are seven imaging protocols with kVp ranging from 60 – 120 kV and 15 mAs for treatment sites in the Cranium, Head and Neck, Thorax, and Abdomen. The output of each image protocol was measured at treatment isocenter. For each site and protocol, Adult body sizes ranging from anorexic to extremely obese were simulated since organ dose depends on patient size. Doses for all organs within the imaging field-of-view of each site were calculated for a single image acquisition from both of the orthogonal x-ray tubes. Results: Average organ doses were <1.0 mGy for every treatment site and imaging protocol. For a given organ, dose increases as kV increases or body size decreases. Higher doses are typically reported for skeletal components, such as the skull, ribs, or clavicles, than for softtissue organs. Typical organ doses due to a single exposure are estimated as 0.23 mGy to the brain, 0.29 mGy to the heart, 0.08 mGy to the kidneys, etc., depending on the imaging protocol and site. Conclusion: The organ doses vary with treatment site, imaging protocol and patient size. Although the organ dose from a single image acquisition resulting from two orthogonal beams is generally insignificant, the sum of repeated image acquisitions (>100) could reach 10–20 cGy for a typical treatment fraction.

Accelerated partial breast irradiation: Using the CyberKnife as the radiation delivery platform in the treatment of early breast cancer

Directory of Open Access Journals (Sweden)

Sandra eVermeulen

2011-11-01

Full Text Available We evaluate the CyberKnife (Accuray, Incorporated, Sunnyvale, CA for non-invasive delivery of accelerated partial breast irradiation (APBI in early breast cancer patients. Between 6/2009 and 5/2011, 9 patients were treated with CyberKnife APBI. Normal tissue constraints were imposed as outlined in the National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 (NSABP/RTOG Protocol (Vicini and White, 2007. Patients received a total dose of 30 Gy in 5 fractions (group 1, n=2 or 34 Gy in 10 fractions (group 2, n=7 delivered to the planning treatment volume (PTV defined as the clinical target volume (CTV + 2 mm. The CTV was defined as either the lumpectomy cavity plus 10 mm (n=2 or 15 mm (n=7. The cavity was defined by a T2-weighted non-contrast breast MRI fused to a planning non-contrast thoracic CT. The CyberKnife Synchrony system tracked gold fiducials sutured into the cavity wall during lumpectomy. Treatments started 4-5 weeks after lumpectomy. The mean PTV was 100 cm3 (range, 92-108 cm3 and 105 cm3 (range, 49-241 cm3 and the mean PTV isodose prescription line was 70% for groups 1 and 2, respectively. The mean percent of whole breast reference volume receiving 100% and 50% of the dose (V100 and V50 for group 1 was 11% (range, 8-13% and 23% (range, 16-30% and for group 2 was 11% (range, 7-14% and 26% (range, 21- 35.0% , respectively. At a median 7 months follow-up (range, 4-26 months, no acute toxicities were seen. Acute cosmetic outcomes were excellent or good in all patients; for those patients with more than 12 months follow-up the late cosmesis outcomes were excellent or good. In conclusion, the lack of observable acute side effects and current excellent/good cosmetic outcomes is promising. We believe this suggests the CyberKnife is a suitable non-invasive radiation platform for delivering APBI with achievable normal tissue constraints.

Liquid Robotics Wave Glider, Honey Badger (G3), 2015, Phytoflash

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Liquid Robotics Wave Glider, Honey Badger (G3), 2015, Phytoflash. The MAGI mission is to use the Wave Glider to sample the late summer chlorophyll bloom that...

Liquid Robotics Wave Glider, Honey Badger (G3), 2015, Weather

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Liquid Robotics Wave Glider, Honey Badger (G3), 2015, Weather. The MAGI mission is to use the Wave Glider to sample the late summer chlorophyll bloom that develops...

Liquid Robotics Wave Glider, Honey Badger (G3), 2015, Telemetry

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Liquid Robotics Wave Glider, Honey Badger (G3), 2015, Telemetry. The MAGI mission is to use the Wave Glider to sample the late summer chlorophyll bloom that develops...

Liquid Robotics Wave Glider, Honey Badger (G3), 2015, MOSE

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Liquid Robotics Wave Glider, Honey Badger (G3), 2015, MOSE. The MAGI mission is to use the Wave Glider to sample the late summer chlorophyll bloom that develops near...

Liquid Robotics Wave Glider, Honey Badger (G3), 2015, AIS

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Liquid Robotics Wave Glider, Honey Badger (G3), 2015, AIS. The MAGI mission is to use the Wave Glider to sample the late summer chlorophyll bloom that develops near...

Liquid Robotics Wave Glider, Honey Badger (G3), 2015, CTD

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Liquid Robotics Wave Glider, Honey Badger (G3), 2015, CTD. The MAGI mission is to use the Wave Glider to sample the late summer chlorophyll bloom that develops near...

TU-F-CAMPUS-T-03: A Novel Iris Quality Assurance Phantom for the CyberKnife Radiosurgery System

Energy Technology Data Exchange (ETDEWEB)

Descovich, M; Pinnaduwage, D; Sudhyadhom, A [University of California San Francisco, San Francisco, CA (United States); Nelson, B [Logos Systems Int’l, Scotts Valley, CA (United States)

2015-06-15

Purpose: A novel CCD camera and conical scintillator based phantom that is capable of measuring the targeting and field size accuracy of a robotic radiosurgery system has been developed. This work investigates its application in measuring the field sizes and beam divergence of the CyberKnife variable aperture collimator (Iris). Methods: The phantom was placed on the treatment couch and the robot position was adjusted to obtain an anterior -posterior beam perpendicular to the cone’s central axis. The FWHM of the 12 Iris apertures (5, 7.5, 10, 12.5, 15, 20, 25, 30, 35, 40, 50, and 60 mm) were measured from the beam flux map on the conical scintillator surface as seen by the CCD camera. For each measurement 30 MU were delivered to the phantom at a dose rate of 1000 MU/min. The measurements were repeated at 4 SAD distances between 75 and 85 cm. These readings were used to project the aperture size as if the flux map on the scintillator were located 80 cm from the source (SSD). These projected FWHM beam diameters were then compared to the commissioning data. Results: A series of 12 beam divergence equations were obtained from the 4 sets of data using linear trend lines on Excel scatter plots. These equations were then used to project the FWHM measurements at 80 cm SSD. The average aperture accuracy for beams from 5 through 40 mm was 0.08 mm. The accuracy for the 50 and 60 mm beams were 0.33 and 0.58 mm when compared to film commissioning data. Conclusion: The experimental results for 10 apertures agree with the stated Iris accuracy of ±0.2 mm at 80 cm SAD. The results for the 50 and 60 mm aperture were repeatable and can serve as a reliable trend indicator of any deviations away from the commissioning values. Brett Nelson is President/CTO of Logos Systems.

Kinematics and Workspace of a 4-DOF Hybrid Palletizing Robot

Directory of Open Access Journals (Sweden)

Yong Tao

2014-06-01

Full Text Available We presented the kinematical analysis of a 4-DOF hybrid palletizing robot. The palletizing robot structure was proposed and the arm model of the robot was presented. The kinematical analysis of the end robotic manipulator was given. As a result, the position, velocity, and acceleration curves as well as the maximum workspace were demonstrated by simulation in Matlab. This study would be useful for the kinematical characteristics of the 4-DOF palletizing robot in space.

Motion compensation for robotic lung tumour radiotherapy in remote locations: A personalised medicine approach

Science.gov (United States)

Ionescu, Clara M.; Copot, Cosmin; Verellen, Dirk

2017-03-01

The purpose of this work is to integrate the concept of patient-in-the-closed-loop application with tumour treatment of cancer-diagnosed patients in remote areas. The generic closed loop control objective is effective synchronisation of the radiation focus to the movement of a lung tissue tumour during actual breathing of the patient. This is facilitated by accurate repositioning of a robotic arm manipulator, i.e. we emulate the Cyberknife Robotic Radiosurgery system. Predictive control with disturbance filter is used in this application in a minimalistic model design. Performance of the control structure is validated by means of simulation using real recorded breathing patterns from patients measured in 3D space. Latency in communication protocol is taken into account, given telerobotics involve autonomous operation of a robot interacting with a human being in different location. Our results suggest that the proposed closed loop control structure has practical potential to individualise the treatment and improves accuracy by at least 15%.

Doses to organs at cerebral risks: optimization by robotized stereotaxic radiotherapy and automatic segmentation atlas versus three dimensional conformal radiotherapy

International Nuclear Information System (INIS)

Bondiau, P.Y.; Thariat, J.; Benezery, K.; Herault, J.; Dalmasso, C.; Marcie, S.; Malandain, G.

2007-01-01

The stereotaxic radiotherapy robotized by 'Cyberknife fourth generation' allows a dosimetric optimization with a high conformity index on the tumor and radiation doses limited on organs at risk. A cerebral automatic anatomic segmentation atlas of organs at risk are used in routine in three dimensions. This study evaluated the superiority of the stereotaxic radiotherapy in comparison with the three dimensional conformal radiotherapy on the preservation of organs at risk in regard of the delivered dose to tumors justifying an accelerated hypo fractionation and a dose escalation. This automatic segmentation atlas should allow to establish correlations between anatomy and cerebral dosimetry; This atlas allows to underline the dosimetry optimization by stereotaxic radiotherapy robotized for organs at risk. (N.C.)

Liquid Robotics Wave Glider, Honey Badger (G3), 2015, C3

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Liquid Robotics Wave Glider, Honey Badger (G3), 2015, C3. C3 board number 8215 (not coated) appears as board_id=32, task_id=23. C3 board number 771 (coated) appears...

SU-E-T-409: Intensity Modulated Robotic Radiotherapy

International Nuclear Information System (INIS)

Wang, B; Jin, L; Li, J; Chen, L; Ma, C; Fan, J; Zhang, C

2014-01-01

Purpose: As compared with the IRIS-based models, the MLC-based CyberKnife system allows more efficient treatment delivery due to its improved coverage of large lesions and intensity modulation. The treatment delivery efficiency is mainly determined by the number of selected nodes. This study aimed to demonstrate that relatively small sets of optimally selected nodes could produce high-quality plans. Methods: The full body path of the CyberKnife system consists of 110 nodes, from which we selected various sets for 4 prostate cancer cases using our in-house beamselection software. With the selected nodes we generated IMRT plans using our in-house beamlet-based inverse-planning optimization program. We also produced IMRT plans using the MultiPlan treatment planning system (version 5.0) for the same cases. Furthermore, the nodes selected by MultiPlan were used to produce plans with our own optimization software so that we could compare the quality of the selected sets of nodes. Results: Our beam-selection program selected one node-set for each case, with the number of nodes ranging from 23 to 34. The IMRT plans based on the selected nodes and our in-house optimization program showed adequate target coverage, with favorable critical structure sparing for the cases investigated. Compared with the plans using the nodes selected by MultiPlan, the plans generated with our selected beams provided superior rectum/bladder sparing for 75% of the cases. The plans produced by MultiPlan with various numbers of nodes also suggested that the plan quality was not compromised significantly when the number of nodes was reduced. Conclusion: Our preliminary results showed that with beamletbased planning optimization, one could produce high-quality plans with an optimal set of nodes for MLC-based robotic radiotherapy. Furthermore, our beam-selection strategy could help further improve critical structure sparing

Hematological Toxicity After Robotic Stereotactic Body Radiosurgery for Treatment of Metastatic Gynecologic Malignancies

Energy Technology Data Exchange (ETDEWEB)

Kunos, Charles A., E-mail: charles.kunos@UHhospitals.org [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Debernardo, Robert [Department of Obstetrics and Gynecology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Radivoyevitch, Tomas [Department of Epidemiology and Biostatistics, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Fabien, Jeffrey; Dobbins, Donald C.; Zhang Yuxia; Brindle, James [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)

2012-09-01

Purpose: To evaluate hematological toxicity after robotic stereotactic body radiosurgery (SBRT) for treatment of women with metastatic abdominopelvic gynecologic malignancies. Methods and Materials: A total of 61 women with stage IV gynecologic malignancies treated with abdominopelvic SBRT were analyzed after ablative radiation (2400 cGy/3 divided consecutive daily doses) delivered by a robotic-armed Cyberknife SBRT system. Abdominopelvic bone marrow was identified using computed tomography-guided contouring. Fatigue and hematologic toxicities were graded by retrospective assignment of common toxicity criteria for adverse events (version 4.0). Bone marrow volume receiving 1000 cGy (V10) was tested for association with post-therapy (median 32 days [25%-75% quartile, 28-45 days]) white- or red-cell counts, hemoglobin levels, and platelet counts as marrow toxicity surrogates. Results: In all, 61 women undergoing abdominopelvic SBRT had a median bone marrow V10 of 2% (25%-75% quartile: 0%-8%). Fifty-seven (93%) of 61 women had received at least 1 pre-SBRT marrow-taxing chemotherapy regimen for metastatic disease. Bone marrow V10 did not associate with hematological adverse events. In all, 15 grade 2 (25%) and 2 grade 3 (3%) fatigue symptoms were self-reported among the 61 women within the first 10 days post-therapy, with fatigue resolved spontaneously in all 17 women by 30 days post-therapy. Neutropenia was not observed. Three (5%) women had a grade 1 drop in hemoglobin level to <10.0 g/dL. Single grade 1, 2, and 3 thrombocytopenias were documented in 3 women. Conclusions: Abdominopelvic SBRT provided ablative radiation dose to cancer targets without increased bone marrow toxicity. Abdominopelvic SBRT for metastatic gynecologic malignancies warrants further study.

Hematological Toxicity After Robotic Stereotactic Body Radiosurgery for Treatment of Metastatic Gynecologic Malignancies

International Nuclear Information System (INIS)

Kunos, Charles A.; Debernardo, Robert; Radivoyevitch, Tomas; Fabien, Jeffrey; Dobbins, Donald C.; Zhang Yuxia; Brindle, James

2012-01-01

Purpose: To evaluate hematological toxicity after robotic stereotactic body radiosurgery (SBRT) for treatment of women with metastatic abdominopelvic gynecologic malignancies. Methods and Materials: A total of 61 women with stage IV gynecologic malignancies treated with abdominopelvic SBRT were analyzed after ablative radiation (2400 cGy/3 divided consecutive daily doses) delivered by a robotic-armed Cyberknife SBRT system. Abdominopelvic bone marrow was identified using computed tomography-guided contouring. Fatigue and hematologic toxicities were graded by retrospective assignment of common toxicity criteria for adverse events (version 4.0). Bone marrow volume receiving 1000 cGy (V10) was tested for association with post-therapy (median 32 days [25%-75% quartile, 28-45 days]) white- or red-cell counts, hemoglobin levels, and platelet counts as marrow toxicity surrogates. Results: In all, 61 women undergoing abdominopelvic SBRT had a median bone marrow V10 of 2% (25%-75% quartile: 0%-8%). Fifty-seven (93%) of 61 women had received at least 1 pre-SBRT marrow-taxing chemotherapy regimen for metastatic disease. Bone marrow V10 did not associate with hematological adverse events. In all, 15 grade 2 (25%) and 2 grade 3 (3%) fatigue symptoms were self-reported among the 61 women within the first 10 days post-therapy, with fatigue resolved spontaneously in all 17 women by 30 days post-therapy. Neutropenia was not observed. Three (5%) women had a grade 1 drop in hemoglobin level to <10.0 g/dL. Single grade 1, 2, and 3 thrombocytopenias were documented in 3 women. Conclusions: Abdominopelvic SBRT provided ablative radiation dose to cancer targets without increased bone marrow toxicity. Abdominopelvic SBRT for metastatic gynecologic malignancies warrants further study.

Intrafraction Prostate Translations and Rotations During Hypofractionated Robotic Radiation Surgery: Dosimetric Impact of Correction Strategies and Margins

Energy Technology Data Exchange (ETDEWEB)

Water, Steven van de, E-mail: s.vandewater@erasmusmc.nl [Erasmus MC Cancer Institute, Department of Radiation Oncology, Rotterdam (Netherlands); Valli, Lorella [Erasmus MC Cancer Institute, Department of Radiation Oncology, Rotterdam (Netherlands); Alma Mater Studiorum, Department of Physics and Astronomy, Bologna University, Bologna (Italy); Aluwini, Shafak [Erasmus MC Cancer Institute, Department of Radiation Oncology, Rotterdam (Netherlands); Lanconelli, Nico [Alma Mater Studiorum, Department of Physics and Astronomy, Bologna University, Bologna (Italy); Heijmen, Ben; Hoogeman, Mischa [Erasmus MC Cancer Institute, Department of Radiation Oncology, Rotterdam (Netherlands)

2014-04-01

Purpose: To investigate the dosimetric impact of intrafraction prostate motion and the effect of robot correction strategies for hypofractionated CyberKnife treatments with a simultaneously integrated boost. Methods and Materials: A total of 548 real-time prostate motion tracks from 17 patients were available for dosimetric simulations of CyberKnife treatments, in which various correction strategies were included. Fixed time intervals between imaging/correction (15, 60, 180, and 360 seconds) were simulated, as well as adaptive timing (ie, the time interval reduced from 60 to 15 seconds in case prostate motion exceeded 3 mm or 2° in consecutive images). The simulated extent of robot corrections was also varied: no corrections, translational corrections only, and translational corrections combined with rotational corrections up to 5°, 10°, and perfect rotational correction. The correction strategies were evaluated for treatment plans with a 0-mm or 3-mm margin around the clinical target volume (CTV). We recorded CTV coverage (V{sub 100%}) and dose-volume parameters of the peripheral zone (boost), rectum, bladder, and urethra. Results: Planned dose parameters were increasingly preserved with larger extents of robot corrections. A time interval between corrections of 60 to 180 seconds provided optimal preservation of CTV coverage. To achieve 98% CTV coverage in 98% of the treatments, translational and rotational corrections up to 10° were required for the 0-mm margin plans, whereas translational and rotational corrections up to 5° were required for the 3-mm margin plans. Rectum and bladder were spared considerably better in the 0-mm margin plans. Adaptive timing did not improve delivered dose. Conclusions: Intrafraction prostate motion substantially affected the delivered dose but was compensated for effectively by robot corrections using a time interval of 60 to 180 seconds. A 0-mm margin required larger extents of additional rotational corrections than a 3

Intrafraction Prostate Translations and Rotations During Hypofractionated Robotic Radiation Surgery: Dosimetric Impact of Correction Strategies and Margins

International Nuclear Information System (INIS)

Water, Steven van de; Valli, Lorella; Aluwini, Shafak; Lanconelli, Nico; Heijmen, Ben; Hoogeman, Mischa

2014-01-01

Purpose: To investigate the dosimetric impact of intrafraction prostate motion and the effect of robot correction strategies for hypofractionated CyberKnife treatments with a simultaneously integrated boost. Methods and Materials: A total of 548 real-time prostate motion tracks from 17 patients were available for dosimetric simulations of CyberKnife treatments, in which various correction strategies were included. Fixed time intervals between imaging/correction (15, 60, 180, and 360 seconds) were simulated, as well as adaptive timing (ie, the time interval reduced from 60 to 15 seconds in case prostate motion exceeded 3 mm or 2° in consecutive images). The simulated extent of robot corrections was also varied: no corrections, translational corrections only, and translational corrections combined with rotational corrections up to 5°, 10°, and perfect rotational correction. The correction strategies were evaluated for treatment plans with a 0-mm or 3-mm margin around the clinical target volume (CTV). We recorded CTV coverage (V 100% ) and dose-volume parameters of the peripheral zone (boost), rectum, bladder, and urethra. Results: Planned dose parameters were increasingly preserved with larger extents of robot corrections. A time interval between corrections of 60 to 180 seconds provided optimal preservation of CTV coverage. To achieve 98% CTV coverage in 98% of the treatments, translational and rotational corrections up to 10° were required for the 0-mm margin plans, whereas translational and rotational corrections up to 5° were required for the 3-mm margin plans. Rectum and bladder were spared considerably better in the 0-mm margin plans. Adaptive timing did not improve delivered dose. Conclusions: Intrafraction prostate motion substantially affected the delivered dose but was compensated for effectively by robot corrections using a time interval of 60 to 180 seconds. A 0-mm margin required larger extents of additional rotational corrections than a 3-mm

CyberKnife with Tumor Tracking: An Effective Treatment for High-Risk Surgical Patients with Stage I Non-Small Cell Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Chen, Viola J.; Oermann, Eric [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); Vahdat, Saloomeh [Department of Pathology, Georgetown University Hospital, Washington, DC (United States); Rabin, Jennifer; Suy, Simeng; Yu, Xia; Collins, Sean P. [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); Subramaniam, Deepa [Division of Hematology and Oncology, Georgetown University Hospital, Washington, DC (United States); Banovac, Filip [Department of Radiology, Georgetown University Hospital, Washington, DC (United States); Anderson, Eric [Division of Pulmonary, Critical Care and Sleep Medicine, Georgetown University Hospital, Washington, DC (United States); Collins, Brian T., E-mail: collinsb@gunet.georgetown.edu [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States)

2012-02-01

Published data suggests that wedge resection for stage I non-small cell lung cancer (NSCLC) is associated with improved overall survival compared to stereotactic body radiation therapy. We report CyberKnife outcomes for high-risk surgical patients with biopsy-proven stage I NSCLC. PET/CT imaging was completed for staging. Three-to-five gold fiducial markers were implanted in or near tumors to serve as targeting references. Gross tumor volumes (GTVs) were contoured using lung windows; the margins were expanded by 5 mm to establish the planning treatment volume (PTV). Treatment plans were designed using a mean of 156 pencil beams. Doses delivered to the PTV ranged from 42 to 60 Gy in three fractions. The 30 Gy isodose contour extended at least 1 cm from the GTV to eradicate microscopic disease. Treatments were delivered using the CyberKnife system with tumor tracking. Examination and PET/CT imaging occurred at 3 month follow-up intervals. Forty patients (median age 76) with a median maximum tumor diameter of 2.6 cm (range, 1.4–5.0 cm) and a mean post-bronchodilator percent predicted forced expiratory volume in 1 s (FEV1) of 57% (range, 21–111%) were treated. A median dose of 48 Gy was delivered to the PTV over 3–13 days (median, 7 days). The 30 Gy isodose contour extended a mean 1.9 cm from the GTV. At a median 44 months (range, 12–72 months) follow-up, the 3 year Kaplan–Meier locoregional control and overall survival estimates compare favorably with contemporary wedge resection outcomes at 91 and 75%, respectively. CyberKnife is an effective treatment approach for stage I NSCLC that is similar to wedge resection, eradicating tumors with 1–2 cm margins in order to preserve lung function. Prospective randomized trials comparing CyberKnife with wedge resection are necessary to confirm equivalence.

SU-F-T-538: CyberKnife with MLC for Treatment of Large Volume Tumors: A Feasibility Study

Energy Technology Data Exchange (ETDEWEB)

Bichay, T; Mayville, A [Mercy Health, Saint Mary’s, Grand Rapids, MI (United States)

2016-06-15

Purpose: CyberKnife is a well-documented modality for SRS and SBRT treatments. Typical tumors are small and 1–5 fractions are usually used. We determined the feasibility of using CyberKnife, with an InCise multileaf collimator option, for larger tumors undergoing standard dose and fractionation. The intent was to understand the limitation of using this modality for other external beam radiation treatments. Methods: Five tumors from different anatomical sites with volumes from 127.8 cc to 1,320.5 cc were contoured and planned on a Multiplan V5.1 workstation. The target average diameter ranged from 7 cm to 13 cm. The dose fractionation was 1.8–2.0 Gy/fraction and 25–45 fractions for total doses of 45–81 Gy. The sites planned were: pancreas, head and neck, prostate, anal, and esophagus. The plans were optimized to meet conventional dose constraints based on various RTOG protocols for conventional fractionation. Results: The Multiplan treatment planning system successfully generated clinically acceptable plans for all sites studied. The resulting dose distributions achieved reasonable target coverage, all greater than 95%, and satisfactory normal tissue sparing. Treatment times ranged from 9 minutes to 38 minutes, the longest being a head and neck plan with dual targets receiving different doses and with multiple adjacent critical structures. Conclusion: CyberKnife, with the InCise multileaf collimation option, can achieve acceptable dose distributions in large volume tumors treated with conventional dose and fractionation. Although treatment times are greater than conventional accelerator time; target coverage and dose to critical structures can be kept within a clinically acceptable range. While time limitations exist, when necessary CyberKnife can provide an alternative to traditional treatment modalities for large volume tumors.

SU-F-SPS-10: The Dosimetric Comparison of GammaKnife and Cyberknife Treatment Plans for Brain SRS Treatment

International Nuclear Information System (INIS)

Sanli, E; Mabhouti, H; Cebe, M; Codel, G; Pacaci, P; Serin, E; Kucuk, N; Kucukmorkoc, E; Doyuran, M; Canoglu, D; Altinok, A; Acar, H; Caglar Ozkok, H

2016-01-01

Purpose: Brain stereotactic radiosurgery (SRS) involves the use of precisely directed, single session radiation to create a desired radiobiologic response within the brain target with acceptable minimal effects on surrounding structures or tissues. In this study, the dosimetric comparison of GammaKnife perfection and Cyberknife M6 treatment plans were made. Methods: Treatment plannings were done for GammaKnife perfection unit using Gammaplan treatment planning system (TPS) on the CT scan of head and neck randophantom simulating the treatment of sterotactic treatments for one brain metastasis. The dose distribution were calculated using TMR 10 algorithm. The treatment planning for the same target were also done for Cyberknife M6 machine using Multiplan (TPS) with Monte Carlo algorithm. Using the same film batch, the net OD to dose calibration curve was obtained using both machine by delivering 0- 800 cGy. Films were scanned 48 hours after irradiation using an Epson 1000XL flatbed scanner. Dose distribution were measured using EBT3 film dosimeter. The measured and calculated doses were compared. Results: The dose distribution in the target and 2 cm beyond the target edge were calculated on TPSs and measured using EBT3 film. For cyberknife treatment plans, the gamma analysis passing rates between measured and calculated dose distributions were 99.2% and 96.7% for target and peripheral region of target respectively. For gammaknife treatment plans, the gamma analysis passing rates were 98.9% and 93.2% for target and peripheral region of target respectively. Conclusion: The study shows that dosimetrically comparable plans are achievable with Cyberknife and GammaKnife. Although TMR 10 algorithm predicts the target dose

SU-F-SPS-10: The Dosimetric Comparison of GammaKnife and Cyberknife Treatment Plans for Brain SRS Treatment

Energy Technology Data Exchange (ETDEWEB)

Sanli, E; Mabhouti, H; Cebe, M; Codel, G; Pacaci, P; Serin, E; Kucuk, N; Kucukmorkoc, E; Doyuran, M; Canoglu, D; Altinok, A; Acar, H; Caglar Ozkok, H [Medipol University, Istanbul, Istanbul (Turkey)

2016-06-15

Purpose: Brain stereotactic radiosurgery (SRS) involves the use of precisely directed, single session radiation to create a desired radiobiologic response within the brain target with acceptable minimal effects on surrounding structures or tissues. In this study, the dosimetric comparison of GammaKnife perfection and Cyberknife M6 treatment plans were made. Methods: Treatment plannings were done for GammaKnife perfection unit using Gammaplan treatment planning system (TPS) on the CT scan of head and neck randophantom simulating the treatment of sterotactic treatments for one brain metastasis. The dose distribution were calculated using TMR 10 algorithm. The treatment planning for the same target were also done for Cyberknife M6 machine using Multiplan (TPS) with Monte Carlo algorithm. Using the same film batch, the net OD to dose calibration curve was obtained using both machine by delivering 0- 800 cGy. Films were scanned 48 hours after irradiation using an Epson 1000XL flatbed scanner. Dose distribution were measured using EBT3 film dosimeter. The measured and calculated doses were compared. Results: The dose distribution in the target and 2 cm beyond the target edge were calculated on TPSs and measured using EBT3 film. For cyberknife treatment plans, the gamma analysis passing rates between measured and calculated dose distributions were 99.2% and 96.7% for target and peripheral region of target respectively. For gammaknife treatment plans, the gamma analysis passing rates were 98.9% and 93.2% for target and peripheral region of target respectively. Conclusion: The study shows that dosimetrically comparable plans are achievable with Cyberknife and GammaKnife. Although TMR 10 algorithm predicts the target dose.

Accuracy of Robotic Radiosurgical Liver Treatment Throughout the Respiratory Cycle

International Nuclear Information System (INIS)

Winter, Jeff D.; Wong, Raimond; Swaminath, Anand; Chow, Tom

2015-01-01

Purpose: To quantify random uncertainties in robotic radiosurgical treatment of liver lesions with real-time respiratory motion management. Methods and Materials: We conducted a retrospective analysis of 27 liver cancer patients treated with robotic radiosurgery over 118 fractions. The robotic radiosurgical system uses orthogonal x-ray images to determine internal target position and correlates this position with an external surrogate to provide robotic corrections of linear accelerator positioning. Verification and update of this internal–external correlation model was achieved using periodic x-ray images collected throughout treatment. To quantify random uncertainties in targeting, we analyzed logged tracking information and isolated x-ray images collected immediately before beam delivery. For translational correlation errors, we quantified the difference between correlation model–estimated target position and actual position determined by periodic x-ray imaging. To quantify prediction errors, we computed the mean absolute difference between the predicted coordinates and actual modeled position calculated 115 milliseconds later. We estimated overall random uncertainty by quadratically summing correlation, prediction, and end-to-end targeting errors. We also investigated relationships between tracking errors and motion amplitude using linear regression. Results: The 95th percentile absolute correlation errors in each direction were 2.1 mm left–right, 1.8 mm anterior–posterior, 3.3 mm cranio–caudal, and 3.9 mm 3-dimensional radial, whereas 95th percentile absolute radial prediction errors were 0.5 mm. Overall 95th percentile random uncertainty was 4 mm in the radial direction. Prediction errors were strongly correlated with modeled target amplitude (r=0.53-0.66, P<.001), whereas only weak correlations existed for correlation errors. Conclusions: Study results demonstrate that model correlation errors are the primary random source of uncertainty

SU-G-JeP3-08: Robotic System for Ultrasound Tracking in Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Kuhlemann, I [University of Luebeck, Luebeck (Germany); Graduate School for Computing in Medicine and Life Sciences, University of Luebeck (Germany); Jauer, P; Schweikard, A; Ernst, F [University of Luebeck, Luebeck (Germany)

2016-06-15

Purpose: For safe and accurate real-time tracking of tumors for IGRT using 4D ultrasound, it is necessary to make use of novel, high-end force-sensitive lightweight robots designed for human-machine interaction. Such a robot will be integrated into an existing robotized ultrasound system for non-invasive 4D live tracking, using a newly developed real-time control and communication framework. Methods: The new KUKA LWR iiwa robot is used for robotized ultrasound real-time tumor tracking. Besides more precise probe contact pressure detection, this robot provides an additional 7th link, enhancing the dexterity of the kinematic and the mounted transducer. Several integrated, certified safety features create a safe environment for the patients during treatment. However, to remotely control the robot for the ultrasound application, a real-time control and communication framework has to be developed. Based on a client/server concept, client-side control commands are received and processed by a central server unit and are implemented by a client module running directly on the robot’s controller. Several special functionalities for robotized ultrasound applications are integrated and the robot can now be used for real-time control of the image quality by adjusting the transducer position, and contact pressure. The framework was evaluated looking at overall real-time capability for communication and processing of three different standard commands. Results: Due to inherent, certified safety modules, the new robot ensures a safe environment for patients during tumor tracking. Furthermore, the developed framework shows overall real-time capability with a maximum average latency of 3.6 ms (Minimum 2.5 ms; 5000 trials). Conclusion: The novel KUKA LBR iiwa robot will advance the current robotized ultrasound tracking system with important features. With the developed framework, it is now possible to remotely control this robot and use it for robotized ultrasound tracking

SU-G-JeP3-08: Robotic System for Ultrasound Tracking in Radiation Therapy

International Nuclear Information System (INIS)

Kuhlemann, I; Jauer, P; Schweikard, A; Ernst, F

2016-01-01

Purpose: For safe and accurate real-time tracking of tumors for IGRT using 4D ultrasound, it is necessary to make use of novel, high-end force-sensitive lightweight robots designed for human-machine interaction. Such a robot will be integrated into an existing robotized ultrasound system for non-invasive 4D live tracking, using a newly developed real-time control and communication framework. Methods: The new KUKA LWR iiwa robot is used for robotized ultrasound real-time tumor tracking. Besides more precise probe contact pressure detection, this robot provides an additional 7th link, enhancing the dexterity of the kinematic and the mounted transducer. Several integrated, certified safety features create a safe environment for the patients during treatment. However, to remotely control the robot for the ultrasound application, a real-time control and communication framework has to be developed. Based on a client/server concept, client-side control commands are received and processed by a central server unit and are implemented by a client module running directly on the robot’s controller. Several special functionalities for robotized ultrasound applications are integrated and the robot can now be used for real-time control of the image quality by adjusting the transducer position, and contact pressure. The framework was evaluated looking at overall real-time capability for communication and processing of three different standard commands. Results: Due to inherent, certified safety modules, the new robot ensures a safe environment for patients during tumor tracking. Furthermore, the developed framework shows overall real-time capability with a maximum average latency of 3.6 ms (Minimum 2.5 ms; 5000 trials). Conclusion: The novel KUKA LBR iiwa robot will advance the current robotized ultrasound tracking system with important features. With the developed framework, it is now possible to remotely control this robot and use it for robotized ultrasound tracking

Direct tumor in vivo dosimetry in highly-conformal radiotherapy: A feasibility study of implantable MOSFETs for hypofractionated extracranial treatments using the Cyberknife system

International Nuclear Information System (INIS)

Scalchi, Paolo; Righetto, Roberto; Cavedon, Carlo; Francescon, Paolo; Colombo, Federico

2010-01-01

further calibration factors to be applied. The final accuracy of implantable MOSFETs when used for such kind of treatments was estimated to be within ±4%. Additional investigations using dose/fraction higher than 12 Gy, different beam configurations, and tracking systems could extend the present findings to other kind of treatments. MOSFET technology was proven to have high versatility in fast adaptation of existing detectors to new applications. It is plausible to expect a general feasibility of implantable MOSFET technology for in vivo dosimetry of the extracranial-targets treatments using the Cyberknife, provided each particular application will be validated by suitable both physical and clinical studies.

Quality assurance for an image-guided frameless radiosurgery system using radiochromic film

International Nuclear Information System (INIS)

Shiomi, Hiroya; Inoue, Takehiro; Nakamura, Satoaki; Inoue, Toshihiko

2000-01-01

The CyberKnife, a new type of machine for stereotactic irradiation, is composed of a combination of a robot (manipulator) and a linear accelerator. We measured the total pointing error of the therapy beam, aiming at improvement in the accuracy of the CyberKnife. The CyberKnife keeps a number of coordinate systems such as the patient's coordinates, robotic coordinates, and IPS (image processing system) coordinates. Precise irradiation is possible if these coordinate systems are matched accurately. We always calculate the overall irradiation error using GAF MD-55 radiochromic film before irradiation treatment of the patient, and we have attempted to improve the accuracy of irradiation with the CyberKnife by feeding back the errors. The median of the error immediately after introducing the CyberKnife was 1.2 mm, and as a result of correction, we succeeded in reducing the error to 0.7 mm (median). Total pointing error after correction was significantly lower than that before correction (p=0.0023). This approach allowed us to reduce errors and establish a method for providing patients with highly accurate stereotactic irradiation. We believe these results endorse the validity of the method presented in this paper. (author)

CyberKnife with tumor tracking: An effective alternative to wedge resection for high-risk surgical patients with stage I non-small cell lung cancer (NSCLC

Directory of Open Access Journals (Sweden)

Sean eCollins

2012-02-01

Full Text Available Published data suggests that wedge resection for stage I NSCLC results in improved overall survival compared to stereotactic body radiation therapy (SBRT. We report CyberKnife outcomes for high-risk surgical patients with biopsy-proven stage I NSCLC. PET/CT imaging was completed for staging. Three-to-five gold fiducial markers were implanted in or near tumors to serve as targeting references. Gross tumor volumes (GTVs were contoured using lung windows; the margins were expanded by 5 mm to establish the planning treatment volume (PTV. Treatment plans were designed using hundreds of pencil beams. Doses delivered to the PTV ranged from 42-60 Gy in 3 fractions. The 30-Gy isodose contour extended at least 1cm from the GTV to eradicate microscopic disease. Treatments were delivered using the CyberKnife system with tumor tracking. Examination and PET/CT imaging occurred at 3-month follow-up intervals. Forty patients (median age 76 with a median maximum tumor diameter of 2.6 cm (range, 1.4-5.0 cm and a mean post-bronchodilator percent predicted forced expiratory volume in 1 second (FEV1 of 57% (range, 21 - 111% were treated. A mean dose of 50 Gy was delivered to the PTV over 3 to 13 days (median, 7 days. The 30-Gy isodose contour extended a mean 1.9 cm from the GTV. At a median 44 months (range, 12 -72 months follow-up, the 3-year Kaplan-Meier locoregional control and overall survival estimates compare favorably with contemporary wedge resection outcomes at 91% and 75% , respectively. CyberKnife is an effective treatment approach for stage I NSCLC that is similar to wedge resection, eradicating tumors with 1 to 2 cm margins in order to preserve lung function. Prospective randomized trials comparing CyberKnife with wedge resection are necessary to confirm equivalence.

Peripheral doses in patients undergoing Cyberknife treatment for intracranial lesions. A single centre experience

International Nuclear Information System (INIS)

Vlachopoulou, Vassiliki; Antypas, Christos; Delis, Harry; Tzouras, Argyrios; Salvaras, Nikolaos; Kardamakis, Dimitrios; Panayiotakis, George

2011-01-01

Stereotactic radiosurgery/radiotherapy procedures are known to deliver a very high dose per fraction, and thus, the corresponding peripheral dose could be a limiting factor for the long term surviving patients. The aim of this clinical study was to measure the peripheral dose delivered to patients undergoing intracranial Cyberknife treatment, using the MOSFET dosimeters. The influence of the supplemental shielding, the number of monitor units and the collimator size to the peripheral dose were investigated. MOSFET dosimeters were placed in preselected anatomical regions of the patient undergoing Cyberknife treatment, namely the thyroid gland, the nipple, the umbilicus and the pubic symphysis. The mean peripheral doses before the supplemental shielding was added to the Cyberknife unit were 51.79 cGy, 13.31 cGy and 10.07 cGy while after the shielding upgrade they were 38.40 cGy, 10.94 cGy, and 8.69 cGy, in the thyroid gland, the umbilicus and the pubic symphysis, respectively. The increase of the collimator size corresponds to an increase of the PD and becomes less significant at larger distances, indicating that at these distances the PD is predominate due to the head leakage and collimator scatter. Weighting the effect of the number of monitor units and the collimator size can be effectively used during the optimization procedure in order to choose the most suitable treatment plan that will deliver the maximum dose to the tumor, while being compatible with the dose constraints for the surrounding organs at risk. Attention is required in defining the thyroid gland as a structure of avoidance in the treatment plan especially in patients with benign diseases

A cross sectional review of patient information available in the World Wide Web on CyberKnife: fallacies and pitfalls.

Science.gov (United States)

Menon, Durgapoorna; Chelakkot, Prameela G; Sunil, Devika; Lakshmaiah, Ashwini

2017-12-01

The purpose of this study is to assess the quality of videos available in YouTube on CyberKnife. The term "CyberKnife" was input into the search window of www.youtube.com on a specific date and the first 50 videos were assessed for technical and content issues. The data was tabulated and analysed. The search yielded 32,300 videos in 0.33 s. Among the first 50 analysed, most were professional videos, mostly on CyberKnife in general and for brain tumours. Most of the videos did not mention anything about patient selection or lesion size. The other technical details were covered by most although they seemed muffled by the animations. Many patient videos were recordings of one entire treatment, thus giving future patients an insight on what to expect. Almost half the videos projected glorified views about the treatment technique. The company videos were reasonably accurate and well presented as were many institutional videos, although there was a tendency to gloss over a few points. The glorification of the treatment technique was a disturbing finding. The profound trust of the patients on the health care system is humbling.

Lung tumor tracking during stereotactic radiotherapy treatment with the CyberKnife: Marker placement and early results

International Nuclear Information System (INIS)

Nuyttens, J.J.; Prevost, J.B.; Praag, J.; Hoogeman, M.; Levendag, P.C.; Klaveren, R.J. van; Pattynama, P.M.T.

2006-01-01

Lung tumor tracking during stereotactic radiotherapy with the CyberKnife requires the insertion of markers in or close to the tumor. To reduce the risk of pneumothorax, three methods of marker placement were used: 1) intravascular coil placement, 2) percutaneous intrathoracal, and 3) percutaneous extrathoracal placement. We investigated the toxicity of marker placement and the tumor response of the lung tumor tracking treatment. Markers were placed in 20 patients with 22 tumors: 13 patients received a curative treatment, seven a palliative. The median Charlson Comorbidity Score was 4 (range: 1-8). Platinum fiducials and intravascular embolisation coils were used as markers. In total, 78 markers were placed: 34 intrathoracal, 23 intravascular and 21 extrathoracal. The PTV equaled the GTV + 5 mm. A median dose of 45 Gy (range: 30-60 Gy, in 3 fractions) was prescribed to the 70-85% isodose. The response was evaluated with a CTscan performed 6-8 weeks after the last treatment and routinely thereafter. The median follow-up was 4 months (range: 2-11). No severe toxicity due to the marker placement was seen. Pneumothorax was not seen. The local control was 100%. Four tumors in four patients showed a complete response, 15 tumors in 14 patients a partial response, and three tumors in two patients with metastatic disease had stable disease. No severe toxicity of marker placement was seen due to the appropriate choice of one of the three methods. CyberKnife tumor tracking with markers is feasible and resulted in excellent tumor response. Longer follow-up is needed to validate the local control

Extracranial Facial Nerve Schwannoma Treated by Hypo-fractionated CyberKnife Radiosurgery

OpenAIRE

Sasaki, Ayaka; Miyazaki, Shinichiro; Hori, Tomokatsu

2016-01-01

Facial nerve schwannoma is a rare intracranial tumor. Treatment for this benign tumor has been controversial. Here, we report a case of extracranial facial nerve schwannoma treated successfully by hypo-fractionated CyberKnife (Accuray, Sunnyvale, CA) radiosurgery?and discuss the efficacy of this treatment. A 34-year-old female noticed a swelling in her right mastoid process. The lesion enlarged over a seven-month period, and she experienced facial spasm on the right side. She was diagnosed wi...

TH-AB-201-05: Determining the Direction Distribution of the Primary Radiation for a Cyberknife-M6

International Nuclear Information System (INIS)

Henzen, D; Schmidhalter, D; Volken, W; Mackeprang, P-H; Malthaner, M; K Fix, M; Manser, P; C Zanella, C

2016-01-01

Purpose: Radiation protection regulatory differentiates between primary and scatter radiation. Whereas for conventional clinical linear accelerators the solid angle for primary radiation is planar, the Cyberknife (Accuray Inc., Sunnyvale, CA) may point its beam in all spatial directions. In order to be able to judge on radiation protection calculations for a Cyberknife-M6 vault, the direction distribution for delivered plans was evaluated based on clinical experiences. Methods: The log-files of 121 delivered patient treatment plans were exported, divided into cranial and extra-cranial treatments and the delivered monitor units (MU) together with the corresponding beam directions were analyzed. This MU-weighted spatial distribution was then projected to a 9.5 × 5.9 × 3.9 m 3 vault, generating an “intensity map” using a binning of 50 × 50 cm 2 . The factor of direction (FOD) is reported as a fraction of the total applied MUs to the walls, ceiling and floor in the perspective of a patient lying in head-first-supine position on the couch. In this study, the term intFOD refers to the integral FOD and maxFOD refers to the maximal FOD for a single bin. Results: For all kind of treatments and collimators, intFOD and maxFOD for the wall behind the patient’s head is 0.0. The intFOD for the floor varies between 0.65 and 0.74. For the ceiling, maxFOD is 0.002 and 0.0 for cranial and extra-cranial cases, respectively. The intFOD for the wall at the patient’s feet, is 0.094 for cranial and 0.005 for extra-cranial cases. There is nearly no difference between the maxFOD of the right and left wall for cranial cases, whereas for extra-cranial cases these numbers differ by a factor of 1.75. Conclusion: The varying FODs for the Cyberknife were quantified based on delivered treatment plans. These findings are helpful regarding the design of Cyberknife vaults.

Peripheral doses in patients undergoing Cyberknife treatment for intracranial lesions. A single centre experience

Directory of Open Access Journals (Sweden)

Vlachopoulou Vassiliki

2011-11-01

Full Text Available Abstract Background Stereotactic radiosurgery/radiotherapy procedures are known to deliver a very high dose per fraction, and thus, the corresponding peripheral dose could be a limiting factor for the long term surviving patients. The aim of this clinical study was to measure the peripheral dose delivered to patients undergoing intracranial Cyberknife treatment, using the MOSFET dosimeters. The influence of the supplemental shielding, the number of monitor units and the collimator size to the peripheral dose were investigated. Methods MOSFET dosimeters were placed in preselected anatomical regions of the patient undergoing Cyberknife treatment, namely the thyroid gland, the nipple, the umbilicus and the pubic symphysis. Results The mean peripheral doses before the supplemental shielding was added to the Cyberknife unit were 51.79 cGy, 13.31 cGy and 10.07 cGy while after the shielding upgrade they were 38.40 cGy, 10.94 cGy, and 8.69 cGy, in the thyroid gland, the umbilicus and the pubic symphysis, respectively. The increase of the collimator size corresponds to an increase of the PD and becomes less significant at larger distances, indicating that at these distances the PD is predominate due to the head leakage and collimator scatter. Conclusion Weighting the effect of the number of monitor units and the collimator size can be effectively used during the optimization procedure in order to choose the most suitable treatment plan that will deliver the maximum dose to the tumor, while being compatible with the dose constraints for the surrounding organs at risk. Attention is required in defining the thyroid gland as a structure of avoidance in the treatment plan especially in patients with benign diseases.

Phase II clinical trial of robotic stereotactic body radiosurgery for metastatic gynecologic malignancies

Directory of Open Access Journals (Sweden)

Charles eKunos

2012-12-01

Full Text Available Background Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT in women with metastatic gynecologic cancers. Methods A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4 metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses. Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0. SBRT target responses were recorded following RECIST criteria (version 1.0. Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan-Meier method and the Cox proportional hazards model was used to control for prognostic variables.Findings SBRT was safely delivered, with 49 (98% of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%, nausea (8% and diarrhea (4%. One (2% grade 4 hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients. A 6-month clinical benefit was recorded in 34 (68% [95% CI, 53.2, 80.1] patients. No SBRT-targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62% patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6. Median overall survival was 20.2 months (95% CI, 10.9, 29.5.Interpretation SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway.Funding Case Comprehensive Cancer Center

Use of novel fibre-coupled radioluminescence and RADPOS dosimetry systems for total scatter factor measurements in small fields

DEFF Research Database (Denmark)

Ploquin, N.; Kertzscher, Gustavo; Vandervoort, E.

2015-01-01

A dosimetry system based on Al2O3:C radioluminescence (RL), and RADPOS, a novel 4D dosimetry system using microMOSFETs, were used to measure total scatter factors, (Sc,p)fclindet, for the CyberKnife robotic radiosugery system. New Monte Carlo calculated correction factors are presented and applied...

Robotic 4D ultrasound solution for real-time visualization and teleoperation

Directory of Open Access Journals (Sweden)

Al-Badri Mohammed

2017-09-01

Full Text Available Automation of the image acquisition process via robotic solutions offer a large leap towards resolving ultrasound’s user-dependency. This paper, as part of a larger project aimed to develop a multipurpose 4d-ultrasonic force-sensitive robot for medical applications, focuses on achieving real-time remote visualisation for 4d ultrasound image transfer. This was possible through implementing our software modification on a GE Vivid 7 Dimension workstation, which operates a matrix array probe controlled by a KUKA LBR iiwa 7 7-DOF robotic arm. With the help of robotic positioning and the matrix array probe, fast volumetric imaging of target regions was feasible. By testing ultrasound volumes, which were roughly 880 kB in size, while using gigabit Ethernet connection, a latency of ∼57 ms was achievable for volume transfer between the ultrasound station and a remote client application, which as a result allows a frame count of 17.4 fps. Our modification thus offers for the first time real-time remote visualization, recording and control of 4d ultrasound data, which can be implemented in teleoperation.

Phase II Clinical Trial of Robotic Stereotactic Body Radiosurgery for Metastatic Gynecologic Malignancies

Energy Technology Data Exchange (ETDEWEB)

Kunos, Charles A.; Brindle, James [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University, School of Medicine, Cleveland, OH (United States); Waggoner, Steven; Zanotti, Kristine; Resnick, Kimberly; Fusco, Nancy; Adams, Ramon; Debernardo, Robert, E-mail: charles.kunos@uhhospitals.org [Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center and Case Western Reserve University, School of Medicine, Cleveland, OH (United States)

2012-12-05

Background: Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT) in women with metastatic gynecologic cancers. Methods: A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4) metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses). Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0). SBRT target responses were recorded following RECIST criteria (version 1.0). Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan–Meier method and the Cox proportional hazards model was used to control for prognostic variables. Findings: SBRT was safely delivered, with 49 (98%) of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%), nausea (8%), and diarrhea (4%). One (2%) grade four hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients). A 6-month clinical benefit was recorded in 34 [68% (95% CI, 53.2, 80.1)] patients. No SBRT targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62%) patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6). Median overall survival was 20.2 months (95% CI, 10.9, 29.5). Interpretation: SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway. Funding: Case Comprehensive Cancer Center.

Phase II Clinical Trial of Robotic Stereotactic Body Radiosurgery for Metastatic Gynecologic Malignancies

International Nuclear Information System (INIS)

Kunos, Charles A.; Brindle, James; Waggoner, Steven; Zanotti, Kristine; Resnick, Kimberly; Fusco, Nancy; Adams, Ramon; Debernardo, Robert

2012-01-01

Background: Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT) in women with metastatic gynecologic cancers. Methods: A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4) metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses). Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0). SBRT target responses were recorded following RECIST criteria (version 1.0). Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan–Meier method and the Cox proportional hazards model was used to control for prognostic variables. Findings: SBRT was safely delivered, with 49 (98%) of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%), nausea (8%), and diarrhea (4%). One (2%) grade four hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients). A 6-month clinical benefit was recorded in 34 [68% (95% CI, 53.2, 80.1)] patients. No SBRT targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62%) patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6). Median overall survival was 20.2 months (95% CI, 10.9, 29.5). Interpretation: SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway. Funding: Case Comprehensive Cancer Center.

TH-AB-201-07: Filmless Treatment Localization QA for the CyberKnife System

Energy Technology Data Exchange (ETDEWEB)

Gersh, J [Gibbs Cancer Center & Research Institute - Pelham, Greer, SC (United States); Spectrum Medical Physics, LLC, Greenville, SC (United States); Noll, M [Accuray Incorporated, Sunnyvale, CA (United States)

2016-06-15

Purpose: Accuray recommends daily evaluation of the treatment localization and delivery systems (TLS/TDS) of the CyberKnife. The vendor-provided solution is a Winston-Lutz-type test that evaluates film shadows from an orthogonal beam pair (known as AQA). Since film-based techniques are inherently inefficient and potentially inconsistent and uncertain, this study explores a method which provides a comparable test with greater efficiency, consistency, and certainty. This test uses the QAStereoChecker (QASC, Standard Imaging, Inc., Middleton, WI), a high-resolution flat-panel detector with coupled fiducial markers for automated alignment. Fiducial tracking is used to achieve high translational and rotational position accuracy. Methods: A plan is generated delivering five circular beams, with varying orientation and angular incidence. Several numeric quantities are calculated for each beam: eccentricity, centroid location, area, major-axis length, minor-axis length, and orientation angle. Baseline values were acquired and repeatability of baselines analyzed. Next, errors were induced in the path calibration of the CK, and the test repeated. A correlative study was performed between the induced errors and quantities measured using the QASC. Based on vendor recommendations, this test should be able to detect a TLS/TDS offset of 0.5mm. Results: Centroid shifts correlated well with induced plane-perpendicular offsets (p < 0.01). Induced vertical shifts correlated best with the absolute average deviation of eccentricities (p < 0.05). The values of these metrics which correlated with the threshold of 0.5mm induced deviation were used as individual pass/fail criteria. These were then used to evaluate induced offsets which shifted the CK in all axes (a clinically-realistic offset), with a total offset of 0.5mm. This test provided high and specificity and sensitivity. Conclusion: From setup to analysis, this filmless TLS/TDS test requires 4 minutes, as opposed to 15–20

TH-AB-201-07: Filmless Treatment Localization QA for the CyberKnife System

International Nuclear Information System (INIS)

Gersh, J; Noll, M

2016-01-01

Purpose: Accuray recommends daily evaluation of the treatment localization and delivery systems (TLS/TDS) of the CyberKnife. The vendor-provided solution is a Winston-Lutz-type test that evaluates film shadows from an orthogonal beam pair (known as AQA). Since film-based techniques are inherently inefficient and potentially inconsistent and uncertain, this study explores a method which provides a comparable test with greater efficiency, consistency, and certainty. This test uses the QAStereoChecker (QASC, Standard Imaging, Inc., Middleton, WI), a high-resolution flat-panel detector with coupled fiducial markers for automated alignment. Fiducial tracking is used to achieve high translational and rotational position accuracy. Methods: A plan is generated delivering five circular beams, with varying orientation and angular incidence. Several numeric quantities are calculated for each beam: eccentricity, centroid location, area, major-axis length, minor-axis length, and orientation angle. Baseline values were acquired and repeatability of baselines analyzed. Next, errors were induced in the path calibration of the CK, and the test repeated. A correlative study was performed between the induced errors and quantities measured using the QASC. Based on vendor recommendations, this test should be able to detect a TLS/TDS offset of 0.5mm. Results: Centroid shifts correlated well with induced plane-perpendicular offsets (p < 0.01). Induced vertical shifts correlated best with the absolute average deviation of eccentricities (p < 0.05). The values of these metrics which correlated with the threshold of 0.5mm induced deviation were used as individual pass/fail criteria. These were then used to evaluate induced offsets which shifted the CK in all axes (a clinically-realistic offset), with a total offset of 0.5mm. This test provided high and specificity and sensitivity. Conclusion: From setup to analysis, this filmless TLS/TDS test requires 4 minutes, as opposed to 15–20

Predictive factors for the response of pulmonary tumours treated by robotic stereotactic radiotherapy; Facteurs predictifs pour la reponse des tumeurs pulmonaires traitees par radiotherapie stereotaxique robotisee

Energy Technology Data Exchange (ETDEWEB)

Doyen, J.; Benezery, K.; Thariat, J.; Angellier, G.; Poudenx, M.; Bondiau, P.Y. [Centre Antoine-Lacassagne, 06 - Nice (France); Beckendorf, V. [Centre Alexis-Vautrin, 54 - Nancy (France); Venissac, N. [Centre hospitalo-universitaire Pasteur, 06 - Nice (France)

2010-10-15

The authors report a study which aimed at identifying factors influencing the response to radiotherapy performed in robotic stereotactic conditions with CyberKnife within the frame of treatment of primitive or secondary pulmonary tumours. Thirty eight stage I cancers, 22 metastases including 17 epidermoid carcinomas, and 43 adenocarcinomas have been treated this way. The analysis of data and results reveals that feminine gender, a biological dose greater than 140 Gy, and an age greater than 65 year old are associated with a better tumour response. Short communication

Prostate-specific antigen kinetics after primary stereotactic body radiation therapy using CyberKnife for localized prostate cancer

Directory of Open Access Journals (Sweden)

Yong Hyun Park

2015-03-01

Conclusions: PSA decline occurred rapidly in the first month, and then the rate of PSA decline fell off steadily over time throughout 2 years after treatment. Also, SBRT using CyberKnife leads to long-term favorable BCR-free survival in localized prostate cancer.

Characteristics and performance of the first commercial multileaf collimator for a robotic radiosurgery system

Energy Technology Data Exchange (ETDEWEB)

Fürweger, Christoph, E-mail: christoph.fuerweger@cyber-knife.net [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam 3075 EA, The Netherlands and European CyberKnife Center Munich, Munich 81377 (Germany); Prins, Paulette; Coskan, Harun; Heijmen, Ben J. M. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam 3075 EA (Netherlands)

2016-05-15

Purpose: The “InCise™ multileaf-collimator (MLC)” is the first commercial MLC to be mounted on a robotic SRS/SBRT platform (CyberKnife). The authors assessed characteristics and performance of this novel device in a preclinical five months test period. Methods: Commissioning beam data were acquired with unshielded diodes. EBT3 radiochromic films were employed for measurement of transmission, leaf/bank position accuracy (garden fence) before and after exercising the MLC, for end-to-end testing and further characterization of the beam. The robot workspace with MLC was assessed analytically by transformation to an Euler geometry (“plane,” “gantry,” and “collimator” angles) and by measuring pointing accuracy at each node. Stability over time was evaluated in picket fence and adapted Winston–Lutz tests (AQA). Results: Beam penumbrae (80%–20%, with 100% = 2 × dose at inflection point for field sizes ≥ 50 × 50 mm{sup 2}) were 2.2–3.7 mm for square fields in reference condition (source-axis-distance 800 mm, depth 15 mm) and depended on field size and off-axis position. Transmission and leakage did not exceed 0.5%. Accessible clinical workspace with MLC covered non-coplanar gantry angles of [−113°; +112°] and collimator angles of [−100°; +107°], with an average robot pointing accuracy of 0.12 ± 0.09 mm. For vertical beams, garden fence tests exhibited an average leaf positioning error of ≤0.2 mm, which increased by 0.25 and 0.30 mm (banks X1 and X2) with leaves traveling parallel to gravity. After execution of a leaf motion stress routine, garden fence tests showed slightly increased jaggedness and allowed to identify one malfunctioning leaf motor. Total system accuracy with MLC was 0.38 ± 0.05 mm in nine end-to-end tests. Picket fence and AQA tests displayed stable results over the test period. Conclusions: The InCise™ MLC for CyberKnife showed high accuracy and adequate characteristics for SRS/SBRT applications. MLC performance

Characteristics and performance of the first commercial multileaf collimator for a robotic radiosurgery system

International Nuclear Information System (INIS)

Fürweger, Christoph; Prins, Paulette; Coskan, Harun; Heijmen, Ben J. M.

2016-01-01

Purpose: The “InCise™ multileaf-collimator (MLC)” is the first commercial MLC to be mounted on a robotic SRS/SBRT platform (CyberKnife). The authors assessed characteristics and performance of this novel device in a preclinical five months test period. Methods: Commissioning beam data were acquired with unshielded diodes. EBT3 radiochromic films were employed for measurement of transmission, leaf/bank position accuracy (garden fence) before and after exercising the MLC, for end-to-end testing and further characterization of the beam. The robot workspace with MLC was assessed analytically by transformation to an Euler geometry (“plane,” “gantry,” and “collimator” angles) and by measuring pointing accuracy at each node. Stability over time was evaluated in picket fence and adapted Winston–Lutz tests (AQA). Results: Beam penumbrae (80%–20%, with 100% = 2 × dose at inflection point for field sizes ≥ 50 × 50 mm"2) were 2.2–3.7 mm for square fields in reference condition (source-axis-distance 800 mm, depth 15 mm) and depended on field size and off-axis position. Transmission and leakage did not exceed 0.5%. Accessible clinical workspace with MLC covered non-coplanar gantry angles of [−113°; +112°] and collimator angles of [−100°; +107°], with an average robot pointing accuracy of 0.12 ± 0.09 mm. For vertical beams, garden fence tests exhibited an average leaf positioning error of ≤0.2 mm, which increased by 0.25 and 0.30 mm (banks X1 and X2) with leaves traveling parallel to gravity. After execution of a leaf motion stress routine, garden fence tests showed slightly increased jaggedness and allowed to identify one malfunctioning leaf motor. Total system accuracy with MLC was 0.38 ± 0.05 mm in nine end-to-end tests. Picket fence and AQA tests displayed stable results over the test period. Conclusions: The InCise™ MLC for CyberKnife showed high accuracy and adequate characteristics for SRS/SBRT applications. MLC performance after

4th International Conference on Robot Intelligence Technology and Applications

CERN Document Server

Karray, Fakhri; Jo, Jun; Sincak, Peter; Myung, Hyun

2017-01-01

This book covers all aspects of robot intelligence from perception at sensor level and reasoning at cognitive level to behavior planning at execution level for each low level segment of the machine. It also presents the technologies for cognitive reasoning, social interaction with humans, behavior generation, ability to cooperate with other robots, ambience awareness, and an artificial genome that can be passed on to other robots. These technologies are to materialize cognitive intelligence, social intelligence, behavioral intelligence, collective intelligence, ambient intelligence and genetic intelligence. The book aims at serving researchers and practitioners with a timely dissemination of the recent progress on robot intelligence technology and its applications, based on a collection of papers presented at the 4th International Conference on Robot Intelligence Technology and Applications (RiTA), held in Bucheon, Korea, December 14 - 16, 2015. For better readability, this edition has the total of 49 article...

Which level of treatment quality can be obtained by a robotized irradiation system conducted by image in radiotherapy (CyberKnifeTM)

International Nuclear Information System (INIS)

Al Khawaja, S.

2011-01-01

The CyberKnife TM consists of a 6 MV LINAC mounted on a robotic arm, with six degree of freedom and is coupled to an image guiding system, allowing us to guide the irradiation beams toward the target. The aim is to improve the treatment accuracy and to reduce the irradiation of critical surrounding organs. The treatment is realized by the isotropic convergence of hundreds of orientations for creating up to 1200 mini-beams, which are orientated to the target with sub-millimetric accuracy. This group is completed by a treatment couch, which is also mounted on a robotized arm, that offers 6 additional degrees of freedom, allowing an additional improvement of accuracy, and eliminates the possible limitations. Using its subsystem Synchrony TM , the CyberKnife TM is capable of treating the abdo-thoracic tumors, which move with respiration, by moving dynamically the LINAC to compensate the respiratory motion of the tumors. The high dose level, which is used in this kind of hypo-fractionated treatment, makes the smallest error unacceptable, and needs a very high geometric accuracy with keeping a maximal dosimetric accuracy. Our work is dedicated to evaluate the quality of treatment, in the terms of dosimetric and geometric accuracies. For the different modes of tracking, which are available in the system in static mode, and dynamic mode with respiratory motion tracking. By using different kinds of detectors (ionization chambers, radiochromic films) and three different platforms, which allow simulating simple respiratory motion, real respiratory motion coming from real treated patients, and finally complex motion with hysteresis. The results show clearly the high dosimetric accuracy of the system; this is accompanied by a sub-millimetric geometric accuracy. This geometric accuracy degrades slightly, when treating in dynamic mode with respiratory tracking by Synchrony TM , and especially when the respiratory cycles show a high variation in amplitudes, while the dosimetric

Histopathology of IgG4-Related Autoimmune Hepatitis and IgG4-Related Hepatopathy in IgG4-Related Disease.

Science.gov (United States)

Nakanuma, Yasuni; Ishizu, Yoji; Zen, Yoh; Harada, Kenichi; Umemura, Takeji

2016-08-01

Immunoglobulin G4-related disease (IgG4-RD) is a systemic disease involving many organs; it includes IgG4-related sclerosing cholangitis and inflammatory pseudotumor in the hepatobiliary system. Two types of hepatic parenchymal involvement have been reported in IgG4-RD: IgG4-related autoimmune hepatitis (AIH) and IgG4-hepatopathy. Moreover, only three cases of IgG4-related AIH have been reported. Immunoglobulin G4-related AIH is clinicopathologically similar to AIH, except for an elevated serum IgG4 level and heavy infiltration of IgG4-positive plasma cells in the liver tissue. Interestingly, IgG4-related AIH can be complicated by well-known IgG4-RD(s). Immunoglobulin G4-hepatopathy, which includes various histopathological lesions encountered in the liver of patients with type I autoimmune pancreatitis, is classified into five histological categories: portal inflammation, large bile duct damage, portal sclerosis, lobular hepatitis, and cholestasis. Immunoglobulin G4-hepatopathy is currently a collective term covering hepatic lesions primarily or secondarily related to IgG4-related sclerosing cholangitis and type 1 autoimmune pancreatitis. In conclusion, the liver is not immune to IgG4-RD, and at least two types of hepatic involvement in IgG4-RD have been reported: IgG4-related AIH and IgG4-hepatopathy. Additional studies are required to clarify their precise clinical significance with respect to IgG4-RD and inherent liver diseases. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Directory of Open Access Journals (Sweden)

Olusola eOBAYOMI-DAVIES

2016-05-01

Full Text Available 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 rationale for SAPBI delivery using the CyberKnife radiosurgery system.Methods: Ten patients completed CyberKnife SAPBI in 2013 at Georgetown University Hospital. Four gold fiducials were implanted around the lumpectomy cavity prior to treatment under ultrasound guidance. The synchrony system tracked intrafraction motion of the fiducials. The clinical target volume (CTV was defined on contrast enhanced CT scans using surgical clips and post-operative changes. A 5 mm expansion was added to create the planning treatment volume (PTV. A total dose of 30 Gy was delivered to the PTV in 5 consecutive fractions. Target and critical structure doses were assessed as per the National Surgical Adjuvant Breast and Bowel Project B-39 study.Results: At least 3 fiducials were tracked in 100% of cases. The Mean treated PTV was 70 cm3 and the mean prescription isodose line was 80%. Mean dose to target volumes and constraints are as follows: 100% of the PTV received the prescription dose (PTV30. The volume of the ipsilateral breast receiving 30 Gy (V30 and above 15 Gy (V>15 was 14% and 31% respectively. The ipsilateral lung volume receiving 9 Gy (V9 was 3% and the contralateral lung volume receiving 1.5 Gy (V1.5 was 8%. For left sided breast cancers, the volume of heart receiving 1.5 Gy (V1.5 was 31%. Maximum skin dose was 36 Gy. At a median follow up of 1.3 years, all patients have experienced excellent/good breast cosmesis outcomes, and no breast events have been recorded

Dosimetric Implications of Residual Tracking Errors During Robotic SBRT of Liver Metastases

Energy Technology Data Exchange (ETDEWEB)

Chan, Mark [Department for Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel (Germany); Tuen Mun Hospital, Hong Kong (China); Grehn, Melanie [Department for Radiation Oncology, University Medical Center Schleswig-Holstein, Lübeck (Germany); Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck (Germany); Cremers, Florian [Department for Radiation Oncology, University Medical Center Schleswig-Holstein, Lübeck (Germany); Siebert, Frank-Andre [Department for Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel (Germany); Wurster, Stefan [Saphir Radiosurgery Center Northern Germany, Güstrow (Germany); Department for Radiation Oncology, University Medicine Greifswald, Greifswald (Germany); Huttenlocher, Stefan [Saphir Radiosurgery Center Northern Germany, Güstrow (Germany); Dunst, Jürgen [Department for Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel (Germany); Department for Radiation Oncology, University Clinic Copenhagen, Copenhagen (Denmark); Hildebrandt, Guido [Department for Radiation Oncology, University Medicine Rostock, Rostock (Germany); Schweikard, Achim [Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck (Germany); Rades, Dirk [Department for Radiation Oncology, University Medical Center Schleswig-Holstein, Lübeck (Germany); Ernst, Floris [Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck (Germany); and others

2017-03-15

Purpose: Although the metric precision of robotic stereotactic body radiation therapy in the presence of breathing motion is widely known, we investigated the dosimetric implications of breathing phase–related residual tracking errors. Methods and Materials: In 24 patients (28 liver metastases) treated with the CyberKnife, we recorded the residual correlation, prediction, and rotational tracking errors from 90 fractions and binned them into 10 breathing phases. The average breathing phase errors were used to shift and rotate the clinical tumor volume (CTV) and planning target volume (PTV) for each phase to calculate a pseudo 4-dimensional error dose distribution for comparison with the original planned dose distribution. Results: The median systematic directional correlation, prediction, and absolute aggregate rotation errors were 0.3 mm (range, 0.1-1.3 mm), 0.01 mm (range, 0.00-0.05 mm), and 1.5° (range, 0.4°-2.7°), respectively. Dosimetrically, 44%, 81%, and 92% of all voxels differed by less than 1%, 3%, and 5% of the planned local dose, respectively. The median coverage reduction for the PTV was 1.1% (range in coverage difference, −7.8% to +0.8%), significantly depending on correlation (P=.026) and rotational (P=.005) error. With a 3-mm PTV margin, the median coverage change for the CTV was 0.0% (range, −1.0% to +5.4%), not significantly depending on any investigated parameter. In 42% of patients, the 3-mm margin did not fully compensate for the residual tracking errors, resulting in a CTV coverage reduction of 0.1% to 1.0%. Conclusions: For liver tumors treated with robotic stereotactic body radiation therapy, a safety margin of 3 mm is not always sufficient to cover all residual tracking errors. Dosimetrically, this translates into only small CTV coverage reductions.

Dosimetric Implications of Residual Tracking Errors During Robotic SBRT of Liver Metastases

International Nuclear Information System (INIS)

Chan, Mark; Grehn, Melanie; Cremers, Florian; Siebert, Frank-Andre; Wurster, Stefan; Huttenlocher, Stefan; Dunst, Jürgen; Hildebrandt, Guido; Schweikard, Achim; Rades, Dirk; Ernst, Floris

2017-01-01

Purpose: Although the metric precision of robotic stereotactic body radiation therapy in the presence of breathing motion is widely known, we investigated the dosimetric implications of breathing phase–related residual tracking errors. Methods and Materials: In 24 patients (28 liver metastases) treated with the CyberKnife, we recorded the residual correlation, prediction, and rotational tracking errors from 90 fractions and binned them into 10 breathing phases. The average breathing phase errors were used to shift and rotate the clinical tumor volume (CTV) and planning target volume (PTV) for each phase to calculate a pseudo 4-dimensional error dose distribution for comparison with the original planned dose distribution. Results: The median systematic directional correlation, prediction, and absolute aggregate rotation errors were 0.3 mm (range, 0.1-1.3 mm), 0.01 mm (range, 0.00-0.05 mm), and 1.5° (range, 0.4°-2.7°), respectively. Dosimetrically, 44%, 81%, and 92% of all voxels differed by less than 1%, 3%, and 5% of the planned local dose, respectively. The median coverage reduction for the PTV was 1.1% (range in coverage difference, −7.8% to +0.8%), significantly depending on correlation (P=.026) and rotational (P=.005) error. With a 3-mm PTV margin, the median coverage change for the CTV was 0.0% (range, −1.0% to +5.4%), not significantly depending on any investigated parameter. In 42% of patients, the 3-mm margin did not fully compensate for the residual tracking errors, resulting in a CTV coverage reduction of 0.1% to 1.0%. Conclusions: For liver tumors treated with robotic stereotactic body radiation therapy, a safety margin of 3 mm is not always sufficient to cover all residual tracking errors. Dosimetrically, this translates into only small CTV coverage reductions.

Preliminary experience of extra-skull radiotherapy in stereotaxic conditions by Cyberknife at the Alexis-Vautrin Centre; Experience preliminaire de radiotherapie en conditions stereoxaques extracranienne par Cyberknife au centre Alexis-Vautrin

Energy Technology Data Exchange (ETDEWEB)

Peiffert, D.; Beckendorf, V.; Marchesi, V.; Noel, A. [Centre Alexis Vautrin, 54 - Vandoeuvre les Nancy (France); Noel, G. [Centre Paul Strauss, 67 -Strasbourg (France); Maingon, P. [Centre Georges Francois Leclerc, 21 - Dijon (France); Bosset, J.F. [Centre Hospitalier Universitaire, 25 - Besancon (France); Unterreiner, M. [Centre Francois Baclesse, 14 - Caen (France)

2007-11-15

The objective of this study is to evaluate the feasibility of the Cyberknife use for extra cerebral tumors by dint of' x.sight' osseous location for para-spinous lesions and 'tracking synchrony' for mobile targets. In conclusion, a training curve is necessary for the patients selection and the treatment implementation. The implantation and follow-up of the pellets need a trained team. A good cooperation of the patient is necessary; the carcinological follow-up will be analyzed ulteriorly. (N.C.)

Robot Futures

DEFF Research Database (Denmark)

Christoffersen, Anja; Grindsted Nielsen, Sally; Jochum, Elizabeth Ann

Robots are increasingly used in health care settings, e.g., as homecare assistants and personal companions. One challenge for personal robots in the home is acceptance. We describe an innovative approach to influencing the acceptance of care robots using theatrical performance. Live performance...... is a useful testbed for developing and evaluating what makes robots expressive; it is also a useful platform for designing robot behaviors and dialogue that result in believable characters. Therefore theatre is a valuable testbed for studying human-robot interaction (HRI). We investigate how audiences...... perceive social robots interacting with humans in a future care scenario through a scripted performance. We discuss our methods and initial findings, and outline future work....

Zero-G experimental validation of a robotics-based inertia identification algorithm

Science.gov (United States)

Bruggemann, Jeremy J.; Ferrel, Ivann; Martinez, Gerardo; Xie, Pu; Ma, Ou

2010-04-01

The need to efficiently identify the changing inertial properties of on-orbit spacecraft is becoming more critical as satellite on-orbit services, such as refueling and repairing, become increasingly aggressive and complex. This need stems from the fact that a spacecraft's control system relies on the knowledge of the spacecraft's inertia parameters. However, the inertia parameters may change during flight for reasons such as fuel usage, payload deployment or retrieval, and docking/capturing operations. New Mexico State University's Dynamics, Controls, and Robotics Research Group has proposed a robotics-based method of identifying unknown spacecraft inertia properties1. Previous methods require firing known thrusts then measuring the thrust, and the velocity and acceleration changes. The new method utilizes the concept of momentum conservation, while employing a robotic device powered by renewable energy to excite the state of the satellite. Thus, it requires no fuel usage or force and acceleration measurements. The method has been well studied in theory and demonstrated by simulation. However its experimental validation is challenging because a 6- degree-of-freedom motion in a zero-gravity condition is required. This paper presents an on-going effort to test the inertia identification method onboard the NASA zero-G aircraft. The design and capability of the test unit will be discussed in addition to the flight data. This paper also introduces the design and development of an airbearing based test used to partially validate the method, in addition to the approach used to obtain reference value for the test system's inertia parameters that can be used for comparison with the algorithm results.

Plan delivery quality assurance for CyberKnife: Statistical process control analysis of 350 film-based patient-specific QAs.

Science.gov (United States)

Bellec, J; Delaby, N; Jouyaux, F; Perdrieux, M; Bouvier, J; Sorel, S; Henry, O; Lafond, C

2017-07-01

Robotic radiosurgery requires plan delivery quality assurance (DQA) but there has never been a published comprehensive analysis of a patient-specific DQA process in a clinic. We proposed to evaluate 350 consecutive film-based patient-specific DQAs using statistical process control. We evaluated the performance of the process to propose achievable tolerance criteria for DQA validation and we sought to identify suboptimal DQA using control charts. DQAs were performed on a CyberKnife-M6 using Gafchromic-EBT3 films. The signal-to-dose conversion was performed using a multichannel-correction and a scanning protocol that combined measurement and calibration in a single scan. The DQA analysis comprised a gamma-index analysis at 3%/1.5mm and a separate evaluation of spatial and dosimetric accuracy of the plan delivery. Each parameter was plotted on a control chart and control limits were calculated. A capability index (Cpm) was calculated to evaluate the ability of the process to produce results within specifications. The analysis of capability showed that a gamma pass rate of 85% at 3%/1.5mm was highly achievable as acceptance criteria for DQA validation using a film-based protocol (Cpm>1.33). 3.4% of DQA were outside a control limit of 88% for gamma pass-rate. The analysis of the out-of-control DQA helped identify a dosimetric error in our institute for a specific treatment type. We have defined initial tolerance criteria for DQA validations. We have shown that the implementation of a film-based patient-specific DQA protocol with the use of control charts is an effective method to improve patient treatment safety on CyberKnife. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Exploratorium: Robots.

Science.gov (United States)

Brand, Judith, Ed.

2002-01-01

This issue of Exploratorium Magazine focuses on the topic robotics. It explains how to make a vibrating robotic bug and features articles on robots. Contents include: (1) "Where Robot Mice and Robot Men Run Round in Robot Towns" (Ray Bradbury); (2) "Robots at Work" (Jake Widman); (3) "Make a Vibrating Robotic Bug" (Modesto Tamez); (4) "The Robot…

Improved robotic stereotactic body radiation therapy plan quality and planning efficacy for organ-confined prostate cancer utilizing overlap-volume histogram-driven planning methodology

International Nuclear Information System (INIS)

Wu, Binbin; Pang, Dalong; Lei, Siyuan; Gatti, John; Tong, Michael; McNutt, Todd; Kole, Thomas; Dritschilo, Anatoly; Collins, Sean

2014-01-01

Background and purpose: This study is to determine if the overlap-volume histogram (OVH)-driven planning methodology can be adapted to robotic SBRT (CyberKnife Robotic Radiosurgery System) to further minimize the bladder and rectal doses achieved in plans manually-created by clinical planners. Methods and materials: A database containing clinically-delivered, robotic SBRT plans (7.25 Gy/fraction in 36.25 Gy) of 425 patients with localized prostate cancer was used as a cohort to establish an organ’s distance-to-dose model. The OVH-driven planning methodology was refined by adding the PTV volume factor to counter the target’s dose fall-off effect and incorporated into Multiplan to automate SBRT planning. For validation, automated plans (APs) for 12 new patients were generated, and their achieved dose/volume values were compared to the corresponding manually-created, clinically-delivered plans (CPs). A two-sided, Wilcoxon rank-sum test was used for statistical comparison with a significance level of p < 0.05. Results: PTV’s V(36.25 Gy) was comparable: 95.6% in CPs comparing to 95.1% in APs (p = 0.2). On average, the refined approach lowered V(18.12 Gy) to the bladder and rectum by 8.2% (p < 0.05) and 6.4% (p = 0.14). A physician confirmed APs were clinically acceptable. Conclusions: The improvements in APs could further reduce toxicities observed in SBRT for organ-confined prostate cancer

SU-F-T-598: Robotic Radiosurgery System Versus Pencil Beam Scanning Proton Therapy for Definitive Intracranial Treatments

International Nuclear Information System (INIS)

Lin, M; Pompos, A; Gu, X; Yan, Y; Abdulrahman, R; Timmerman, R; Jiang, S

2016-01-01

Purpose: To characterize the dose distributions of Cyberknife and intensity-modulated-proton-therapy (IMPT). Methods: A total of 20 patients previously treated with Cyberknife were selected. The original planning-target-volume (PTV) was used in the ‘IMPT-ideal’ plan assuming a comparable image-guidance with Cyberknife. A 3mm expansion was made to create the proton-PTV for the ‘IMPT-3mm’ plan representing the current proton-therapy where a margin of 3mm is used to account for the inferior image-guidance. The proton range uncertainty was taken-care in beam-design by adding the proximal- and distal-margins (3%water-equivalent-depth+1mm) for both proton plans. The IMPT plans were generated to meet the same target coverage as the Cyberknife-plans. The plan quality of IMPT-ideal and IMPT-3mm were compared to the Cyberknife-plan. To characterize plan quality, we defined the ratio(R) of volumes encompassed by the selected isodose surfaces for Cyberknife and IMPT plans (VCK/VIMPT). Comparisons were made for both Cyberknife versus IMPT-ideal and Cyberknife versusIMPT-3mm to further discuss the impact of setup error margins used in proton therapy and the correlation with target size and location. Results: IMPT-ideal plans yield comparable plan quality as CK plans and slightly better OAR sparing while the IMPT-3mm plan results in a higher dose to the OARs, especially for centralized tumors. Comparing to the IMPT-ideal plans, a slightly larger 80% (Ravg=1.05) dose cloud and significantly larger 50% (Ravg=1.3) and 20% (Ravg=1.60) dose clouds are seen in CK plans. However, the 3mm expansion results in a larger high and medium dose clouds in IMPT-3mm plans (Ravg=0.65 for 80%-isodose; Ravg=0.93 for 50%-isodose). The trend increases with the size of the target and the distance from the brainstem to the center of target. Conclusion: Cyberknife is more preferable for treating centralized targets and proton therapy is advantageous for the large and peripheral targets. Advanced

SU-F-T-598: Robotic Radiosurgery System Versus Pencil Beam Scanning Proton Therapy for Definitive Intracranial Treatments

Energy Technology Data Exchange (ETDEWEB)

Lin, M; Pompos, A; Gu, X; Yan, Y; Abdulrahman, R; Timmerman, R; Jiang, S [UT Southwestern Medical Center, Dallas, TX (United States)

2016-06-15

Purpose: To characterize the dose distributions of Cyberknife and intensity-modulated-proton-therapy (IMPT). Methods: A total of 20 patients previously treated with Cyberknife were selected. The original planning-target-volume (PTV) was used in the ‘IMPT-ideal’ plan assuming a comparable image-guidance with Cyberknife. A 3mm expansion was made to create the proton-PTV for the ‘IMPT-3mm’ plan representing the current proton-therapy where a margin of 3mm is used to account for the inferior image-guidance. The proton range uncertainty was taken-care in beam-design by adding the proximal- and distal-margins (3%water-equivalent-depth+1mm) for both proton plans. The IMPT plans were generated to meet the same target coverage as the Cyberknife-plans. The plan quality of IMPT-ideal and IMPT-3mm were compared to the Cyberknife-plan. To characterize plan quality, we defined the ratio(R) of volumes encompassed by the selected isodose surfaces for Cyberknife and IMPT plans (VCK/VIMPT). Comparisons were made for both Cyberknife versus IMPT-ideal and Cyberknife versusIMPT-3mm to further discuss the impact of setup error margins used in proton therapy and the correlation with target size and location. Results: IMPT-ideal plans yield comparable plan quality as CK plans and slightly better OAR sparing while the IMPT-3mm plan results in a higher dose to the OARs, especially for centralized tumors. Comparing to the IMPT-ideal plans, a slightly larger 80% (Ravg=1.05) dose cloud and significantly larger 50% (Ravg=1.3) and 20% (Ravg=1.60) dose clouds are seen in CK plans. However, the 3mm expansion results in a larger high and medium dose clouds in IMPT-3mm plans (Ravg=0.65 for 80%-isodose; Ravg=0.93 for 50%-isodose). The trend increases with the size of the target and the distance from the brainstem to the center of target. Conclusion: Cyberknife is more preferable for treating centralized targets and proton therapy is advantageous for the large and peripheral targets. Advanced

JPRS Report, Science & Technology, Japan, 4th Intelligent Robots Symposium, Volume 1

Science.gov (United States)

1989-03-16

Robots 43064062 Tokyo 4TH INTELLIGENT ROBOTS SYMPOSIUM PAPERS in Japanese 13/14 Jun 88 No 106 pp 39-44 [Article by H. Kimura , I. Shimoyama, and H. Miura...pp 237-239. 3. K. Kondo and F. Kimura , "High-Speed Orbit Planning Based on Labyrinthine Method," Ibid., pp 261-262. 4. T. Hasegawa, "Planning of...Satoshi Okada, Kazuhiro Tsumura, Hisashi Hozeki, Katsumi Kubo, and Akira Abe, Toshiba Corporation] [Text] 1. Introduction In recent years, the

Serum IgG2 and tissue IgG2 plasma cell elevation in orbital IgG4-related disease (IgG4-RD): Potential use in IgG4-RD assessment.

Science.gov (United States)

Chan, Anita S Y; Mudhar, Hardeep; Shen, Sunny Yu; Lang, Stephanie S; Fernando, Malee; Hilmy, Maryam Hazly; Guppy, Naomi Jayne; Rennie, Ian; Dunkley, Lisa; Al Jajeh, Issam

2017-11-01

To determine the role of serum and tissue IgG2 in orbital biopsies with the histological features of IgG4-related disease (IgG4-RD) in comparison with non-IgG4-related orbital inflammatory disorders (OID), including autoimmune disorders. This is an international (Sheffield, UK, and Singapore) collaborative, retrospective case review of 69 patients (38 from Singapore National Eye Centre and 31 from Royal Hallamshire Hospital, Sheffield) with orbital inflammatory biopsies between 2002 and 2016. Clinical information and histology were reviewed and cases were classified into three groups: Group 1: IgG4-RD orbital inflammation (n=43); Group 2: idiopathic OID (n=12) and Group 3: autoimmune OID (n=14). Serum IgG1, IgG2, IgG3 and IgG4 levels were collated where available and immunohistochemistry (IHC) for tissue IgG2 plasma cells was performed. Dual IHC showed IgG2 plasma cells as a distinct population from IgG4 plasma cells. Significant (twofold) serum IgG2 elevation was noted among IgG4-RD (group 1), idiopathic (group 2) and autoimmune OID (group 3). Similarly, significant elevation of tissue IgG2 plasma cells was also seen among IgG4-RD (group 1), idiopathic and autoimmune OID (groups 2 and 3). Significant elevations of serum IgG2 and tissue IgG2 plasma cells are present in orbital IgG4-RD in comparison with non-IgG4 orbital inflammation (idiopathic and autoimmune OID), suggesting that IgG2 may play a role in IgG4-RD. A serum IgG2 cut-off >5.3 g/L was found to be 80% sensitive and 91.7% specific for orbital IgG4-RD, with an accuracy of 0.90. Tissue IgG2 and IgG4 subclass reporting may provide additional insight regarding the 'IgG4-RD' pathogenesis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

4th International Conference on Advanced Robotics

CERN Document Server

1989-01-01

The Fourth International Conference on Advanced Robotics was held in Columbus, Ohio, U. S. A. on June 13th to 15th, 1989. The first two conferences in this series were held in Tokyo. The third was held in Versailles, France in October 1987. The International Conference on Advanced Robotics is affiliated with the International Federation of Robotics. This conference was sponsored by The Ohio State University. The American Society of Mechanical Engineers was a cooperating co-sponsor. The objective of the International Conference on Advanced Robotics is to provide an international exchange of information on the topic of advanced robotics. This was adopted as one of the themes for international research cooperation at a meeting of representatives of seven industrialized countries held in Williamsburg, U. S. A. in May 1983. The present conference is truly international in character with contributions from authors of twelve countries. (Bulgaria, Canada, France, Great Britain, India, Italy, Japan, Peoples Republic o...

Stormram 4: An MR Safe Robotic System for Breast Biopsy.

Science.gov (United States)

Groenhuis, Vincent; Siepel, Françoise J; Veltman, Jeroen; van Zandwijk, Jordy K; Stramigioli, Stefano

2018-05-21

Suspicious lesions in the breast that are only visible on magnetic resonance imaging (MRI) need to be biopsied under MR guidance with high accuracy and efficiency for accurate diagnosis. The aim of this study is to present a novel robotic system, the Stormram 4, and to perform preclinical tests in an MRI environment. Excluding racks and needle, its dimensions are 72 × 51 × 40 mm. The Stormram 4 is driven by two linear and two curved pneumatic stepper motors. The linear motor is capable of exerting 63 N of force at a pressure of 0.65 MPa. In an MRI environment the maximum observed stepping frequency is 30 Hz (unloaded), or 8 Hz when full force is needed. The Stormram 4's mean positioning error is 0.73 ± 0.47 mm in free air, and 1.29 ± 0.59 mm when targeting breast phantoms in MRI. Excluding the off-the-shelf needle, the robot is inherently MR safe. The robot is able to accurately target lesions under MRI guidance, reducing tissue damage and risk of false negatives. These results are promising for clinical experiments, improving the quality of healthcare in the field of MRI-guided breast biopsies.

Cutoff Values of Serum IgG4 and Histopathological IgG4+ Plasma Cells for Diagnosis of Patients with IgG4-Related Disease

Directory of Open Access Journals (Sweden)

Yasufumi Masaki

2012-01-01

Full Text Available IgG4-related disease is a new disease classification established in Japan in the 21st century. Patients with IgG4-related disease display hyper-IgG4-gammaglobulinemia, massive infiltration of IgG4+ plasma cells into tissue, and good response to glucocorticoids. Since IgG4 overexpression is also observed in other disorders, it is necessary to diagnose IgG4-related disease carefully and correctly. We therefore sought to determine cutoff values for serum IgG4 and IgG4/IgG and for IgG4+/IgG+ plasma cells in tissue diagnostic of IgG4-related disease. Patients and Methods. We retrospectively analyzed serum IgG4 concentrations and IgG4/IgG ratio and IgG4+/IgG+ plasma cell ratio in tissues of 132 patients with IgG4-related disease and 48 patients with other disorders. Result. Serum IgG4 >135  mg/dl demonstrated a sensitivity of 97.0% and a specificity of 79.6% in diagnosing IgG4-related disease, and serum IgG4/IgG ratios >8% had a sensitivity and specificity of 95.5% and 87.5%, respectively. IgG4+cell/IgG+ cell ratio in tissues >40% had a sensitivity and specificity of 94.4% and 85.7%, respectively. However, the number of IgG4+ cells was reduced in severely fibrotic parts of tissues. Conclusion. Although a recent unanimous consensus of all relevant researchers in Japan recently established the diagnostic criteria for IgG4-related disease, findings such as ours indicate that further discussion is needed.

IgG4 Cholangiopathy

Directory of Open Access Journals (Sweden)

Yoh Zen

2012-01-01

Full Text Available IgG4 cholangiopathy can involve any level of the biliary tree which exhibits sclerosing cholangitis or pseudotumorous hilar lesions. Most cases are associated with autoimmune pancreatitis, an important diagnostic clue. Without autoimmune pancreatitis, however, the diagnosis of IgG4-cholangiopathy is challenging. Indeed such cases have been treated surgically. IgG4-cholangiopathy should be diagnosed based on serological examinations including serum IgG4 concentrations, radiological features, and histological evidence of IgG4+ plasma cell infiltration. Steroid therapy is very effective even at disease relapse. A Th2-dominant immune response or the activation of regulatory T cells seems to be involved in the underlying immune reaction. It is still unknown why IgG4 levels are specifically elevated in patients with this disease. IgG4 might be secondarily overexpressed by Th2 or regulatory cytokines given the lack of evidence that IgG4 is an autoantibody.

IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy.

Science.gov (United States)

Li, Dujuan; Kan, Yunzhen; Fu, Fangfang; Wang, Shuhuan; Shi, Ligang; Liu, Jie; Kong, Lingfei

2015-01-01

Immunoglobulin G4-related disease (IgG4-RD) is a recently described inflammatory disease involving multiple organs. Prostate involvement with IgG4-RD is very rare. In this report, we describe a case of IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy. This patient was present with urine retention symptoms. MRI and CT examination revealed the prostatic enlargement and the multiple lymphadenopathy. Serum IgG4 levels were elevated. Prostatic tissue samples resected both this time and less than 1 year earlier showed the same histological type of prostatitis with histopathologic and immunohistochemical findings characteristic of IgG4-RD. The right submandibular lymph nodes excised 2 years earlier were eventually proven to be follicular hyperplasia-type IgG4-related lymphadenopathy. This is the first case of IgG4-RD that began as localized IgG4-related lymphadenopathy and progressed into a systemic disease involving prostate and multiple lymph nodes. This patient showed a good response to steroid therapy. This leads us to advocate a novel pathogenesis of prostatitis, and a novel therapeutic approach against prostatitis. Pathologists and urologists should consider this disease entity in the patients with elevated serum IgG4 levels and the symptoms of prostatic hyperplasia to avoid ineffective medical or unnecessary surgical treatment.

A Retrospective Comparison of Robotic Stereotactic Body Radiotherapy and Three-Dimensional Conformal Radiotherapy for the Reirradiation of Locally Recurrent Nasopharyngeal Carcinoma

International Nuclear Information System (INIS)

Ozyigit, Gokhan; Cengiz, Mustafa; Yazici, Gozde; Yildiz, Ferah; Gurkaynak, Murat; Zorlu, Faruk; Yildiz, Demet; Hosal, Sefik; Gullu, Ibrahim; Akyol, Fadil

2011-01-01

Purpose: We assessed therapeutic outcomes of reirradiation with robotic stereotactic radiotherapy (SBRT) for locally recurrent nasopharyngeal carcinoma (LRNPC) patients and compared those results with three-dimensional conformal radiotherapy (CRT) with or without brachytherapy (BRT). Methods and Materials: Treatment outcomes were evaluated retrospectively in 51 LRNPC patients receiving either robotic SBRT (24 patients) or CRT with or without BRT (27 patients) in our department. CRT was delivered with a 6-MV linear accelerator, and a median total reirradiation dose of 57 Gy in 2 Gy/day was given. Robotic SBRT was delivered with CyberKnife (Accuray, Sunnyvale, CA). Patients in the SBRT arm received 30 Gy over 5 consecutive days. We calculated actuarial local control and cancer-specific survival rates for the comparison of treatment outcomes in SBRT and CRT arms. The Common Terminology Criteria for Adverse Events v3.0 was used for toxicity evaluation. Results: The median follow-up was 24 months for all patients. Two-year actuarial local control rates were 82% and 80% for SBRT and CRT arms, respectively (p = 0.6). Two-year cancer-specific survival rates were 64% and 47% for the SBRT and CRT arms, respectively (p = 0.4). Serious late toxicities (Grade 3 and above) were observed in 21% of patients in the SBRT arm, whereas 48% of patients had serious toxicity in the CRT arm (p = 0.04). Fatal complications occurred in three patients (12.5%) of the SBRT arm, and four patients (14.8%) of the CRT arm (p = 0.8). T stage at recurrence was the only independent predictor for local control and survival. Conclusion: Our robotic SBRT protocol seems to be feasible and less toxic in terms of late effects compared with CRT arm for the reirradiation of LRNPC patients.

Determination of small field synthetic single-crystal diamond detector correction factors for CyberKnife, Leksell Gamma Knife Perfexion and linear accelerator.

Science.gov (United States)

Veselsky, T; Novotny, J; Pastykova, V; Koniarova, I

2017-12-01

The aim of this study was to determine small field correction factors for a synthetic single-crystal diamond detector (PTW microDiamond) for routine use in clinical dosimetric measurements. Correction factors following small field Alfonso formalism were calculated by comparison of PTW microDiamond measured ratio M Qclin fclin /M Qmsr fmsr with Monte Carlo (MC) based field output factors Ω Qclin,Qmsr fclin,fmsr determined using Dosimetry Diode E or with MC simulation itself. Diode measurements were used for the CyberKnife and Varian Clinac 2100C/D linear accelerator. PTW microDiamond correction factors for Leksell Gamma Knife (LGK) were derived using MC simulated reference values from the manufacturer. PTW microDiamond correction factors for CyberKnife field sizes 25-5 mm were mostly smaller than 1% (except for 2.9% for 5 mm Iris field and 1.4% for 7.5 mm fixed cone field). The correction of 0.1% and 2.0% for 8 mm and 4 mm collimators, respectively, needed to be applied to PTW microDiamond measurements for LGK Perfexion. Finally, PTW microDiamond M Qclin fclin /M Qmsr fmsr for the linear accelerator varied from MC corrected Dosimetry Diode data by less than 0.5% (except for 1 × 1 cm 2 field size with 1.3% deviation). Regarding low resulting correction factor values, the PTW microDiamond detector may be considered an almost ideal tool for relative small field dosimetry in a large variety of stereotactic and radiosurgery treatment devices. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Determination of gonad doses during robotic stereotactic radiosurgery for various tumor sites

International Nuclear Information System (INIS)

Zorlu, Faruk; Dugel, Gozde; Ozyigit, Gokhan; Hurmuz, Pervin; Cengiz, Mustafa; Yildiz, Ferah; Akyol, Fadil; Gurkaynak, Murat

2013-01-01

Purpose: The authors evaluated the absorbed dose received by the gonads during robotic stereotactic radiosurgery (SRS) for the treatment of different tumor localizations. Methods: The authors measured the gonad doses during the treatment of head and neck, thoracic, abdominal, or pelvic tumors in both RANDO phantom and actual patients. The computerized tomography images were transferred to the treatment planning system. The contours of tumor and critical organs were delineated on each slice, and treatment plans were generated. Measurements for gonad doses were taken from the geometric projection of the ovary onto the skin for female patients, and from the scrotal skin for male patients by attaching films and Thermoluminescent dosimeters (TLDs). SRS was delivered with CyberKnife (Accuray Inc., Sunnyvale, CA). Results: The median gonadal doses with TLD and film dosimeter in actual patients were 0.19 Gy (range, 0.035–2.71 Gy) and 0.34 Gy (range, 0.066–3.18 Gy), respectively. In the RANDO phantom, the median ovarian doses with TLD and film dosimeter were 0.08 Gy (range, 0.03–0.159 Gy) and 0.05 Gy (range, 0.015–0.13 Gy), respectively. In the RANDO phantom, the median testicular doses with TLD and film dosimeter were 0.134 Gy (range 0.056–1.97 Gy) and 0.306 Gy (range, 0.065–2.25 Gy). Conclusions: Gonad doses are below sterility threshold in robotic SRS for different tumor localizations. However, particular attention should be given to gonads during robotic SRS for pelvic tumors.

Determination of gonad doses during robotic stereotactic radiosurgery for various tumor sites

Energy Technology Data Exchange (ETDEWEB)

Zorlu, Faruk; Dugel, Gozde; Ozyigit, Gokhan; Hurmuz, Pervin; Cengiz, Mustafa; Yildiz, Ferah; Akyol, Fadil; Gurkaynak, Murat [Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara 06100 (Turkey)

2013-04-15

Purpose: The authors evaluated the absorbed dose received by the gonads during robotic stereotactic radiosurgery (SRS) for the treatment of different tumor localizations. Methods: The authors measured the gonad doses during the treatment of head and neck, thoracic, abdominal, or pelvic tumors in both RANDO phantom and actual patients. The computerized tomography images were transferred to the treatment planning system. The contours of tumor and critical organs were delineated on each slice, and treatment plans were generated. Measurements for gonad doses were taken from the geometric projection of the ovary onto the skin for female patients, and from the scrotal skin for male patients by attaching films and Thermoluminescent dosimeters (TLDs). SRS was delivered with CyberKnife (Accuray Inc., Sunnyvale, CA). Results: The median gonadal doses with TLD and film dosimeter in actual patients were 0.19 Gy (range, 0.035-2.71 Gy) and 0.34 Gy (range, 0.066-3.18 Gy), respectively. In the RANDO phantom, the median ovarian doses with TLD and film dosimeter were 0.08 Gy (range, 0.03-0.159 Gy) and 0.05 Gy (range, 0.015-0.13 Gy), respectively. In the RANDO phantom, the median testicular doses with TLD and film dosimeter were 0.134 Gy (range 0.056-1.97 Gy) and 0.306 Gy (range, 0.065-2.25 Gy). Conclusions: Gonad doses are below sterility threshold in robotic SRS for different tumor localizations. However, particular attention should be given to gonads during robotic SRS for pelvic tumors.

Centre of Gravity (C.O.G)-Based Analysis on the Dynamics of the Extendable Double-Link Two-Wheeled Mobile Robot

International Nuclear Information System (INIS)

Rahman, M T Abdul; Ahmad, S; Akmeliawati, R; Altalmas, T; Aula, A

2013-01-01

This paper discusses about the analysis on the centre of gravity (C.O.G) in affecting the input reference of the motion control of the extendable double-link of two-wheeled mobile robot. The proposed system mimics double inverted pendulum, where the angular position of the first link (Link1) is to be varied depends on the value of the angular position of the second link (Link2) and the elongation of the extendable-link (Link3) that is attached to Link2 with different payload. The two-wheeled mobile robot together with the extendable link on Link2 makes that system become more flexible but yet, the system has become more unstable. The inclination of extendable link at any interest angle will affect the C.O.G of the system especially when the payload is having a significant weight. This two-wheeled mobile robot can be balanced on the condition that the system's center of gravity must be located on the centre of the wheels. Therefore the input reference of Link1 will be determined from the C.O.G analysis of the system with the payload. Preliminary results show that the angular position of Link1 can be set at suitable degree based on C.O.G analysis that is used for motion control

Development of Industrial High-Speed Transfer Parallel Robot

International Nuclear Information System (INIS)

Kim, Byung In; Kyung, Jin Ho; Do, Hyun Min; Jo, Sang Hyun

2013-01-01

Parallel robots used in industry require high stiffness or high speed because of their structural characteristics. Nowadays, the importance of rapid transportation has increased in the distribution industry. In this light, an industrial parallel robot has been developed for high-speed transfer. The developed parallel robot can handle a maximum payload of 3 kg. For a payload of 0.1 kg, the trajectory cycle time is 0.3 s (come and go), and the maximum velocity is 4.5 m/s (pick amp, place work, adept cycle). In this motion, its maximum acceleration is very high and reaches approximately 13g. In this paper, the design, analysis, and performance test results of the developed parallel robot system are introduced

SU-F-T-293: Experimental Comparisons of Ionization Chambers with Different Volumes for CyberKnife Delivery Quality Assurance

Energy Technology Data Exchange (ETDEWEB)

Nakayama, M [Kobe Minimally invasive Cancer Center, Kobe, Hyogo (Japan); Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Munetomo, Y; Ogata, T; Uehara, K; Tsudou, S; Nishimura, H; Mayahara, H [Kobe Minimally invasive Cancer Center, Kobe, Hyogo (Japan); Sasaki, R [Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan)

2016-06-15

Purpose: To evaluate the practicality use of ionization chambers with different volumes for delivery quality assurance of CyberKnife plans, Methods: Dosimetric measurements with a spherical solid water phantom and three ionization chambers with volumes of 0.13, 0.04, and 0.01 cm3 (IBA CC13, CC04, and CC01, respectively) were performed for various CyberKnife clinical treatment plans including both isocentric and nonisocentric delivery. For each chamber, the ion recombination correction factors Ks were calculated using the Jaffe plot method and twovoltage method at a 10-cm depth for a 60-mm collimator field in a water phantom. The polarity correction factors Kpol were determined for 5–60-mm collimator fields in same experimental setup. The measured doses were compared to the doses for the detectors calculated using a treatment planning system. Results: The differences in the Ks between the Jaffe plot method and two-voltage method were −0.12, −0.02, and 0.89% for CC13, CC04, and CC01, respectively. The changes in Kpol for the different field sizes were 0.2, 0.3, and 0.8% for CC13, CC04, and CC01, respectively. The measured doses for CC04 and CC01 were within 3% of the calculated doses for the clinical treatment plans with isocentric delivery with collimator fields greater than 12.5 mm. Those for CC13 had differences of over 3% for the plans with isocentric delivery with collimator fields less than 15 mm. The differences for the isocentric plans were similar to those for the single beam plans. The measured doses for each chamber were within 3% of the calculated doses for the non-isocentric plans except for that with a PTV volume less than 1.0 cm{sup 3}. Conclusion: Although there are some limitations, the ionization chamber with a smaller volume is a better detector for verification of the CyberKnife plans owing to the high spatial resolution.

Multi-staged robotic stereotactic radiosurgery for large cerebral arteriovenous malformations

International Nuclear Information System (INIS)

Ding, Chuxiong; Solberg, Timothy D.; Hrycushko, Brian; Medin, Paul; Whitworth, Louis; Timmerman, Robert D.

2013-01-01

Purpose: To investigate a multi-staged robotic stereotactic radiosurgery (SRS) delivery technique for the treatment of large cerebral arteriovenous malformations (AVMs). The treatment planning process and strategies to optimize both individual and composite dosimetry are discussed. Methods: Eleven patients with large (30.7 ± 19.2 cm 3 ) AVMs were selected for this study. A fiducial system was designed for fusion of targets between planar angiograms and simulation CT scans. AVMs were contoured based on single contrast CT, MRI and orthogonal angiogram images. AVMs were divided into 3–8 sub-target volumes (3–7 cm 3 ) for sequential treatment at 1–4 week intervals to a prescription dose of 16–20 Gy. Forward and inversely developed treatment plans were optimized for 95% coverage of the total AVM volume by dose summation from each sub-volume, while minimizing dose to surrounding tissues. Dose-volume analysis was used to evaluate the PTV coverage, dose conformality (CI), and R 50 and V 12Gy parameters. Results: The treatment workflow was commissioned and able to localize within 1 mm. Inverse optimization outperformed forward planning for most patients for each index considered. Dose conformality was shown comparable to staged Gamma Knife treatments. Conclusion: The CyberKnife system is shown to be a practical delivery platform for multi-staged treatments of large AVMs using forward or inverse planning techniques

CyberKnife Radiosurgery in the Multimodal Management of Patients with Cushing Disease.

Science.gov (United States)

Moore, Justin M; Sala, Elisa; Amorin, Alvaro; Martinez, Hector; Bhowmik, Aprotim C; Chang, Steven D; Soltys, Scott G; Harsh, Griffith R; Katznelson, Laurence

2018-04-01

Surgery is the primary treatment for Cushing disease. When surgery is unsuccessful in normalizing hypercortisolism, adjuvant radiation, such as stereotactic radiosurgery, may be useful to improve biochemical control. This retrospective study included a cohort of consecutive patients treated with CyberKnife (CK) radiosurgery for active Cushing disease at Stanford Hospital and Clinics. As first-line treatment, all patients underwent transsphenoidal surgery with histologic demonstration of an adrenocorticotropic hormone-producing pituitary adenoma. CK was performed as adjuvant therapy for persistent or recurrent disease. The median time between surgery and CK was 14 ± 34 months. Before CK, median maximal diameter of tumors was 9 mm (range, 7-32 mm), with cavernous sinus invasion in all patients (100%) and abutment of the optic chiasm in 1 patient (14.2%). With an average follow-up of 55.4 months, normalization of hypercortisolism was achieved in 4 patients (57.1%): 2 patients (28.5%) achieved normalization of the hypothalamic-pituitary-adrenal axis without glucocorticoid replacement, and 2 patients developed hypoadrenalism (28.5%). The median time to biochemical remission was 12.5 months. Hypopituitarism occurred in only 1 patient (14.2%), and no patients had visual complications. Time between surgery and radiotherapy of Cushing disease, we demonstrate that CK is an effective treatment with rare complications. Copyright © 2018 Elsevier Inc. All rights reserved.

Fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body metastases: acceptable local control and normal tissue tolerance with 5 fraction approach

Energy Technology Data Exchange (ETDEWEB)

Gill, Beant; Oermann, Eric; Ju, Andrew; Suy, Simeng; Yu, Xia; Rabin, Jennifer [Department of Radiation Medicine, Georgetown University Hospital,, Washington, DC (United States); Kalhorn, Christopher; Nair, Mani N.; Voyadzis, Jean-Marc [Department of Neurosurgery, Georgetown University Hospital,, Washington, DC (United States); Unger, Keith; Collins, Sean P.; Harter, K. W.; Collins, Brian T., E-mail: collinsb@gunet.georgetown.edu [Department of Radiation Medicine, Georgetown University Hospital,, Washington, DC (United States)

2012-04-26

This retrospective analysis examines the local control and toxicity of five-fraction fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body (VB) metastases. All patients had favorable performance status (ECOG 0–1), oligometastatic disease, and no prior spine irradiation. A prescribed dose of 30–35 Gy was delivered in five fractions to the planning target volume (PTV) using the CyberKnife with X-sight spine tracking. Suggested maximum spinal cord and esophagus point doses were 30 and 40 Gy, respectively. A median 30 Gy (IQR, 30–35 Gy) dose was delivered to a median prescription isodose line of 70% (IQR, 65–77%) to 20 patients. At 34 months median follow-up (IQR, 25–40 months) for surviving patients, the 1- and 2-year Kaplan–Meier local control estimates were 80 and 73%, respectively. Two of the five local failures were infield in patients who had received irradiation to the gross tumor volume and three were paravertebral failures just outside the PTV in patients with prior corpectomy. No local failures occurred in patients who completed VB radiation alone. The 1- and 2-year Kaplan–Meier overall survival estimates were 80 and 57%, respectively. Most deaths were attributed to metastatic disease; one death was attributed to local recurrence. The mean maximum point doses were 26.4 Gy (SD, 5.1 Gy) to the spinal cord and 29.1 Gy (SD, 8.9 Gy) to the esophagus. Patients receiving maximum esophagus point doses greater than 35 Gy experienced acute dysphagia (Grade I/II). No spinal cord toxicity was documented. Five-fraction fiducial-free CyberKnife SBRT is an acceptable treatment option for newly diagnosed VB metastases with promising local control rates and minimal toxicity despite the close proximity of such tumors to the spinal cord and esophagus. A prospective study aimed at further enhancing local control by targeting the intact VB and escalating the total dose is planned.

Validation of a pretreatment delivery quality assurance method for the CyberKnife Synchrony system

Energy Technology Data Exchange (ETDEWEB)

Mastella, E., E-mail: edoardo.mastella@cnao.it [Medical Physics Unit, CNAO Foundation—National Centre for Oncological Hadron Therapy, Pavia I-27100, Italy and Medical Physics Unit, IEO—European Institute of Oncology, Milan I-20141 (Italy); Vigorito, S.; Rondi, E.; Cattani, F. [Medical Physics Unit, IEO—European Institute of Oncology, Milan I-20141 (Italy); Piperno, G.; Ferrari, A.; Strata, E.; Rozza, D. [Department of Radiation Oncology, IEO—European Institute of Oncology, Milan I-20141 (Italy); Jereczek-Fossa, B. A. [Department of Radiation Oncology, IEO—European Institute of Oncology, Milan I-20141, Italy and Department of Oncology and Hematology Oncology, University of Milan, Milan I-20122 (Italy)

2016-08-15

Purpose: To evaluate the geometric and dosimetric accuracies of the CyberKnife Synchrony respiratory tracking system (RTS) and to validate a method for pretreatment patient-specific delivery quality assurance (DQA). Methods: An EasyCube phantom was mounted on the ExacTrac gating phantom, which can move along the superior–inferior (SI) axis of a patient to simulate a moving target. The authors compared dynamic and static measurements. For each case, a Gafchromic EBT3 film was positioned between two slabs of the EasyCube, while a PinPoint ionization chamber was placed in the appropriate space. There were three steps to their evaluation: (1) the field size, the penumbra, and the symmetry of six secondary collimators were measured along the two main orthogonal axes. Dynamic measurements with deliberately simulated errors were also taken. (2) The delivered dose distributions (from step 1) were compared with the planned ones, using the gamma analysis method. The local gamma passing rates were evaluated using three acceptance criteria: 3% local dose difference (LDD)/3 mm, 2%LDD/2 mm, and 3%LDD/1 mm. (3) The DQA plans for six clinical patients were irradiated in different dynamic conditions, to give a total of 19 cases. The measured and planned dose distributions were evaluated with the same gamma-index criteria used in step 2 and the measured chamber doses were compared with the planned mean doses in the sensitive volume of the chamber. Results: (1) A very slight enlargement of the field size and of the penumbra was observed in the SI direction (on average <1 mm), in line with the overall average CyberKnife system error for tracking treatments. (2) Comparison between the planned and the correctly delivered dose distributions confirmed the dosimetric accuracy of the RTS for simple plans. The multicriteria gamma analysis was able to detect the simulated errors, proving the robustness of their method of analysis. (3) All of the DQA clinical plans passed the tests, both in

Scaling Robotic Displays: Displays and Techniques for Dismounted Movement with Robots

Science.gov (United States)

2010-04-01

you are performing the low crawl 4.25 5.00 Drive the robot while you are negotiating the hill 6.00 5.00 Drive the robot while you are climbing the... stairs 4.67 5.00 Drive the robot while you are walking 5.70 5.27 HMD It was fairly doable. 1 When you’re looking through the lens, it’s not...Scaling Robotic Displays: Displays and Techniques for Dismounted Movement with Robots by Elizabeth S. Redden, Rodger A. Pettitt

Dose-Escalated Robotic SBRT for Stage I-II Prostate Cancer

Directory of Open Access Journals (Sweden)

Robert eMeier

2015-04-01

Full Text Available Abstract: Stereotactic body radiotherapy (SBRT is the precise external delivery of very high-dose radiotherapy to targets in the body, with treatment completed in one to five fractions. SBRT should be an ideal approach for organ-confined prostate cancer because (I dose escalation should yield improved rates of cancer control; (II the unique radiobiology of prostate cancer favors hypofractionation and (III the conformal nature of SBRT minimizes high-dose radiation delivery to immediately adjacent organs, potentially reducing complications. This approach is also more convenient for patients, and is cheaper than intensity modulated radiotherapy (IMRT. Several external beam platforms are capable of delivering SBRT for early-stage prostate cancer, although most of the mature reported series have employed a robotic non-coplanar platform (i.e., CyberKnife. Several large studies report 5-year biochemical relapse rates which compare favorably to IMRT. Rates of late GU toxicity are similar to those seen with IMRT, and rates of late rectal toxicity may be less than with IMRT and low dose rate (LDR brachytherapy. Patient-reported quality of life (QOL outcomes appear similar to IMRT in the urinary domain. Bowel QOL may be less adversely affected by SBRT than with other radiation modalities. After five years of follow-up, SBRT delivered on a robotic platform is yielding outcomes at least as favorable as IMRT, and may be considered appropriate therapy for stage I-II prostate cancer.

IgG4-related disease

DEFF Research Database (Denmark)

Detlefsen, Sönke; Klöppel, Günter

2018-01-01

disease (IgG4-RD). The histologic key findings are lymphoplasmacytic infiltration rich in IgG4-positive plasma cells combined with storiform fibrosis and obliterative phlebitis. Among the organs mainly affected by IgG4-RD are the pancreas and the extrahepatic bile ducts. The pancreatic and biliary...... alterations have been described under the terms autoimmune pancreatitis (AIP) and sclerosing cholangitis, respectively. These diseases are currently more precisely called IgG4-related pancreatitis (or type 1 AIP to distinguish it from type 2 AIP that is unrelated to IgG4-RD) and IgG4-related sclerosing...... cholangitis (IgG4-related SC). Clinically and grossly, both diseases commonly imitate pancreatic and biliary adenocarcinoma, tumors that are well known for their dismal prognosis. As IgG4-RD responds to steroid treatment, making a resection of a suspected tumor unnecessary, a biopsy is often required...

A condition closely mimicking IgG4-related disease despite the absence of serum IgG4 elevation and IgG4-positive plasma cell infiltration.

Science.gov (United States)

Hara, Satoshi; Kawano, Mitsuhiro; Mizushima, Ichiro; Yamada, Kazunori; Fujita, Kentaro; Harada, Kenichi; Matsumura, Masami; Yamagishi, Masakazu; Sato, Yasuharu; Yamaguchi, Yutaka; Nakanuma, Yasuni; Nagata, Michio

2016-09-01

We describe a 74-year-old Japanese man with systemic fibroinflammatory conditions closely resembling those of immunoglobulin G4-related disease (IgG4-RD). Radiology and histology showed characteristics of IgG4-related tubulointerstitial nephritis, despite normal serum IgG4 value and scanty IgG4-positive plasma cell infiltration in each organ. This case suggests that a condition closely mimicking IgG4-RD may develop without IgG4-positive plasma cells and those exceptional cases should also be taken into account in the differential diagnosis of IgG4-RD.

SU-F-SPS-11: The Dosimetric Comparison of Truebeam 2.0 and Cyberknife M6 Treatment Plans for Brain SRS Treatment

Energy Technology Data Exchange (ETDEWEB)

Mabhouti, H; Sanli, E; Cebe, M; Codel, G; Pacaci, P; Serin, E; Kucuk, N; Kucukmorkoc, E; Doyuran, M; Canoglu, D; Altinok, A; Acar, H; Caglar Ozkok, H [Medipol University, Istanbul, Istanbul (Turkey)

2016-06-15

Purpose: Brain stereotactic radiosurgery involves the use of precisely directed, single session radiation to create a desired radiobiologic response within the brain target with acceptable minimal effects on surrounding structures or tissues. In this study, the dosimetric comparison of Truebeam 2.0 and Cyberknife M6 treatment plans were made. Methods: For Truebeam 2.0 machine, treatment planning were done using 2 full arc VMAT technique with 6 FFF beam on the CT scan of Randophantom simulating the treatment of sterotactic treatments for one brain metastasis. The dose distribution were calculated using Eclipse treatment planning system with Acuros XB algorithm. The treatment planning of the same target were also done for Cyberknife M6 machine with Multiplan treatment planning system using Monte Carlo algorithm. Using the same film batch, the net OD to dose calibration curve was obtained using both machine by delivering 0- 800 cGy. Films were scanned 48 hours after irradiation using an Epson 1000XL flatbed scanner. Dose distribution were measured using EBT3 film dosimeter. The measured and calculated doses were compared. Results: The dose distribution in the target and 2 cm beyond the target edge were calculated on TPSs and measured using EBT3 film. For cyberknife plans, the gamma analysis passing rates between measured and calculated dose distributions were 99.2% and 96.7% for target and peripheral region of target respectively. For Truebeam plans, the gamma analysis passing rates were 99.1% and 95.5% for target and peripheral region of target respectively. Conclusion: Although, target dose distribution calculated accurately by Acuros XB and Monte Carlo algorithms, Monte carlo calculation algorithm predicts dose distribution around the peripheral region of target more accurately than Acuros algorithm.

IgG4 related sclerosing mastitis: expanding the morphological spectrum of IgG4 related diseases.

Science.gov (United States)

Chougule, Abhijit; Bal, Amanjit; Das, Ashim; Singh, Gurpreet

2015-01-01

IgG4 related disease (IgG4RD) is a recently recognised condition characterised by mass forming lesions associated with storiform fibrosis, obliterative phlebitis, lymphoplasmacytic infiltrate rich in IgG4 positive plasma cells and elevated serum IgG4 levels. Although rare, mammary involvement has been reported as IgG4 related sclerosing mastitis, the morphological counterpart of a growing family of IgG4 related diseases. A total of 17 cases belonging to mass forming benign inflammatory breast lesions such as plasma cell mastitis, granulomatous lobular mastitis, non-specific mastitis and inflammatory pseudotumour were investigated as a possible member of IgG4 related sclerosing mastitis. Clinical, radiological, histopathological and immunohistochemistry findings were noted in all cases. Cases diagnosed as inflammatory pseudotumour showed all the histopathological features of IgG4RD along with increased number of IgG4 positive plasma cells and IgG4/IgG ratio >40%. However, only a few IgG4 positive cells were seen in plasma cell mastitis, granulomatous lobular mastitis and non-specific mastitis cases. These cases also did not fulfill the morphological criteria for the diagnosis of IgG4 related diseases. IgG4RD should be excluded in plasma cell rich lesions diagnosed on core biopsies by IgG4 immunostaining. This can avoid unnecessary surgery as IgG4 related diseases respond to simple and effective steroid treatment.

Nozzle Mounting Method Optimization Based on Robot Kinematic Analysis

Science.gov (United States)

Chen, Chaoyue; Liao, Hanlin; Montavon, Ghislain; Deng, Sihao

2016-08-01

Nowadays, the application of industrial robots in thermal spray is gaining more and more importance. A desired coating quality depends on factors such as a balanced robot performance, a uniform scanning trajectory and stable parameters (e.g. nozzle speed, scanning step, spray angle, standoff distance). These factors also affect the mass and heat transfer as well as the coating formation. Thus, the kinematic optimization of all these aspects plays a key role in order to obtain an optimal coating quality. In this study, the robot performance was optimized from the aspect of nozzle mounting on the robot. An optimized nozzle mounting for a type F4 nozzle was designed, based on the conventional mounting method from the point of view of robot kinematics validated on a virtual robot. Robot kinematic parameters were obtained from the simulation by offline programming software and analyzed by statistical methods. The energy consumptions of different nozzle mounting methods were also compared. The results showed that it was possible to reasonably assign the amount of robot motion to each axis during the process, so achieving a constant nozzle speed. Thus, it is possible optimize robot performance and to economize robot energy.

IgG4-related nephropathy.

Science.gov (United States)

Quattrocchio, Giacomo; Roccatello, Dario

2016-08-01

IgG4-related disease (IgG4-RD) is a recently recognized disorder, often with multiple organ involvement, characterized by dense tissue infiltration of IgG4-positive plasma cells, storiform fibrosis, obliterative phlebitis and frequently elevated serum IgG4 concentration. The kidney can be involved either directly or indirectly. The most frequent direct renal manifestations of IgG4-RD are IgG4-related tubulointerstitial nephritis (TIN) and membranous glomerulonephropathy. Retroperitoneal fibrosis (RPF) is another condition that is frequently IgG4-related and that can indirectly affect the kidney causing ureteral obstruction and hydronephrosis. Contrast-enhanced computerized tomography, magnetic resonance imaging and (18)F-fluorodeoxyglucose positron emission tomography/computed tomography show different imaging findings and are useful tools for monitoring therapeutic response. Steroid treatment is the first line of therapy, but relapsing or refractory forms of the disease are frequently observed and require more aggressive therapeutic approaches. At our centre, we treated three cases of aggressive IgG4-related TIN and two cases of IgG4-related RPF with an intensified, immune suppressive protocol, obtaining good results without severe adverse effects.

Medical robotics.

Science.gov (United States)

Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra

2011-01-01

Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management.

4th IFToMM International Symposium on Robotics and Mechatronics

CERN Document Server

Laribi, Med; Gazeau, Jean-Pierre

2016-01-01

This volume contains papers that have been selected after review for oral presentation at ISRM 2015, the Fourth IFToMM International Symposium on Robotics and Mechatronics held in Poitiers, France 23-24 June 2015. These papers  provide a vision of the evolution of the disciplines of robotics and mechatronics, including but not limited to: mechanism design; modeling and simulation; kinematics and dynamics of multibody systems; control methods; navigation and motion planning; sensors and actuators; bio-robotics; micro/nano-robotics; complex robotic systems; walking machines, humanoids-parallel kinematic structures: analysis and synthesis; smart devices; new design; application and prototypes. The book can be used by researchers and engineers in the relevant areas of robotics and mechatronics.

IgG4-Related Tubulointerstitial Nephritis.

Science.gov (United States)

Zhang, Pingchuan; Cornell, Lynn D

2017-03-01

Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a fibroinflammatory disorder that can involve nearly any organ. The disorder has increasingly become known as a distinct clinical entity during the last decade. IgG4-related tubulointerstitial nephritis (IgG4-TIN) is the most common manifestation of IgG4-RD in the kidney. Many patients with IgG4-TIN are diagnosed after IgG4-RD has been recognized in other organ systems, but the kidney may also be the first or only site involved. The presenting clinical features of IgG4-TIN are most commonly kidney insufficiency, kidney mass lesion(s), or both. On biopsy, IgG4-TIN shows a dense lymphoplasmacytic infiltrate, increased IgG4+ plasma cells, storiform fibrosis, and often tubular basement membrane immune complex deposits. Elevation of serum IgG4 often accompanies IgG4-RD; however, it is not specific in reaching the diagnosis. Like IgG4-RD in other organs, IgG4-TIN characteristically responds promptly to steroids, although there is a high relapse rate on discontinuation of immunosuppression. The pathogenesis of IgG4-RD is not understood. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Human IgG4 binds to IgG4 and conformationally altered IgG1 via Fc-Fc interactions

NARCIS (Netherlands)

Rispens, Theo; Ooievaar-de Heer, Pleuni; Vermeulen, Ellen; Schuurman, Janine; van der Neut Kolfschoten, Marijn; Aalberse, Rob C.

2009-01-01

The Fc fragment of IgG4 can interact with the Fc fragment of another IgG molecule. This interaction is a confounding factor when measuring IgG4 rheumatoid factor levels. Recently, we demonstrated that half-molecules of IgG4 can exchange to form a bispecific Ab. We expected these two phenomena to be

Cyberknife Relative Output Factor measurements using fiber-coupled luminescence, MOSFETS and RADPOS dosimetry system

DEFF Research Database (Denmark)

Ploquin, N.; Kertzscher Schwencke, Gustavo Adolfo Vladimir; Vandervoort, E.

2012-01-01

from 5 to 60 mm. ROFs were also measured using a mobileMOSFET system (Best Medical Canada) and EBT1 and EBT2 GAFCHROMIC® (ISP, Ashland) radiochromic films. For cone sizes 12.5–60 mm all detector results were in agreement within the measurement uncertainty. The microMOSFET/RADPOS measurements (published.......3% and 0.865 ± 0.3% for 5, 7.5 and 10 mm cones. Our study shows that the microMOSFET/RADPOS and optical fiber‐coupled RL dosimetry system are well suited for Cyberknife cone output factors measurements over the entire range of field sizes, provided that appropriate correction factors are applied...

Put Your Robot In, Put Your Robot Out: Sequencing through Programming Robots in Early Childhood

Science.gov (United States)

Kazakoff, Elizabeth R.; Bers, Marina Umaschi

2014-01-01

This article examines the impact of programming robots on sequencing ability in early childhood. Thirty-four children (ages 4.5-6.5 years) participated in computer programming activities with a developmentally appropriate tool, CHERP, specifically designed to program a robot's behaviors. The children learned to build and program robots over three…

Exposure of Surgeons to Magnetic Fields during Laparoscopic and Robotic Gynecologic Surgeries.

Science.gov (United States)

Park, Jee Soo; Chung, Jai Won; Choi, Soo Beom; Kim, Deok Won; Kim, Young Tae; Kim, Sang Wun; Nam, Eun Ji; Cho, Hee Young

2015-01-01

To measure and compare levels of extremely-low-frequency magnetic field (ELF-MF) exposure to surgeons during laparoscopic and robotic gynecologic surgeries. Prospective case-control study. Canadian Task Force I. Gynecologic surgeries at the Yonsei University Health System in Seoul, Korea from July to October in 2014. Ten laparoscopic gynecologic surgeries and 10 robotic gynecologic surgeries. The intensity of ELF-MF exposure to surgeons was measured every 4 seconds during 10 laparoscopic gynecologic surgeries and 10 robotic gynecologic surgeries using portable ELF-MF measuring devices with logging capability. The mean ELF-MF exposures were .1 ± .1 mG for laparoscopic gynecologic surgeries and .3 ± .1 mG for robotic gynecologic surgeries. ELF-MF exposure levels to surgeons during robotic gynecologic surgery were significantly higher than those during laparoscopic gynecologic surgery (p gynecologic surgery and conventional laparoscopic surgery, hoping to alleviate concerns regarding the hazards of MF exposure posed to surgeons and hospital staff. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Robotics

Energy Technology Data Exchange (ETDEWEB)

Lorino, P; Altwegg, J M

1985-05-01

This article, which is aimed at the general reader, examines latest developments in, and the role of, modern robotics. The 7 main sections are sub-divided into 27 papers presented by 30 authors. The sections are as follows: 1) The role of robotics, 2) Robotics in the business world and what it can offer, 3) Study and development, 4) Utilisation, 5) Wages, 6) Conditions for success, and 7) Technological dynamics.

Diagnostic Performance of Serum IgG4 Levels in Patients With IgG4-Related Disease

Science.gov (United States)

Yu, Kuang-Hui; Chan, Tien-Ming; Tsai, Ping-Han; Chen, Ching-Hui; Chang, Pi-Yueh

2015-01-01

Abstract The aim of this study is to study the clinical features and diagnostic performance of IgG4 in Chinese populations with IgG4-related diseases (IgG4-RDs). The medical records of 2901 adult subjects who underwent serum IgG4 level tests conducted between December 2007 and May 2014 were reviewed. Serum concentrations of IgG4 were measured in 2901 cases, including 161 (5.6%) patients with IgG4-RD and 2740 (94.4%) patients without IgG4-RD (non-IgG4-RD group). The mean age of the IgG4-RD patients was 58.4 ± 16.1 years (range: 21–87), and 48 (29.8%) were women. The mean serum IgG4 level was significantly much higher in IgG4-RD patients than in non-IgG4-RD (1062.6 vs 104.3 mg/dL, P IgG4 >135 mg/dL, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio (LR)+, and LR− were 86%, 77%, 18%, 99%, 3.70, and 0.19, respectively. When the upper limit of normal was doubled for an IgG4 >270 mg/dL, the corresponding data were 75%, 94%, 43%, 98%, 12.79, and 0.26, respectively. For IgG4 >405 mg/dL (tripling the upper limit of normal), the corresponding data were 62%, 98%, 68%, 98%, 37.00, and 0.39, respectively. When calculated according to the manufacturer's package insert cutoff (>201 mg/dL) for the diagnosis of IgG4-RD, the corresponding sensitivity, specificity, PPV, NPV, LR+, and LR− were 80%, 89%, 29%, 99%, 7.00, and 0.23, respectively. For IgG4 >402 mg/dL (>2× the upper limit of the normal range), the corresponding data were 62%, 98%, 68%, 98%, 36.21, and 0.39, respectively. For IgG4 >603 mg/dL (>3× the upper limit of the normal range), the corresponding data were 50%, 99%, 84%, 97%, 90.77 and 0.51, respectively. The optimal cutoff value of serum IgG4 (measured by nephelometry using a Siemens BN ProSpec instrument and Siemens reagent) for the diagnosis of IgG4-RD was 248 mg/dL, the sensitivity and specificity were 77.6% and 92.8%, respectively. The present study demonstrated that 2 or

Modular robotic tiles: experiments for children with autism

DEFF Research Database (Denmark)

Lund, Henrik Hautop; Dam Pedersen, Martin; Beck, Richard

2009-01-01

rehabilitation), and with the proper radio communication mechanism they may give unique possibilities for documentation of the physical activity (e.g., therapeutic treatment). A major point of concern in modular robotics is the connection mechanism, so we investigated different solutions for the connection......We developed a modular robotic tile and a system composed of a number of these modular robotic tiles. The system composed of the modular robotic tiles engages the user in physical activities, e.g., physiotherapy, sports, fitness, and entertainment. The modular robotic tiles motivate the user...... to perform physical activities by providing immediate feedback based upon their physical interaction with the system. With the modular robotic tiles, the user is able to make new physical set-ups within less than a minute. The tiles are applicable for different forms of physical activities (e.g., therapeutic...

IgG4-related disease.

Science.gov (United States)

Bozzalla Cassione, Emanuele; Stone, John H

2017-05-01

Remarkable insights have been gleaned recently with regard to the pathophysiology of IgG4-related disease (IgG4-RD). These findings have direct implications for the development of targeted strategies for the treatment of this condition. Oligoclonal expansions of cells of both the B and T lymphocyte lineages are present in the blood of patients with IgG4-RD. Oligoclonal expansions of plasmablasts are a good biomarker for disease activity. An oligoclonally expanded population of CD4+ cytotoxic T lymphocytes is found not only in the peripheral blood but also at tissue sites of active disease. This cell elaborates cytokines that may drive the fibrosis characteristic of IgG4-RD. T follicular helper cells (Tfhc), particularly the Tfhc2 subset, appear to play a major role in driving the class switch to IgG4 that typifies this disease. The relationship between malignancy and IgG4-RD remains an area of interest. Advances in understanding the pathophysiology of IgG4-RD have proceeded swiftly, leading to the identification of a number of potential targeted treatment strategies. The completion of classification criteria for IgG4-RD, an effort supported jointly by the American College of Rheumatology and the European League Against Rheumatism, will further facilitate studies on this disease.

Stormram 4: An MR Safe Robotic System for Breast Biopsy

NARCIS (Netherlands)

Groenhuis, Vincent; Siepel, Françoise Jeanette; Veltman, Jeroen; van Zandwijk, Jordy Kristian; Stramigioli, Stefano

2018-01-01

Suspicious lesions in the breast that are only visible on magnetic resonance imaging (MRI) need to be biopsied under MR guidance with high accuracy and efficiency for accurate diagnosis. The aim of this study is to present a novel robotic system, the Stormram 4, and to perform preclinical tests in

Robot-Assisted Antegrade In-Situ Fenestrated Stent Grafting

International Nuclear Information System (INIS)

Riga, Celia V.; Bicknell, Colin D.; Wallace, Daniel; Hamady, Mohamad; Cheshire, Nicholas

2009-01-01

To determine the technical feasibility of a novel approach of in-situ fenestration of aortic stent grafts by using a remotely controlled robotic steerable catheter system in the porcine model. A 65-kg pig underwent robot-assisted bilateral antegrade in-situ renal fenestration of an abdominal aortic stent graft with subsequent successful deployment of a bare metal stent into the right renal artery. A 16-mm iliac extension covered stent served as the porcine aortic endograft. Under fluoroscopic guidance, the graft was punctured with a 20-G customized diathermy needle that was introduced and kept in place by the robotic arm. The needle was exchanged for a 4 x 20 mm cutting balloon before successful deployment of the renal stent. Robot-assisted antegrade in-situ fenestration is technically feasible in a large mammalian model. The robotic system enables precise manipulation, stable positioning, and minimum instrumentation of the aorta and its branches while minimizing radiation exposure.

IgG4 plasma cell myeloma: new insights into the pathogenesis of IgG4-related disease.

Science.gov (United States)

Geyer, Julia T; Niesvizky, Ruben; Jayabalan, David S; Mathew, Susan; Subramaniyam, Shivakumar; Geyer, Alexander I; Orazi, Attilio; Ely, Scott A

2014-03-01

IgG4-related disease is a newly described systemic fibroinflammatory process, characterized by increase in IgG4-positive plasma cells. Its pathogenesis, including the role of IgG4, remains poorly understood. Plasma cell myeloma is typically associated with a large monoclonal serum spike, which is frequently of IgG isotype. We sought to identify and characterize a subset of IgG4-secreting myeloma, as it may provide a biological model of disease with high serum levels of IgG4. Six out of 158 bone marrow biopsies (4%) from patients with IgG myeloma expressed IgG4. Four patients were men and two were women, with a mean age of 64 (range 53-87) years. Imaging showed fullness of pancreatic head (1), small non-metabolic lymphadenopathy (1), and bone lytic lesions (6). Two patients developed necrotizing fasciitis. All had elevated serum M-protein (mean 2.4, range 0.5-4.2 g/dl), and none had definite signs or symptoms of IgG4-related disease. Four myelomas had plasmablastic morphology. Four had kappa and two had lambda light chain expression. Three cases expressed CD56. Two patients had a complex karyotype. In conclusion, the frequency of IgG4 myeloma correlates with the normal distribution of IgG4 isoform. The patients with IgG4 myeloma appear to have a high rate of plasmablastic morphology and could be predisposed to necrotizing fasciitis. Despite high serum levels of IgG4, none had evidence of IgG4-related disease. These findings suggest that the increased number of IgG4-positive plasma cells is not the primary etiologic agent in IgG4-related disease. Elevated serum levels of IgG4 is not sufficient to produce the typical disease presentation and should not be considered diagnostic of IgG4-related disease.

Industrial Robots.

Science.gov (United States)

Reed, Dean; Harden, Thomas K.

Robots are mechanical devices that can be programmed to perform some task of manipulation or locomotion under automatic control. This paper discusses: (1) early developments of the robotics industry in the United States; (2) the present structure of the industry; (3) noneconomic factors related to the use of robots; (4) labor considerations…

Analysis of the factors affecting the safety of robotic stereotactic body radiation therapy for hepatocellular carcinoma patients

Directory of Open Access Journals (Sweden)

Liu XJ

2017-11-01

Full Text Available Xiaojie Liu,1,* Yongchun Song,1,* Ping Liang,2 Tingshi Su,2 Huojun Zhang,3 Xianzhi Zhao,3 Zhiyong Yuan,1 Ping Wang1 1Department of Radiotherapy,Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, 2Cyberknife Center, Ruikang Hospital, Guangxi Traditional Chinese Medical University, Nanning, 3Department of Radiotherapy, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China *These authors contributed equally to this work Objective: The objective of this study was to investigate the safety of robotic stereotactic body radiation therapy (SBRT for hepatocellular carcinoma (HCC patients and its related factors.Methods: A total of 74 HCC patients with Child–Turcotte–Pugh (CTP Class A were included in a multi-institutional, single-arm Phase II trial (NCT 02363218 between February 2013 and August 2016. All patients received SBRT treatment at a dose of 45 Gy/3f. The liver function was compared before and after SBRT treatment by the analysis of adverse hepatic reactions and changes in CTP classification.Results: After SBRT treatment, eight patients presented with decreases in CTP classification and 13 patients presented with ≥ grade 2 hepatic adverse reactions. For patients presenting with ≥ grade 2 hepatic adverse reactions, the total liver volume of ≤1,162 mL and a normal liver volume (total liver volume – gross tumor volume [GTV] of ≤1,148 mL were found to be independent risk factors and statistically significant (P<0.05.Conclusion: The total liver volume and normal liver volume are associated with the occurrence of ≥ grade 2 hepatic adverse reactions after SBRT treatment on HCC patients. Therefore, if the fractionated scheme of 45 Gy/3f is applied in SBRT for HCC patients, a total liver volume >1,162 mL and a normal liver

Ocean robotics: 21st century sustainable science & marine resource management

CSIR Research Space (South Africa)

Swart, S

2015-10-01

Full Text Available marine robots? Swart et al., 2012 The CSIR Glider Fleet 14 GLIDERS: 5 PROFILING & 4 SURFACE GLIDERS = Glider deployment & ship CTD station = ship based underway measurements September 2012 – March 2013 Gough&Is. STF SAF APF G o u g h / T r i...

Dose Calculation Accuracy of the Monte Carlo Algorithm for CyberKnife Compared with Other Commercially Available Dose Calculation Algorithms

International Nuclear Information System (INIS)

Sharma, Subhash; Ott, Joseph; Williams, Jamone; Dickow, Danny

2011-01-01

Monte Carlo dose calculation algorithms have the potential for greater accuracy than traditional model-based algorithms. This enhanced accuracy is particularly evident in regions of lateral scatter disequilibrium, which can develop during treatments incorporating small field sizes and low-density tissue. A heterogeneous slab phantom was used to evaluate the accuracy of several commercially available dose calculation algorithms, including Monte Carlo dose calculation for CyberKnife, Analytical Anisotropic Algorithm and Pencil Beam convolution for the Eclipse planning system, and convolution-superposition for the Xio planning system. The phantom accommodated slabs of varying density; comparisons between planned and measured dose distributions were accomplished with radiochromic film. The Monte Carlo algorithm provided the most accurate comparison between planned and measured dose distributions. In each phantom irradiation, the Monte Carlo predictions resulted in gamma analysis comparisons >97%, using acceptance criteria of 3% dose and 3-mm distance to agreement. In general, the gamma analysis comparisons for the other algorithms were <95%. The Monte Carlo dose calculation algorithm for CyberKnife provides more accurate dose distribution calculations in regions of lateral electron disequilibrium than commercially available model-based algorithms. This is primarily because of the ability of Monte Carlo algorithms to implicitly account for tissue heterogeneities, density scaling functions; and/or effective depth correction factors are not required.

Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

Directory of Open Access Journals (Sweden)

Mohammad Ali Ahmadi-Pajouh

2017-02-01

Full Text Available Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist disable people to eat and perform daily activities. There are also clinical rehabilitation robots which can train handicaps. They can help subjects as a passive tool that improves low level impairments such as rigidity. On the other hand robots can train brain as an active tool to have a better movement again. We will see how robots can help therapist to apply repetitive passive movements in quadriplegic subject (i.e. in Brunnstrom stages 1 to 3. On the other hand they can teach subjects how to complete a task in an active manner (i.e. in stages 5 and 6 which can facilitate neuroplasticity. There are different robots designed for different organs; for example rehabilitation of upper extremities (e.g. Gloreha or lower extremities (e.g. Lokomat. There are also exoskeleton robots to help subjects to grip objects and perform ADLs easily (e.g. Bioservo or help paraplegic patient to walk again (e.g. Rewalk. In this talk, we will also discuss about how robots are helping rehab specialist to improve standard protocols. For example we will show how action observation therapy, bimanual therapy, assistive active therapy, proprioceptive facilitation and passive mobilization therapy are realized using an upper extremity rehabilitation robot. Robotics is the future of technology and rehabilitation needs this technology. Be part of this technology!

IgG4-producing lymphoma arising in a patient with IgG4-related disease.

Science.gov (United States)

Igawa, Takuro; Hayashi, Toshiaki; Ishiguro, Kazuya; Maruyama, Yumiko; Takeuchi, Mai; Takata, Katsuyoshi; Yoshino, Tadashi; Sato, Yasuharu

2016-12-01

We herein report a case in which an IgG4-producing lymphoma arose in a patient with a previous diagnosis consistent with an IgG4-related disease. A 43-year-old man presented with enlarged cervical lymph nodes and was treated with steroids and radiation for what was initially assumed to be Kimura's disease, although the lesions were later histologically re-diagnosed as IgG4-related lymphadenopathy. Fourteen years later, when the patient was 58-years-old, he presented with retroperitoneal fibrosis and swollen lymph nodes. The suspicious lesions were not histologically examined as the patient did not give consent. However, the serum IgG4 concentration was high (1400 mg/dL) and he was clinically diagnosed with systemic IgG4-related disease. Although steroid administration reduced the size of the lesions, tapering the dose finally resulted in systemic, prominently enlarged lymph nodes. Analysis of the biopsy specimen revealed that these multiple lymph node lesions were marginal zone B cell lymphomas that themselves expressed IgG4. Complete remission was achieved after a total of six courses of chemotherapy including rituximab. This case suggests that the infiltrating IgG4-expressing cells observed in IgG4-related disease can clonally expand to malignant lymphomas.

Detection of Serum IgG4 Levels in Patients with IgG4-Related Disease and Other Disorders

Science.gov (United States)

Wang, Chenqiong; Wu, Xuefen; Miao, Ye; Xiong, Hui; Bai, Lin; Dong, Lingli

2015-01-01

Objective Elevated serum IgG4 levels are an important hallmark for diagnosing IgG4-related disease (IgG4-RD), but can also be observed in other diseases. This study aimed to compare two different testing methods for IgG4: ELISA and nephelometric assay. Both assays were used to measure serum IgG4 concentrations, and to assess the prevalence of high serum IgG4 levels in both IgG4-RD and non-IgG4-RD diseases. Methods A total of 80 serum samples were tested using the nephelometric assay and ELISA method that we established. Serum IgG4 concentrations were determined by ELISA for 957 patients with distinct diseases, including 12 cases of IgG4-RD and 945 cases of non-IgG4-RD. Results IgG4 levels from 80 selected serum samples examined by ELISA were in agreement with those detected using the nephelometry assay. Meanwhile, the serum IgG4 concentrations measured by ELISA were also consistent with the clinical diagnoses of patients with IgG4-RD during the course of disease. The Elevated levels of serum IgG4 (>1.35 g/L) were detected in all IgG4-RD (12/12) patients, and the prevalence of high IgG4 serum levels was 3.39% in non-IgG4-RD cases. Among them, the positive rates of serum IgG4 were 2.06% in patients with carcinoma and 6.3% in patients with other non-IgG4 autoimmune diseases. Conclusion Our established ELISA method is a reliable and convenient technique, which could be extensively used in the clinic to measure serum IgG4 levels. High levels of IgG4 were observed in IgG4-RD. However, this phenomenon could also be observed in other diseases, such as carcinomas and other autoimmune diseases. Thus, a diagnosis of IgG4 disease cannot only be dependent on the detection of elevated serum IgG4 levels. PMID:25885536

The Immunobiology of Immunoglobulin G4

NARCIS (Netherlands)

Lighaam, Laura C.; Rispens, Theo

2016-01-01

Human immunoglobulin G4 (IgG4) antibodies are in many ways unusual. In this review, an overview is given of the structural and functional aspects of IgG4 antibodies, the consequences of IgG4 antibody formation in various disease settings, and the factors involved in the regulation of IgG4 responses.

EVOLUTION OF THE ROBOT DESIGN

Directory of Open Access Journals (Sweden)

POPA Marina Andreea

2011-11-01

Full Text Available This paper presents the construction of a robot used at a national robot competition in Romania. The robot consists of datasheet sensors (2 long distance measuring sensors, 4 reflective object sensors, 4 engines, 4 gears, a battery and the plates with microcontrollers

On the role of IgG4 in inflammatory conditions: lessons for IgG4-related disease

NARCIS (Netherlands)

Trampert, David C.; Hubers, Lowiek M.; van de Graaf, Stan F. J.; Beuers, Ulrich

2017-01-01

The pathophysiology of immunoglobulin G4-related disease (IgG4-RD) and its most common manifestations, IgG4-associated (sclerosing) cholangitis and autoimmune pancreatitis, remains largely unknown, but IgG4 is presumably involved. IgG4 is a promiscuous antibody, which could be directly pathogenic,

First Application of Robot Teaching in an Existing Industry 4.0 Environment: Does It Really Work?

Directory of Open Access Journals (Sweden)

Astrid Weiss

2016-07-01

Full Text Available This article reports three case studies on the usability and acceptance of an industrial robotic prototype in the context of human-robot cooperation. The three case studies were conducted in the framework of a two-year project named AssistMe, which aims at developing different means of interaction for programming and using collaborative robots in a user-centered manner. Together with two industrial partners and a technological partner, two different application scenarios were implemented and studied with an off-the-shelf robotic system. The operators worked with the robotic prototype in laboratory conditions (two days, in a factory context (one day and in an automotive assembly line (three weeks. In the article, the project and procedures are described in detail, including the quantitative and qualitative methodology. Our results show that close human-robot cooperation in the industrial context needs adaptive pacing mechanisms in order to avoid a change of working routines for the operators and that an off-the-shelf robotic system is still limited in terms of usability and acceptance. The touch panel, which is needed for controlling the robot, had a negative impact on the overall user experience. It creates a further intermediate layer between the user, the robot and the work piece and potentially leads to a decrease in productivity. Finally, the fear of the worker of being replaced by an improved robotic system was regularly expressed and adds an additional anthropocentric dimension to the discussion of human-robot cooperation, smart factories and the upcoming Industry 4.0.

Falsely low immunoglobulin (Ig)G4 in routine analysis: how not to miss IgG4 disease.

Science.gov (United States)

Egner, W; Swallow, K; Lock, R J; Patel, D

2016-10-01

Immunoglobulin (Ig)G4 disease can have apparently 'normal' levels of IgG4 due to antigen excess conditions. IgG4 measurement therefore appears falsely low. UK National External Quality Assurance Scheme (UK NEQAS) data and other reports have suggested that this problem occurred despite pre-existing antigen excess detection steps. To determine the clinical relevance of the problem, we examined the prevalence and characteristics of prozoning in our laboratory and patient cohorts. We establish that the prevalence of raised IgG4 in routine IgG4 analysis is low (IgG4 samples in our patients. This may explain the previous reports of low sensitivity of raised IgG4 for IgG4RD, and predictive values should be re-evaluated in this disease using modified prozone-resistant protocols. All laboratories providing IgG4 measurements should verify that their assays are fit for the clinical quality requirement of detection raised IgG4 levels and must verify the upper limit of their reference ranges and freedom from prozoning. © 2016 British Society for Immunology.

IgG4-Related Sclerosing Cholangitis.

Science.gov (United States)

Nakazawa, Takahiro; Shimizu, Shuya; Naitoh, Itaru

2016-08-01

More men than women develop immunoglobulin G4-related sclerosing cholangitis (IgG4-SC). Age at clinical onset is significantly older in patients with IgG4-SC. Patients with IgG4-SC appear similar to those with cholangiocarcinoma and primary sclerosing cholangitis (PSC). The association between IgG4-SC and autoimmune pancreatitis (AIP) is useful for the diagnosis of IgG4-SC. However, some IgG4-SC cases are isolated from AIP and are difficult to diagnose. The authors focus on three distinct features of IgG4-SC. First, diffuse inflammation induces a longer stenosis on cholangiography in contrast to the short stenosis of patients with PSC. Second, fibroinflammatory involvement is observed mainly in the stroma of the bile duct wall, whereas the bile duct epithelium is intact. Third, steroid therapy results in remarkable improvement. Although the prognosis of patients with IgG4-SC is good, some cases have developed portal hypertension and liver cirrhosis during their clinical course. Further study is needed to elucidate the long-term outcomes and mechanism of IgG4-SC. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Colias: An Autonomous Micro Robot for Swarm Robotic Applications

Directory of Open Access Journals (Sweden)

Farshad Arvin

2014-07-01

Full Text Available Robotic swarms that take inspiration from nature are becoming a fascinating topic for multi-robot researchers. The aim is to control a large number of simple robots in order to solve common complex tasks. Due to the hardware complexities and cost of robot platforms, current research in swarm robotics is mostly performed by simulation software. The simulation of large numbers of these robots in robotic swarm applications is extremely complex and often inaccurate due to the poor modelling of external conditions. In this paper, we present the design of a low-cost, open-platform, autonomous micro-robot (Colias for robotic swarm applications. Colias employs a circular platform with a diameter of 4 cm. It has a maximum speed of 35 cm/s which enables it to be used in swarm scenarios very quickly over large arenas. Long-range infrared modules with an adjustable output power allow the robot to communicate with its direct neighbours at a range of 0.5 cm to 2 m. Colias has been designed as a complete platform with supporting software development tools for robotics education and research. It has been tested in both individual and swarm scenarios, and the observed results demonstrate its feasibility for use as a micro-sized mobile robot and as a low-cost platform for robot swarm applications.

Soft robotics: a review and progress towards faster and higher torque actuators (presentation video)

Science.gov (United States)

Shepherd, Robert

2014-03-01

Last year, nearly 160,000 industrial robots were shipped worldwide—into a total market valued at 26 Bn (including hardware, software, and peripherals).[1] Service robots for professional (e.g., defense, medical, agriculture) and personal (e.g., household, handicap assistance, toys, and education) use accounted for 16,000 units, 3.4 Bn and 3,000,000 units, $1.2 Bn respectively.[1] The vast majority of these robotic systems use fully actuated, rigid components that take little advantage of passive dynamics. Soft robotics is a field that is taking advantage of compliant actuators and passive dynamics to achieve several goals: reduced design, manufacturing and control complexity, improved energy efficiency, more sophisticated motions, and safe human-machine interactions to name a few. The potential for societal impact is immense. In some instances, soft actuators have achieved commercial success; however, large scale adoption will require improved methods of controlling non-linear systems, greater reliability in their function, and increased utility from faster and more forceful actuation. In my talk, I will describe efforts from my work in the Whitesides group at Harvard to prove sophisticated motions in these machines using simple controls, as well capabilities unique to soft machines. I will also describe the potential for combinations of different classes of soft actuators (e.g., electrically and pneumatically actuated systems) to improve the utility of soft robots. 1. World Robotics - Industrial Robots 2013, 2013, International Federation of Robotics.

Pathogenicity of IgG in patients with IgG4-related disease.

Science.gov (United States)

Shiokawa, Masahiro; Kodama, Yuzo; Kuriyama, Katsutoshi; Yoshimura, Kenichi; Tomono, Teruko; Morita, Toshihiro; Kakiuchi, Nobuyuki; Matsumori, Tomoaki; Mima, Atsushi; Nishikawa, Yoshihiro; Ueda, Tatsuki; Tsuda, Motoyuki; Yamauchi, Yuki; Minami, Ryuki; Sakuma, Yojiro; Ota, Yuji; Maruno, Takahisa; Kurita, Akira; Sawai, Yugo; Tsuji, Yoshihisa; Uza, Norimitsu; Matsumura, Kazuyoshi; Watanabe, Tomohiro; Notohara, Kenji; Tsuruyama, Tatsuaki; Seno, Hiroshi; Chiba, Tsutomu

2016-08-01

IgG4-related disease (IgG4-RD) is a systemic disease characterised by elevated serum IgG4 and IgG4-positive lymphoplasmacytic infiltration in the affected tissues. The pathogenic role of IgGs, including IgG4, in patients with IgG4-RD, however, is unknown. We examined the pathogenic activity of circulating IgGs in patients with IgG4-RD by injecting their IgGs into neonatal male Balb/c mice. Binding of patient IgGs to pancreatic tissue was also analysed in an ex vivo mouse organ culture model and in tissue samples from patients with autoimmune pancreatitis (AIP). Subcutaneous injection of patient IgG, but not control IgG, resulted in pancreatic and salivary gland injuries. Pancreatic injury was also induced by injecting patient IgG1 or IgG4, with more destructive changes induced by IgG1 than by IgG4. The potent pathogenic activity of patient IgG1 was significantly inhibited by simultaneous injection of patient IgG4. Binding of patient IgG, especially IgG1 and IgG4, to pancreatic tissue was confirmed in both the mouse model and AIP tissue samples. IgG1 and IgG4 from patients with IgG4-RD have pathogenic activities through binding affected tissues in neonatal mice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Toward a framework for levels of robot autonomy in human-robot interaction.

Science.gov (United States)

Beer, Jenay M; Fisk, Arthur D; Rogers, Wendy A

2014-07-01

A critical construct related to human-robot interaction (HRI) is autonomy, which varies widely across robot platforms. Levels of robot autonomy (LORA), ranging from teleoperation to fully autonomous systems, influence the way in which humans and robots may interact with one another. Thus, there is a need to understand HRI by identifying variables that influence - and are influenced by - robot autonomy. Our overarching goal is to develop a framework for levels of robot autonomy in HRI. To reach this goal, the framework draws links between HRI and human-automation interaction, a field with a long history of studying and understanding human-related variables. The construct of autonomy is reviewed and redefined within the context of HRI. Additionally, the framework proposes a process for determining a robot's autonomy level, by categorizing autonomy along a 10-point taxonomy. The framework is intended to be treated as guidelines to determine autonomy, categorize the LORA along a qualitative taxonomy, and consider which HRI variables (e.g., acceptance, situation awareness, reliability) may be influenced by the LORA.

A phase I/II study on stereotactic body radiotherapy with real-time tumor tracking using CyberKnife based on the Monte Carlo algorithm for lung tumors.

Science.gov (United States)

Iwata, Hiromitsu; Ishikura, Satoshi; Murai, Taro; Iwabuchi, Michio; Inoue, Mitsuhiro; Tatewaki, Koshi; Ohta, Seiji; Yokota, Naoki; Shibamoto, Yuta

2017-08-01

In this phase I/II study, we assessed the safety and initial efficacy of stereotactic body radiotherapy (SBRT) for lung tumors with real-time tumor tracking using CyberKnife based on the Monte Carlo algorithm. Study subjects had histologically confirmed primary non-small-cell lung cancer staged as T1a-T2aN0M0 and pulmonary oligometastasis. The primary endpoint was the incidence of Grade ≥3 radiation pneumonitis (RP) within 180 days of the start of SBRT. The secondary endpoint was local control and overall survival rates. Five patients were initially enrolled at level 1 [50 Gy/4 fractions (Fr)]; during the observation period, level 0 (45 Gy/4 Fr) was opened. The dose was escalated to the next level when grade ≥3 RP was observed in 0 out of 5 or 1 out of 10 patients. Virtual quality assurance planning was performed for 60 Gy/4 Fr; however, dose constraints for the organs at risk did not appear to be within acceptable ranges. Therefore, level 2 (55 Gy/4 Fr) was regarded as the upper limit. After the recommended dose (RD) was established, 15 additional patients were enrolled at the RD. The prescribed dose was normalized at the 95% volume border of the planning target volume based on the Monte Carlo algorithm. Between September 2011 and September 2015, 40 patients (primary 30; metastasis 10) were enrolled. Five patients were enrolled at level 0, 15 at level 1, and 20 at level 2. Only one grade 3 RP was observed at level 1. Two-year local control and overall survival rates were 98 and 81%, respectively. The RD was 55 Gy/4 Fr. SBRT with real-time tumor tracking using CyberKnife based on the Monte Carlo algorithm was tolerated well and appeared to be effective for solitary lung tumors.

Integration of g4tools in Geant4

International Nuclear Information System (INIS)

Hřivnáčová, Ivana

2014-01-01

g4tools, that is originally part of the inlib and exlib packages, provides a very light and easy to install set of C++ classes that can be used to perform analysis in a Geant4 batch program. It allows to create and manipulate histograms and ntuples, and write them in supported file formats (ROOT, AIDA XML, CSV and HBOOK). It is integrated in Geant4 through analysis manager classes, thus providing a uniform interface to the g4tools objects and also hiding the differences between the classes for different supported output formats. Moreover, additional features, such as for example histogram activation or support for Geant4 units, are implemented in the analysis classes following users requests. A set of Geant4 user interface commands allows the user to create histograms and set their properties interactively or in Geant4 macros. g4tools was first introduced in the Geant4 9.5 release where its use was demonstrated in one basic example, and it is already used in a majority of the Geant4 examples within the Geant4 9.6 release. In this paper, we will give an overview and the present status of the integration of g4tools in Geant4 and report on upcoming new features.

Verification of Accuracy of CyberKnife Tumor-tracking Radiation Therapy Using Patient-specific Lung Phantoms

International Nuclear Information System (INIS)

Jung, Jinhong; Song, Si Yeol; Yoon, Sang Min; Kwak, Jungwon; Yoon, KyoungJun; Choi, Wonsik; Jeong, Seong-Yun; Choi, Eun Kyung; Cho, Byungchul

2015-01-01

Purpose: To investigate the accuracy of the CyberKnife Xsight Lung Tracking System (XLTS) compared with that of a fiducial-based target tracking system (FTTS) using patient-specific lung phantoms. Methods and Materials: Three-dimensional printing technology was used to make individualized lung phantoms that closely mimicked the lung anatomy of actual patients. Based on planning computed tomographic data from 6 lung cancer patients who underwent stereotactic ablative radiation therapy using the CyberKnife, the volume above a certain Hounsfield unit (HU) was assigned as the structure to be filled uniformly with polylactic acid material by a 3-dimensional printer (3D Edison, Lokit, Korea). We evaluated the discrepancies between the measured and modeled target positions, representing the total tracking error, using 3 log files that were generated during each treatment for both the FTTS and the XLTS. We also analyzed the γ index between the film dose measured under the FTTS and XLTS. Results: The overall mean values and standard deviations of total tracking errors for the FTTS were 0.36 ± 0.39 mm, 0.15 ± 0.64 mm, and 0.15 ± 0.62 mm for the craniocaudal (CC), left–right (LR), and anteroposterior (AP) components, respectively. Those for the XLTS were 0.38 ± 0.54 mm, 0.13 ± 0.18 mm, and 0.14 ± 0.37 mm for the CC, LR, and AP components, respectively. The average of γ passing rates was 100% for the criteria of 3%, 3 mm; 99.6% for the criteria of 2%, 2 mm; and 86.8% for the criteria of 1%, 1 mm. Conclusions: The XLTS has segmentation accuracy comparable with that of the FTTS and small total tracking errors

SU-F-T-601: Equivalence of CyberKnife and TrueBeam STx for Spine Irradiation

Energy Technology Data Exchange (ETDEWEB)

Herrington, J [University of Rhode Island, Kingston, RI (United States); Price, M; Brindle, J [University of Rhode Island, Kingston, RI (United States); Rhode Island Hospital, Providence, RI (United States); Alpert Medical School of Brown University (United States); Schmidt, M; Knutson, N [University of Rhode Island, Kingston, RI (United States); Rhode Island Hospital, Providence, RI (United States)

2016-06-15

Purpose: To evaluate the equivalence of spine SBRT treatment plans created in Eclipse for the TrueBeam STx (Varian Medical System, Palo Alto, CA) compared to plans using CyberKnife and MultiPlan (Accuray, Sunnyvale, CA). Methods: CT data and contours for 23 spine SBRT patients previously treated using CyberKnife (CK) were exported from MultiPlan treatment planning system into Eclipse where they were planned using static IMRT 6MV coplanar beams. Plans were created according to the original prescription dose and fractionation schedule while limiting spinal dose according to the RTOG 0631 protocol and maintaining target coverage comparable to the original CK plans. Plans were evaluated using new conformity index (nCI), homogeneity index (HI), dose-volume histogram data, number of MU, and estimated treatment time. To ensure all Eclipse plans were deliverable, standard clinical IMRT QA was performed. The plan results were matched with their complimentary CK plans for paired statistical analysis. Results: Plans generated in Eclipse demonstrated statistically significant (p<0.01) improvements compared to complimentary CK plans in median values of maximum spinal cord dose (17.39 vs. 18.12 Gy), RTOG spinal cord constraint dose (14.50 vs. 16.93 Gy), nCI (1.28 vs. 1.54), HI (1.13 vs. 1.27), MU (3918 vs. 36416), and estimated treatment time (8 vs. 48 min). All Eclipse generated plans passed our clinically used protocols for IMRT QA. Conclusion: CK spine SBRT replanned utilizing Eclipse for LINAC delivery demonstrated dosimetric advantages. We propose improvements in plan quality metrics reviewed in this study may be attributed to dynamic MLCs that facilitate treatment of complicated geometries as well as posterior beams ideal for centrally located and/or posterior targets afforded by gantry-based RT delivery.

Verification of Accuracy of CyberKnife Tumor-tracking Radiation Therapy Using Patient-specific Lung Phantoms

Energy Technology Data Exchange (ETDEWEB)

Jung, Jinhong [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul (Korea, Republic of); Song, Si Yeol, E-mail: coocoori@gmail.com [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yoon, Sang Min; Kwak, Jungwon; Yoon, KyoungJun [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Wonsik [Department of Radiation Oncology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of); Jeong, Seong-Yun [Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Eun Kyung; Cho, Byungchul [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2015-07-15

Purpose: To investigate the accuracy of the CyberKnife Xsight Lung Tracking System (XLTS) compared with that of a fiducial-based target tracking system (FTTS) using patient-specific lung phantoms. Methods and Materials: Three-dimensional printing technology was used to make individualized lung phantoms that closely mimicked the lung anatomy of actual patients. Based on planning computed tomographic data from 6 lung cancer patients who underwent stereotactic ablative radiation therapy using the CyberKnife, the volume above a certain Hounsfield unit (HU) was assigned as the structure to be filled uniformly with polylactic acid material by a 3-dimensional printer (3D Edison, Lokit, Korea). We evaluated the discrepancies between the measured and modeled target positions, representing the total tracking error, using 3 log files that were generated during each treatment for both the FTTS and the XLTS. We also analyzed the γ index between the film dose measured under the FTTS and XLTS. Results: The overall mean values and standard deviations of total tracking errors for the FTTS were 0.36 ± 0.39 mm, 0.15 ± 0.64 mm, and 0.15 ± 0.62 mm for the craniocaudal (CC), left–right (LR), and anteroposterior (AP) components, respectively. Those for the XLTS were 0.38 ± 0.54 mm, 0.13 ± 0.18 mm, and 0.14 ± 0.37 mm for the CC, LR, and AP components, respectively. The average of γ passing rates was 100% for the criteria of 3%, 3 mm; 99.6% for the criteria of 2%, 2 mm; and 86.8% for the criteria of 1%, 1 mm. Conclusions: The XLTS has segmentation accuracy comparable with that of the FTTS and small total tracking errors.

Potential Applications of Light Robotics in Nanomedicine

DEFF Research Database (Denmark)

Glückstad, Jesper

We have recently pioneered a new generation of 3D micro-printed light robotic structures with multi-functional biophotonics capabilities. The uniqueness of this light robotic approach is that even if a micro-biologist aims at exploring e.g. cell biology at nanoscopic scales, the main support...... of each micro-robotic structure can be 3D printed to have a size and shape that allows convenient laser manipulation in full 3D – even using relatively modest numerical aperture optics. An optical robot is typically equipped with a number of 3D printed "track-balls" that allow for real-time 3D light...... manipulation with six-degrees-of-freedom. This creates a drone-like functionality where each light-driven robot can be e.g. joystick-controlled and provide the user a feeling of stretching his/her hands directly into and interacting with the biologic micro-environment. The light-guided robots can thus act...

Nano-biophotonics explored by Light Robotics

DEFF Research Database (Denmark)

Glückstad, Jesper; Villangca, Mark Jayson; Palima, Darwin

for harnessing most of the functionalities required to develop the fascinating concept of true so-­‐called Light Robotics. We foresee that it will soon become possible to equip 3D laser-printed robotic micro-­‐structures with multi functional biophotonics nanoprobes or nanotips fabricated with true nanoscopic...... resolution. The uniqueness of such an approach is that even if a micro biologist aims at exploring e.g. cell biology at nanoscopic scales, the main support of each laser-­‐robotic structure can be 3D printed to have a size and shape that allows convenient laser manipulation in full 3D– even using relatively...... modest numerical aperture optics. An optical robot is typically equipped with a number of 3D printed "trackballs" that allow for real-­‐time 3D light manipulation with six-­‐degrees-­‐of-­‐freedom. This creates a drone-­‐like functionality where each light-­‐driven robot can be e.g. joystick...

Risk-adapted robotic stereotactic body radiation therapy for inoperable early-stage non-small-cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Temming, Susanne; Kocher, Martin; Baus, Wolfgang W.; Semrau, Robert; Baues, Christian; Marnitz, S. [University of Cologne, Department of Radiation Oncology, Center for Integrated Oncology, Cologne (Germany); Stoelben, Erich [Hospital of Cologne, Lung Clinic Merheim, Cologne (Germany); Hagmeyer, Lars [University of Cologne, Bethanien Hospital, Institute of Pneumology, Solingen (Germany); Chang, De-Hua [University of Cologne, Department of Diagnostic and Interventional Radiology, Center for Integrated Oncology, Cologne (Germany); Frank, Konrad [Heart Centre of the University of Cologne, Department III of Internal Medicine, Cologne (Germany); Hekmat, Khosro [University of Cologne, Department of Cardiothoracic Surgery, Center for Integrated Oncology, Cologne (Germany); Wolf, Juergen [University Hospital of Cologne, First Department of Internal Medicine, Center for Integrated Oncology, Cologne (Germany)

2018-02-15

To evaluate efficacy and toxicity of stereotactic body radiation therapy (SBRT) with CyberKnife {sup registered} (Accuray, Sunnyvale, CA, USA) in a selected cohort of primary, medically inoperable early-stage non-small cell lung cancer (NSCLC) patients. From 2012 to 2016, 106 patients (median age 74 years, range 50-94 years) with primary NSCLC were treated with SBRT using CyberKnife {sup registered}. Histologic confirmation was available in 87 patients (82%). For mediastinal staging, 92 patients (87%) underwent {sup 18}F-fluorodeoxyglucose positron-emission tomography (18-FDG-PET) and/or endobronchial ultrasound (EBUS)-guided lymph node biopsy or mediastinoscopy. Tumor stage (UICC8, 2017) was IA/B (T1a-c, 1-3 cm) in 86 patients (81%) and IIA (T2a/b, 3-5 cm) in 20 patients (19%). Depending on tumor localization, three different fractionation schedules were used: 3 fractions of 17Gy, 5 fractions of 11Gy, or 8 fractions of 7.5 Gy. Tracking was based on fiducial implants in 13 patients (12%) and on image guidance without markers in 88%. Median follow-up was 15 months (range 0.5-46 months). Acute side effects were mild (fatigue grade 1-2 in 20% and dyspnea grade 1-2 in 17%). Late effects were observed in 4 patients (4%): 3 patients developed pneumonitis requiring therapy (grade 2) and 1 patient suffered a rib fracture (grade 3). In total, 9/106 patients (8%) experienced a local recurrence, actuarial local control rates were 88% (95% confidence interval, CI, 80-96%) at 2 years and 77% (95%CI 56-98%) at 3 years. The median disease-free survival time was 27 months (95%CI 23-31 months). Overall survival was 77% (95%CI 65-85%) at 2 years and 56% (95%CI 39-73%) at 3 years. CyberKnife {sup registered} lung SBRT which allows for real-time tumor tracking and risk-adapted fractionation achieves satisfactory local control and low toxicity rates in inoperable early-stage primary lung cancer patients. (orig.) [German] Untersuchung von Wirkung und Toxizitaet einer stereotaktischen

Towards Light‐guided Micro‐robotics

DEFF Research Database (Denmark)

Glückstad, Jesper

‐dimensional microstructures. Furthermore, we exploit the light shaping capabilities available in the workstation to demonstrate a new strategy for controlling microstructures that goes beyond the typical refractive light deflections that are exploited in conventional optical trapping and manipulation e.g. of micro......Robotics in the macro‐scale typically uses light for carrying information in machine vision for monitoring and feedback in intelligent robotic guidance systems. With light’s miniscule momentum, shrinking robots down to the micro‐scale regime creates opportunities for exploiting optical forces...... and torques in micro‐robotic actuation and control. Indeed, the literature on optical trapping and micro‐manipulation attests to the possibilities for optical micro‐robotics. Advancing light‐driven micro‐robotics requires the optimization of optical force and optical torque that, in turn, requires...

An accuracy analysis of Cyberknife tumor tracking radiotherapy according to unpredictable change of respiration

International Nuclear Information System (INIS)

Seo, Jung Min; Lee, Chang Yeol; Huh, Hyun Do; Kim, Wan Sun

2015-01-01

Cyber-Knife tumor tracking system, based on the correlation relationship between the position of a tumor which moves in response to the real time respiratory cycle signal and respiration was obtained by the LED marker attached to the outside of the patient, the location of the tumor to predict in advance, the movement of the tumor in synchronization with the therapeutic device to track real-time tumor, is a system for treating. The purpose of this study, in the cyber knife tumor tracking radiation therapy, trying to evaluate the accuracy of tumor tracking radiation therapy system due to the change in the form of unpredictable sudden breathing due to cough and sleep. Materials and Methods : Breathing Log files that were used in the study, based on the Respiratory gating radiotherapy and Cyber-knife tracking radiosurgery breathing Log files of patients who received herein, measured using the Log files in the form of a Sinusoidal pattern and Sudden change pattern. it has been reconstituted as possible. Enter the reconstructed respiratory Log file cyber knife dynamic chest Phantom, so that it is possible to implement a motion due to respiration, add manufacturing the driving apparatus of the existing dynamic chest Phantom, Phantom the form of respiration we have developed a program that can be applied to. Movement of the phantom inside the target (Ball cube target) was driven by the displacement of three sizes of according to the size of the respiratory vertical (Superior-Inferior) direction to the 5 mm, 10 mm, 20 mm. Insert crosses two EBT3 films in phantom inside the target in response to changes in the target movement, the End-to-End (E2E) test provided in Cyber-Knife manufacturer depending on the form of the breathing five times each. It was determined by carrying. Accuracy of tumor tracking system is indicated by the target error by analyzing the inserted film, additional E2E test is analyzed by measuring the correlation error while being advanced. If the target

An accuracy analysis of Cyberknife tumor tracking radiotherapy according to unpredictable change of respiration

Energy Technology Data Exchange (ETDEWEB)

Seo, Jung Min; Lee, Chang Yeol; Huh, Hyun Do; Kim, Wan Sun [Dept. of Radiation Oncology, Inha university hospital, Incheon (Korea, Republic of)

2015-12-15

Cyber-Knife tumor tracking system, based on the correlation relationship between the position of a tumor which moves in response to the real time respiratory cycle signal and respiration was obtained by the LED marker attached to the outside of the patient, the location of the tumor to predict in advance, the movement of the tumor in synchronization with the therapeutic device to track real-time tumor, is a system for treating. The purpose of this study, in the cyber knife tumor tracking radiation therapy, trying to evaluate the accuracy of tumor tracking radiation therapy system due to the change in the form of unpredictable sudden breathing due to cough and sleep. Materials and Methods : Breathing Log files that were used in the study, based on the Respiratory gating radiotherapy and Cyber-knife tracking radiosurgery breathing Log files of patients who received herein, measured using the Log files in the form of a Sinusoidal pattern and Sudden change pattern. it has been reconstituted as possible. Enter the reconstructed respiratory Log file cyber knife dynamic chest Phantom, so that it is possible to implement a motion due to respiration, add manufacturing the driving apparatus of the existing dynamic chest Phantom, Phantom the form of respiration we have developed a program that can be applied to. Movement of the phantom inside the target (Ball cube target) was driven by the displacement of three sizes of according to the size of the respiratory vertical (Superior-Inferior) direction to the 5 mm, 10 mm, 20 mm. Insert crosses two EBT3 films in phantom inside the target in response to changes in the target movement, the End-to-End (E2E) test provided in Cyber-Knife manufacturer depending on the form of the breathing five times each. It was determined by carrying. Accuracy of tumor tracking system is indicated by the target error by analyzing the inserted film, additional E2E test is analyzed by measuring the correlation error while being advanced. If the target

IgG4-related spinal pachymeningitis.

Science.gov (United States)

Lu, Zhang; Tongxi, Liu; Jie, Luo; Yujuan, Jiao; Wei, Jiang; Xia, Liu; Yumin, Zheng; Xin, Lu

2016-06-01

The aim of this study is to study the clinical, laboratory, imaging pathology, and prognosis features of IgG4-related spinal pachymeningitis. We worked with a 55-year-old man suffering from IgG4-related spinal pachymeningitis who had the most widespread lesion in his dura mater. We also review previous related studies and discuss the clinical characteristics of this rare disease. In total, eight IgG4-related spinal pachymeningitis patients have been reported in the literature since 2009. They were mostly male patients, 51.7 ± 11.9 years old on average. Cervical and thoracic vertebrae were the most common sites for lesions. The most prominent symptom was varying numbness and weakness of the limbs and/or body associated with spinal cord compression. There was one patient (1/5) with elevated serum IgG4 levels and three patients (3/3) with increased cerebrospinal fluid (CSF) IgG4 index. Positive histopathologic findings are the strongest basis for a diagnosis. All the patients with IgG4-related spinal pachymeningitis responded well to glucocorticoid therapy. IgG4-related spinal pachymeningitis is an orphan disease that mainly occurs in cervical and thoracic vertebrae. Older males are the most susceptible group. Serum IgG4 levels were consistently normal in these cases, so analysis of CSF for IgG4 production (IgG4 index) could become a useful tool. Pathological findings remain the gold standard for diagnosis. Most patients responded favorably to glucocorticoid treatment.

Histopathologie der IgG4-RD

DEFF Research Database (Denmark)

Detlefsen, S; Klöppel, G

2016-01-01

infiltrate, 2) storiform fibrosis and 3) obliterative phlebitis. The diagnosis is further supported by immunohistochemical demonstration of an increased infiltration of IgG4-positive plasma cells and an elevated IgG4/IgG ratio. The morphological criteria of IgG4-RD are in most cases detectable in biopsies...

Social categorization of social robots: anthropomorphism as a function of robot group membership.

Science.gov (United States)

Eyssel, Friederike; Kuchenbrandt, Dieta

2012-12-01

Previous work on social categorization has shown that people often use cues such as a person's gender, age, or ethnicity to categorize and form impressions of others. The present research investigated effects of social category membership on the evaluation of humanoid robots. More specifically, participants rated a humanoid robot that either belonged to their in-group or to a national out-group with regard to anthropomorphism (e.g., mind attribution, warmth), psychological closeness, contact intentions, and design. We predicted that participants would show an in-group bias towards the robot that ostensibly belonged to their in-group--as indicated by its name and location of production. In line with our hypotheses, participants not only rated the in-group robot more favourably--importantly, they also anthropomorphized it more strongly than the out-group robot. Our findings thus document that people even apply social categorization processes and subsequent differential social evaluations to robots. ©2011 The British Psychological Society.

Analysis of IgG4-positive clones in affected organs of IgG4-related disease.

Science.gov (United States)

Kakuchi, Yasushi; Yamada, Kazunori; Ito, Kiyoaki; Hara, Satoshi; Fujii, Hiroshi; Yamagishi, Masakazu; Kawano, Mitsuhiro

2016-11-01

We investigated class switch reaction (CSR) in affected organs and evaluated whether the same or genetically related clones exist in IgG4-RD. We studied three patients with IgG4-RD. Total cellular RNA was extracted from salivary glands and peripheral blood and lung tissue. Activation-induced cytidine deaminase (AID) and immunoglobulin heavy chain third complementarity determining region (IgVH-CDR3) of IgM and IgG4 were detected by reverse transcription polymerase chain reaction (RT-PCR). We analyzed the clonal relationship of infiltrating IgG4-positive cells, as compared with IgM. We determined the existence of common clones among organs and patients. AID was expressed in salivary glands of all patients and lung tissue in one. Closely related IgVH-CDR3 sequences in infiltrating IgG4-positive cells were detected in salivary glands and lung tissue. Identical IgVH-CDR3 sequence between IgM and IgG4 in salivary glands was detected in one patient, indicating CSR in salivary glands. Identical IgVH-CDR3 sequences of IgG4-positive cells were detected between salivary glands and peripheral blood in two patients. Four identical sequences of IgVH-CDR3 existed between patients. Interestingly, one of the four sequences was detected in all patients. Our results demonstrate the existence of common antigen(s) shared by patients with IgG4-RD.

Serum levels of IgG and IgG4 in Hashimoto thyroiditis.

Science.gov (United States)

Kawashima, Sachiko-Tsukamoto; Tagami, Tetsuya; Nakao, Kanako; Nanba, Kazutaka; Tamanaha, Tamiko; Usui, Takeshi; Naruse, Mitsuhide; Minamiguchi, Sachiko; Mori, Yusuke; Tsuji, Jun; Tanaka, Issei; Shimatsu, Akira

2014-03-01

Although IgG4-related disease is characterized by extensive infiltration of IgG4-positive plasma cells and lymphocytes of various organs, the details of this systemic disease are still unclear. We screened serum total IgG levels in the patients with Hashimoto thyroiditis (HT) to illustrate the prevalence of IgG4-related thyroiditis in HT. Twenty-four of 94 patients with HT (25.5%) had elevated serum IgG levels and their serum IgG4 was measured. Five of the 24 cases had more than 135 mg/dL of IgG4, which is the serum criterion of IgG4-related disease. One was a female patient who was initially treated as Graves' disease and rapidly developed a firm goiter and hypothyroidism. The biopsy of her thyroid gland revealed that follicular cells were atrophic with squamous metaplasia, replaced with fibrosis, which was compatible with the fibrous variant of HT. Immunohistochemical examination revealed diffuse infiltration of IgG4-positive plasma cells, and the serum IgG4 level was 179 mg/dL. The levels of IgG and IgG4 were positively correlated with the titers of anti-thyroglobulin antibody or anti-thyroid peroxidase antibody. In conclusion, at least a small portion of patients with HT with high titers of anti-thyroid antibodies may overlap the IgG4-related thyroiditis.

IgG4 breaking the rules

NARCIS (Netherlands)

Aalberse, Rob C.; Schuurman, Janine

2002-01-01

Immunoglobulin G4 (IgG4) antibodies have been known for some time to be functionally monovalent. Recently, the structural basis for this monovalency has been elucidated: the in vivo exchange of IgG half-molecules (one H-plus one L-chain) among IgG4. This process results in bispecific antibodies that

Wheeled hopping robot

Science.gov (United States)

Fischer, Gary J [Albuquerque, NM

2010-08-17

The present invention provides robotic vehicles having wheeled and hopping mobilities that are capable of traversing (e.g. by hopping over) obstacles that are large in size relative to the robot and, are capable of operation in unpredictable terrain over long range. The present invention further provides combustion powered linear actuators, which can include latching mechanisms to facilitate pressurized fueling of the actuators, as can be used to provide wheeled vehicles with a hopping mobility.

4G/5G polymorphism modulates PAI-1 circulating levels in obese women.

Science.gov (United States)

Fernandes, Karla S; Sandrim, Valéria C

2012-05-01

The increase in plasminogen activator inhibitor type 1 (PAI-1) has been described as a risk factor to thrombosis-related diseases. In addition, it has been demonstrated that the variant 4G of polymorphism 4G/5G located in promoter region of PAI-1 gene is associated with higher PAI-1 levels. We investigate the role of this polymorphism on circulating PAI-1 concentration in a population of 57 obese women (23%, 4G/4G; 49%, 4G/5G and 28%, 5G/5G genotypes). Our results demonstrate a genotype-specific modulation on PAI-1 levels in obese women, thus 5G/5G genotype presented significantly lower levels of plasma PAI-1 when compared to 4G/4G group (46 ± 19 ng/mL vs. 63 ± 13 ng/mL, respectively). Our findings indicate that obese carriers of 4G/4G genotype may have increased risk to develop thrombotic diseases.

Robots conquering local government services

DEFF Research Database (Denmark)

Nielsen, Jeppe Agger; Andersen, Kim Normann; Sigh, Anne

2016-01-01

labour-intensive services, the public administration research community is short on knowledge of the impact on the work processes carried out in public organizations and how staff and clients react toward robots. This case study investigates the implementation and use of robot vacuum cleaners in Danish......The movement of robots from the production line to the service sector provides a potentially radical solution to innovate and transform public service delivery. Although robots are increasingly being adopted in service delivery (e.g., health- and eldercare) to enhance and in some cases substitute...... eldercare, demonstrating how robot vacuums have proven to have considerable interpretive flexibility with variation in the perceived nature of technology, technology strategy, and technology use between key stakeholders in eldercare....

Serum total IgG and IgG4 levels in thyroid eye disease

Directory of Open Access Journals (Sweden)

Sy A

2016-10-01

Full Text Available Aileen Sy, Rona Z Silkiss Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA Purpose: To investigate the relationship between immunoglobulin G (IgG4-related disease (IgG4-RD and thyroid eye disease (TED with respect to IgG levels. Patients and methods: A retrospective review of total IgG, IgG subclass, and thyroid stimulating immunoglobulin (TSI levels in 24 patients with TED. Results: Five patients (20.8% demonstrated serum IgG4 levels consistent with IgG4-RD without any additional systemic disease. Total IgG and IgG subclass levels were found to be an inadequate proxy for TSI elevation. Conclusion: There may be a subtype of TED patients with elevated IgG4 in the absence of IgG4-RD systemic findings. Keywords: thyroid eye disease, IgG subclass, IgG4, Graves’ disease, Graves’ ophthalmopathy, IgG4-RD

A Comparative Analysis of Serum IgG4 Levels in Patients With IgG4-Related Disease and Other Disorders.

Science.gov (United States)

Wang, Li; Chu, Xinmin; Ma, Yan; Zhang, Min; Wang, Xue; Jin, Li; Tan, Zhen; Li, Xiangpei; Li, Xiaomei

2017-09-01

Elevated serum IgG4 levels are an important hallmark for diagnosing IgG4-related disease (IgG4-RD) but can also be found and reported in other diseases. The present study intended to compare the serum IgG4 levels in both IgG4-RD and non-IgG4-RD and determine the serum IgG4 levels in patients with IgG4-RD before and after glucocorticoid therapy. The study included 323 patients from Anhui Medical University Affiliated Provincial Hospital (China) and was conducted from July 2014-January 2016. A total of 25 patients were eventually diagnosed as having IgG4-RD, according to the IgG4-RD diagnostic criteria. Our study also included 108 patients with connective tissue disease, 94 patients with pancreatic lesions, 66 patients with bile duct lesions, 13 patients with carcinoma of the duodenal papilla and 20 control participants. The assay for serum IgG4 detection was peformed using the nephelometric method. Elevated levels of serum IgG4 (>1.35g/L) were detected in all patients with IgG4-RD, and reduced levels of serum IgG4 (IgG4-RD. The serum IgG4 level in patients with IgG4-RD after glucocorticoid therapy was significantly lower than that before glucocorticoid therapy (t = 2.426, P = 0.04). High levels of IgG4 were observed in IgG4-RD. However, a diagnosis of IgG4 disease can not only be dependent on the detection of elevated serum IgG4 levels but also may need clinical manifestations, serology, histopathology and other comprehensive information for verification. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Histopathological Diagnostic Value of the IgG4+/IgG+ Ratio of Plasmacytic Infiltration for IgG4-Related Diseases

Science.gov (United States)

Deng, Chuiwen; Li, Wenli; Chen, Si; Zhang, Wen; Li, Jing; Hu, Chaojun; Wen, Xiaoting; Zhang, Fengchun; Li, Yongzhe

2015-01-01

Abstract This article aims to perform a meta-analysis to evaluate the diagnostic value of the immunoglobulin G (IgG)4+/IgG+ ratio of plasmacytic infiltration for IgG4-related diseases. Four databases—EMBASE, ISI Web of Knowledge, PubMed, and the Cochrane Library—were systematically searched. Approximately 200 participants from several studies were included in this research. STATA 11.2 software (Stata Corporation, College Station, TX) and Meta-DiSc 1.4 (Unit of Clinical Biostatistics, Ramon y Cajal Hospital, Madrid, Spain) were used to perform the meta-analysis. Nine studies were included in the meta-analysis. The pooled diagnostic odds ratio was 18.94 [95% confidence interval (CI), 2.89–124.30]. The sensitivity was 58.80% (95% CI, 50.90–66.30) and the specificity was 90.20% (95% CI, 81.20–95.80). The positive and negative likelihood ratios were 3.12 (95% CI, 1.07–9.16) and 0.26 (95% CI, 0.09–0.70), respectively. The area under the curve of the summary receiver-operating characteristic was 0.88. To conclude, the IgG4+/IgG+ ratio of plasmacytic infiltration is modestly effective in diagnosing IgG-related disease. PMID:25738476

Studying social robots in practiced places

DEFF Research Database (Denmark)

Hasse, Cathrine; Bruun, Maja Hojer; Hanghøj, Signe

2015-01-01

values, social relations and materialities. Though substantial funding has been invested in developing health service robots, few studies have been undertaken that explore human-robot interactions as they play out in everyday practice. We argue that the complex learning processes involve not only so...... of technologies in use, e.g., technologies as multistable ontologies. The argument builds on an empirical study of robots at a Danish rehabilitation centre. Ethnographic methods combined with anthropological learning processes open up new way for exploring how robots enter into professional practices and change...

Robot Control Overview: An Industrial Perspective

Directory of Open Access Journals (Sweden)

T. Brogårdh

2009-07-01

Full Text Available One key competence for robot manufacturers is robot control, defined as all the technologies needed to control the electromechanical system of an industrial robot. By means of modeling, identification, optimization, and model-based control it is possible to reduce robot cost, increase robot performance, and solve requirements from new automation concepts and new application processes. Model-based control, including kinematics error compensation, optimal servo reference- and feed-forward generation, and servo design, tuning, and scheduling, has meant a breakthrough for the use of robots in industry. Relying on this breakthrough, new automation concepts such as high performance multi robot collaboration and human robot collaboration can be introduced. Robot manufacturers can build robots with more compliant components and mechanical structures without loosing performance and robots can be used also in applications with very high performance requirements, e.g., in assembly, machining, and laser cutting. In the future it is expected that the importance of sensor control will increase, both with respect to sensors in the robot structure to increase the control performance of the robot itself and sensors outside the robot related to the applications and the automation systems. In this connection sensor fusion and learning functionalities will be needed together with the robot control for easy and intuitive installation, programming, and maintenance of industrial robots.

Multi-optimization Criteria-based Robot Behavioral Adaptability and Motion Planning

International Nuclear Information System (INIS)

Pin, Francois G.

2002-01-01

Robotic tasks are typically defined in Task Space (e.g., the 3-D World), whereas robots are controlled in Joint Space (motors). The transformation from Task Space to Joint Space must consider the task objectives (e.g., high precision, strength optimization, torque optimization), the task constraints (e.g., obstacles, joint limits, non-holonomic constraints, contact or tool task constraints), and the robot kinematics configuration (e.g., tools, type of joints, mobile platform, manipulator, modular additions, locked joints). Commercially available robots are optimized for a specific set of tasks, objectives and constraints and, therefore, their control codes are extremely specific to a particular set of conditions. Thus, there exist a multiplicity of codes, each handling a particular set of conditions, but none suitable for use on robots with widely varying tasks, objectives, constraints, or environments. On the other hand, most DOE missions and tasks are typically ''batches of one''. Attempting to use commercial codes for such work requires significant personnel and schedule costs for re-programming or adding code to the robots whenever a change in task objective, robot configuration, number and type of constraint, etc. occurs. The objective of our project is to develop a ''generic code'' to implement this Task-space to Joint-Space transformation that would allow robot behavior adaptation, in real time (at loop rate), to changes in task objectives, number and type of constraints, modes of controls, kinematics configuration (e.g., new tools, added module). Our specific goal is to develop a single code for the general solution of under-specified systems of algebraic equations that is suitable for solving the inverse kinematics of robots, is useable for all types of robots (mobile robots, manipulators, mobile manipulators, etc.) with no limitation on the number of joints and the number of controlled Task-Space variables, can adapt to real time changes in number and

IgG4 Aortitis: A Case Report.

Science.gov (United States)

Marketkar, Shivali; LeGolvan, Mark

2017-04-03

IgG4 aortitis is one of the entities seen in the spectrum of IgG4-related disease (IgG4-RD). It is characterized by serologic (elevated serum IgG4) and histologic features including a lymphoplasmacytic infiltrate with increased numbers of IgG4-positive plasma cells, storiform fibrosis and obliterative phlebitis. Some studies have described a correlation between infections and IgG4 aortitis. We describe a patient with an aneurysm of the infrarenal descending abdominal aorta with features of IgG4-RD, as well as culture evidence of Streptococcus sanguis. [Full article available at http://rimed.org/rimedicaljournal-2017-04.asp].

Adaptive Behavior for Mobile Robots

Science.gov (United States)

Huntsberger, Terrance

2009-01-01

The term "System for Mobility and Access to Rough Terrain" (SMART) denotes a theoretical framework, a control architecture, and an algorithm that implements the framework and architecture, for enabling a land-mobile robot to adapt to changing conditions. SMART is intended to enable the robot to recognize adverse terrain conditions beyond its optimal operational envelope, and, in response, to intelligently reconfigure itself (e.g., adjust suspension heights or baseline distances between suspension points) or adapt its driving techniques (e.g., engage in a crabbing motion as a switchback technique for ascending steep terrain). Conceived for original application aboard Mars rovers and similar autonomous or semi-autonomous mobile robots used in exploration of remote planets, SMART could also be applied to autonomous terrestrial vehicles to be used for search, rescue, and/or exploration on rough terrain.

Increased IgG4-Positive Plasma Cells in Granulomatosis with Polyangiitis: A Diagnostic Pitfall of IgG4-Related Disease

Directory of Open Access Journals (Sweden)

Sing Yun Chang

2012-01-01

Full Text Available Granulomatosis with polyangiitis (Wegener’s (GPA may mimic IgG4-related disease (IgG4-RD on histologic examination of some biopsies, especially those from head and neck sites. IgG4 immunostain is often performed in this context for differential diagnosis with IgG4-RD. However, the prevalence of IgG4+ cells in GPA has not been explored. We examined the IgG4+ cells in 26 cases confirmed as GPA by a thorough clinical and pathologic assessment. Twenty-six biopsies consisted of 14 sinonasal/oral cavity/nasopharynx, 7 orbit/periorbital, 3 lung/pleura, 1 iliac fossa/kidney, and 1 dura specimens. Eight of 26 (31% biopsies revealed increased IgG4+ cells (>30/HPF and >40% in IgG4+/IgG+ ratio. The IgG4+ cells and IgG4+/IgG+ ratio ranged 37–137/hpf and 44–83%, respectively. Eight biopsies with increased IgG4+ cells were from sinonasal (n=4 or orbital/periorbital (n=4 sites. In conclusion, increased IgG4+ cells are not uncommonly seen in sinonasal or orbital/periorbital biopsies of GPA, which could pose as a diagnostic pitfall.

Pain relief by Cyberknife radiosurgery for spinal metastasis.

Science.gov (United States)

Lee, Sunyoung; Chun, Mison

2012-01-01

To report pain relief effect in patients with spinal metastases treated with Cyberknife® and to analyze the factors associated with pain relapse after initial pain relief. We retrospectively analyzed patients with spinal metastasis treated with stereotactic body radiosurgery between April 2007 and June 2009. A total of 57 patients with 73 lesions were available for analysis with a median follow-up of 6.8 months (range, 1-30). Pain was assessed by a verbal/visual analogue scale at each visit: from 0 to 10. Pain relief was defined as a decrease of at least three levels of the pain score without an increase in analgesic use. Complete relief was defined as no analgesics or a score 0 or 1. Pain relief was achieved in 88% of the lesions, with complete relief in 51% within 7 days from the start of radiosurgery. The median duration of pain relief was 3.2 months (range, 1-30). Pain reappeared in 16 patients (27%). Spinal cord compression (P = 0.001) and performance status (P = 0.01) were predictive of pain relapse by multivariate Cox analysis. All 6 patients treated with solitary spinal metastasis experienced pain relief; 5 of them were alive without evidence of disease at a median of 16 months (range, 7-30). As previous studies have shown, our study confirms that pain relief with spinal radiosurgery is around 90%. In particular, long-term pain relief and disease control was observed in patients with solitary spinal metastasis.

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy

Science.gov (United States)

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-01

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy.

Science.gov (United States)

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-05

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP

Mycobacterium tuberculosis DinG is a structure-specific helicase that unwinds G4 DNA: implications for targeting G4 DNA as a novel therapeutic approach.

Science.gov (United States)

Thakur, Roshan Singh; Desingu, Ambika; Basavaraju, Shivakumar; Subramanya, Shreelakshmi; Rao, Desirazu N; Nagaraju, Ganesh

2014-09-05

The significance of G-quadruplexes and the helicases that resolve G4 structures in prokaryotes is poorly understood. The Mycobacterium tuberculosis genome is GC-rich and contains >10,000 sequences that have the potential to form G4 structures. In Escherichia coli, RecQ helicase unwinds G4 structures. However, RecQ is absent in M. tuberculosis, and the helicase that participates in G4 resolution in M. tuberculosis is obscure. Here, we show that M. tuberculosis DinG (MtDinG) exhibits high affinity for ssDNA and ssDNA translocation with a 5' → 3' polarity. Interestingly, MtDinG unwinds overhangs, flap structures, and forked duplexes but fails to unwind linear duplex DNA. Our data with DNase I footprinting provide mechanistic insights and suggest that MtDinG is a 5' → 3' polarity helicase. Notably, in contrast to E. coli DinG, MtDinG catalyzes unwinding of replication fork and Holliday junction structures. Strikingly, we find that MtDinG resolves intermolecular G4 structures. These data suggest that MtDinG is a multifunctional structure-specific helicase that unwinds model structures of DNA replication, repair, and recombination as well as G4 structures. We finally demonstrate that promoter sequences of M. tuberculosis PE_PGRS2, mce1R, and moeB1 genes contain G4 structures, implying that G4 structures may regulate gene expression in M. tuberculosis. We discuss these data and implicate targeting G4 structures and DinG helicase in M. tuberculosis could be a novel therapeutic strategy for culminating the infection with this pathogen. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

Immunochemical characteristics of IgG4 antibodies

NARCIS (Netherlands)

van der Zee, J. S.; Aalberse, R. C.

1988-01-01

Although a small part of the IgG4 subclass probably can bind to basophils (and mast cells), IgG4 antibodies usually do not behave as anaphylactic antibodies. Therefore, detection of IgG4 antibodies in serum is not a suitable in vitro assay for IgG-S-TS activity. Furthermore, differences between IgG4

Robotics: The next step?

Science.gov (United States)

Broeders, Ivo A M J

2014-02-01

Robotic systems were introduced 15 years ago to support complex endoscopic procedures. The technology is increasingly used in gastro-intestinal surgery. In this article, literature on experimental- and clinical research is reviewed and ergonomic issues are discussed. literature review was based on Medline search using a large variety of search terms, including e.g. robot(ic), randomized, rectal, oesophageal, ergonomics. Review articles on relevant topics are discussed with preference. There is abundant evidence of supremacy in performing complex endoscopic surgery tasks when using the robot in an experimental setting. There is little high-level evidence so far on translation of these merits to clinical practice. Robotic systems may appear helpful in complex gastro-intestinal surgery. Moreover, dedicated computer based technology integrated in telepresence systems opens the way to integration of planning, diagnostics and therapy. The first high tech add-ons such as near infrared technology are under clinical evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Overview of IgG4 - Related Disease.

Science.gov (United States)

Opriţă, R; Opriţă, B; Berceanu, D; Diaconescu, I B

2017-01-01

Rationale (hypothesis): IgG4-related disease (IgG4-RD) is a pathological entity recently recognized by the medical world that can affect any organ or system. However, there is insufficient data about this disease in medical literature. Aim (objective): A more extensive clarification of the IgG4 molecule, the diversified aspects of IgG4-related disease, and the response of this disease to treatment, will provide a crucial understanding of the immune system and other diseases now known to be associated with IgG4. The MEDLINE online medical database was used, and, after a comprehensive review of medical articles regarding IgG4-RD, published after 2003, using the search words "IgG4- related disease" and "IgG4 molecule", we have described the clinical, pathological and therapeutic features of IgG4-RD, as well as the presence of the IgG4 molecule in the evolution, diagnosis and management of this syndrome. We characterized the potential disease mechanisms and discussed early observations related to treatment. Given the response to immunosuppressive therapy, it is hypothesized that IgG4-related disease is most likely an autoimmune disease. Therefore, IgG4-related disease is a fibro-inflammatory condition that can affect any organ and can lead to the formation of pseudotumoral lesions requiring differential diagnosis with various malignancies. Positive diagnostic criteria are histopathological and require at least two features out of the following three: dense limphoplasmocitary infiltrate, storiform fibrosis, obliterative phlebitis.

Robots in the Roses

OpenAIRE

2014-01-01

2014-04 Robots in the Roses A CRUSER Sponsored Event. The 4th Annual Robots in the Roses provides a venue for Faculty & NPS Students to showcase unmanned systems research (current or completed) and recruit NPS Students to join in researching on your project. Posters, robots, vehicles, videos, and even just plain humans welcome! Families are welcome to attend Robots in the Roses as we'll have a STEM activity for children to participate in.

IgG4-gerelateerde ziekte

NARCIS (Netherlands)

Maillette de Buy Wenniger, Lucas J.; Doorenspleet, Marieke E.; Verheij, Joanne; de Vries, Niek; Beuers, Ulrich

2013-01-01

The diagnosis IgG4-related disease (IgG4-RD) is often difficult to make. The clinical spectrum is diverse, with a variety of organ systems that may be affected simultaneously or sequentially. Patients often present with symptoms that mimic a malignant disease, for example, symptoms compatible with a

IgG4-Related Perineural Disease

Directory of Open Access Journals (Sweden)

Dai Inoue

2012-01-01

Full Text Available Aims. To elucidate characteristics of IgG4-related disease involving the peripheral nervous system. Methods. Retrospective review of 106 patients with IgG4-related disease identified 21 peripheral nerve lesions in 7 patients. Clinicopathological and radiological features were examined. Results. Peripheral nerve lesions were commonly identified in orbital or paravertebral area, involving orbital (=9, optic (=4, spinal (=7, and great auricular nerves (=1. The predominant radiological feature was a distinct perineural soft tissue mass, ranging 8 to 30 mm in diameter. Histologically, the epineurium was preferentially involved by massive lymphoplasmacytic infiltration rich in IgG4+ plasma cells. All lesions were neurologically asymptomatic and steroid-responsive at the first presentation, but one recurrent lesion around the optic nerve caused failing vision. Conclusion. IgG4-related disease of the peripheral nervous system is characterized by orbital or paravertebral localization, perineural mass formation, and rare neurologic symptoms. The term “IgG4-related perineural disease” seems appropriate to describe this entity.

Immunoglobulin G4-Related Disease: An Update

Directory of Open Access Journals (Sweden)

Abdullah Al-Mujaini

2018-03-01

Full Text Available Immunoglobulin G4-related disease (IgG4-RD is an increasingly recognized immune-mediated condition comprised of a collection of disorders that share specific pathological, serological, and clinical features. IgG4-RD is a fibroinflammatory condition with a tendency to form tumors with inflammatory infiltrate with IgG4 rich plasma cells and elevation of serum IgG4, which may affect virtually every organ and tissue. IgG4-related ophthalmic disease may present as dacryoadenitis, myositis, or involvement of other orbital tissue. Hypophysitis or pachymeningitis may manifest as cranial neuropathies. The diagnosis of IgG4-RD is based on a typical clinical scenario, supportive laboratory test, expected radiological characteristics, and distinct histopathological and immunohistochemical features. Corticosteroids and immunosuppressives form the mainline treatment.

[IgG4 immunohistochemistry in Riedle thyroiditis].

Science.gov (United States)

Wang, S; Luo, Y F; Cao, J L; Zhang, H; Shi, X H; Liang, Z Y; Feng, R E

2017-03-08

Objective: To observe the histopathological changes and immunohistochemical expression of IgG4 in Riedle thyroiditis (RT) and to study the relationship between RT and IgG4-related diseases (IgG4-RD). Methods: A total of 5 RT patients were collected from the Department of Pathology, Peking Union Medical College Hospital during April 2012 to August 2014. The clinical and immunohistochemical features were analyzed in the 5 patients. Histopathologic analysis was performed on hematoxylin and eosin-stained sections. Results: There were one male and four female patients, aged 52 to 78 years (median 59 years). Five cases were characterized by multiple nodules of thyroid, which increased year by year. All patients were found to have surrounding tissue compression symptoms and signs. Two female patients were found to have hypothyroidism. The serum concentration of IgG was elevated in 2 cases, and the serum concentration of IgG was not tested before operation in the remaining patients. By ultrasound, all presented as low echo or medium low echo. Strong echo occasionally appeared in hypoechoic nodules. Microscopically, fibrous tissue hyperplasia was infiltrated with varying numbers of lymphocytes and plasma cells. The occlusion of phlebitis was found in 4 cases and eosinophils were found in 3 cases. IgG4 counts and IgG4/IgG ratios in 5 cases were 20/HPF, 16%; 60/HPF, 82%; 22/HPF, 28%; 400/HPF, 266% and 33/HPF, 71%, respectively. Conclusions: With the similar pathological manifestations between RT and IgG4-RD, immunohistochemical staining shows that the number of IgG4 positive plasma cells and IgG4/IgG ratio of RT are increased in varying degrees. Some cases meet the diagnostic criteria of IgG4-RD, and speculate that some cases of RT belong to IgG4-RD.

Exploring the ethical landscape of robot-assisted Search and Rescue

NARCIS (Netherlands)

Harbers, M.; Greeff, J. de; Kruijff-Korbayová, I.; Neerincx, M.A.; Hindriks, K.V.

2017-01-01

As robots are increasingly used in Search and Rescue (SAR) missions, it becomes highly relevant to study how SAR robots can be developed and deployed in a responsible way. In contrast to some other robot application domains, e.g. military and healthcare, the ethics of robot-assisted SAR are

Exploring child-robot engagement in a collaborative task

NARCIS (Netherlands)

Zaga, Cristina; Truong, Khiet Phuong; Lohse, M.; Evers, Vanessa

Imagine a room with toys scattered on the floor and a robot that is motivating a small group of children to tidy up. This scenario poses real-world challenges for the robot, e.g., the robot needs to navigate autonomously in a cluttered environment, it needs to classify and grasp objects, and it

Modular robotics for playful physiotherapy

DEFF Research Database (Denmark)

Lund, Henrik Hautop

2009-01-01

We developed modular robotic tiles to be used for playful physiotherapy, which is supposed to motivate patients to engage in and perform physical rehabilitation exercises. We tested the modular robotic tiles for an extensive period of time (3 years) in daily use in a hospital rehabilitation unit e.......g. for cardiac patients. Also, the tiles were tested for performing physical rehabilitation of stroke patients in their private home. In all pilot test cases qualitative feedback indicate that the patients find the playful use of modular robotic tiles engaging and motivating for them to perform...

Sociable mobile robots through self-maintained energy

DEFF Research Database (Denmark)

Ngo, Trung Dung; Schiøler, Henrik

2006-01-01

society, collecting and sharing are experimentally recognized as the highest property. This paper issues an approach to sociable robots using self-maintained energy in robot society, which is naturally inspired from swarm behavior of honey-bee and ant. Typically, autonomous mobile robots are usually......Research of sociable robots has emphasized interaction and coordination of mobile robots with inspiration from natural behavior of birds, insects, and fish: flocking, foraging, collecting, sharing and so forth. However, the animal behaviors are looking for food towards survival. In an animal...... equipped with a finite energy, thus they can operate in a finite time. To overcome the limitation, we describe practical deployment of a group of mobile robot with the possibility of carrying and exchanging fuel, e.g. battery to other robots. Early implementation that includes modular hardware and control...

Anatomy-Based Organization of Modular Robots

DEFF Research Database (Denmark)

Christensen, David Johan; Campbell, Jason

2008-01-01

This paper presents a novel biologically inspired hierarchical approach to organizing and controlling modular robots. The purpose of our approach is to decompose the complexity of assembling and commanding a functional robot made of numerous simple modules (thousands to millions) by introducing...... a hierarchy of structure and control. The robots we describe incorporate anatomically inspired parts such as muscles, bones and joints, and these parts in turn are assembled from modules. Each of those parts encapsulates one or more functions, e.g. a muscle can contract. Control of the robot can then be cast...... as a problem of controlling its anatomical parts rather than each discrete module. We show simulation results from experiments using gradient-based primitives to control parts of increasingly complex robots, including snake, crawler, cilia-surface, arm-joint-muscle and grasping robots. We conclude...

Cholangiocarcinoma with respect to IgG4 Reaction

Directory of Open Access Journals (Sweden)

Kenichi Harada

2014-01-01

Full Text Available IgG4 reactions marked by infiltration of IgG4-positive plasma cells in affected organs occur in cancer patients and in patients with IgG4-related diseases. Extrahepatic cholangiocarcinomas including gall bladder cancer are often accompanied by significant IgG4 reactions; these reactions show a negative correlation with CD8-positive cytotoxic T cells, suggesting that the evasion of immune surveillance is associated with cytotoxic T cells. The regulatory cytokine IL-10 may induce IgG4-positive plasma cell differentiation or promote B cell switching to IgG4 in the presence of IL-4. Cholangiocarcinoma cells may function as nonprofessional antigen presenting cells that indirectly induce IgG4 reactions via the IL-10-producing cells and/or these may act as Foxp3-positive and IL-10-producing cells that directly induce IgG4 reactions. Moreover, IgG4-related disease is a high-risk factor for cancer development; IgG4-related sclerosing cholangitis (IgG4-SC cases associated with cholangiocarcinoma or its precursor lesion biliary intraepithelial neoplasia (BilIN have been reported. IgG4-positive cell infiltration is an important finding of IgG4-SC but is not a histological hallmark of IgG4-SC. For the diagnosis of IgG4-SC, its differentiation from cholangiocarcinoma remains important.

Evaluación experimental del caminado en tiempo real de un robot bípedo de 5 g.d.l. con marcha basada en movimientos cicloidales

Directory of Open Access Journals (Sweden)

Víctor De-León-Gómez

2015-10-01

Full Text Available Resumen: En este artículo se presentan los resultados de las pruebas de caminado realizadas con el robot bípedo de 5 grados de libertad (g.d.l. desarrollado en el Instituto Tecnológico de la Laguna (ITLag. El patrón de marcha que se aplica en este robot se basa en leyes de movimiento de tipo cicloidal, las cuales le permiten avanzar mediante pasos sin impactos. Los experimentos realizados mostraron un adecuado comportamiento mecánico del robot y un desempeño eficaz de la ley de control aplicada para mantener el ZMP (acrónimo de Zero Moment Point dentro del polígono de soporte de los pies del robot durante la marcha. Los parámetros especificados para el patrón de marcha aseguraron un caminado estable del robot, sin saturar los pares demandados a los actuadores. Abstract: The results of experimental tests of walking of the 5 degrees of freedom (dof biped robot developed at the Instituto Tecnológico de la Laguna (ITLag are presented in this paper. The gait pattern that is applied in this robot is based on cycloidal motion-type laws, which allow to advance by steps without impacts. Experiments showed an adequate mechanical behavior of the robot and effective performance of the control law applied to keep the ZMP (Zero Moment Point inside of the support polygon of the robot's feet during walking. The specified parameters for gait pattern ensured a stable walking of the robot, without saturating the torque applied by the actuators. Palabras clave: Robots bípedos, patrones de marcha, ZMP, movimiento cicloidal, seguimiento de trayectorias., Keywords: Biped robots, gait patterns, ZMP, cycloidal motion, path tracking.

Plasminogen activator inhibitor I 4G/5G polymorphism in neonatal respiratory distress syndrome.

Science.gov (United States)

Armangil, Didem; Yurdakök, Murat; Okur, Hamza; Gürgey, Aytemiz

2011-08-01

Fibrin monomers inhibit surfactant function. 4G/5G insertion/deletion polymorphism plays an important role in the regulation of plasminogen activator inhibitor 1 (PAI-1) gene expression. To examine the genotype distribution of PAI-1 polymorphism in 60 infants with respiratory distress syndrome (RDS) and 53 controls, an allele-specific polymerase chain reaction (PCR) was used. The proportion of 4G/4G, 4G/5G, and 5G/5G genotypes did not differ statistically between the RDS and control groups (P > .05). Having PAI-1 4G/4G genotype polymorphism appears to increase the risk of RDS (odds ratio [OR] =1.5; 95% confidence interval [CI], 0.5-4.3), although it was not statistically significant. No relation was found between the PAI-1 4G/5G polymorphisms and RDS, but there was an increased risk associated with the 4G variant of the PAI-1 gene. We believe that our findings of increased 4G allele of the PAI-1 gene in infants with RDS would also help to clarify the pathogenesis of RDS.

SU-F-T-569: Implementation of a Patient Specific QA Method Using EBT-XD for CyberKnife SRS/SBRT Plans

Energy Technology Data Exchange (ETDEWEB)

Zerouali, K; Aubry, J; Doucet, R [Centre hospitalier de l’Universite de Montreal, Montreal, Quebec (Canada)

2016-06-15

Purpose: To implement the new EBT-XD Gafchromic films for accurate dosimetric and geometric validation of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) CyberKnife (CK) patient specific QA. Methods: Film calibration was performed using a triplechannel film analysis on an Epson 10000XL scanner. Calibration films were irradiated using a Varian Clinac 21EX flattened beam (0 to 20 Gy), to ensure sufficient dose homogeneity. Films were scanned to a resolution of 0.3 mm, 24 hours post irradiation following a well-defined protocol. A set of 12 QA was performed for several types of CK plans: trigeminal neuralgia, brain metastasis, prostate and lung tumors. A custom made insert for the CK head phantom has been manufactured to yield an accurate measured to calculated dose registration. When the high dose region was large enough, absolute dose was also measured with an ionization chamber. Dose calculation is performed using MultiPlan Ray-tracing algorithm for all cases since the phantom is mostly made from near water-equivalent plastic. Results: Good agreement (<2%) was found between the dose to the chamber and the film, when a chamber measurement was possible The average dose difference and standard deviations between film measurements and TPS calculations were respectively 1.75% and 3%. The geometric accuracy has been estimated to be <1 mm, combining robot positioning uncertainty and film registration to calculated dose. Conclusion: Patient specific QA measurements using EBT-XD films yielded a full 2D dose plane with high spatial resolution and acceptable dose accuracy. This method is particularly promising for trigeminal neuralgia plan QA, where the positioning of the spatial dose distribution is equally or more important than the absolute delivered dose to achieve clinical goals.

Hand Gesture Based Wireless Robotic Arm Control for Agricultural Applications

Science.gov (United States)

Kannan Megalingam, Rajesh; Bandhyopadhyay, Shiva; Vamsy Vivek, Gedela; Juned Rahi, Muhammad

2017-08-01

One of the major challenges in agriculture is harvesting. It is very hard and sometimes even unsafe for workers to go to each plant and pluck fruits. Robotic systems are increasingly combined with new technologies to automate or semi automate labour intensive work, such as e.g. grape harvesting. In this work we propose a semi-automatic method for aid in harvesting fruits and hence increase productivity per man hour. A robotic arm fixed to a rover roams in the in orchard and the user can control it remotely using the hand glove fixed with various sensors. These sensors can position the robotic arm remotely to harvest the fruits. In this paper we discuss the design of hand glove fixed with various sensors, design of 4 DoF robotic arm and the wireless control interface. In addition the setup of the system and the testing and evaluation under lab conditions are also presented in this paper.

Control of free-flying space robot manipulator systems

Science.gov (United States)

Cannon, Robert H., Jr.

1990-01-01

New control techniques for self contained, autonomous free flying space robots were developed and tested experimentally. Free flying robots are envisioned as a key element of any successful long term presence in space. These robots must be capable of performing the assembly, maintenance, and inspection, and repair tasks that currently require human extravehicular activity (EVA). A set of research projects were developed and carried out using lab models of satellite robots and a flexible manipulator. The second generation space robot models use air cushion vehicle (ACV) technology to simulate in 2-D the drag free, zero g conditions of space. The current work is divided into 5 major projects: Global Navigation and Control of a Free Floating Robot, Cooperative Manipulation from a Free Flying Robot, Multiple Robot Cooperation, Thrusterless Robotic Locomotion, and Dynamic Payload Manipulation. These projects are examined in detail.

To Err Is Robot: How Humans Assess and Act toward an Erroneous Social Robot

Directory of Open Access Journals (Sweden)

Nicole Mirnig

2017-05-01

Full Text Available We conducted a user study for which we purposefully programmed faulty behavior into a robot’s routine. It was our aim to explore if participants rate the faulty robot different from an error-free robot and which reactions people show in interaction with a faulty robot. The study was based on our previous research on robot errors where we detected typical error situations and the resulting social signals of our participants during social human–robot interaction. In contrast to our previous work, where we studied video material in which robot errors occurred unintentionally, in the herein reported user study, we purposefully elicited robot errors to further explore the human interaction partners’ social signals following a robot error. Our participants interacted with a human-like NAO, and the robot either performed faulty or free from error. First, the robot asked the participants a set of predefined questions and then it asked them to complete a couple of LEGO building tasks. After the interaction, we asked the participants to rate the robot’s anthropomorphism, likability, and perceived intelligence. We also interviewed the participants on their opinion about the interaction. Additionally, we video-coded the social signals the participants showed during their interaction with the robot as well as the answers they provided the robot with. Our results show that participants liked the faulty robot significantly better than the robot that interacted flawlessly. We did not find significant differences in people’s ratings of the robot’s anthropomorphism and perceived intelligence. The qualitative data confirmed the questionnaire results in showing that although the participants recognized the robot’s mistakes, they did not necessarily reject the erroneous robot. The annotations of the video data further showed that gaze shifts (e.g., from an object to the robot or vice versa and laughter are typical reactions to unexpected robot behavior

Human IgG4: a structural perspective.

Science.gov (United States)

Davies, Anna M; Sutton, Brian J

2015-11-01

IgG4, the least represented human IgG subclass in serum, is an intriguing antibody with unique biological properties, such as the ability to undergo Fab-arm exchange and limit immune complex formation. The lack of effector functions, such as antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity, is desirable for therapeutic purposes. IgG4 plays a protective role in allergy by acting as a blocking antibody, and inhibiting mast cell degranulation, but a deleterious role in malignant melanoma, by impeding IgG1-mediated anti-tumor immunity. These findings highlight the importance of understanding the interaction between IgG4 and Fcγ receptors. Despite a wealth of structural information for the IgG1 subclass, including complexes with Fcγ receptors, and structures for intact antibodies, high-resolution crystal structures were not reported for IgG4-Fc until recently. Here, we highlight some of the biological properties of human IgG4, and review the recent crystal structures of IgG4-Fc. We discuss the unexpected conformations adopted by functionally important Cγ2 domain loops, and speculate about potential implications for the interaction between IgG4 and FcγRs. © 2015 The Authors. Immunological Reviews Published by John Wiley & Sons Ltd.

Transmission techniques for 4G systems

CERN Document Server

Da Silva, Mario Marques

2012-01-01

Fourth Generation (4G) wireless communication systems support current and emergent multimedia services such as mobile TV, social networks and gaming, high-definition TV, video teleconferencing, and messaging services. These systems feature the All-over-IP concept and boast improved quality of service. Several important R&D activities are currently under way in the field of wireless communications for 4G systems, but the coverage is widespread in the literature. Transmission Techniques for 4G Systems presents a compilation of the latest developments in the field of wireless communications for 4

A robotic approach to 4D real-time tumor tracking for radiotherapy

International Nuclear Information System (INIS)

Buzurovic, I; Yu, Y; Huang, K; Podder, T K

2011-01-01

Respiratory and cardiac motions induce displacement and deformation of the tumor volumes in various internal organs. To accommodate this undesired movement and other errors, physicians incorporate a large margin around the tumor to delineate the planning target volume, so that the clinical target volume receives the prescribed radiation dose under any scenario. Consequently, a large volume of healthy tissue is irradiated and sometimes it is difficult to spare critical organs adjacent to the tumor. In this study we have proposed a novel approach to the 4D active tracking and dynamic delivery incorporating the tumor motion prediction technique. This method has been applied to the two commercially available robotic treatment couches. The proposed algorithm can predict the tumor position and the robotic systems are able to continuously track the tumor during radiation dose delivery. Therefore a precise dose is given to a moving target while the dose to the nearby critical organs is reduced to improve the patient treatment outcome. The efficacy of the proposed method has been investigated by extensive computer simulation. The tumor tracking method is simulated for two couches: HexaPOD robotic couch and ELEKTA Precise Table. The comparison results have been presented in this paper. In order to assess the clinical significance, dosimetric effects of the proposed method have been analyzed.

Laws on Robots, Laws by Robots, Laws in Robots : Regulating Robot Behaviour by Design

NARCIS (Netherlands)

Leenes, R.E.; Lucivero, F.

2015-01-01

Speculation about robot morality is almost as old as the concept of a robot itself. Asimov’s three laws of robotics provide an early and well-discussed example of moral rules robots should observe. Despite the widespread influence of the three laws of robotics and their role in shaping visions of

Epstein-Barr virus-infected cells in IgG4-related lymphadenopathy with comparison with extranodal IgG4-related disease.

Science.gov (United States)

Takeuchi, Mai; Sato, Yasuharu; Yasui, Hiroshi; Ozawa, Hiroaki; Ohno, Kyotaro; Takata, Katsuyoshi; Gion, Yuka; Orita, Yorihisa; Tachibana, Tomoyasu; Itoh, Tomoo; Asano, Naoko; Nakamura, Shigeo; Swerdlow, Steven H; Yoshino, Tadashi

2014-07-01

IgG4-related lymphadenopathy with increased numbers of Epstein-Barr virus (EBV)-infected cells has been reported but not fully described. We analyzed 31 cases of IgG4-related lymphadenopathy and 24 cases of extranodal IgG4-related diseases for their possible relationship with EBV. Other types of reactive lymph nodes (22) and angioimmunoblastic T-cell lymphoma (AITL) (10) were also studied for comparison. EBV-encoded RNA (EBER) in situ hybridization revealed EBER(+) cells in 18 of 31 cases (58%) of IgG4-related lymphadenopathy. Increased EBER(+) cells were found in only 4 of 22 (18.1%) non-IgG4-related reactive lymphoid hyperplasia in patients of a similar age (P=0.002) and in only 5 of 24 (21%) extranodal IgG4-related biopsies (P=0.006). Interestingly, all patients with EBER(+) progressively transformed germinal center-type IgG4-related lymphadenopathy had systemic lymphadenopathy and/or extranodal involvement. AITL also is associated with EBV, and IgG4-related lymphadenopathy sometimes mimics the morphology of AITL; however, the number of IgG4(+) cells in AITL was significantly less than that in IgG4-related lymphadenopathy (Pdisease; however, there was not a significant difference between the EBER(+) and EBER(-) cases. In conclusion, the presence of increased numbers of EBV-infected cells in IgG4-related lymphadenopathy, compared with other reactive lymphadenopathy or extranodal IgG4-related disease, suggests that there may be a relationship at least between nodal IgG4-related disease and EBV. It is important to avoid overdiagnosing these cases as malignant lymphomas or EBV-related lymphoproliferative disorders.

Robotics and remote systems applications

International Nuclear Information System (INIS)

Rabold, D.E.

1996-01-01

This article is a review of numerous remote inspection techniques in use at the Savannah River (and other) facilities. These include: (1) reactor tank inspection robot, (2) californium waste removal robot, (3) fuel rod lubrication robot, (4) cesium source manipulation robot, (5) tank 13 survey and decontamination robots, (6) hot gang valve corridor decontamination and junction box removal robots, (7) lead removal from deionizer vessels robot, (8) HB line cleanup robot, (9) remote operation of a front end loader at WIPP, (10) remote overhead video extendible robot, (11) semi-intelligent mobile observing navigator, (12) remote camera systems in the SRS canyons, (13) cameras and borescope for the DWPF, (14) Hanford waste tank camera system, (15) in-tank precipitation camera system, (16) F-area retention basin pipe crawler, (17) waste tank wall crawler and annulus camera, (18) duct inspection, and (19) deionizer resin sampling

The prevalence of PAI-1 4G/5G gene variant in Serbian population

Directory of Open Access Journals (Sweden)

Đorđević Valentina

2013-01-01

Full Text Available Introduction: Plasminogen activator inhibitor 1 (PAI-1 has a major role in inhibition of firinolysis and normal haemostasis. The presence of the PAI-1 4G/4G genotype leads to increased expression of PAI-1. High blood level of PAI-1 is associated with many diseases such as thrombosis, cerebral insult, myocardial infarction, pregnancy loss, preeclampsia, insulin resistance, type 2 diabetes, breast cancer and asthma. In this study, the prevalence of PAI-1 4G/5G gene variant was determined in healthy subjects from Serbian population. Methods: The study was carried out in a group of 210 healthy subjects (105 women and 105 men. The presence of PAI-1 4G/5G gene variant was detected by PCR-RFLP analysis. Results: The prevalence of PAI-1 4G/4G genotype was 34.76% and it was increased compared to PAI-1 5G/5G genotype (19.05%. The most frequent was PAI-1 4G/5G genotype (46.19%. Allelic frequency for 4G allele was higher (0.58 compared to 5G allele (0.42. Conclusions: The prevalence of PAI-1 4G/5G gene variant in Serbian population is similar to the neighboring populations. Results of this study represent the first data for Serbian population. This study could be useful for further research where the role of PAI-1 4G/5G gene variant will be assessed in the pathogenesis of many diseases.

A Case Study: Motivational Attributes of 4-H Participants Engaged in Robotics

Science.gov (United States)

Smith, Mariah Lea

2013-01-01

Robotics has gained a great deal of popularity across the United States as a means to engage youth in science, technology, engineering, and math. Understanding what motivates youth and adults to participate in a robotics project is critical to understanding how to engage others. By developing a robotics program built on a proper understanding of…

Book Review: Robotic Surgery by G Watanabe | Dawka | Archives of ...

African Journals Online (AJOL)

Archives of Medical and Biomedical Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 1, No 3 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Book Review: Robotic Surgery by G ...

[PAL-1 5G/4G polymorphism in patients with systemic lupus erythematosus].

Science.gov (United States)

Savov, A; Andonova, S; Tanev, D; Robeva, R; Marincheva, Ts; Tomova, A; Kumanov, Ph; Rashkov, R; Kolarov, Zl

2014-01-01

Systemic lupus erythematosus (SLE) is a connective tissue disease affecting predominantly women that has been widely associated with obstetric complications. Inherited thrombophilias are significant risk factors for pregnancy loss, but their role in patients with SLE, and especially in those without concomitant secondary antiphospholipid syndrome (APS) has not been clarified. The aim of the present study was to study PAI-1 5G/4G polymorphism in women with lupus. A total of 103 SLE patients as well as 69 healthy volunteers were genotyped for PAI-1 5G/4G (rs1799889). No significant differences in the PAI-1 5G/4G genotype prevalence between patients and controls were found. After exclusion of the women with secondary APS, the frequency of pregnancies and spontaneous abortions, as well as the number of live births were similar in the studied patients with different PAI-1 genotype (p> 0.05). PAI-1 5G/4G polymorphism was not significantly related to any of the lupus ACR criteria or disease activity (p > 0.05), but it could influence the platelet number in the studied patients (263.52 ± 91.10 [5G/5G genotype] versus 210.12 ± 71.79 [4G/4G genotype], p = 0.023). In conclusion, our results showed that PAI-1 4G/5G polymorphism did not worsen the reproductive outcome in SLE women without secondary APS.

Investigating intertemporal choice through experimental evolutionary robotics.

Science.gov (United States)

Paglieri, Fabio; Parisi, Domenico; Patacchiola, Massimiliano; Petrosino, Giancarlo

2015-06-01

In intertemporal choices, subjects face a trade-off between value and delay: achieving the most valuable outcome requires a longer time, whereas the immediately available option is objectively poorer. Intertemporal choices are ubiquitous, and comparative studies reveal commonalities and differences across species: all species devalue future rewards as a function of delay (delay aversion), yet there is a lot of inter-specific variance in how rapidly such devaluation occurs. These differences are often interpreted in terms of ecological rationality, as depending on environmental factors (e.g., feeding ecology) and the physiological and morphological constraints of different species (e.g., metabolic rate). Evolutionary hypotheses, however, are hard to verify in vivo, since it is difficult to observe precisely enough real environments, not to mention ancestral ones. In this paper, we discuss the viability of an approach based on evolutionary robotics: in Study 1, we evolve robots without a metabolism in five different ecologies; in Study 2, we evolve metabolic robots (i.e., robots that consume energy over time) in three different ecologies. The intertemporal choices of the robots are analyzed both in their ecology and under laboratory conditions. Results confirm the generality of delay aversion and the usefulness of studying intertemporal choice through experimental evolutionary robotics. Copyright © 2015 Elsevier B.V. All rights reserved.

PAI-1 4G/5G polymorphism contributes to cancer susceptibility: evidence from meta-analysis.

Science.gov (United States)

Wang, Shangqian; Cao, Qiang; Wang, Xiaoxiang; Li, Bingjie; Tang, Min; Yuan, Wanqing; Fang, Jianzheng; Qian, Jian; Qin, Chao; Zhang, Wei

2013-01-01

The plasminogen activator inhibitor-1 (PAI-1) is expressed in many cancer cell types and allows the modulation of cancer growth, invasion and angiogenesis. To date, studies investigated the association between a functional polymorphism in PAI-1 (4G/5G) and risk of cancer have shown inclusive results. A meta-analysis based on 25 case-control studies was performed to address this issue. Odds ratios (OR) with corresponding 95% confidence intervals (CIs) were used to assess the association. The statistical heterogeneity across studies was examined with I(2) test. Overall, a significant increased risk of cancer was associated with the PAI-1 4G/4G polymorphism for the allele contrast (4G vs. 5G: OR = 1.10, CI = 1.03-1.18, I(2) = 49.5%), the additive genetic model (4G/4G vs. 5G/5G: OR = 1.21, CI = 1.06-1.39, I(2) = 51.9%), the recessive genetic model (4G/4G vs. 4G/5G+5G/5G: OR = 1.11, CI = 1.04-1.18, I(2) = 20.8%). In the subgroup analysis by ethnicity, the results indicated that individuals with 4G/4G genotype had a significantly higher cancer risk among Caucasians (4G/4G vs. 5G/5G: OR = 1.31, 95%CI = 1.09-1.59, I(2) = 59.6%; 4G/4G vs. 4G/5G: OR = 1.12, 95%CI = 1.04-1.21, I(2) = 3.6%; recessive model: OR = 1.12, 95%CI = 1.05-1.21, I(2) = 25.3%). The results of the present meta-analysis support an association between the PAI-1 4G/5G polymorphism and increasing cancer risk, especially among Caucasians, and those with 4G allele have a high risk to develop colorectal cancer and endometrial cancer.

CyberKnife : kirjallisuuskatsaus sädehoitolaitteesta ja sen käyttökohteista syövän ja muiden sairauksien hoidossa

OpenAIRE

Sormunen, Santtu; Laaksoranta, Eero-Pekka

2013-01-01

Uusia syöpien hoitolaitteita ja -menetelmiä kehitetään koko ajan. Suomeen saatiin vuonna 2012 Pohjoismaiden ensimmäinen CyberKnife-hoitolaite. Tästä laitteesta ei ole vielä tehty kattavaa suomenkielistä kirjallisuuskatsausta. Tämän opinnäytetyön tarkoituksena oli selvittää, millainen hoitolaite CyberKnife on ja millaisia sairauksia sillä voidaan hoitaa. Tavoitteenamme oli tuoda esille monipuolista tietoa CK-hoitolaitteesta terveydenhuoltoalan ammattilaisille ja opiskelijoille. Työ tehtiin sov...

Cultural Robotics: The Culture of Robotics and Robotics in Culture

Directory of Open Access Journals (Sweden)

Hooman Samani

2013-12-01

Full Text Available In this paper, we have investigated the concept of “Cultural Robotics” with regard to the evolution of social into cultural robots in the 21st Century. By defining the concept of culture, the potential development of a culture between humans and robots is explored. Based on the cultural values of the robotics developers, and the learning ability of current robots, cultural attributes in this regard are in the process of being formed, which would define the new concept of cultural robotics. According to the importance of the embodiment of robots in the sense of presence, the influence of robots in communication culture is anticipated. The sustainability of robotics culture based on diversity for cultural communities for various acceptance modalities is explored in order to anticipate the creation of different attributes of culture between robots and humans in the future.

Friendly network robotics; Friendly network robotics

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-03-01

This paper summarizes the research results on the friendly network robotics in fiscal 1996. This research assumes an android robot as an ultimate robot and the future robot system utilizing computer network technology. The robot aiming at human daily work activities in factories or under extreme environments is required to work under usual human work environments. The human robot with similar size, shape and functions to human being is desirable. Such robot having a head with two eyes, two ears and mouth can hold a conversation with human being, can walk with two legs by autonomous adaptive control, and has a behavior intelligence. Remote operation of such robot is also possible through high-speed computer network. As a key technology to use this robot under coexistence with human being, establishment of human coexistent robotics was studied. As network based robotics, use of robots connected with computer networks was also studied. In addition, the R-cube (R{sup 3}) plan (realtime remote control robot technology) was proposed. 82 refs., 86 figs., 12 tabs.

Designing human-robot collaborations in industry 4.0: explorative case studies

DEFF Research Database (Denmark)

Kadir, Bzhwen A; Broberg, Ole; Souza da Conceição, Carolina

2018-01-01

We are experiencing an increase in human-robot interactions and the use of collaborative robots (cobots) in industrial work systems. To make full use of cobots, it is essential to understand emerging challenges and opportunities. In this paper, we analyse three successful industrial case studies...... of cobots’ implementation. We highlight the top three challenges and opportunities, from the empirical evidence, relate them to current available literature on the topic, and use them to identify key design factor to consider when designing industrial work system with human-robot collaborations....

Robot vision for nuclear advanced robot

International Nuclear Information System (INIS)

Nakayama, Ryoichi; Okano, Hideharu; Kuno, Yoshinori; Miyazawa, Tatsuo; Shimada, Hideo; Okada, Satoshi; Kawamura, Astuo

1991-01-01

This paper describes Robot Vision and Operation System for Nuclear Advanced Robot. This Robot Vision consists of robot position detection, obstacle detection and object recognition. With these vision techniques, a mobile robot can make a path and move autonomously along the planned path. The authors implemented the above robot vision system on the 'Advanced Robot for Nuclear Power Plant' and tested in an environment mocked up as nuclear power plant facilities. Since the operation system for this robot consists of operator's console and a large stereo monitor, this system can be easily operated by one person. Experimental tests were made using the Advanced Robot (nuclear robot). Results indicate that the proposed operation system is very useful, and can be operate by only person. (author)

The autoimmune IgG4 -associated endocrine pathology

Directory of Open Access Journals (Sweden)

Marina Yu. Yukina

2017-11-01

Full Text Available Immunoglobulin G4-associated diseases (IgG4-AD arethe group of chronic progressive autoimmune fibro-inflammatory pathology of various organs and tissues, characterized by their enlargement and abundant infiltration of immunoglobulin G4-positive plasma cells, as well as an increase in the level of serum immunoglobulin G4 (IgG4.In most patients, the disease is characterized by a mild course.However, there is evidence of a high incidence of malignancies in patients with IgG4-AD.Among endocrine IgG4-associated pathologies, pancreatitis with outcome in diabetes mellitus, hypophysitis and thyroiditis are described. Laboratory examination usually reveals an increased level of IgG4. However, the concentration of IgG4 could not be used as the only diagnostic criterion.The possibility of plasmablastsdetermining as a marker of the disease is discussed.Among the imaging techniques CT, MRI and 18F-FDG-PET/CT are used.However, the most informative method of diagnosis is biopsy. Randomized clinical trials to determine clear recommendations for the treatment of IgG4-AD were not conducted.In most cases, glucocorticoids are prescribed, and immunosuppressive therapy is sometimes used.According to the results of recent studies, the genetically engineered drug rituximab is relatively effective in inducing remission of the disease.Given the high recurrence rate and the risk of malignancy, patients with IgG4-AD require careful long-term follow-up. Thus, the review describes the clinical manifestations of IgG4-AD, examines the possibilities of their diagnosis and presents the existing methods of treatment.However, given the fact that IgG4-AD became a separate group of autoimmune pathology less than 20 years ago, there are insufficient data on these diseases. Researches related to epidemiology, pathophysiology, diagnosis and effective treatment of IgG4-AD are actual.

Plasminogen activator inhibitor 1 4G/5G and -844G/A variants in idiopathic recurrent pregnancy loss.

Science.gov (United States)

Magdoud, Kalthoum; Herbepin, Viviana G; Touraine, Renaud; Almawi, Wassim Y; Mahjoub, Touhami

2013-09-01

Plasminogen activator inhibitor type 1 (PAI-1) regulates fibrinolysis, and the common promoter region variants -675G/A (4G/5G) and -844G/A are associated with increased thrombotic risk. Despite evidence linking altered fibrinolysis with adverse pregnancy events, including idiopathic recurrent pregnancy loss (RPL), the contribution of PAI-1 variants to RPL risk remains controversial. We investigated the association between the PAI-1 -844G/A and 4G/5G (-675G/A) variants with altered risk of RPL. This was a case-control study involving 304 women with confirmed RPL and 371 age- and ethnically matched control women. PAI-1 genotyping was performed by PCR single-specific primer -675 (G/A) and real-time PCR (-844G/A) analysis. Minor allele frequency (MAF) of 4G/5G (P 5G single-nucleotide polymorphism (SNP) was significantly associated with RPL under additive, dominant, and recessive genetic models; no association of -844G/A with RPL was seen irrespective of the genetic model tested. Taking common -844G/5G haplotype as reference (OR = 1.00), multivariate analysis confirmed the association of 4G-containing -844A/4G (P 5G, but not -844G/A, PAI-1 variant is associated with an increased risk of RPL. © 2013 John Wiley & Sons Ltd.

In the Hands of Service Robots

DEFF Research Database (Denmark)

Peronard, Jean-Paul

the benefits of applying robots in professional service e.g. healthcare are extensive, the research into consumer motivation is limited. There is a need for a greater understanding of the individual differences in beliefs and perception in relation to service technology in general and in particular for service...... robots. Therefore, this article proposes a general typology of consumer attitudes and expectations towards service robots. Four types of values are identified and labelled critical, practical, affectionate, and desirable. Based on these values four consumer types are then theoretically develop and may...

Model and Behavior-Based Robotic Goalkeeper

DEFF Research Database (Denmark)

Lausen, H.; Nielsen, J.; Nielsen, M.

2003-01-01

This paper describes the design, implementation and test of a goalkeeper robot for the Middle-Size League of RoboCub. The goalkeeper task is implemented by a set of primitive tasks and behaviours coordinated by a 2-level hierarchical state machine. The primitive tasks concerning complex motion...... control are implemented by a non-linear control algorithm, adapted to the different task goals (e.g., follow the ball or the robot posture from local features extracted from images acquired by a catadioptric omni-directional vision system. Most robot parameters were designed based on simulations carried...

TREATMENT OF IgG4-RELATED DISEASE

Directory of Open Access Journals (Sweden)

E. V. Sokol

2016-01-01

Full Text Available IgG4-related disease (IgG4-RD is a fibroinflammatory condition characterized by the occurrence of tumor-like foci in different organs with a unique histological pattern (moirо-like fibrosis, obvious lymphoplasmacytic infiltration with large numbers of IgG4+ plasma cells, and obliterating phlebitis and elevated serum IgG4 levels in the majority of patients. Its first-line therapy is glucocorticoids at a starting dose of 0.6 mg/kg/day (equivalent to prednisolone; however, this treatment entails a great number of adverse events and high recurrence rates. The paper provides a review of today's literature on the treatment of IgG4-RD; particular emphasis is laid on the description of therapy with glucocorticoids and rituximab.

Iterative Goal Refinement for Robotics

Science.gov (United States)

2014-06-01

Researchers have used a variety of ways to represent such constraints (e.g., as a constraint satisfaction problem ( Scala , to appear), in PDDL (Vaquro...lifecycle to recent models of replanning (Talamadupala et al., 2013) and continual planning ( Scala , to appear). We described goal reasoning in...F., & Barreiro, J. (2013). Towards deliberative control in marine robotics. In Marine Robot Autonomy (pp. 91–175). Springer. Scala , E. (to appear

Soft mobile robots driven by foldable dielectric elastomer actuators

Energy Technology Data Exchange (ETDEWEB)

Sun, Wenjie; Liu, Fan; Ma, Ziqi; Li, Chenghai; Zhou, Jinxiong, E-mail: jxzhouxx@mail.xjtu.edu.cn [State Key Laboratory for Strength and Vibration of Mechanical Structures and School of Aerospace, Xi' an Jiaotong University, Xi' an 710049 (China)

2016-08-28

A cantilever beam with elastic hinge pulled antagonistically by two dielectric elastomer (DE) membranes in tension forms a foldable actuator if one DE membrane is subject to a voltage and releases part of tension. Simply placing parallel rigid bars on the prestressed DE membranes results in enhanced actuators working in a pure shear state. We report design, analysis, fabrication, and experiment of soft mobile robots that are moved by such foldable DE actuators. We describe systematic measurement of the foldable actuators and perform theoretical analysis of such actuators based on minimization of total energy, and a good agreement is achieved between model prediction and measurement. We develop two versions of prototypes of soft mobile robots driven either by two sets of DE membranes or one DE membrane and elastic springs. We demonstrate locomotion of these soft mobile robots and highlight several key design parameters that influence locomotion of the robots. A 45 g soft robot driven by a cyclic triangle voltage with amplitude 7.4 kV demonstrates maximal stroke 160 mm or maximal rolling velocity 42 mm/s. The underlying mechanics and physics of foldable DE actuators can be leveraged to develop other soft machines for various applications.

Clinical features of IgG4-related rhinosinusitis.

Science.gov (United States)

Hanaoka, Machiko; Kammisawa, Terumi; Koizumi, Satomi; Kuruma, Sawako; Chiba, Kazuro; Kikuyama, Masataka; Shirakura, Satoshi; Sugimoto, Taro; Hishima, Tsunekazu

2017-09-01

IgG4-related disease is a systemic disease that affects various organs of the body. Aim of this study is to elucidate the clinical characteristics of IgG4-related rhinosinusitis. Clinical features, laboratory findings, radiological and endoscopic findings, associated disease, treatment and prognosis were retrospectively examined in 10 patients with IgG4-related rhinosinusitis. The age was 59.1±11.3 years old and male-to-female ratio was 1:1. The chief nasal complaints were hyposmia (n=4), nasal obstruction (n=3), and nothing (n=3). Serum IgG4 levels were elevated in all patients and the value was 740.4±472.4mg/dl. Other IgG4-related diseases were associated in all 10 patients, including IgG4-related sialadenitis (n=6), IgG4-related dacryoadenitis (n=5), and autoimmune pancreatitis (n=5). Imaging findings on CT/MRI were obstruction of the way of elimination (n=10), thickening of the sinus mucous membrane (n=10), and fluid in the sinus (n=6). All of the cases had bilateral findings. Nasal endoscopic findings were chiefly deviated nasal septum (n=5), polyps (n=4), edema of the mucous membrane (n=3). Histologically, abundant infiltration of IgG4 positive plasma cell and lymphocyte and an elevated IgG4+/IgG+ cell ration was detected in all 8 patients and 5 patients, respectively. Endoscopic sinus surgery was performed in 8 patients. Eight patients were treated with steroid therapy for other associated IgG4-related diseases. Symptoms improved in all 6 patients after an initial treatment (endoscopic surgery (n=5) and steroids (n=1)), but one patient suffered relapse. IgG4-related rhinosinusitis is a distinct entity of IgG4-related disease, and is associated in patients with multiple IgG4-related diseases. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

Gesture-Based Extraction of Robot Skill Parameters for Intuitive Robot Programming

DEFF Research Database (Denmark)

Pedersen, Mikkel Rath; Krüger, Volker

2015-01-01

a working system capable of TbD would be ideal. Contrary to current TbD approaches, that generally aim to recognize both action and where it is applied, we propose a division of labor, where the operator manually specifies the action the robot should perform, while gestures are used for specifying...... the relevant action parameter (e.g. on which object to apply the action). Using this two-step method has the advantages that there is no uncertainty of which action the robot will perform, it takes into account that the environment changes, so objects do not need to be at predefined locations......, and the parameter specification is possible even for inexperienced users. Experiments with 24 people in 3 different environments verify that it is indeed intuitive, even for a robotics novice, to program a mobile manipulator using this method....

IMac G4/800 (Flat Panel)

CERN Multimedia

2002-01-01

Apple introduced the iMac G4/800 on January 7, 2002. The total cost was about $2000 (base price of $1799 plus RAM upgrade). The iMac G4/800 has an 800 MHz G4 processor. The G4/800 has the following ports: three USB 1.1 ports, two Fire Wire 400-Mbps ports, one RJ-45, 10/100BASE-T Ethernet port, one RJ-11 56K V.90 modem port, one Mini-VGA output port, one speaker jack, and one headphone jack. There is a built in microphone set on the front of the monitor in the bottom left corner. There is a single internal SuperDrive capable of reading and writing CDs and DVDs. The disk drive is on the front of the computer. It opens by pushing the disk drive button on the iMac's keyboard. The monitor size is 15 inches. The G4/800 has a NVIDIA GeForce2 MX graphics processor with AGP 2X support that provides 32 MB of dedicated Double Data Rate (DDR) video memory. Native resolution is 1024 x 768, but the built in monitor is also capable of 640 x 480 and 800 x 600. RAM can be changed by removing a panel on the bottom of the chas...

Current Concept of IgG4-Related Disease.

Science.gov (United States)

Okazaki, Kazuichi; Umehara, Hisanori

2017-01-01

IgG4-related disease (IgG4-RD) is a fibroinflammatory disease of unknown etiology, which is characterized by a tendency to form tumefactive lesions, increased serum levels of IgG4, and massive infiltration of IgG4-positive plasma cells with storiform fibrosis and/or obliterative phlebitis. Patients with IgG4-RD have frequently multiorgan involvements such as the pancreas, biliary tree, salivary glands, periorbital tissues, kidneys, lungs, lymph nodes, and retroperitoneum. IgG4-RD mainly affects middle-aged to elderly men except for involvement in lachrymal and salivary glands, so-called Mikulicz's disease. The clinical manifestations of IgG4-RD depend on individually involved organs and respond well to steroid, but the prognosis still remains unclear. Some patients develop serious complications such as obstructive jaundice due to hepatic, gallbladder, or pancreatic lesions; hydronephrosis due to retroperitoneal fibrosis; or respiratory symptoms due to pulmonary lesions. Nomenclatures of individual organ manifestation of IgG4-RD have been internationally consented.

Polymyositis with elevated serum IgG4 levels and abundant IgG4+ plasma cell infiltration: A case report and literature review.

Science.gov (United States)

Anan, Ryusuke; Akiyama, Mitsuhiro; Kaneko, Yuko; Kikuchi, Jun; Suzuki, Kazuko; Matsubara, Shiro; Takeuchi, Tsutomu

2017-12-01

Polymyositis (PM) is a type of autoimmune, inflammatory myopathy. IgG4-related disease (IgG4-RD) is a recently recognized disease entity characterized by elevated serum IgG4 levels and IgG4 plasma-cell infiltration of various organs. However, several reports have described cases of other diseases that present with those features, suggesting the importance of careful differential diagnosis. Herein, we report the first case of PM with elevated serum IgG4 levels and IgG4 plasma cells in the muscles, mimicking IgG4-RD.A 73-year-old woman visited our hospital because of proximal muscle weakness of both thighs. Her blood test showed high levels of serum creatinine kinase, aldolase, and IgG4. Magnetic resonance imaging of the thighs showed muscle edema. Needle electromyography showed findings typical of myositis. Histological analysis of her left quadriceps revealed infiltration of IgG4 plasma cells as well as CD8 T cells. Scattered necrotic and regenerating muscle fibers with no specific findings for IgG4-RD (storiform fibrosis and obliterative phlebitis) were typical for PM. We diagnosed her condition as PM and treated her with 40 mg/day of prednisolone that decreased levels of muscle enzymes and improved muscle weakness. Our case indicated that PM could present with high serum IgG4 levels and IgG4 plasma-cell infiltration, mimicking IgG4-RD. Although the mechanism of IgG4 elevation in such PM is unclear, our case highlights the necessity to recognize that high serum IgG4 levels and IgG4 plasma-cell infiltration in organs are not specific for IgG4-RD.

R and D on robots for nuclear power plants in 'advanced robot technology' project

International Nuclear Information System (INIS)

Ando, Hiroaki

1987-01-01

The project aims at developing a safe man-robot system of high mobility and workability, highly adaptable to the working environment, and readily and reliably remote-controlled. The plan is to develop 'multi-purpose robots' that can do monitoring, inspection and light work quickly and correctly in areas where access of humans is difficult (e.g. hot spots and the inner space of the primary containment vessel), and 'robots used exclusively for valves, pumps, and other equipment, multi-functional to be used only for specific purposes'. This can be expected to be completed on the basis of results in research and development for the multi-purpose robots. R and D on the total system means manufacturing an optimum system with sufficient functions and performance required for the robot by combining existing technologies most adequately on the basis of the results of research and development on the project. After conceptual drawing and conceptual design, the system will be manufactured and demonstration tests will be completed by fiscal 1987 or 1988. This report describes the total image of the robots concerning the shape, locomotion, manipulation, perception, communication, control management, reliability and environmental durability, and then outlines the research and development activities regarding locomotion, manipulator, tectile sensor, actuator, single-eye three-dimensional measurement, visual data processing, optical spacial transmission, failure repair controller, functional reduction, robot health care and radiation resistance. (Nogami, K.)

Robotic presacral neurectomy - technique and results.

Science.gov (United States)

Kapetanakis, Vasilis; Jacob, Kristina; Klauschie, Jennifer; Kho, Rosanne; Magrina, Javier

2012-03-01

The feasibility, safety and outcomes of robotic presacral neurectomy were evaluated. A retrospective analysis was performed of 33 patients with midline chronic pelvic pain, who underwent robotic presacral neurectomy. Data were collected during the period March 2004-March 2010. All patients underwent robotic presacral neurectomy and additional robotic procedures. Mean operating time for robotic presacral neurectomy was 5.8 (range 4.4-6.9) min. Mean blood loss, including concomitant procedures, was 39 (range 15-150) ml. Most patients were discharged the same day (60%) and mean hospital stay was 0.39 (range 0-2) days. There were no conversions or intra-operative complications. There were two postoperative complications: one pelvic abscess and one Clostridium difficile colitis. Pain improvement was reported by 73% (22/30) of patients. Robotic presacral neurectomy is safe and feasible, resulting in improvement of pelvic pain in selected patients. Copyright © 2011 John Wiley & Sons, Ltd.

Relationship between post-SARS osteonecrosis and PAI-1 4G/5G gene polymorphisms.

Science.gov (United States)

Sun, Wei; Li, Zirong; Shi, Zhengcai; Wang, Bailiang; Gao, Fuqiang; Yang, Yurun; Guo, Wanshou

2014-05-01

To explore the correlation between post-severe acute respiratory symptom (SARS) patients with osteonecrosis, investigate the etiology of post-SARS osteonecrosis and select the sensitive molecular symbols for early diagnosis and distinguish the high-risk population. The studied subjects were divided into two groups. Sixty-two post-SARS patients with osteonecrosis were one group, and 52 age- and sex-matched healthy people were as normal controlled group. Empty stomach blood samples from cubital veins were collected from both groups. Plasminogen activator inhibitor (PAI) by means of enzyme-linked immunosorbent assay and PAI-1 4G/5G polymorphism was detected by polymerase chain reaction and solid phase oligonucleotide assay. The blood agents of post-SARS patients changed obviously with 15.64 ± 13.85 U/ml while the control group 7.96 ± 4.27 U/ml; 4G/4G genotype for the PAI-1 polymorphism detected in post-SARS group was more than that of the control group, but had no statistical significance. The plasma PAI activity was related to homozygote 4G/4G genotype. This reveals that homozygote 4G/4G genotype may be a susceptible gene mark to Chinese osteonecrosis patients. Plasminogen activator inhibitor-1 is sensitive blood symbol for screening high-risk susceptible population; 4G/4G PAI-1 genotype may be an etiological factor in osteonecrosis.

Intrathoracic Manifestations of IgG4-Related Disease

Directory of Open Access Journals (Sweden)

Sian Yik Lim

2016-10-01

Full Text Available Intrathoracic involvement with IgG4-related disease (IgG4-RD is frequently overlooked in IgG4-related disease patients. In this article we review the intrathoracic findings of IgG4-RD which are variable and protean. IgG4-related disease has been reported to affect the lung parenchyma, pleura, mediastinal/hilar lymph nodes, vasculature, and pericardium within the thorax. Mediastinal and hilar lymphadenopathy is the most common intrathoracic manifestation of IgG4-RD. Four main patterns of pulmonary disease have been described, including the solid nodular type, the bronchovascular type, the alveolar interstitial type, and the round shaped ground glass type. When feasible, a biopsy should be obtained to confirm the diagnosis. Most lesions show characteristic pathologic findings of IgG4-RD: dense lymphoplasmacytic infiltrate, storiform fibrosis, and obliterative phlebitis. While this helps establish the diagnosis, the interpretation of pathology findings in the clinical context is key in making an accurate diagnosis. Mimickers of IgG4-RD should be ruled out, before making a diagnosis. The intrathoracic findings of IgG4-RD can be treated effectively with prednisone, but may require additional immunosuppressive therapies, including rituximab.

Robotics in scansorial environments

Science.gov (United States)

Autumn, Kellar; Buehler, Martin; Cutkosky, Mark; Fearing, Ronald; Full, Robert J.; Goldman, Daniel; Groff, Richard; Provancher, William; Rizzi, Alfred A.; Saranli, Uluc; Saunders, Aaron; Koditschek, Daniel E.

2005-05-01

We review a large multidisciplinary effort to develop a family of autonomous robots capable of rapid, agile maneuvers in and around natural and artificial vertical terrains such as walls, cliffs, caves, trees and rubble. Our robot designs are inspired by (but not direct copies of) biological climbers such as cockroaches, geckos, and squirrels. We are incorporating advanced materials (e.g., synthetic gecko hairs) into these designs and fabricating them using state of the art rapid prototyping techniques (e.g., shape deposition manufacturing) that permit multiple iterations of design and testing with an effective integration path for the novel materials and components. We are developing novel motion control techniques to support dexterous climbing behaviors that are inspired by neuroethological studies of animals and descended from earlier frameworks that have proven analytically tractable and empirically sound. Our near term behavioral targets call for vertical climbing on soft (e.g., bark) or rough surfaces and for ascents on smooth, hard steep inclines (e.g., 60 degree slopes on metal or glass sheets) at one body length per second.

The Fab Conformations in the Solution Structure of Human Immunoglobulin G4 (IgG4) Restrict Access to Its Fc Region

Science.gov (United States)

Rayner, Lucy E.; Hui, Gar Kay; Gor, Jayesh; Heenan, Richard K.; Dalby, Paul A.; Perkins, Stephen J.

2014-01-01

Human IgG4 antibody shows therapeutically useful properties compared with the IgG1, IgG2, and IgG3 subclasses. Thus IgG4 does not activate complement and shows conformational variability. These properties are attributable to its hinge region, which is the shortest of the four IgG subclasses. Using high throughput scattering methods, we studied the solution structure of wild-type IgG4(Ser222) and a hinge mutant IgG4(Pro222) in different buffers and temperatures where the proline substitution suppresses the formation of half-antibody. Analytical ultracentrifugation showed that both IgG4 forms were principally monomeric with sedimentation coefficients s20,w0 of 6.6–6.8 S. A monomer-dimer equilibrium was observed in heavy water buffer at low temperature. Scattering showed that the x-ray radius of gyration Rg was unchanged with concentration in 50–250 mm NaCl buffers, whereas the neutron Rg values showed a concentration-dependent increase as the temperature decreased in heavy water buffers. The distance distribution curves (P(r)) revealed two peaks, M1 and M2, that shifted below 2 mg/ml to indicate concentration-dependent IgG4 structures in addition to IgG4 dimer formation at high concentration in heavy water. Constrained x-ray and neutron scattering modeling revealed asymmetric solution structures for IgG4(Ser222) with extended hinge structures. The IgG4(Pro222) structure was similar. Both IgG4 structures showed that their Fab regions were positioned close enough to the Fc region to restrict C1q binding. Our new molecular models for IgG4 explain its inability to activate complement and clarify aspects of its stability and function for therapeutic applications. PMID:24876381

Robotics

Science.gov (United States)

Popov, E. P.; Iurevich, E. I.

The history and the current status of robotics are reviewed, as are the design, operation, and principal applications of industrial robots. Attention is given to programmable robots, robots with adaptive control and elements of artificial intelligence, and remotely controlled robots. The applications of robots discussed include mechanical engineering, cargo handling during transportation and storage, mining, and metallurgy. The future prospects of robotics are briefly outlined.

Multicenter review of robotic versus laparoscopic ventral hernia repair: is there a role for robotics?

Science.gov (United States)

Walker, Peter A; May, Audriene C; Mo, Jiandi; Cherla, Deepa V; Santillan, Monica Rosales; Kim, Steven; Ryan, Heidi; Shah, Shinil K; Wilson, Erik B; Tsuda, Shawn

2018-04-01

The utilization of robotic platforms for general surgery procedures such as hernia repair is growing rapidly in the United States. A limited amount of data are available evaluating operative outcomes in comparison to standard laparoscopic surgery. We completed a retrospective review comparing robotic and laparoscopic ventral hernia repair to provide safety and outcomes data to help design a future prospective trial design. A retrospective review of 215 patients undergoing ventral hernia repair (142 robotic and 73 laparoscopic) was completed at two large academic centers. Primary outcome measure evaluated was recurrence. Secondary outcomes included incidence of primary fascial closure, and surgical site occurrences. Propensity for treatment match comparison demonstrated that robotic repair was associated with a decreased incidence of recurrence (2.1 versus 4.2%, p robotic repair was associated with increased incidence of primary fascial closure (77.1 versus 66.7%, p robotic repairs were completed on patients with lower body mass index (28.1 ± 3.6 versus 34.2 ± 6.4, p robotic repair was associated with decreased recurrence and surgical site occurrence. However, the differences noted in the patient populations limit the interpretability of these results. As adoption of robotic ventral hernia repair increases, prospective trials need to be designed in order to investigate the efficacy, safety, and cost effectiveness of this evolving technique.

Soft segmented inchworm robot with dielectric elastomer muscles

Science.gov (United States)

Conn, Andrew T.; Hinitt, Andrew D.; Wang, Pengchuan

2014-03-01

Robotic devices typically utilize rigid components in order to produce precise and robust operation. Rigidity becomes a significant impediment, however, when navigating confined or constricted environments e.g. search-and-rescue, industrial pipe inspection. In such cases adaptively conformable soft structures become optimal. Dielectric elastomers (DEs) are well suited for developing such soft robots since they are inherently compliant and can produce large musclelike actuation strains. In this paper, a soft segmented inchworm robot is presented that utilizes pneumatically-coupled DE membranes to produce inchworm-like locomotion. The robot is constructed from repeated body segments, each with a simple control architecture, so that the total length can be readily adapted by adding or removing segments. Each segment consists of a soft inflatable shell (internal pressure in range of 1.0-15.9 mBar) and a pair of antagonistic DE membranes (VHB 4905). Experimental testing of a single body segment is presented and the relationship between drive voltage, pneumatic pressure and active displacement is characterized. This demonstrates that pneumatic coupling of DE membranes induces complex non-linear electro-mechanical behaviour as drive voltage and pneumatic pressure are altered. Locomotion of a two-segment inchworm robot prototype with a passive length of 80 mm is presented. Artificial setae are included on the body shell to generate anisotropic friction for locomotion. A maximum locomotion speed of 4.1 mm/s was recorded at a drive frequency of 1.5 Hz, which compares favourably to biological counterparts. Future development of the soft inchworm robot are discussed including reflexive low-level control of individual segments.

International Conference Educational Robotics 2016

CERN Document Server

Moro, Michele; Menegatti, Emanuele

2017-01-01

This book includes papers presented at the International Conference “Educational Robotics 2016 (EDUROBOTICS)”, Athens, November 25, 2016. The papers build on constructivist and constructionist pedagogy and cover a variety of topics, including teacher education, design of educational robotics activities, didactical models, assessment methods, theater robotics, programming & making electronics with Snap4Arduino, the Duckietown project, robotics driven by tangible programming, Lego Mindstorms combined with App Inventor, the Orbital Education Platform, Anthropomorphic Robots and Human Meaning Makers in Education, and more. It provides researchers interested in educational robotics with the latest advances in the field with a focus on science, technology, engineering, arts and mathematics (STEAM) education. At the same time it offers teachers and educators from primary to secondary and tertiary education insights into how educational robotics can trigger the development of technological interest and 21st c...

G4CEP: A G4 theory modification by including pseudopotential for molecules containing first-, second- and third-row representative elements

Energy Technology Data Exchange (ETDEWEB)

Silva, Cleuton de Souza [Instituto de Química, Universidade Estadual de Campinas, Barão Geraldo, P.O. Box 6154, 13083-970 Campinas, São Paulo (Brazil); Instituto de Ciências Exatas e Tecnologia, Universidade Federal do Amazonas, Campus de Itacoatiara, 69100-021 Itacoatiara, Amazonas (Brazil); Pereira, Douglas Henrique [Departamento de Ciências Exatas e Biotecnológicas, Universidade Federal do Tocantins, Campus de Gurupi, 77410-530 Gurupi, Tocantins (Brazil); Custodio, Rogério, E-mail: roger@iqm.unicamp.br [Instituto de Química, Universidade Estadual de Campinas, Barão Geraldo, P.O. Box 6154, 13083-970 Campinas, São Paulo (Brazil)

2016-05-28

The G4CEP composite method was developed from the respective G4 all-electron version by considering the implementation of compact effective pseudopotential (CEP). The G3/05 test set was used as reference to benchmark the adaptation by treating in this work atoms and compounds from the first and second periods of the periodic table, as well as representative elements of the third period, comprising 440 thermochemical data. G4CEP has not reached a so high level of accuracy as the G4 all-electron theory. G4CEP presented a mean absolute error around 1.09 kcal mol{sup −1}, while the original method presents a deviation corresponding to 0.83 kcal mol{sup −1}. The similarity of the optimized molecular geometries between G4 and G4CEP indicates that the core-electron effects and basis set adjustments may be pointed out as a significant factor responsible for the large discrepancies between the pseudopotential results and the experimental data, or even that the all-electron calculations are more efficient either in its formulation or in the cancellation of errors. When the G4CEP mean absolute error (1.09 kcal mol{sup −1}) is compared to 1.29 kcal mol{sup −1} from G3CEP, it does not seem so efficient. However, while the G3CEP uncertainty is ±4.06 kcal mol{sup −1}, the G4CEP deviation is ±2.72 kcal mol{sup −1}. Therefore, the G4CEP theory is considerably more reliable than any previous combination of composite theory and pseudopotential, particularly for enthalpies of formation and electron affinities.

A Quadruped Micro-Robot Based on Piezoelectric Driving

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Qi Su

2018-03-01

Full Text Available Inspired by a way of rowing, a new piezoelectric driving quadruped micro-robot operating in bending-bending hybrid vibration modes was proposed and tested in this work. The robot consisted of a steel base, four steel connecting pins and four similar driving legs, and all legs were bonded by four piezoelectric ceramic plates. The driving principle is discussed, which is based on the hybrid of first order vertical bending and first order horizontal bending vibrations. The bending-bending hybrid vibration modes motivated the driving foot to form an elliptical trajectory in space. The vibrations of four legs were used to provide the driving forces for robot motion. The proposed robot was fabricated and tested according to driving principle. The vibration characteristics and elliptical movements of the driving feet were simulated by FEM method. Experimental tests of vibration characteristics and mechanical output abilities were carried out. The tested resonance frequencies and vibration amplitudes agreed well with the FEM calculated results. The size of robot is 36 mm × 98 mm × 14 mm, its weight is only 49.8 g, but its maximum load capacity achieves 200 g. Furthermore, the robot can achieve a maximum speed of 33.45 mm/s.

Isolated Mass-Forming IgG4-Related Cholangitis as an Initial Clinical Presentation of Systemic IgG4-Related Disease

Directory of Open Access Journals (Sweden)

Seokhwi Kim

2016-07-01

Full Text Available IgG4-related disease (IgG4-RD may involve multiple organs. Although it usually presents as diffuse organ involvement, localized mass-forming lesions have been occasionally encountered in pancreas. However, the same pattern has been seldom reported in biliary tract. A 61-year-old male showed a hilar bile duct mass with multiple enlarged lymph nodes in imaging studies and he underwent trisectionectomy under impression of cholangiocarcinoma. Gross examination revealed a mass-like lesion around hilar bile duct. Histopathologically, dense lymphoplasmacytic infiltration and storiform fibrosis were identified without evidence of malignancy. Immunohistochemical stain demonstrated rich IgG4-positive plasma cell infiltration. Follow-up imaging studies disclosed multiple enlarged lymph nodes with involvement of pancreas and perisplenic soft tissue. The lesions have been significantly reduced after steroid treatment, which suggests multi-organ involvement of systemic IgG4-RD. Here, we report an unusual localized mass-forming IgG4-related cholangitis as an initial presentation of IgG4-RD, which was biliary manifestation of systemic IgG4-related autoimmune disease.

Immunoglobulin G4: an odd antibody

NARCIS (Netherlands)

Aalberse, R. C.; Stapel, S. O.; Schuurman, J.; Rispens, T.

2009-01-01

Despite its well-known association with IgE-mediated allergy, IgG4 antibodies still have several poorly understood characteristics. IgG4 is a very dynamic antibody: the antibody is involved in a continuous process of half-molecules (i.e. a heavy and attached light-chain) exchange. This process, also

Spontaneous compactification of a (4+d)-dimensional Kaluza-Klein theory into M4xG/H for arbitrary G and H

International Nuclear Information System (INIS)

Randjbar-Daemi, S.; Percacci, R.

1982-05-01

Einstein-Yang-Mills theory in 4+d dimensions admits a solution of the form M 4 xG/H, where M 4 is Einstein and G/H is symmetric, if the gauge group is H (or larger). The gauge fields of this solution are topologically nontrivial. The symmetry group is G 4 xGxH, G 4 being the isometry group of M 4 ; M 4 could be Minkowski or anti-de-Sitter space. (author)

IgG4-Related Disease: A Multispecialty Condition

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Iuri Usêda Santana

2014-01-01

Full Text Available IgG4-related disease (IgG4-RD is a recently recognized group of conditions, characterized by tumor-like swelling of involved organs, lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, variable degrees of fibrosis, and elevated serum IgG4 concentrations. Currently IgG4-RD is recognized as a systemic condition that can affect several organs and tissues. Herein we report the case of a 34-year-old male patient who was admitted to our hospital with diffuse abdominal pain, weight loss, and painful stiffness in his neck. He had a history of tumoral mass of the left maxillary region, right palpebral ptosis with protrusion of the eyeball, and chronic dry cough for about 6 years. Laboratory tests revealed polyclonal hypergammaglobulinemia and increased serum IgG4 levels. Immunohistochemical staining of the maxillary biopsy was compatible with IgG4-RD. He had an excellent response to corticosteroid therapy. This case highlights that IgG4-RD should be included in the differential diagnosis with multisystem diseases.

Immunology of IgG4-related disease

Science.gov (United States)

Della-Torre, E; Lanzillotta, M; Doglioni, C

2015-01-01

Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition that derives its name from the characteristic finding of abundant IgG4+ plasma cells in affected tissues, as well as the presence of elevated serum IgG4 concentrations in many patients. In contrast to fibrotic disorders, such as systemic sclerosis or idiopathic pulmonary fibrosis in which the tissues fibrosis has remained largely intractable to treatment, many IgG4-RD patients appear to have a condition in which the collagen deposition is reversible. The mechanisms underlying this peculiar feature remain unknown, but the remarkable efficacy of B cell depletion in these patients supports an important pathogenic role of B cell/T cell collaboration. In particular, aberrant T helper type 2 (Th2)/regulatory T cells sustained by putative autoreactive B cells have been proposed to drive collagen deposition through the production of profibrotic cytokines, but definitive demonstrations of this hypothesis are lacking. Indeed, a number of unsolved questions need to be addressed in order to fully understand the pathogenesis of IgG4-RD. These include the identification of an antigenic trigger(s), the implications (if any) of IgG4 antibodies for pathophysiology and the precise immunological mechanisms leading to fibrosis. Recent investigations have also raised the possibility that innate immunity might precede adaptive immunity, thus further complicating the pathological scenario. Here, we aim to review the most recent insights on the immunology of IgG4-RD, focusing on the relative contribution of innate and adaptive immune responses to the full pathological phenotype of this fibrotic condition. Clinical, histological and therapeutic features are also addressed. PMID:25865251

Robot 2015 : Second Iberian Robotics Conference : Advances in Robotics

CERN Document Server

Moreira, António; Lima, Pedro; Montano, Luis; Muñoz-Martinez, Victor

2016-01-01

This book contains a selection of papers accepted for presentation and discussion at ROBOT 2015: Second Iberian Robotics Conference, held in Lisbon, Portugal, November 19th-21th, 2015. ROBOT 2015 is part of a series of conferences that are a joint organization of SPR – “Sociedade Portuguesa de Robótica/ Portuguese Society for Robotics”, SEIDROB – Sociedad Española para la Investigación y Desarrollo de la Robótica/ Spanish Society for Research and Development in Robotics and CEA-GTRob – Grupo Temático de Robótica/ Robotics Thematic Group. The conference organization had also the collaboration of several universities and research institutes, including: University of Minho, University of Porto, University of Lisbon, Polytechnic Institute of Porto, University of Aveiro, University of Zaragoza, University of Malaga, LIACC, INESC-TEC and LARSyS. Robot 2015 was focussed on the Robotics scientific and technological activities in the Iberian Peninsula, although open to research and delegates from other...

G4-STORK: A Geant4-based Monte Carlo reactor kinetics simulation code

International Nuclear Information System (INIS)

Russell, Liam; Buijs, Adriaan; Jonkmans, Guy

2014-01-01

Highlights: • G4-STORK is a new, time-dependent, Monte Carlo code for reactor physics applications. • G4-STORK was built by adapting and expanding on the Geant4 Monte Carlo toolkit. • G4-STORK was designed to simulate short-term fluctuations in reactor cores. • G4-STORK is well suited for simulating sub- and supercritical assemblies. • G4-STORK was verified through comparisons with DRAGON and MCNP. - Abstract: In this paper we introduce G4-STORK (Geant4 STOchastic Reactor Kinetics), a new, time-dependent, Monte Carlo particle tracking code for reactor physics applications. G4-STORK was built by adapting and expanding on the Geant4 Monte Carlo toolkit. The toolkit provides the fundamental physics models and particle tracking algorithms that track each particle in space and time. It is a framework for further development (e.g. for projects such as G4-STORK). G4-STORK derives reactor physics parameters (e.g. k eff ) from the continuous evolution of a population of neutrons in space and time in the given simulation geometry. In this paper we detail the major additions to the Geant4 toolkit that were necessary to create G4-STORK. These include a renormalization process that maintains a manageable number of neutrons in the simulation even in very sub- or supercritical systems, scoring processes (e.g. recording fission locations, total neutrons produced and lost, etc.) that allow G4-STORK to calculate the reactor physics parameters, and dynamic simulation geometries that can change over the course of simulation to illicit reactor kinetics responses (e.g. fuel temperature reactivity feedback). The additions are verified through simple simulations and code-to-code comparisons with established reactor physics codes such as DRAGON and MCNP. Additionally, G4-STORK was developed to run a single simulation in parallel over many processors using MPI (Message Passing Interface) pipes

Robots Conquering the Homeland of the Vikings

DEFF Research Database (Denmark)

Agger Nielsen, Jeppe; Sigh, Anne; Andersen, Kim Normann

The movement of robots from the production line to the service sector provides a protein solution to innovate and transform public service delivery. However, although robots increasingly are adopted in public service delivery (e.g., in healthcare and eldercare) as an alternative to traditional...... labor intensive services, little is known about their impact on organizations work processes, and how key stakeholders react toward robots. On this backdrop, this single case study investigates implementation and use of robot vacuum cleaners in Danish eldercare at the local government level. Using...... an extended version of the technological frame concept, this paper illustrates how technologist, managers, frontline staff and clients have different perceptions towards robot vacuum cleaning. The technologist and managers praise the new innovation for facilitating savings on the current accounts. By contrast...

Diagnosis of IgG4-related sclerosing cholangitis

Science.gov (United States)

Nakazawa, Takahiro; Naitoh, Itaru; Hayashi, Kazuki; Miyabe, Katsuyuki; Simizu, Shuya; Joh, Takashi

2013-01-01

IgG4-related sclerosing cholangitis (IgG4-SC) is often associated with autoimmune pancreatitis. However, the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis (PSC), and the presence of segmental stenosis suggests cholangiocarcinoma (CC). IgG4-SC responds well to steroid therapy, whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention. Since IgG4-SC was first described, it has become a third distinct clinical entity of sclerosing cholangitis. The aim of this review was to introduce the diagnostic methods for IgG4-SC. IgG4-SC should be carefully diagnosed based on a combination of characteristic clinical, serological, morphological, and histopathological features after cholangiographic classification and targeting of a disease for differential diagnosis. When intrapancreatic stenosis is detected, pancreatic cancer or CC should be ruled out. If multiple intrahepatic stenoses are evident, PSC should be distinguished on the basis of cholangiographic findings and liver biopsy with IgG4 immunostaining. Associated inflammatory bowel disease is suggestive of PSC. If stenosis is demonstrated in the hepatic hilar region, CC should be discriminated by ultrasonography, intraductal ultrasonography, bile duct biopsy, and a higher cutoff serum IgG4 level of 182 mg/dL. PMID:24282356

Towards Human-Friendly Efficient Control of Multi-Robot Teams

Science.gov (United States)

Stoica, Adrian; Theodoridis, Theodoros; Barrero, David F.; Hu, Huosheng; McDonald-Maiers, Klaus

2013-01-01

This paper explores means to increase efficiency in performing tasks with multi-robot teams, in the context of natural Human-Multi-Robot Interfaces (HMRI) for command and control. The motivating scenario is an emergency evacuation by a transport convoy of unmanned ground vehicles (UGVs) that have to traverse, in shortest time, an unknown terrain. In the experiments the operator commands, in minimal time, a group of rovers through a maze. The efficiency of performing such tasks depends on both, the levels of robots' autonomy, and the ability of the operator to command and control the team. The paper extends the classic framework of levels of autonomy (LOA), to levels/hierarchy of autonomy characteristic of Groups (G-LOA), and uses it to determine new strategies for control. An UGVoriented command language (UGVL) is defined, and a mapping is performed from the human-friendly gesture-based HMRI into the UGVL. The UGVL is used to control a team of 3 robots, exploring the efficiency of different G-LOA; specifically, by (a) controlling each robot individually through the maze, (b) controlling a leader and cloning its controls to followers, and (c) controlling the entire group. Not surprisingly, commands at increased G-LOA lead to a faster traverse, yet a number of aspects are worth discussing in this context.

Robots in mining

CSIR Research Space (South Africa)

Green, J

2010-09-01

Full Text Available ? • FOG – Fall of ground • Who is at risk? • What is the cost of incident? • What can we do about it? The Robot Potential • Technology • Conclusion © CSIR 2010 Slide 3 Yes Robots can improve mine safety Robot patrols unoccupied areas Generates a... risk map Additional tool Inform miners in making safe © CSIR 2010 Slide 4 Miner Safety Statistics • from DME (2010/03) • March 2010 • 490 000 employed • 400 000 suppliers1 • 9 died, 7 in rockfall incidents 2 • Prior year- March 2010 • 152...

Establishment of a serum IgG4 cut-off value for the differential diagnosis of IgG4-related disease in Chinese population.

Science.gov (United States)

Li, Ping; Chen, Hua; Deng, Chuiwen; Wu, Ziyan; Lin, Wei; Zeng, Xiaofeng; Zhang, Wen; Zhang, Fengchun; Li, Yongzhe

2016-07-01

This study was performed to better know diagnosis associated with serum IgG4 concentration, and to explore the possibility for development of a serum IgG4 for IgG4-related disease (IgG4-RD) in Chinese populations. We studied retrospectively 497 IgG4 serum subclass measurements from Peking Union Medical College Hospital during the four-year period, including 242 IgG4-RD, 130 other diseases and 125 healthy individuals. Serum IgG4 concentrations were significantly higher in IgG4-RD than in other pathologies (1662.9 ± 3760.9 mg/L, p IgG4 level between other pathologies group and healthy individuals (p = 0.075). Among the 242 IgG4-RD patients analyzed, serum IgG4 concentrations were normal in 46 patients (19.0%). We found 32 patients (24.6%) with elevated serum IgG4 levels among the 130 patients who suffered from other pathologies. There were seven (5.6%) with serum IgG4 over 1350 mg/L in healthy individuals. The ROC curve analysis revealed that the optimal sensitivity and specificity were 80.0% and 88.2%, respectively, at the concentration of 1575 mg/L for Chinese patients. Our study demonstrated that serum IgG4 elevation was not specific of IgG4-RD. Further studies are needed to define the sensibility and specificity of IgG4 values for the diagnosis of IgG4-RD.

Robotics On-Board Trainer (ROBoT)

Science.gov (United States)

Johnson, Genevieve; Alexander, Greg

2013-01-01

ROBoT is an on-orbit version of the ground-based Dynamics Skills Trainer (DST) that astronauts use for training on a frequent basis. This software consists of two primary software groups. The first series of components is responsible for displaying the graphical scenes. The remaining components are responsible for simulating the Mobile Servicing System (MSS), the Japanese Experiment Module Remote Manipulator System (JEMRMS), and the H-II Transfer Vehicle (HTV) Free Flyer Robotics Operations. The MSS simulation software includes: Robotic Workstation (RWS) simulation, a simulation of the Space Station Remote Manipulator System (SSRMS), a simulation of the ISS Command and Control System (CCS), and a portion of the Portable Computer System (PCS) software necessary for MSS operations. These components all run under the CentOS4.5 Linux operating system. The JEMRMS simulation software includes real-time, HIL, dynamics, manipulator multi-body dynamics, and a moving object contact model with Tricks discrete time scheduling. The JEMRMS DST will be used as a functional proficiency and skills trainer for flight crews. The HTV Free Flyer Robotics Operations simulation software adds a functional simulation of HTV vehicle controllers, sensors, and data to the MSS simulation software. These components are intended to support HTV ISS visiting vehicle analysis and training. The scene generation software will use DOUG (Dynamic On-orbit Ubiquitous Graphics) to render the graphical scenes. DOUG runs on a laptop running the CentOS4.5 Linux operating system. DOUG is an Open GL-based 3D computer graphics rendering package. It uses pre-built three-dimensional models of on-orbit ISS and space shuttle systems elements, and provides realtime views of various station and shuttle configurations.

Robotic surgery of the pancreas

Science.gov (United States)

Joyce, Daniel; Morris-Stiff, Gareth; Falk, Gavin A; El-Hayek, Kevin; Chalikonda, Sricharan; Walsh, R Matthew

2014-01-01

Pancreatic surgery is one of the most challenging and complex fields in general surgery. While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open fashion. This is attributed to the retroperitoneal location of the pancreas, its intimate relationship to major vasculature and the complexity of reconstruction in the case of pancreatoduodenectomy. Herein, we describe the application of robotic technology to minimally invasive pancreatic surgery. The unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes (e.g., decreased length of stay, less surgical site infections) to conventional open surgery. However, it is unclear whether the robotic approach is truly superior to traditional laparoscopy; this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities. PMID:25356035

Cultural Robotics: The Culture of Robotics and Robotics in Culture

OpenAIRE

Hooman Samani; Elham Saadatian; Natalie Pang; Doros Polydorou; Owen Noel Newton Fernando; Ryohei Nakatsu; Jeffrey Tzu Kwan Valino Koh

2013-01-01

In this paper, we have investigated the concept of “Cultural Robotics” with regard to the evolution of social into cultural robots in the 21st Century. By defining the concept of culture, the potential development of a culture between humans and robots is explored. Based on the cultural values of the robotics developers, and the learning ability of current robots, cultural attributes in this regard are in the process of being formed, which would define the new concept of cultural robotics. Ac...

Concurrent IgG4-related tubulointerstitial nephritis and IgG4 myeloperoxidase-anti-neutrophil cytoplasmic antibody positive crescentic glomerulonephritis: A case report.

Science.gov (United States)

Su, Tao; Yang, Li; Cui, Zhao; Wang, Su-Xia; Zhao, Ming-Hui

2017-05-01

IgG4-related disease (IgG4-RD) is a newly recognized systemic disease. The typical pathological finding in the kidney is abundant IgG4-positive plasma cell infiltration with characteristic storiform fibrosis in the interstitium. Antibodies of the IgG4 subclass have been linked to certain autoimmune diseases including antiproteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA) of the IgG4 subclass. Here, we report a rare case of kidney injury with concurrent typical IgG4-related tubulointerstitial nephritis and IgG4 subclass of myeloperoxidase (MPO) ANCA-positive necrotizing crescentic glomerulonephritis. A 42-year-old Chinese man presented with repeated epigastric pain, sausage-shaped pancreas observed morphologically in computed tomography, effectiveness of prednisone therapy and was diagnosed with autoimmune pancreatitis. He subsequently developed acute kidney injury. The patient had an elevated serum IgG4, eosinophilia, and positive MPO-ANCA of IgG4-dominant subclass. Renal biopsy revealed necrotizing crescentic nephritis and typical IgG4-related tubulointerstitial nephritis. The patient was treated with a combination of corticosteroids and cyclophosphamide, and a course of rituximab was later added to deplete peripheral B cells. The patient responded well and his renal function improved. This is the first case report of an IgG4-RD with concurrent IgG4-related tubulointerstitial nephritis and IgG4 MPO-ANCA-associated necrotizing crescentic glomerulonephritis. It raises the difficulty in differentiation diagnosis of the two separate diseases that is worthy of further study.

IgG4-RELATED DISEASE. CLINICAL NOTES

Directory of Open Access Journals (Sweden)

Vladimir Ivanovich Vasilyev

2013-01-01

Full Text Available IgG4-related diseases are a new nosological entity that encompasses a few previously known diseases. IgG4-related systemic disease is diagnosed if two or more affected organs are detected. This group of diseases has two similar signs: serological (elevated serum IgG4 subclass concentrations and histological (organ and tissue infiltration from plasmo-cytes secreting IgG4, and eosinophils, and the development of fibrosclerosis and phlebitis obliterans. The paper describes two cases. In one case, a multisystemic disease was observed virtually at its onset whereas in the other this lesion was diagnosed several years after the natural course of the disease.

Robot Actors, Robot Dramaturgies

DEFF Research Database (Denmark)

Jochum, Elizabeth

This paper considers the use of tele-operated robots in live performance. Robots and performance have long been linked, from the working androids and automata staged in popular exhibitions during the nineteenth century and the robots featured at Cybernetic Serendipity (1968) and the World Expo...

A Meta-Analysis of Factors Affecting Trust in Human-Robot Interaction

Science.gov (United States)

2011-10-01

directly affects the willingness of people to accept robot -produced information, follow robots ’ suggestions, and thus benefit from the advantages inherent...perceived complexity of operation). Consequently, if the perceived risk of using the robot exceeds its perceived benefit , practical operators almost...necessary presence of a human caregiver (Graf, Hans, & Schraft, 2004). Other robotic devices, such as wheelchairs (Yanco, 2001) and exoskeletons (e.g

IgG4-related kidney disease – an update

Science.gov (United States)

Kawano, Mitsuhiro; Saeki, Takako

2015-01-01

Purpose of review IgG4-related disease (IgG4-RD) is a recently recognized systemic inflammatory disorder that can affect most organs/tissues such as sarcoidosis. The kidney is a frequently affected organ with tubulointerstitial nephritis (TIN), the representative lesion of IgG4-RD. This review focuses on the latest knowledge of IgG4-related kidney disease (IgG4-RKD). Recent findings A wide range of renal manifestations of IgG4-RD, that is TIN, membranous glomerulonephritis (MGN) and other glomerular lesions, and pyelitis, are collectively referred to as IgG4-RKD. Clinically, decreased renal function, or characteristic imaging findings such as multiple low-density lesions on contrast-enhanced computed tomography or diffuse thickening of the renal pelvic wall, are typical presenting features. Although a rapid response to corticosteroid therapy is a very important feature of IgG4-TIN, in cases in which renal function is moderately to severely decreased before therapy, only partial recovery of renal function is obtained. Summary TIN with characteristic imaging findings is a typical manifestation of IgG4-RKD in the interstitium, while MGN is a representative manifestation of the glomerular lesions. Although IgG4 is a central feature of IgG4-RD, the recent discovery of IgG4-negative IgG4-RD raises questions about the causative role of the IgG4 molecule in this context. PMID:25594543

Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer

International Nuclear Information System (INIS)

Jung, In Hye; Song, Si Yeol; Cho, Byung Chul; Kwak, Jung Won; Jung, Nuri Hyun; Kim, Su Ssan; Choi, Eun Kyung; Jung, Jin Hong; Je, Hyoung Uk; Choi, Won Sik

2015-01-01

To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS). From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21. The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression. The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication

Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Jung, In Hye; Song, Si Yeol; Cho, Byung Chul; Kwak, Jung Won; Jung, Nuri Hyun; Kim, Su Ssan; Choi, Eun Kyung [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Jung, Jin Hong [Dept. of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul (Korea, Republic of); Je, Hyoung Uk [Dept. of Radiation Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of); Choi, Won Sik [Dept. of Radiation Oncology, Gangneung Asan Hospital, Uiversity of Ulsan College of Medicine, Gangneung (Korea, Republic of)

2015-06-15

To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS). From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21. The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression. The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.

Report on the actual situations of the commercially applied, industrial robots; Sangyoyo robot ni kansuru kigyo jittai chosa hokokusho

Energy Technology Data Exchange (ETDEWEB)

NONE

1991-08-01

Described herein are the actual situations of industrial robots as the FY 1991 questionnaire survey results. The questionnaires were sent to 541 factories, and 74% thereof were recovered. The major machine types fall into categories of manual manipulator, stationary sequence manipulator, remote controlling robot, sequence robot, playback robot, numerically controlling robot and intelligent robot. They are mainly driven by hydraulic, pneumatic, or electrical power. Their mechanism types cover polar coordinate, cylindrical coordinate, rectangular coordinate and articulation types, among others. They are mainly controlled by electronically, electrically (hydraulic or relay), or pneumatically. The major purposes for general works include casting, forging, resin processing, heat treatment, pressing, welding, coating, machining, cutting, assembling, reception/delivery of goods, and testing/inspection. The special works they are in service include those for power/gas/water services, construction works, and research and development. By work step, they are in service, e.g., for loading/unloading goods, palletising/packing goods, supporting, screening, welding, spraying/coating, grinding, clamping, assembling, and riveting. (NEDO)

4D printed actuators with soft-robotic functions

NARCIS (Netherlands)

López-Valdeolivas, M.; Liu, D.; Broer, D.J.; Sánchez-Somolinos, C.

2018-01-01

Soft matter elements undergoing programed, reversible shape change can contribute to fundamental advance in areas such as optics, medicine, microfluidics, and robotics. Crosslinked liquid crystalline polymers have demonstrated huge potential to implement soft responsive elements; however, the

Robotics at Savannah River

International Nuclear Information System (INIS)

Byrd, J.S.

1983-01-01

A Robotics Technology Group was organized at the Savannah River Laboratory in August 1982. Many potential applications have been identified that will improve personnel safety, reduce operating costs, and increase productivity using modern robotics and automation. Several active projects are under way to procure robots, to develop unique techniques and systems for the site's processes, and to install the systems in the actual work environments. The projects and development programs are involved in the following general application areas: (1) glove boxes and shielded cell facilities, (2) laboratory chemical processes, (3) fabrication processes for reactor fuel assemblies, (4) sampling processes for separation areas, (5) emergency response in reactor areas, (6) fuel handling in reactor areas, and (7) remote radiation monitoring systems. A Robotics Development Laboratory has been set up for experimental and development work and for demonstration of robotic systems

Introducing autonomy to robotic manipulators in the nuclear industry

International Nuclear Information System (INIS)

Boddy, C.L.; Webster, A.W.

1991-01-01

The National Advanced Robotics Research Centre was set up in 1988 to provide a forum for the development and transfer to industry of the technology of Advanced Robotics. In the area of robot manipulators, research has been carried out into increasing the low-level autonomy of such devices e.g. reactive collision avoidance, gross base disturbance rejection. This groundwork has proven the feasibility of using advanced control concepts in robotic manipulators, and, indeed, indicated new areas of robot kinematic design which can now be successfully exploited. Within the newly defined BNFL Integrated Robotics Programme a number of joint projects have been defined to demonstrate this technology in realistic environments, including the use of advanced interactive computer simulation and kinematically redundant manipulators. (author)

The Histopathology of IgG4-Related Disease.

Science.gov (United States)

Avincsal, Mehmet Ozgur; Zen, Yoh

2017-01-01

IgG4-related disease is a multi-organ immune-mediated chronic fibroinflammatory condition characterized by elevated serum IgG4 concentrations, tumefaction, and tissue infiltration by IgG4-positive plasma cells. The exact etiology of IgG4-related disease remains unclear with no known role of the IgG4 molecule itself being identified. Although the pancreas and salivary glands are the main organs affected, the involvement of other organs has also been reported. This multi-organ disease mimics a large number of malignant, infectious, and inflammatory disorders; therefore, a prompt differential diagnosis is important for selecting the right therapeutic strategy. Early steroid therapy assists in preventing tissue fibrosis, parenchymal extinction, and severe functional impairments in the affected organs. The definitive and prompt diagnosis of IgG4-related disease requires both histopathological confirmation and clinicopathological correlations. A histopathological examination is mandatory to exclude neoplastic or inflammatory conditions that mimic IgG4-related disease. The histological changes that occur are basically similar in any organ manifestation, with several site-specific findings being recognized. This chapter summarizes general rules for the pathological examination of IgG4-related disease, as well as the histopathological features and differential diagnoses of major organ manifestations.

IgG4-Associated Cholangitis--A Mimic of PSC

NARCIS (Netherlands)

Beuers, Ulrich; Hubers, Lowiek M.; Doorenspleet, Marieke; Maillette de Buy Wenniger, Lucas; Klarenbeek, Paul L.; Boonstra, Kirsten; Ponsioen, Cyriel; Rauws, Erik; de Vries, Niek

2015-01-01

IgG4-associated cholangitis (IAC) is an inflammatory disorder of the biliary tract representing a major manifestation of IgG4-related disease (IgG4-RD) often with elevation of serum IgG4 levels, infiltration of IgG4+ plasma cells in the affected tissue and good response to immunosuppressive

How to Build an Intentional Android: Infants' Imitation of a Robot's Goal-Directed Actions

Science.gov (United States)

Itakura, Shoji; Ishida, Hiraku; Kanda, Takayuki; Shimada, Yohko; Ishiguro, Hiroshi; Lee, Kang

2008-01-01

This study examined whether young children are able to imitate a robot's goal-directed actions. Children (24-35 months old) viewed videos showing a robot attempting to manipulate an object (e.g., putting beads inside a cup) but failing to achieve its goal (e.g., beads fell outside the cup). In 1 video, the robot made eye contact with a human…

Robotics research at Electrotechnical Laboratory-R and D program for advanced robot technology

Energy Technology Data Exchange (ETDEWEB)

Wakamatsu, S; Akahori, H; Shirai, Y; Kakikura, M

1983-01-01

The purposes of this paper are both to introduce the outline of robotics researches at Electrotechnical Laboratory and to describe the relation between those researches and the national project so called robotics for critical work. The authors first describe the robotics researches and related topics historically which have been continued from the latter half of 1960s as a part of researches on artificial intelligence at Electrotechnical Laboratory. Secondly, they mention the present aspects of our researches, its relation with past results, and changes of basic concepts on robotics systems. Finally, as an extension of our researches, they propose some approaches to establish the following techniques which make very important roles for the success of the national project; (1) manipulation techniques, (2) sensor techniques, (3) autonomous robot control techniques, (4) advanced tele-operation techniques and, (5) system totalizing techniques. 15 references.

Pathomorphological characteristic of IgG4-related diseases

Directory of Open Access Journals (Sweden)

O. O. Dyadyk

2016-08-01

Full Text Available IgG4-related diseases are a relatively new group of diseases of unknown etiology which are characterized by the development of fibrosis of organs with the presence of big amounts of IgG4-positive plasma-cells in the area of the lesions and increased levels of IgG4 in serum. The organs that may be affected are pancreas, salivary gland, and others, clinical cases of kidney damage are described as well. Renal involvement in IgG4-related diseases most often occurs on the type of tubulointerstitial nephritis, with the further development of acute or chronic kidney injury. The clinic may be represented by the pseudotumor of kidney, renal tissue heterogeneity on the results of CT-studies; acute or chronic renal disease; combination with other organ damage (autoimmune pancreatitis, sclerosing cholangitis, sclerosing lymphoplasmacytic cholecystitis, colitis, sialadenitis, retroperitoneal fibrosis, etc.. Laboratory findings include an increased level of IgG4 in the blood serum, hypocomplementemia, eosinophilia. Histologically, there is interstitial inflammation with many plasma cells, interstitial fibrosis, tubular atrophy, thickening of the tubular basement membrane, some cases are a type of membranous glomerulonephritis. The aim of the study is to identify the patients with IgG4-related diseases with renal impairment and widening the pathological database of such patients with renal impairment to determine the classification criteria of this pathological condition. Materials and methods will include the deceased kidney screening, screening of patients with autoimmune and allergic diseases, nephrological patients screening with the lifetime biopsy (in some cases – repeat biopsy with chronic or acute kidney impairment. There will be clinical and pathological comparison in kidney damage and other diseases with the development of criteria for the classification of lesions in the presence of IgG4-positive substrates and further development of practical

Robot assistant versus human or another robot assistant in patients undergoing laparoscopic cholecystectomy.

Science.gov (United States)

Gurusamy, Kurinchi Selvan; Samraj, Kumarakrishnan; Fusai, Giuseppe; Davidson, Brian R

2012-09-12

trial. There was no significant difference in the proportion of patients who required conversion to open cholecystectomy (2 trials; 4/63 (weighted proportion 6.4%) in the robot assistant group versus 5/70 (7.1%) in the human assistant group; RR 0.90; 95% CI 0.25 to 3.20). There was no significant difference in the operating time between the two groups (4 trials; 324 patients; MD 5.00 minutes; 95% CI -0.55 to 10.54). In one trial, about one sixth of the laparoscopic cholecystectomies in which a robot assistant was used required temporary use of a human assistant. In another trial, there was no requirement for human assistants. One trial did not report this information. It appears that there was little or no requirement for human assistants in the other three trials. There were no randomised trials comparing one type of robot versus another type of robot. Robot assisted laparoscopic cholecystectomy does not seem to offer any significant advantages over human assisted laparoscopic cholecystectomy. However, all trials had a high risk of systematic errors or bias (that is, risk of overestimation of benefit and underestimation of harm). All trials were small, with few or no outcomes. Hence, the risk of random errors (that is, play of chance) is high. Further randomised trials with low risk of bias or random errors are needed.

Is Ethics of Robotics about Robots? Philosophy of Robotics Beyond Realism and Individualilsm.

NARCIS (Netherlands)

Coeckelbergh, Mark

2011-01-01

If we are doing ethics of robotics, what exactly is the object of our inquiry? This paper challenges 'individualist' robot ontology and 'individualist' social philosophy of robots. It is argued that ethics of robotics should not study and evaluate robotics exclusively in terms of individual

Value of serum IgG4 in the diagnosis of IgG4-related disease and in differentiation from rheumatic diseases and other diseases.

Science.gov (United States)

Yamamoto, Motohisa; Tabeya, Tetsuya; Naishiro, Yasuyoshi; Yajima, Hidetaka; Ishigami, Keisuke; Shimizu, Yui; Obara, Mikiko; Suzuki, Chisako; Yamashita, Kentaro; Yamamoto, Hiroyuki; Hayashi, Toshiaki; Sasaki, Shigeru; Sugaya, Toshiaki; Ishida, Tadao; Takano, Ken-Ichi; Himi, Tetsuo; Suzuki, Yasuo; Nishimoto, Norihiro; Honda, Saho; Takahashi, Hiroki; Imai, Kohzoh; Shinomura, Yasuhisa

2012-06-01

IgG4-related disease (IgG4-RD) is a novel disease entity that includes Mikulicz's disease, autoimmune pancreatitis (AIP), and many other conditions. It is characterized by elevated serum IgG4 levels and abundant IgG4-bearing plasmacyte infiltration of involved organs. We postulated that high levels of serum IgG4 would comprise a useful diagnostic tool, but little information is available about IgG4 in conditions other than IgG4-RD, including rheumatic diseases. Several reports have described cutoff values for serum IgG4 when diagnosing IgG4-RD, but these studies mostly used 135 mg/dL in AIP to differentiate from pancreatic cancer instead of rheumatic and other common diseases. There is no evidence for a cutoff serum IgG4 level of 135 mg/dL for rheumatic diseases and common diseases that are often complicated with rheumatic diseases. The aim of this work was to re-evaluate the usual cutoff serum IgG4 value in AIP (135 mg/dL) that is used to diagnose whole IgG4-RD in the setting of a rheumatic clinic by measuring serum IgG4 levels in IgG4-RD and various disorders. We therefore constructed ROC curves of serum IgG4 levels in 418 patients who attended Sapporo Medical University Hospital due to IgG4-RD and various rheumatic and common disorders. The optimal cut-off value of serum IgG4 for a diagnosis of IgG4-RD was 144 mg/dL, and the sensitivity and specificity were 95.10 and 90.76%, respectively. Levels of serum IgG4 were elevated in IgG4-RD, Churg-Strauss syndrome, multicentric Castleman's disease, eosinophilic disorders, and in some patients with rheumatoid arthritis, systemic sclerosis, chronic hepatitis, and liver cirrhosis. The usual cut-off value of 135 mg/dL in AIP is useful for diagnosing whole IgG4-RD, but high levels of serum IgG4 are sometimes observed in not only IgG4-RD but also other rheumatic and common diseases.

IgG4-Associated Cholangitis Can Mimic Hilar Cholangiocarcinoma.

Science.gov (United States)

Zaydfudim, Victor M; Wang, Andrew Y; de Lange, Eduard E; Zhao, Zimin; Moskaluk, Christopher A; Bauer, Todd W; Adams, Reid B

2015-07-01

IgG4-associated cholangitis can mimic hilar cholangiocarcinoma. Previously reported patients with IgG4-associated cholangitis mimicking cholangiocarcinoma had elevated serum IgG4 levels and long-segment biliary strictures. However, in the absence of other diagnostic criteria for malignancy, IgG4-associated cholangitis should remain a consideration among patients with normal serum IgG4 and a hilar mass suspicious for cholangiocarcinoma. The presence of a hilar mass and a malignant-appearing biliary stricture in two patients with normal serum IgG4 prompted further evaluation and subsequent concomitant liver and bile duct resection and reconstruction. The diagnosis of IgG4-associated cholangitis was established during the pathologic evaluation of the resected specimens. IgG4-associated cholangitis is a known imitator of hilar cholangiocarcinoma and should be considered in the differential diagnosis even among serologically IgG4-negative patients with a hilar mass prior to operative resection.

IgG4-related Disease and the Liver.

Science.gov (United States)

Chen, Jonathan H; Deshpande, Vikram

2017-06-01

Pathologists are likely to encounter IgG4-related disease in several organ systems. This article focuses on helping pathologists diagnose IgG4-related disease in the hepatobiliary system. Missing the diagnosis can result in unnecessary organ damage and/or unnecessary surgical and cancer therapy. In the liver, tumefactive lesion(s) involving the bile ducts with storiform fibrosis and an IgG4-enriched lymphoplasmacytic infiltrate are highly concerning for IgG4-related disease. The recent identification of oligoclonal populations of T cells and B cells in IgG4-related disease may lead to molecular tests, new therapeutics, and a greater mechanistic understanding of the disease. Copyright © 2017 Elsevier Inc. All rights reserved.

IgG4-related Disease of the Genitourinary Tract

Directory of Open Access Journals (Sweden)

Mukul K. Divatia

2014-02-01

Full Text Available IgG4-related disease (IgG4-RD is a recently established albeit well recognized fibro-inflammatory condition with distinctive features including a characteristic histopathological appearance; a propensity to develop tumefactive lesions in multiple body sites; and oft elevated serum IgG4 levels. The consensus statement on IgG-4 RD equips practicing pathologists with a set of working guidelines for the diagnosis of pathologic lesions identified in a host of different organ system affected with this disease. The diagnosis of IgG4-RD requires the combined presence of the characteristic histopathological appearance and increased numbers of IgG4-positive plasma cells. The essential histopathological features include a dense lymphoplasmacytic infiltrate, a storiform pattern of fibrosis, and obliterative phlebitis. Tissue IgG4-positive plasma cell counts and IgG4: IgG ratios are significant ancillary aids in establishing the diagnosis. The spectrum of IgG4-RD continues to expand and involve multiple body sites. The genitourinary system comprising of the kidneys, ureters, urinary bladder, urethra, prostate gland, testes and penis is one of the multiple organ systems to be affected by IgG4-RD. This review describes the clinical and histopathologic patterns of involvement of the genitourinary system by IgG4-RD, in association with serologic and radiological features. [J Interdiscipl Histopathol 2014; 2(1.000: 3-18

Therapeutic IgG4 antibodies engage in Fab-arm exchange with endogenous human IgG4 in vivo

NARCIS (Netherlands)

Labrijn, Aran F.; Buijsse, Antonio Ortiz; van den Bremer, Ewald T. J.; Verwilligen, Annemiek Y. W.; Bleeker, Wim K.; Thorpe, Susan J.; Killestein, Joep; Polman, Chris H.; Aalberse, Rob C.; Schuurman, Janine; van de Winkel, Jan G. J.; Parren, Paul W. H. I.

Two humanized IgG4 antibodies, natalizumab and gemtuzumab, are approved for human use, and several others, like TGN1412, are or have been in clinical development. Although IgG4 antibodies can dynamically exchange half-molecules(1), Fab-arm exchange with therapeutic antibodies has not been

Therapeutic IgG4 antibodies engage in Fab-arm exchange with endogenous human IgG4 in vivo

NARCIS (Netherlands)

Labrijn, Aran F.; Buijsse, Antonio Ortiz; van den Bremer, Ewald T. J.; Verwilligen, Annemiek Y. W.; Bleeker, Wim K.; Thorpe, Susan J.; Killestein, Joep; Polman, Chris H.; Aalberse, Rob C.; Schuurman, Janine; van de Winkel, Jan G. J.; Parren, Paul W. H. I.

2009-01-01

Two humanized IgG4 antibodies, natalizumab and gemtuzumab, are approved for human use, and several others, like TGN1412, are or have been in clinical development. Although IgG4 antibodies can dynamically exchange half-molecules, Fab-arm exchange with therapeutic antibodies has not been demonstrated

Cloning of pCDNA3-IgG4 and pQE-2-IgG4 human hinge region ...

African Journals Online (AJOL)

GREGORY

2011-12-16

Dec 16, 2011 ... diseases and in allergy-related immunoassays, thus, anti-hIgG4 antibody is of interest in the development of ... pQE-2-. IgG4 will be used for protein expression in M15 prokaryotic .... Solution conformation of wild-type and ...

IgG4-Related Autoimmune Prostatitis: Is It an Unusual or Underdiagnosed Manifestation of IgG4-Related Disease?

Directory of Open Access Journals (Sweden)

María T. Bourlon

2013-01-01

Full Text Available IgG4-related disease (IgG4-RD encompasses a wide range of extrapancreatic manifestations. Albeit some are relatively well known, others such as autoimmune prostatitis remain poorly described. We present a 61-year-old Latin-American male with autoimmune pancreatitis (AIP who presented with lower urinary tract symptoms (LUTS, normal prostate specific antigen (PSA test, and prostate enlargement attributed to benign prostatic hyperplasia (BPH. He underwent a transurethral resection of the prostate (TURP after which symptoms were resolved. On histopathology, prostatic stroma had a dense inflammatory infiltrate rich in plasma cells and lymphocytes; immunohistochemical morphometric assessment showed >10 IgG4-positive plasma cells/high power field (HPF. The diagnosis of IgG4-related prostatitis was postoperatively. We compared the patient characteristics with those of previous reports on Asian patients. Shared findings included prostate enlargement, LUTS (symptoms that can be confused with BPH, and PSA within normal limits or mild elevations. IgG4-related prostatitis is rarely considered as a preprocedural diagnosis, even in patients with evidence of IgG4-RD. Involved prostate zones include mainly central and transitional zones and less frequently the peripheral. Currently, there is insufficient data about the natural history and outcome. Whether steroids, transurethral resection, or both are the treatment of choice needs to be elucidated.

The Plasminogen Activator Inhibitor 1 4G/5G Polymorphism and the Risk of Alzheimer's Disease.

Science.gov (United States)

Fekih-Mrissa, Najiba; Mansour, Malek; Sayeh, Aicha; Bedoui, Ines; Mrad, Meriem; Riahi, Anis; Mrissa, Ridha; Nsiri, Brahim

2017-09-01

The aim of this study was to determine whether plasminogen activator inhibitor 1 (PAI-1) is associated with the risk of Alzheimer's disease (AD) in Tunisian patients. We analyzed the genotype and allele frequency distribution of the PAI-1 polymorphism in 60 Tunisian patients with AD and 120 healthy controls. The results show a significantly increased risk of AD in carriers of the 4G/4G and 4G/5G genotypes versus the wild-type 5G/5G genotype (4G/4G: 28.33% in patients vs 10.0% in controls; P 5G: 55.0% in patients vs 38.33% in controls; OR = 4.45; P < 10 -3 ). The 4G allele was also more frequently found in patients compared with controls; P < 10 -3 ; OR = 3.07. For all participants and by gender, homozygotic carriers (4G/4G) were at an increased risk of AD over heterozygotes and women were at an increased risk over their male genotype counterparts. The odds ratio for AD among 4G/4G carriers for any group was approximately twice that of heterozygotes in the same group. Women homozygotes ranked highest for AD risk (OR = 20.8) and, in fact, women heterozygotes (OR = 9.03) ranked higher for risk than male homozygotes (OR = 6.12). These preliminary exploratory results should be confirmed in a larger study.

An automated miniature robotic vehicle inspection system

Energy Technology Data Exchange (ETDEWEB)

Dobie, Gordon; Summan, Rahul; MacLeod, Charles; Pierce, Gareth; Galbraith, Walter [Centre for Ultrasonic Engineering, University of Strathclyde, 204 George Street, Glasgow, G1 1XW (United Kingdom)

2014-02-18

A novel, autonomous reconfigurable robotic inspection system for quantitative NDE mapping is presented. The system consists of a fleet of wireless (802.11g) miniature robotic vehicles, each approximately 175 × 125 × 85 mm with magnetic wheels that enable them to inspect industrial structures such as storage tanks, chimneys and large diameter pipe work. The robots carry one of a number of payloads including a two channel MFL sensor, a 5 MHz dry coupled UT thickness wheel probe and a machine vision camera that images the surface. The system creates an NDE map of the structure overlaying results onto a 3D model in real time. The authors provide an overview of the robot design, data fusion algorithms (positioning and NDE) and visualization software.

An automated miniature robotic vehicle inspection system

International Nuclear Information System (INIS)

Dobie, Gordon; Summan, Rahul; MacLeod, Charles; Pierce, Gareth; Galbraith, Walter

2014-01-01

A novel, autonomous reconfigurable robotic inspection system for quantitative NDE mapping is presented. The system consists of a fleet of wireless (802.11g) miniature robotic vehicles, each approximately 175 × 125 × 85 mm with magnetic wheels that enable them to inspect industrial structures such as storage tanks, chimneys and large diameter pipe work. The robots carry one of a number of payloads including a two channel MFL sensor, a 5 MHz dry coupled UT thickness wheel probe and a machine vision camera that images the surface. The system creates an NDE map of the structure overlaying results onto a 3D model in real time. The authors provide an overview of the robot design, data fusion algorithms (positioning and NDE) and visualization software

A treatment planning comparison between a novel rotating gamma system and robotic linear accelerator based intracranial stereotactic radiosurgery/radiotherapy

Science.gov (United States)

Fareed, Muhammad M.; Eldib, Ahmed; Weiss, Stephanie E.; Hayes, Shelly B.; Li, Jinsheng; C-M Ma, Charlie

2018-02-01

To compare the dosimetric parameters of a novel rotating gamma ray system (RGS) with well-established CyberKnife system (CK) for treating malignant brain lesions. RGS has a treatment head of 16 cobalt-60 sources focused to the isocenter, which can rotate 360° on the ring gantry and swing 35° in the superior direction. We compared several dosimetric parameters in 10 patients undergoing brain stereotactic radiosurgery including plan normalization, number of beams and nodes for CK and shots for RGS, collimators used, estimated treatment time, D 2 cm and conformity index (CI) among two modalities. The median plan normalization for RGS was 56.7% versus 68.5% (p  =  0.002) for CK plans. The median number of shots from RGS was 7.5 whereas the median number of beams and nodes for CK was 79.5 and 46. The median collimator’s diameter used was 3.5 mm for RGS as compared to 5 mm for CK (p  =  0.26). Mean D 2 cm was 5.57 Gy for CyberKnife whereas it was 3.11 Gy for RGS (p  =  0.99). For RGS plans, the median CI was 1.4 compared to 1.3 for the CK treatment plans (p  =  0.98). The average minimum and maximum doses to optic chiasm were 21 and 93 cGy for RGS as compared to 32 and 209 cGy for CK whereas these were 0.5 and 364 cGy by RGS and 18 and 399 cGy by CK to brainstem. The mean V12 Gy for brain predicting for radionecrosis with RGS was 3.75 cm3 as compared to 4.09 cm3 with the CK (p  =  0.41). The dosimetric parameters of a novel RGS with a ring type gantry are comparable with CyberKnife, allowing its use for intracranial lesions and is worth exploring in a clinical setting.

Soft Dielectric Elastomer Oscillators Driving Bioinspired Robots.

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Henke, E-F Markus; Schlatter, Samuel; Anderson, Iain A

2017-12-01

Entirely soft robots with animal-like behavior and integrated artificial nervous systems will open up totally new perspectives and applications. To produce them, we must integrate control and actuation in the same soft structure. Soft actuators (e.g., pneumatic and hydraulic) exist but electronics are hard and stiff and remotely located. We present novel soft, electronics-free dielectric elastomer oscillators, which are able to drive bioinspired robots. As a demonstrator, we present a robot that mimics the crawling motion of the caterpillar, with an integrated artificial nervous system, soft actuators and without any conventional stiff electronic parts. Supplied with an external DC voltage, the robot autonomously generates all signals that are necessary to drive its dielectric elastomer actuators, and it translates an in-plane electromechanical oscillation into a crawling locomotion movement. Therefore, all functional and supporting parts are made of polymer materials and carbon. Besides the basic design of this first electronic-free, biomimetic robot, we present prospects to control the general behavior of such robots. The absence of conventional stiff electronics and the exclusive use of polymeric materials will provide a large step toward real animal-like robots, compliant human machine interfaces, and a new class of distributed, neuron-like internal control for robotic systems.

Plasminogen activator inhibitor-1 4G/5G polymorphism in infertile women with and without endometriosis.

Science.gov (United States)

Gonçalves-Filho, Rubens P; Brandes, Ariel; Christofolini, Denise M; Lerner, Tatiana G; Bianco, Bianca; Barbosa, Caio P

2011-05-01

To evaluate PAI-1 genotypes in a group of infertile women with or without endometriosis and control subjects. Case-control study. Human Reproduction Center of Medicina do ABC Faculty. One hundred and forty infertile women with endometriosis, 64 women with idiopathic infertility and 148 fertile women as control subjects. The PAI-1 4G/5G polymorphism was identified by restriction fragment length polymorphism-polymerase chain reaction. Genotype distribution and allele frequency of the 4G/5G polymorphism of the PAI-1 gene. The frequencies of genotypes 4G/4G, 4G/5G and 5G/5G of the PAI-1 gene in the infertile women with endometriosis were 38.6, 37.1 and 24.3%, respectively, and in the control group 24.3, 33.8 and 41.9%, respectively (p=0.003). When the infertile women with endometriosis were divided according to their endometriosis stage, genotypes 4G/4G, 4G/5G and 5G/5G were identified, respectively, in 36.7, 32.9 and 30.4% of the patients with minimal/mild endometriosis (p=0.102) and in 41.0, 42.6 and 16.4% of the patients with moderate/severe endometriosis (p=0.001); in the women with idiopathic infertility, these genotypes were found at a frequency of 29.7, 34.3 and 36%, respectively (p=0.637). The data suggest that, in Brazilian women, the PAI-1 4G/5G polymorphism may be associated with a risk of endometriosis-associated infertility. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

NOSC/ONR Robotics Bibliography (1961-1981).

Science.gov (United States)

1982-09-01

28, 6 Dec., 1979 @, p4 "DEFENSE EQUIPMENT FIRM TRAINS ROBOT TO PERFORM CRAFTSMAN-SKILLED TASK", Industrial Engineering, vol 13, no 5, May 1981 @, p90...1974 @, pCI-I-8 Gupton, J. A. Jr., "BUILD THIS UNICORN -i ROBOT PART I", Radio-Electronics, vol 51, no 8, 1980 @, p 3 7 ,4 1 ,76 Gupton, J. A. Jr...34BUILD THIS UNICORN -i ROBOT PART II", Radio-Electronics, vol 51, no 9, Sept. 1980 @, p55-8 Gupton, J. A., Jr., "TALK TO A TURTLE; BUILD A COMPUTER

Patient-specific quality assurance for intracranial cases in robotic radiosurgery system.

Science.gov (United States)

Koksal, Canan; Akbas, Ugur; Donmez Kesen, Nazmiye; Okutan, Murat; Bilge, Hatice; Kemikler, Gonul

2018-01-01

The purpose of this study was to perform pretreatment patient-specific quality assurance (QA) for intracranial irradiation using CyberKnife with an ion chamber. Twenty-five intracranial plans created using the ray-tracing algorithm were used for this study. Computed tomography (CT) images of the water-equivalent RW3 slab phantom with PinPoint ionization chamber were acquired with 1-mm slice thickness and transferred to the MultiPlan treatment planning system (TPS). Four gold fiducial markers embedded into two different plates were used to tracking during the irradiation. Intracranial plans were transferred to CT images of the RW3 phantom. The isodose curves and sensitive volume of ion chamber were overlapped. Point dose measurements were performed three times and the mean point doses were calculated for each plan. The mean doses measured by the PinPoint ion chamber were compared with those of the calculated by MultiPlan TPS in the sensitive volume of PinPoint. The mean percentage difference (MPD) in point dose measurements was -2.44±1.97 for 25 plans. The maximum and minimum percentage differences between the measured and calculated absolute point doses were -7.14 and 0.23, respectively. The MPD was -1.70±1.90 for 12 plans using a fixed collimator and -3.11±1.86 for 13 plans using an IRIS cone. Point dose measurement is a reliable and functional method for pre-treatment patient-specific QA in intracranial CyberKnife plans. Point dose verification should be performed to correct any possible errors prior to patient treatment. It is recommended for use in patient-specific QA process in the CyberKnife plans.

IgG4-related disease in autoimmune lymphoproliferative syndrome.

Science.gov (United States)

van de Ven, Annick A J M; Seidl, Maximilian; Drendel, Vanessa; Schmitt-Graeff, Annette; Voll, Reinhard E; Rensing-Ehl, Anne; Speckmann, Carsten; Ehl, Stephan; Warnatz, Klaus; Kollert, Florian

2017-07-01

A patient with autoimmune lymphoproliferative disorder (ALPS) developed IgG4-related disease. In retrospect, he had high levels of serum IgG4 for several years prior to presenting with IgG4-related pancreatitis. These high IgG4 levels were masked by hypergammaglobulinemia, a common feature of ALPS. We next screened 18 ALPS patients; four of them displayed increased levels of IgG4. Hence, IgG4-related disease should be considered in ALPS patients, especially in those manifesting lymphocytic organ infiltration or excessive hypergammaglobulinaemia. Screening of IgG4-related disease patients for ALPS-associated mutations would provide further information on whether this disease could be a late-onset atypical presentation of ALPS. Copyright © 2017 Elsevier Inc. All rights reserved.

Robotics in surgery: is a robot necessary? For what?

Science.gov (United States)

Ross, Sharona B; Downs, Darrell; Saeed, Sabrina M; Dolce, John K; Rosemurgy, Alexander S

2017-02-01

Every operation can be categorized along a spectrum from "most invasive" to "least invasive", based on the approach(es) through which it is commonly undertaken. Operations that are considered "most invasive" are characterized by "open" approaches with a relatively high degree of morbidity, while operations that are considered "least invasive" are undertaken with minimally invasive techniques and are associated with relatively improved patient outcomes, including faster recovery times and fewer complications. Because of the potential for reduced morbidity, movement along the spectrum towards minimally invasive surgery (MIS) is associated with a host of salutary benefits and, as well, lower costs of patient care. Accordingly, the goal of all stakeholders in surgery should be to attain universal application of the most minimally invasive approaches. Yet the difficulty of performing minimally invasive operations has largely limited its widespread application in surgery, particularly in the context of complex operations (i.e., those requiring complex extirpation and/or reconstruction). Robotic surgery, however, may facilitate application of minimally invasive techniques requisite for particular operations. Enhancements in visualization and dexterity offered by robotic surgical systems allow busy surgeons to quickly gain proficiency in demanding techniques (e.g., pancreaticojejunostomy), within a short learning curve. That is not to say, however, that all operations undertaken with minimally invasive techniques require robotic technology. Herein, we attempt to define how surgeon skill, operative difficulty, patient outcomes, and cost factors determine when robotic technology should be reasonably applied to patient care in surgery.

Robotics

International Nuclear Information System (INIS)

Scheide, A.W.

1983-01-01

This article reviews some of the technical areas and history associated with robotics, provides information relative to the formation of a Robotics Industry Committee within the Industry Applications Society (IAS), and describes how all activities relating to robotics will be coordinated within the IEEE. Industrial robots are being used for material handling, processes such as coating and arc welding, and some mechanical and electronics assembly. An industrial robot is defined as a programmable, multifunctional manipulator designed to move material, parts, tools, or specialized devices through variable programmed motions for a variety of tasks. The initial focus of the Robotics Industry Committee will be on the application of robotics systems to the various industries that are represented within the IAS

Hydro-Quebec inspection robot RIT-LRG

International Nuclear Information System (INIS)

Champagne, D.; Rinfret, F.; Bourgault, Y.G.

2008-01-01

Hydro Quebec's Research Centre (IREQ), has developed a variety of inspection tools over the years. The Metar bracelet for the feeder tubes, the REC robot for the heat exchanger and the RIT robot for the Delayed Neutron system just to name a few. This paper discusses with the successful deployment of the Camera Probe Positioning robot for Visual Inspection of the sample lines of the delayed neutron system of CANDU power plants. This RIT robot has three possible configurations (Face, Cabinet and LRG configurations) and has remained a prototype version although it has been used over the years in many outage inspection campaigns since 1997. The main advantages of using this robot are: the significant reduction in radiation exposure, the high quality of the data collected and the archiving of inspection data for further analysis and reports. In 2007, Gentilly-2 (G-2), decided to industrialize the LRG configuration of the RIT robot and to designate it the standard tool for the inspection of the Delayed Neutron System. An improved RIT-LRG robot, along with its control box and command station was developed. The software had to be rewritten requiring an ergonomics analysis of user tasks, work station and interface display. These issues included both physical and cognitive requirements aspects. The two principal topics of this paper will be on the Inspection Robot Technology developed and highlights of the 2008 outage inspection campaign. (author)

Hydro-Quebec inspection robot RIT-LRG

Energy Technology Data Exchange (ETDEWEB)

Champagne, D., E-mail: champagne.dominique@ireq.ca [Inst. de recherche d' Hydro-Quebec, Quebec (Canada); Rinfret, F.; Bourgault, Y.G., E-mail: rinfret.francois@hydro.qc.ca, E-mail: bourgault.yves.g@hydro.qc.ca [Hydro-Quebec, Becancour, Quebec (Canada)

2008-07-01

Hydro Quebec's Research Centre (IREQ), has developed a variety of inspection tools over the years. The Metar bracelet for the feeder tubes, the REC robot for the heat exchanger and the RIT robot for the Delayed Neutron system just to name a few. This paper discusses with the successful deployment of the Camera Probe Positioning robot for Visual Inspection of the sample lines of the delayed neutron system of CANDU power plants. This RIT robot has three possible configurations (Face, Cabinet and LRG configurations) and has remained a prototype version although it has been used over the years in many outage inspection campaigns since 1997. The main advantages of using this robot are: the significant reduction in radiation exposure, the high quality of the data collected and the archiving of inspection data for further analysis and reports. In 2007, Gentilly-2 (G-2), decided to industrialize the LRG configuration of the RIT robot and to designate it the standard tool for the inspection of the Delayed Neutron System. An improved RIT-LRG robot, along with its control box and command station was developed. The software had to be rewritten requiring an ergonomics analysis of user tasks, work station and interface display. These issues included both physical and cognitive requirements aspects. The two principal topics of this paper will be on the Inspection Robot Technology developed and highlights of the 2008 outage inspection campaign. (author)

The Making of a 3D-Printed, Cable-Driven, Single-Model, Lightweight Humanoid Robotic Hand

Directory of Open Access Journals (Sweden)

Li Tian

2017-12-01

Full Text Available Dexterity robotic hands can (Cummings, 1996 greatly enhance the functionality of humanoid robots, but the making of such hands with not only human-like appearance but also the capability of performing the natural movement of social robots is a challenging problem. The first challenge is to create the hand’s articulated structure and the second challenge is to actuate it to move like a human hand. A robotic hand for humanoid robot should look and behave human like. At the same time, it also needs to be light and cheap for widely used purposes. We start with studying the biomechanical features of a human hand and propose a simplified mechanical model of robotic hands, which can achieve the important local motions of the hand. Then, we use 3D modeling techniques to create a single interlocked hand model that integrates pin and ball joints to our hand model. Compared to other robotic hands, our design saves the time required for assembling and adjusting, which makes our robotic hand ready-to-use right after the 3D printing is completed. Finally, the actuation of the hand is realized by cables and motors. Based on this approach, we have designed a cost-effective, 3D printable, compact, and lightweight robotic hand. Our robotic hand weighs 150 g, has 15 joints, which are similar to a real human hand, and 6 Degree of Freedom (DOFs. It is actuated by only six small size actuators. The wrist connecting part is also integrated into the hand model and could be customized for different robots such as Nadine robot (Magnenat Thalmann et al., 2017. The compact servo bed can be hidden inside the Nadine robot’s sleeve and the whole robotic hand platform will not cause extra load to her arm as the total weight (150 g robotic hand and 162 g artificial skin is almost the same as her previous unarticulated robotic hand which is 348 g. The paper also shows our test results with and without silicon artificial hand skin, and on Nadine robot.

M.I.N.G., Mars Investment for a New Generation: Robotic construction of a permanently manned Mars base

Science.gov (United States)

Amos, Jeff; Beeman, Randy; Brown, Susan; Calhoun, John; Hill, John; Howorth, Lark; Mcfaden, Clay; Nguyen, Paul; Reid, Philip; Rexrode, Stuart

1989-01-01

A basic procedure for robotically constructing a manned Mars base is outlined. The research procedure was divided into three areas: environment, robotics, and habitat. The base as designed will consist of these components: two power plants, communication facilities, a habitat complex, and a hangar, a garage, recreation and manufacturing facilities. The power plants will be self-contained nuclear fission reactors placed approx. 1 km from the base for safety considerations. The base communication system will use a combination of orbiting satellites and surface relay stations. This system is necessary for robotic contact with Phobos and any future communication requirements. The habitat complex will consist of six self-contained modules: core, biosphere, science, living quarters, galley/storage, and a sick bay which will be brought from Phobos. The complex will be set into an excavated hole and covered with approximately 0.5 m of sandbags to provide radiation protection for the astronauts. The recreation, hangar, garage, and manufacturing facilities will each be transformed from the four one-way landers. The complete complex will be built by autonomous, artificially intelligent robots. Robots incorporated into the design are as follows: Large Modular Construction Robots with detachable arms capable of large scale construction activities; Small Maneuverable Robotic Servicers capable of performing delicate tasks normally requiring a suited astronaut; and a trailer vehicle with modular type attachments to complete specific tasks; and finally, Mobile Autonomous Rechargeable Transporters capable of transferring air and water from the manufacturing facility to the habitat complex.

M.I.N.G., Mars Investment for a New Generation: Robotic construction of a permanently manned Mars base

Science.gov (United States)

Amos, Jeff; Beeman, Randy; Brown, Susan; Calhoun, John; Hill, John; Howorth, Lark; McFaden, Clay; Nguyen, Paul; Reid, Philip; Rexrode, Stuart

1989-05-01

A basic procedure for robotically constructing a manned Mars base is outlined. The research procedure was divided into three areas: environment, robotics, and habitat. The base as designed will consist of these components: two power plants, communication facilities, a habitat complex, and a hanger, a garage, recreation and manufacturing facilities. The power plants will be self-contained nuclear fission reactors placed approx. 1 km from the base for safety considerations. The base communication system will use a combination of orbiting satellites and surface relay stations. This system is necessary for robotic contact with Phobos and any future communication requirements. The habitat complex will consist of six self-contained modules: core, biosphere, science, living quarters, galley/storage, and a sick bay which will be brought from Phobos. The complex will be set into an excavated hole and covered with approximately 0.5 m of sandbags to provide radiation protection for the astronauts. The recreation, hangar, garage, and manufacturing facilities will each be transformed from the four one-way landers. The complete complex will be built by autonomous, artificially intelligent robots. Robots incorporated into the design are as follows: Large Modular Construction Robots with detachable arms capable of large scale construction activities; Small Maneuverable Robotic Servicers capable of performing delicate tasks normally requiring a suited astronaut; and a trailer vehicle with modular type attachments to complete specific tasks; and finally, Mobile Autonomous Rechargeable Transporters capable of transferring air and water from the manufacturing facility to the habitat complex.

Riedel's thyroiditis association with IgG4-related disease.

Science.gov (United States)

Stan, Marius N; Sonawane, Vikram; Sebo, Thomas J; Thapa, Prabin; Bahn, Rebecca S

2017-03-01

IgG4-positive (+) plasma cells have been reported in both Riedel's thyroiditis (RT) and Hashimoto's thyroiditis (HT). These cells are the hallmark of IgG4-related disease (IgG4-RD). We sought to determine whether RT is part of IgG4-RD spectrum. This was a case-control study performed at a tertiary medical centre. We included RT cases from the period 1958 to 2008 that had sufficient paraffin-embedded tissue for IgG4 immunostaining. Controls were patients with HT, age and gender matched, with similar pathology criteria. The main outcome measures were the intensity of the IgG4 staining and the clinical and histological correlates with IgG4-RD. Six pairs of RT and HT were analysed. The mean age was 44·7 years. In both groups, 5/6 cases had positive IgG4 staining. The mean number of IgG4 + cells/ HPF, normalized to the degree of inflammation, was 3·2 ± 3·0 SD (RT) vs 0·9 ± 0·7 (HT), P = 0·15, for fibrotic areas and 2·1 ± 2·3 SD vs 1·0 ± 0·8 (P = 0·39) for areas with lymphoid aggregates. We found the number of IgG4 +  cells in RT to be inversely correlated with the duration of disease (P = 0·046). Three RT cases had associated comorbidities from the IgG4-RD spectrum while none of the HT cases had such conditions. Riedel's thyroiditis is a component of IgG4-RD with the density of the IgG4 +  lymphocytic infiltrate being time dependent. In this small study, we did not identify differences in IgG4 infiltration between RT and HT, minimizing the utility of this marker in RT diagnosis. © 2016 John Wiley & Sons Ltd.

12 CFR 563g.4 - Non-public offering.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Non-public offering. 563g.4 Section 563g.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SECURITIES OFFERINGS § 563g.4 Non-public offering. Offers and sales of securities by an issuer that satisfy the conditions of...

Yeast Sub1 and human PC4 are G-quadruplex binding proteins that suppress genome instability at co-transcriptionally formed G4 DNA.

Science.gov (United States)

Lopez, Christopher R; Singh, Shivani; Hambarde, Shashank; Griffin, Wezley C; Gao, Jun; Chib, Shubeena; Yu, Yang; Ira, Grzegorz; Raney, Kevin D; Kim, Nayun

2017-06-02

G-quadruplex or G4 DNA is a non-B secondary DNA structure consisting of a stacked array of guanine-quartets that can disrupt critical cellular functions such as replication and transcription. When sequences that can adopt Non-B structures including G4 DNA are located within actively transcribed genes, the reshaping of DNA topology necessary for transcription process stimulates secondary structure-formation thereby amplifying the potential for genome instability. Using a reporter assay designed to study G4-induced recombination in the context of an actively transcribed locus in Saccharomyces cerevisiae, we tested whether co-transcriptional activator Sub1, recently identified as a G4-binding factor, contributes to genome maintenance at G4-forming sequences. Our data indicate that, upon Sub1-disruption, genome instability linked to co-transcriptionally formed G4 DNA in Top1-deficient cells is significantly augmented and that its highly conserved DNA binding domain or the human homolog PC4 is sufficient to suppress G4-associated genome instability. We also show that Sub1 interacts specifically with co-transcriptionally formed G4 DNA in vivo and that yeast cells become highly sensitivity to G4-stabilizing chemical ligands by the loss of Sub1. Finally, we demonstrate the physical and genetic interaction of Sub1 with the G4-resolving helicase Pif1, suggesting a possible mechanism by which Sub1 suppresses instability at G4 DNA. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.