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Sample records for imaging-guided high intensity

  1. Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus

    Zhang Lian; Chen Wenzhi; Liu Yinjiang; Hu Xiao; Zhou Kun; Chen Li; Peng Song; Zhu Hui; Zou Huiling; Bai Jin; Wang Zhibiao

    2010-01-01

    Purpose: To prospectively evaluate the feasibility of magnetic resonance (MR) imaging-guided high intensity focused ultrasound (HIFU) therapeutic ablation of uterine fibroids in patients with bowel lies anterior to uterus. Materials and methods: Twenty-one patients with 23 uterine fibroids underwent MR imaging-guided high intensity focused ultrasound treatment, with a mean age of 39.4 ± 6.9 (20-49) years, with fibroids average measuring 6.0 ± 1.6 (range, 2.9-9.5) cm in diameter. After being compressed with a degassed water balloon on abdominal wall, MR imaging-guided high intensity focused ultrasound treatment was performed under conscious sedation by using fentanyl and midazolam. This procedure was performed by a Haifu JM focused ultrasound tumour therapeutic system (JM2.5C, Chongqing Haifu Technology Co., Ltd., China), in combination with a 1.5-Tesla MRI system (Symphony, Siemens, Germany), which provides real-time guidance and control. Contrast-enhanced MR imaging was performed to evaluate the efficacy of thermal ablation immediately and 3 months after HIFU treatment. The treatment time and adverse events were recorded. Results: The mean fibroid volume was 97.0 ± 78.3 (range, 12.7-318.3) cm 3 . According to the treatment plan, an average 75.0 ± 11.4% (range, 37.8-92.4%) of the fibroid volume was treated. The mean fibroid volume immediately after HIFU was 109.7 ± 93.1 (range, 11.9-389.6) cm 3 , slightly enlarged because of edema. The average non-perfused volume was 83.3 ± 71.7 (range, 7.7-282.9) cm 3 , the average fractional ablation, which was defined as non-perfused volume divided by the fibroid volume immediately after HIFU treatment, was 76.9 ± 18.7% (range, 21.0-97.0%). There were no statistically significant differences between the treatment volume and the non-perfused volume. Follow-up magnetic resonance imaging (MRI) at 3 months obtained in 12 patients, the fibroid volume decreased by 31.4 ± 29.3% (range, -1.9 to 60.0%) in average, with paired t

  2. Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus

    Zhang Lian; Chen Wenzhi [Clinical Center for Tumour Therapy of 2nd Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing 400010 (China); Liu Yinjiang; Hu Xiao [National Engineering Research Center of Ultrasound Medicine, Chongqing 400010 (China); Zhou Kun [Clinical Center for Tumour Therapy of 2nd Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing 400010 (China); Chen Li [National Engineering Research Center of Ultrasound Medicine, Chongqing 400010 (China); Peng Song; Zhu Hui [Clinical Center for Tumour Therapy of 2nd Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing 400010 (China); Zou Huiling [National Engineering Research Center of Ultrasound Medicine, Chongqing 400010 (China); Bai Jin [Institute of Ultrasound Engineering in Medicine of Chongqing University of Medical Sciences, Chongqing 400016 (China); Wang Zhibiao [Clinical Center for Tumour Therapy of 2nd Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing 400010 (China); National Engineering Research Center of Ultrasound Medicine, Chongqing 400010 (China); Institute of Ultrasound Engineering in Medicine of Chongqing University of Medical Sciences, Chongqing 400016 (China)], E-mail: wangzhibiao@haifu.com.cn

    2010-02-15

    Purpose: To prospectively evaluate the feasibility of magnetic resonance (MR) imaging-guided high intensity focused ultrasound (HIFU) therapeutic ablation of uterine fibroids in patients with bowel lies anterior to uterus. Materials and methods: Twenty-one patients with 23 uterine fibroids underwent MR imaging-guided high intensity focused ultrasound treatment, with a mean age of 39.4 {+-} 6.9 (20-49) years, with fibroids average measuring 6.0 {+-} 1.6 (range, 2.9-9.5) cm in diameter. After being compressed with a degassed water balloon on abdominal wall, MR imaging-guided high intensity focused ultrasound treatment was performed under conscious sedation by using fentanyl and midazolam. This procedure was performed by a Haifu JM focused ultrasound tumour therapeutic system (JM2.5C, Chongqing Haifu Technology Co., Ltd., China), in combination with a 1.5-Tesla MRI system (Symphony, Siemens, Germany), which provides real-time guidance and control. Contrast-enhanced MR imaging was performed to evaluate the efficacy of thermal ablation immediately and 3 months after HIFU treatment. The treatment time and adverse events were recorded. Results: The mean fibroid volume was 97.0 {+-} 78.3 (range, 12.7-318.3) cm{sup 3}. According to the treatment plan, an average 75.0 {+-} 11.4% (range, 37.8-92.4%) of the fibroid volume was treated. The mean fibroid volume immediately after HIFU was 109.7 {+-} 93.1 (range, 11.9-389.6) cm{sup 3}, slightly enlarged because of edema. The average non-perfused volume was 83.3 {+-} 71.7 (range, 7.7-282.9) cm{sup 3}, the average fractional ablation, which was defined as non-perfused volume divided by the fibroid volume immediately after HIFU treatment, was 76.9 {+-} 18.7% (range, 21.0-97.0%). There were no statistically significant differences between the treatment volume and the non-perfused volume. Follow-up magnetic resonance imaging (MRI) at 3 months obtained in 12 patients, the fibroid volume decreased by 31.4 {+-} 29.3% (range, -1.9 to 60

  3. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance.

    Sveistrup, Joen; af Rosenschöld, Per Munck; Deasy, Joseph O; Oh, Jung Hun; Pommer, Tobias; Petersen, Peter Meidahl; Engelholm, Svend Aage

    2014-02-04

    Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1-2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5-7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. The 2-year actuarial likelihood of developing grade > = 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p analysis, 3DCRT was associated with a significantly increased risk of developing grade > = 2 GI toxicity compared to IG-IMRT (p analysis there was no difference in biochemical progression-free survival between 3DCRT and IG-IMRT. The difference in toxicity can be attributed to the combination of the IMRT technique with reduced dose to organs-at-risk, daily image guidance and margin reduction.

  4. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance

    Sveistrup, Joen; Rosenschöld, Per Munck af; Deasy, Joseph O; Oh, Jung Hun; Pommer, Tobias; Petersen, Peter Meidahl; Engelholm, Svend Aage

    2014-01-01

    Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1–2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5–7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. The 2-year actuarial likelihood of developing grade > = 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p < 0.001). For GU toxicity the numbers were 41.8% and 29.7%, respectively (p = 0.011). On multivariate analysis, 3DCRT was associated with a significantly increased risk of developing grade > = 2 GI toxicity compared to IG-IMRT (p < 0.001, HR = 11.59 [CI: 6.67-20.14]). 3DCRT was also associated with an increased risk of developing GU toxicity compared to IG-IMRT. The 3-year actuarial biochemical progression-free survival probability was 86.0% for 3DCRT and 90.3% for IG-IMRT (p = 0.386). On multivariate analysis there was no difference in biochemical progression-free survival between 3DCRT and IG-IMRT. The difference in toxicity can be attributed to the combination of the IMRT technique with reduced dose to organs-at-risk, daily image guidance and margin reduction

  5. Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

    Chen Yu-Jen

    2011-01-01

    Full Text Available Abstract Background The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT for postoperative high-risk oral cavity cancer. Methods From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84% or without (16% chemotherapy. Results The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. Conclusions HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings.

  6. Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

    Hsieh, Chen-Hsi; Hsieh, Yen-Ping; Lin, Shoei Long; Chen, Chun-Yi; Chen, Chien-An; Shueng, Pei-Wei; Kuo, Ying-Shiung; Liao, Li-Jen; Hu, Kawang-Yu; Lin, Shih-Chiang; Wu, Le-Jung; Lin, Yu-Chin; Chen, Yu-Jen; Wang, Li-Ying

    2011-01-01

    The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT) for postoperative high-risk oral cavity cancer. From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84%) or without (16%) chemotherapy. The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings

  7. HematoPorphyrin Monomethyl Ether polymer contrast agent for ultrasound/photoacoustic dual-modality imaging-guided synergistic high intensity focused ultrasound (HIFU) therapy.

    Yan, Sijing; Lu, Min; Ding, Xiaoya; Chen, Fei; He, Xuemei; Xu, Chunyan; Zhou, Hang; Wang, Qi; Hao, Lan; Zou, Jianzhong

    2016-08-18

    This study is to prepare a hematoporphyrin monomethyl ether (HMME)-loaded poly(lactic-co-glycolic acid) (PLGA) microcapsules (HMME/PLGA), which could not only function as efficient contrast agent for ultrasound (US)/photoacoustic (PA) imaging, but also as a synergistic agent for high intensity focused ultrasound (HIFU) ablation. Sonosensitizer HMME nanoparticles were integrated into PLGA microcapsules with the double emulsion evaporation method. After characterization, the cell-killing and cell proliferation-inhibiting effects of HMME/PLGA microcapsules on ovarian cancer SKOV3 cells were assessed. The US/PA imaging-enhancing effects and synergistic effects on HIFU were evaluated both in vitro and in vivo. HMME/PLGA microcapsules were highly dispersed with well-defined spherical morphology (357 ± 0.72 nm in diameter, PDI = 0.932). Encapsulation efficiency and drug-loading efficiency were 58.33 ± 0.95% and 4.73 ± 0.15%, respectively. The HMME/PLGA microcapsules remarkably killed the SKOV3 cells and inhibited the cell proliferation, significantly enhanced the US/PA imaging results and greatly enhanced the HIFU ablation effects on ovarian cancer in nude mice by the HMME-mediated sono-dynamic chemistry therapy (SDT). HMME/PLGA microcapsules represent a potential multifunctional contrast agent for HIFU diagnosis and treatment, which might provide a novel strategy for the highly efficient imaging-guided non-invasive HIFU synergistic therapy for cancers by SDT in clinic.

  8. Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids

    Kim, Young-sun; Kim, Tae-Joong; Lee, Jeong-Won; Kim, Byoung-Gie; Lim, Hyo Keun; Rhim, Hyunchul; Jung, Sin-Ho; Ahn, Joong Hyun

    2017-01-01

    To evaluate the integrity of endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) ablation of submucosal uterine fibroids based on contrast-enhanced MRI findings, and to identify the risk factors for endometrial impairment. In total, 117 submucosal fibroids (diameter: 5.9 ± 3.0 cm) in 101 women (age: 43.6 ± 4.4 years) treated with MR-HIFU ablation were retrospectively analysed. Endometrial integrity was assessed with contrast-enhanced T1-weighted images at immediate (n = 101), 3-month (n = 62) and 12-month (n = 15) follow-ups. Endometrial impairment was classified into grades 0 (continuous endometrium), 1 (pin-point, full-thickness discontinuity), 2 (between grade 1 and 3), or 3 (full-thickness discontinuity >1 cm). Risk factors were assessed with generalized estimating equation (GEE) analysis. Among 117 fibroids, grades 0, 1, 2 and 3 endometrial impairments were observed at initial examination in 56.4%, 24.8%, 13.7% and 4.3%, respectively. Among 37 fibroid cases of endometrial impairment for which follow-ups were conducted, 30 showed improvements at 3- and/or 12-month follow-up. GEE analysis revealed the degree of endometrial protrusion was significantly associated with severity of endometrial injury (P < 0.0001). After MR-HIFU ablation of submucosal fibroids, endometrial enhancement was preserved intact or minimally impaired in most cases. Impaired endometrium, which is more common after treating endometrially-protruded fibroids, may recover spontaneously. (orig.)

  9. Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids

    Kim, Young-sun [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Uterine Fibroid Integrated Management Center, MINT Intervention Hospital, Department of Radiology, Seoul (Korea, Republic of); Kim, Tae-Joong; Lee, Jeong-Won; Kim, Byoung-Gie [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Lim, Hyo Keun [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); SAIHST, Sungkyunkwan University, Department of Health Sciences and Technology, Seoul (Korea, Republic of); Rhim, Hyunchul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Jung, Sin-Ho [SAIHST, Sungkyunkwan University, Department of Health Sciences and Technology, Seoul (Korea, Republic of); Samsung Medical Center, Department of Biostatistics and Clinical Epidemiology, Seoul (Korea, Republic of); Ahn, Joong Hyun [Samsung Biomedical Research Institute, Samsung Medical Center, Biostatistics Team, Seoul (Korea, Republic of)

    2017-09-15

    To evaluate the integrity of endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) ablation of submucosal uterine fibroids based on contrast-enhanced MRI findings, and to identify the risk factors for endometrial impairment. In total, 117 submucosal fibroids (diameter: 5.9 ± 3.0 cm) in 101 women (age: 43.6 ± 4.4 years) treated with MR-HIFU ablation were retrospectively analysed. Endometrial integrity was assessed with contrast-enhanced T1-weighted images at immediate (n = 101), 3-month (n = 62) and 12-month (n = 15) follow-ups. Endometrial impairment was classified into grades 0 (continuous endometrium), 1 (pin-point, full-thickness discontinuity), 2 (between grade 1 and 3), or 3 (full-thickness discontinuity >1 cm). Risk factors were assessed with generalized estimating equation (GEE) analysis. Among 117 fibroids, grades 0, 1, 2 and 3 endometrial impairments were observed at initial examination in 56.4%, 24.8%, 13.7% and 4.3%, respectively. Among 37 fibroid cases of endometrial impairment for which follow-ups were conducted, 30 showed improvements at 3- and/or 12-month follow-up. GEE analysis revealed the degree of endometrial protrusion was significantly associated with severity of endometrial injury (P < 0.0001). After MR-HIFU ablation of submucosal fibroids, endometrial enhancement was preserved intact or minimally impaired in most cases. Impaired endometrium, which is more common after treating endometrially-protruded fibroids, may recover spontaneously. (orig.)

  10. Long-term outcomes from dose-escalated image-guided intensity-modulated radiotherapy with androgen deprivation: encouraging results for intermediate- and high-risk prostate cancer

    Wilcox SW

    2014-08-01

    Full Text Available Shea W Wilcox,1,4 Noel J Aherne,2,4 Linus C Benjamin,1 Bosco Wu,1 Thomaz de Campos Silva,3 Craig S McLachlan,4 Michael J McKay,3,5 Andrew J Last,1 Thomas P Shakespeare1–4 1North Coast Cancer Institute, Port Macquarie, NSW, Australia; 2North Coast Cancer Institute, Coffs Harbour, NSW, Australia; 3North Coast Cancer Institute, Lismore, NSW, Australia; 4The University of New South Wales, Rural Clinical School, Sydney, NSW, Australia; 5The University of Sydney, Sydney, NSW, Australia Purpose: Dose-escalated (DE radiotherapy in the setting of localized prostate cancer has been shown to improve biochemical disease-free survival (bDFS in several studies. In the same group of patients, androgen deprivation therapy (ADT has been shown to confer a survival benefit when combined with radiotherapy doses of up to 70 Gy; however, there is currently little long-term data on patients who have received high-dose intensity-modulated radiotherapy (IMRT with ADT. We report the long-term outcomes in a large cohort of patients treated with the combination of DE image-guided IMRT (IG-IMRT and ADT. Methods and materials: Patients with localized prostate cancer were identified from a centralized database across an integrated cancer center. All patients received DE IG-IMRT, combined with ADT, and had a minimum follow up of 12 months post-radiotherapy. All relapse and toxicity data were collected prospectively. Actuarial bDFS, metastasis-free survival, prostate cancer-specific survival, and multivariate analyses were calculated using the SPSS v20.0 statistical package. Results: Seven hundred and eighty-two eligible patients were identified with a median follow up of 46 months. Overall, 4.3% of patients relapsed, 2.0% developed distant metastases, and 0.6% died from metastatic prostate cancer. At 5-years, bDFS was 88%, metastasis-free survival was 95%, and prostate cancer-specific survival was 98%. Five-year grade 2 genitourinary and gastrointestinal toxicity was 2

  11. Long-term outcomes from dose-escalated image-guided intensity-modulated radiotherapy with androgen deprivation: encouraging results for intermediate- and high-risk prostate cancer.

    Wilcox, Shea W; Aherne, Noel J; Benjamin, Linus C; Wu, Bosco; de Campos Silva, Thomaz; McLachlan, Craig S; McKay, Michael J; Last, Andrew J; Shakespeare, Thomas P

    2014-01-01

    Dose-escalated (DE) radiotherapy in the setting of localized prostate cancer has been shown to improve biochemical disease-free survival (bDFS) in several studies. In the same group of patients, androgen deprivation therapy (ADT) has been shown to confer a survival benefit when combined with radiotherapy doses of up to 70 Gy; however, there is currently little long-term data on patients who have received high-dose intensity-modulated radiotherapy (IMRT) with ADT. We report the long-term outcomes in a large cohort of patients treated with the combination of DE image-guided IMRT (IG-IMRT) and ADT. Patients with localized prostate cancer were identified from a centralized database across an integrated cancer center. All patients received DE IG-IMRT, combined with ADT, and had a minimum follow up of 12 months post-radiotherapy. All relapse and toxicity data were collected prospectively. Actuarial bDFS, metastasis-free survival, prostate cancer-specific survival, and multivariate analyses were calculated using the SPSS v20.0 statistical package. Seven hundred and eighty-two eligible patients were identified with a median follow up of 46 months. Overall, 4.3% of patients relapsed, 2.0% developed distant metastases, and 0.6% died from metastatic prostate cancer. At 5-years, bDFS was 88%, metastasis-free survival was 95%, and prostate cancer-specific survival was 98%. Five-year grade 2 genitourinary and gastrointestinal toxicity was 2.1% and 3.4%, respectively. No grade 3 or 4 late toxicities were reported. Pretreatment prostate specific antigen (P=0.001) and Gleason score (P=0.03) were significant in predicting biochemical failure on multivariate analysis. There is a high probability of tumor control with DE IG-IMRT combined with androgen deprivation, and this is a technique with a low probability of significant late toxicity. Our long term results corroborate the safety and efficacy of treating with IG-IMRT to high doses and compares favorably with published series for

  12. Endoluminal ultrasound applicator with an integrated RF coil for high-resolution magnetic resonance imaging-guided high-intensity contact ultrasound thermotherapy

    Rata, Mihaela; Salomir, Rares; Lafon, Cyril; Umathum, Reiner; Jenne, Juergen; Bock, Michael; Cotton, Francois

    2008-01-01

    High-intensity contact ultrasound (HICU) under MRI guidance may provide minimally invasive treatment of endocavitary digestive tumors in the esophagus, colon or rectum. In this study, a miniature receive-only coil was integrated into an endoscopic ultrasound applicator to offer high-resolution MRI guidance of thermotherapy. A cylindrical plastic support with an incorporated single element flat transducer (9.45 MHz, water cooling tip) was made and equipped with a rectangular RF loop coil surrounding the active element. The integrated coil provided significantly higher sensitivity than a four-element extracorporeal phased array coil, and the standard deviation of the MR thermometry (SDT) improved up to a factor of 7 at 10 mm depth in tissue. High-resolution morphological images (T1w-TFE and IR-T1w-TSE with a voxel size of 0.25 x 0.25 x 3 mm 3 ) and accurate thermometry data (the PRFS method with a voxel size of 0.5 x 0.5 x 5 mm 3 , 2.2 s/image, 0.3 deg. C voxel-wise SDT) were acquired in an ex vivo esophagus sample, on a clinical 1.5T scanner. The endoscopic device was actively operated under automatic temperature control, demonstrating a high level of accuracy (1.7% standard deviation, 1.1% error of mean value), which indicates that this technology may be suitable for HICU therapy of endoluminal cancer.

  13. Endoluminal ultrasound applicator with an integrated RF coil for high-resolution magnetic resonance imaging-guided high-intensity contact ultrasound thermotherapy

    Rata, Mihaela; Salomir, Rares; Umathum, Reiner; Jenne, Jürgen; Lafon, Cyril; Cotton, François; Bock, Michael

    2008-11-01

    High-intensity contact ultrasound (HICU) under MRI guidance may provide minimally invasive treatment of endocavitary digestive tumors in the esophagus, colon or rectum. In this study, a miniature receive-only coil was integrated into an endoscopic ultrasound applicator to offer high-resolution MRI guidance of thermotherapy. A cylindrical plastic support with an incorporated single element flat transducer (9.45 MHz, water cooling tip) was made and equipped with a rectangular RF loop coil surrounding the active element. The integrated coil provided significantly higher sensitivity than a four-element extracorporeal phased array coil, and the standard deviation of the MR thermometry (SDT) improved up to a factor of 7 at 10 mm depth in tissue. High-resolution morphological images (T1w-TFE and IR-T1w-TSE with a voxel size of 0.25 × 0.25 × 3 mm3) and accurate thermometry data (the PRFS method with a voxel size of 0.5 × 0.5 × 5 mm3, 2.2 s/image, 0.3 °C voxel-wise SDT) were acquired in an ex vivo esophagus sample, on a clinical 1.5T scanner. The endoscopic device was actively operated under automatic temperature control, demonstrating a high level of accuracy (1.7% standard deviation, 1.1% error of mean value), which indicates that this technology may be suitable for HICU therapy of endoluminal cancer.

  14. Treatment outcome of high-dose image-guided intensity-modulated radiotherapy using intra-prostate fiducial markers for localized prostate cancer at a single institute in Japan

    Takeda, Ken; Shimizu, Eiji; Abe, Keiko; Shirata, Yuko; Ishikawa, Yohjiro

    2012-01-01

    Several studies have confirmed the advantages of delivering high doses of external beam radiotherapy to achieve optimal tumor-control outcomes in patients with localized prostate cancer. We evaluated the medium-term treatment outcome after high-dose, image-guided intensity-modulated radiotherapy (IMRT) using intra-prostate fiducial markers for clinically localized prostate cancer. In total, 141 patients with localized prostate cancer treated with image-guided IMRT (76 Gy in 13 patients and 80 Gy in 128 patients) between 2003 and 2008 were enrolled in this study. The patients were classified according to the National Comprehensive Cancer Network-defined risk groups. Thirty-six intermediate-risk patients and 105 high-risk patients were included. Androgen-deprivation therapy was performed in 124 patients (88%) for a median of 11 months (range: 2–88 months). Prostate-specific antigen (PSA) relapse was defined according to the Phoenix-definition (i.e., an absolute nadir plus 2 ng/ml dated at the call). The 5-year actuarial PSA relapse-free survival, the 5-year distant metastasis-free survival, the 5-year cause-specific survival (CSS), the 5-year overall survival (OS) outcomes and the acute and late toxicities were analyzed. The toxicity data were scored according to the Common Terminology Criteria for Adverse Events, version 4.0. The median follow-up was 60 months. The 5-year PSA relapse-free survival rates were 100% for the intermediate-risk patients and 82.2% for the high-risk patients; the 5-year actuarial distant metastasis-free survival rates were 100% and 95% for the intermediate- and high-risk patients, respectively; the 5-year CSS rates were 100% for both patient subsets; and the 5-year OS rates were 100% and 91.7% for the intermediate- and high-risk patients, respectively. The Gleason score (<8 vs. ≥8) was significant for the 5-year PSA relapse-free survival on multivariate analysis (p = 0.044). There was no grade 3 or 4 acute toxicity. The incidence of

  15. Multifractionated image-guided and stereotactic intensity-modulated radiotherapy of paraspinal tumors: A preliminary report

    Yamada, Yoshiya; Lovelock, D. Michael; Yenice, Kamil M.; Bilsky, Mark H.; Hunt, Margaret A.; Zatcky, Joan; Leibel, Steven A.

    2005-01-01

    Purpose: The use of image-guided and stereotactic intensity-modulated radiotherapy (IMRT) techniques have made the delivery of high-dose radiation to lesions within close proximity to the spinal cord feasible. This report presents clinical and physical data regarding the use of IMRT coupled with noninvasive body frames (stereotactic and image-guided) for multifractionated radiotherapy. Methods and Materials: The Memorial Sloan-Kettering Cancer Center (Memorial) stereotactic body frame (MSBF) and Memorial body cradle (MBC) have been developed as noninvasive immobilizing devices for paraspinal IMRT using stereotactic (MSBF) and image-guided (MBC) techniques. Patients were either previously irradiated or prescribed doses beyond spinal cord tolerance (54 Gy in standard fractionation) and had unresectable gross disease involving the spinal canal. The planning target volume (PTV) was the gross tumor volume with a 1 cm margin. The PTV was not allowed to include the spinal cord contour. All treatment planning was performed using software developed within the institution. Isocenter verification was performed with an in-room computed tomography scan (MSBF) or electronic portal imaging devices, or both. Patients were followed up with serial magnetic resonance imaging every 3-4 months, and no patients were lost to follow-up. Kaplan-Meier statistics were used for analysis of clinical data. Results: Both the MSBF and MBC were able to provide setup accuracy within 2 mm. With a median follow-up of 11 months, 35 patients (14 primary and 21 secondary malignancies) underwent treatment. The median dose previously received was 3000 cGy in 10 fractions. The median dose prescribed for these patients was 2000 cGy/5 fractions (2000-3000 cGy), which provided a median PTV V100 of 88%. In previously unirradiated patients, the median prescribed dose was 7000 cGy (5940-7000 cGy) with a median PTV V100 of 90%. The median Dmax to the cord was 34% and 68% for previously irradiated and never

  16. Stereotactic Image-Guided Intensity Modulated Radiotherapy Using the HI-ART II Helical Tomotherapy System

    Holmes, Timothy W.; Hudes, Richard; Dziuba, Sylwester; Kazi, Abdul; Hall, Mark; Dawson, Dana

    2008-01-01

    The highly integrated adaptive radiation therapy (HI-ART II) helical tomotherapy unit is a new radiotherapy machine designed to achieve highly precise and accurate treatments at all body sites. The precision and accuracy of the HI-ART II is similar to that provided by stereotactic radiosurgery systems, hence the historical distinction between external beam radiotherapy and stereotactic procedures based on differing precision requirements is removed for this device. The objectives of this work are: (1) to describe stereotactic helical tomotherapy processes (SRS, SBRT); (2) to show that the precision and accuracy of the HI-ART meet the requirements defined for SRS and SBRT; and (3) to describe the clinical implementation of a stereotactic image-guided intensity modulated radiation therapy (IG-IMRT) system that incorporates optical motion management

  17. Toxicity after intensity-modulated, image-guided radiotherapy for prostate cancer

    Flentje, Michael; Guckenberger, Matthias; Ok, Sami; Polat, Buelent; Sweeney, Reinhart A.

    2010-01-01

    Purpose: To evaluate toxicity after dose-escalated radiotherapy for prostate cancer using intensity-modulated treatment planning (IMRT) and image-guided treatment (IGRT) delivery. Patients and Methods: 100 patients were treated with simultaneous integrated boost (SIB) IMRT for prostate cancer: doses of 76.23 Gy and 60 Gy in 33 fractions were prescribed to the prostate and the seminal vesicles, respectively, for intermediate- and high-risk patients (n = 74). The total dose was 73.91 Gy in 32 fractions for low-risk patients and after transurethral resection of the prostate (n = 26). The pelvic lymphatics were treated with 46 Gy in 25 fractions in patients with high risk of lymph node metastases using an SIB to the prostate (n = 25). IGRT was practiced with cone-beam computed tomography. Acute and late gastrointestinal (GI) and genitourinary (GU) toxicity was evaluated prospectively (CTCAE v3.0). Results: Treatment was completed as planned by all patients. Acute GI and GU toxicity grade ≥ 2 was observed in 12% and 42% of the patients, respectively, with 4% suffering from GU toxicity grade 3. 6 weeks after treatment, the incidence of acute toxicity grade ≥ 2 had decreased to 12%. With a median follow-up of 26 months, late GI and GU toxicity grade ≥ 2 was seen in 1.5% and 7.7% of the patients at 24 months. Four patients developed late toxicity grade 3 (GI n = 1; GU n = 3). Presence of acute GI and GU toxicity was significantly associated with late GI (p = 0.0007) and GU toxicity (p = 0.006). Conclusion: High-dose radiotherapy for prostate cancer using IMRT and IGRT resulted in low rates of acute toxicity and preliminary results of late toxicity are promising. (orig.)

  18. Toxicity after intensity-modulated, image-guided radiotherapy for prostate cancer

    Flentje, Michael [Dept. of Radiotherapy, Univ. Hospital Wuerzburg (Germany); Guckenberger, Matthias; Ok, Sami; Polat, Buelent; Sweeney, Reinhart A.

    2010-10-15

    Purpose: To evaluate toxicity after dose-escalated radiotherapy for prostate cancer using intensity-modulated treatment planning (IMRT) and image-guided treatment (IGRT) delivery. Patients and Methods: 100 patients were treated with simultaneous integrated boost (SIB) IMRT for prostate cancer: doses of 76.23 Gy and 60 Gy in 33 fractions were prescribed to the prostate and the seminal vesicles, respectively, for intermediate- and high-risk patients (n = 74). The total dose was 73.91 Gy in 32 fractions for low-risk patients and after transurethral resection of the prostate (n = 26). The pelvic lymphatics were treated with 46 Gy in 25 fractions in patients with high risk of lymph node metastases using an SIB to the prostate (n = 25). IGRT was practiced with cone-beam computed tomography. Acute and late gastrointestinal (GI) and genitourinary (GU) toxicity was evaluated prospectively (CTCAE v3.0). Results: Treatment was completed as planned by all patients. Acute GI and GU toxicity grade {>=} 2 was observed in 12% and 42% of the patients, respectively, with 4% suffering from GU toxicity grade 3. 6 weeks after treatment, the incidence of acute toxicity grade {>=} 2 had decreased to 12%. With a median follow-up of 26 months, late GI and GU toxicity grade {>=} 2 was seen in 1.5% and 7.7% of the patients at 24 months. Four patients developed late toxicity grade 3 (GI n = 1; GU n = 3). Presence of acute GI and GU toxicity was significantly associated with late GI (p = 0.0007) and GU toxicity (p = 0.006). Conclusion: High-dose radiotherapy for prostate cancer using IMRT and IGRT resulted in low rates of acute toxicity and preliminary results of late toxicity are promising. (orig.)

  19. Promising results with image guided intensity modulated radiotherapy for muscle invasive bladder cancer

    Whalley, D.; Caine, H.; McCloud, P.; Guo, L.; Kneebone, A.; Eade, T.

    2015-01-01

    To describe the feasibility of image guided intensity modulated radiotherapy (IG-IMRT) using daily soft tissue matching in the treatment of bladder cancer. Twenty-eight patients with muscle-invasive carcinoma of the bladder were recruited to a protocol of definitive radiation using IMRT with accelerated hypofractionation with simultaneous integrated boost (SIB). Isotropic margins of .5 and 1 cm were used to generate the high risk and intermediate risk planning target volumes respectively. Cone beam CT (CBCT) was acquired daily and a soft tissue match was performed. Cystoscopy was scheduled 6 weeks post treatment. The median age was 83 years (range 58-92). Twenty patients had stage II or III disease, and eight were stage IV. Gross disease received 66 Gy in 30 fractions in 11 patients (ten with concurrent chemotherapy) or 55 Gy in 20 fractions for those of poorer performance status or with palliative intent. All patients completed radiation treatment as planned. Three patients ceased chemotherapy early due to toxicity. Six patients (21 %) had acute Grade ≥ 2 genitourinary (GU) toxicity and six (21 %) had acute Grade ≥ 2 gastrointestinal (GI) toxicity. Five patients (18 %) developed Grade ≥2 late GU toxicity and no ≥2 late GI toxicity was observed. Nineteen patients underwent cystoscopy following radiation, with complete response (CR) in 16 cases (86 %), including all patients treated with chemoradiotherapy. Eight patients relapsed, four of which were local relapses. Of the patients with local recurrence, one underwent salvage cystectomy. For patients treated with definitive intent, freedom from locoregional recurrence (FFLR) and overall survival (OS) was 90 %/100 % for chemoradiotherapy versus 86 %/69 % for radiotherapy alone. IG- IMRT using daily soft tissue matching is a feasible in the treatment of bladder cancer, enabling the delivery of accelerated synchronous integrated boost with good early local control outcomes and low toxicity

  20. Feasibility of intensity-modulated and image-guided radiotherapy for locally advanced esophageal cancer

    Nguyen, Nam P; Desai, Anand; Smith-Raymond, Lexie; Jang, Siyoung; Vock, Jacqueline; Vinh-Hung, Vincent; Chi, Alexander; Vos, Paul; Pugh, Judith; Vo, Richard A; Ceizyk, Misty

    2014-01-01

    In this study the feasibility of intensity-modulated radiotherapy (IMRT) and tomotherapy-based image-guided radiotherapy (IGRT) for locally advanced esophageal cancer was assessed. A retrospective study of ten patients with locally advanced esophageal cancer who underwent concurrent chemotherapy with IMRT (1) and IGRT (9) was conducted. The gross tumor volume was treated to a median dose of 70 Gy (62.4-75 Gy). At a median follow-up of 14 months (1-39 months), three patients developed local failures, six patients developed distant metastases, and complications occurred in two patients (1 tracheoesophageal fistula, 1 esophageal stricture requiring repeated dilatations). No patients developed grade 3-4 pneumonitis or cardiac complications. IMRT and IGRT may be effective for the treatment of locally advanced esophageal cancer with acceptable complications

  1. Temporary organ displacement coupled with image-guided, intensity-modulated radiotherapy for paraspinal tumors

    Katsoulakis, Evangelia; Thornton, Raymond H; Yamada, Yoshiya; Solomon, Stephen B; Maybody, Majid; Housman, Douglas; Niyazov, Greg; Riaz, Nadeem; Lovelock, Michael; Spratt, Daniel E; Erinjeri, Joseph P

    2013-01-01

    To investigate the feasibility and dosimetric improvements of a novel technique to temporarily displace critical structures in the pelvis and abdomen from tumor during high-dose radiotherapy. Between 2010 and 2012, 11 patients received high-dose image-guided intensity-modulated radiotherapy with temporary organ displacement (TOD) at our institution. In all cases, imaging revealed tumor abutting critical structures. An all-purpose drainage catheter was introduced between the gross tumor volume (GTV) and critical organs at risk (OAR) and infused with normal saline (NS) containing 5-10% iohexol. Radiation planning was performed with the displaced OARs and positional reproducibility was confirmed with cone-beam CT (CBCT). Patients were treated within 36 hours of catheter placement. Radiation plans were re-optimized using pre-TOD OARs to the same prescription and dosimetrically compared with post-TOD plans. A two-tailed permutation test was performed on each dosimetric measure. The bowel/rectum was displaced in six patients and kidney in four patients. One patient was excluded due to poor visualization of the OAR; thus 10 patients were analyzed. A mean of 229 ml (range, 80–1000) of NS 5-10% iohexol infusion resulted in OAR mean displacement of 17.5 mm (range, 7–32). The median dose prescribed was 2400 cGy in one fraction (range, 2100–3000 in 3 fractions). The mean GTV D min and PTV D min pre- and post-bowel TOD IG-IMRT dosimetry significantly increased from 1473 cGy to 2086 cGy (p=0.015) and 714 cGy to 1214 cGy (p=0.021), respectively. TOD increased mean PTV D95 by 27.14% of prescription (p=0.014) while the PTV D05 decreased by 9.2% (p=0.011). TOD of the bowel resulted in a 39% decrease in mean bowel D max (p=0.008) confirmed by CBCT. TOD of the kidney significantly decreased mean kidney dose and D max by 25% (0.022). TOD was well tolerated, reproducible, and facilitated dose escalation to previously radioresistant tumors abutting critical structures while

  2. CT image-guided intensity-modulated therapy for paraspinal tumors using stereotactic immobilization

    Yenice, Kamil M.; Lovelock, D. Michael; Hunt, Margie A.; Lutz, Wendell R.; Fournier-Bidoz, Nathalie; Hua, C.-H.; Yamada, Josh; Bilsky, Mark; Lee, Henry; Pfaff, Karl; Spirou, Spiridon V.; Amols, Howard I.

    2003-01-01

    Purpose: To design and implement a noninvasive stereotactic immobilization technique with daily CT image-guided positioning to treat patients with paraspinal lesions accurately and to quantify the systematic and random patient setup errors occurring with this method. Methods and Materials: A stereotactic body frame (SBF) was developed for 'rigid' immobilization of paraspinal patients. The inherent accuracy of this system for stereotactic CT-guided treatment was evaluated with phantom studies. Seven patients with thoracic and lumbar spine lesions were immobilized with the SBF and positioned for 33 treatment fractions using daily CT scans. For all 7 patients, the daily setup errors, as assessed from the daily CT scans, were corrected at each treatment fraction. A retrospective analysis was also performed to assess what the impact on patient treatment would have been without the CT-based corrections (i.e., if patient setup had been performed only with the SBF). Results: The average magnitude of systematic and random errors from uncorrected patient setups using the SBF was approximately 2 mm and 1.5 mm (1 SD), respectively. For fixed phantom targets, the system accuracy for the SBF localization and treatment was shown to be within 1 mm (1 SD) in any direction. Dose-volume histograms incorporating these uncertainties for an intensity-modulated radiotherapy plan for lumbar spine lesions were generated, and the effects on the dose-volume histograms were studied. Conclusion: We demonstrated a very accurate and precise method of patient immobilization and treatment delivery based on a noninvasive SBF and daily image guidance for paraspinal lesions. The SBF provides excellent immobilization for paraspinal targets, with setup accuracy better than 2 mm (1 SD). However, for highly conformal paraspinal treatments, uncorrected systematic and random errors of 2 mm in magnitude can result in a significantly greater (>100%) dose to the spinal cord than planned, even though the

  3. Rationale and development of image-guided intensity-modulated radiotherapy post-prostatectomy: the present standard of care?

    Murray JR

    2015-11-01

    Full Text Available Julia R Murray,1,2 Helen A McNair,2 David P Dearnaley1,2 1Academic Urology Unit, Institute of Cancer Research, London, 2Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, Sutton, UK Abstract: The indications for post-prostatectomy radiotherapy have evolved over the last decade, although the optimal timing, dose, and target volume remain to be well defined. The target volume is susceptible to anatomical variations with its borders interfacing with the rectum and bladder. Image-guided intensity-modulated radiotherapy has become the gold standard for radical prostate radiotherapy. Here we review the current evidence for image-guided techniques with intensity-modulated radiotherapy to the prostate bed and describe current strategies to reduce or account for interfraction and intrafraction motion. Keywords: radiotherapy, prostate cancer, post-prostatectomy, image-guided radiation therapy

  4. Integral test phantom for dosimetric quality assurance of image guided and intensity modulated stereotactic radiotherapy

    Letourneau, Daniel; Keller, Harald; Sharpe, Michael B.; Jaffray, David A.

    2007-01-01

    The objective of this work is to develop a dosimetric phantom quality assurance (QA) of linear accelerators capable of cone-beam CT (CBCT) image guided and intensity-modulated radiotherapy (IG-IMRT). This phantom is to be used in an integral test to quantify in real-time both the performance of the image guidance and the dose delivery systems in terms of dose localization. The prototype IG-IMRT QA phantom consisted of a cylindrical imaging phantom (CatPhan) combined with an array of 11 radiation diodes mounted on a 10 cm diameter disk, oriented perpendicular to the phantom axis. Basic diode response characterization was performed for 6 and 18 MV photons. The diode response was compared to planning system calculations in the open and penumbrae regions of simple and complex beam arrangements. The clinical use of the QA phantom was illustrated in an integral test of an IG-IMRT treatment designed for a clinical spinal radiosurgery case. The sensitivity of the phantom to multileaf collimator (MLC) calibration and setup errors in the clinical setting was assessed by introducing errors in the IMRT plan or by displacing the phantom. The diodes offered good response linearity and long-term reproducibility for both 6 and 18 MV. Axial dosimetry of coplanar beams (in a plane containing the beam axes) was made possible with the nearly isoplanatic response of the diodes over 360 deg. of gantry (usually within ±1%). For single beam geometry, errors in phantom placement as small as 0.5 mm could be accurately detected (in gradient ≥1%/mm). In clinical setting, MLC systematic errors of 1 mm on a single MLC bank introduced in the IMRT plan were easily detectable with the QA phantom. The QA phantom demonstrated also sufficient sensitivity for the detection of setup errors as small as 1 mm for the IMRT delivery. These results demonstrated that the prototype can accurately and efficiently verify the entire IG-IMRT process. This tool, in conjunction with image guidance capabilities

  5. Integral test phantom for dosimetric quality assurance of image guided and intensity modulated stereotactic radiotherapy.

    Létourneau, Daniel; Keller, Harald; Sharpe, Michael B; Jaffray, David A

    2007-05-01

    The objective of this work is to develop a dosimetric phantom quality assurance (QA) of linear accelerators capable of cone-beam CT (CBCT) image guided and intensity-modulated radiotherapy (IG-IMRT). This phantom is to be used in an integral test to quantify in real-time both the performance of the image guidance and the dose delivery systems in terms of dose localization. The prototype IG-IMRT QA phantom consisted of a cylindrical imaging phantom (CatPhan) combined with an array of 11 radiation diodes mounted on a 10 cm diameter disk, oriented perpendicular to the phantom axis. Basic diode response characterization was performed for 6 and 18 MV photons. The diode response was compared to planning system calculations in the open and penumbrae regions of simple and complex beam arrangements. The clinical use of the QA phantom was illustrated in an integral test of an IG-IMRT treatment designed for a clinical spinal radiosurgery case. The sensitivity of the phantom to multileaf collimator (MLC) calibration and setup errors in the clinical setting was assessed by introducing errors in the IMRT plan or by displacing the phantom. The diodes offered good response linearity and long-term reproducibility for both 6 and 18 MV. Axial dosimetry of coplanar beams (in a plane containing the beam axes) was made possible with the nearly isoplanatic response of the diodes over 360 degrees of gantry (usually within +/-1%). For single beam geometry, errors in phantom placement as small as 0.5 mm could be accurately detected (in gradient > or = 1% /mm). In clinical setting, MLC systematic errors of 1 mm on a single MLC bank introduced in the IMRT plan were easily detectable with the QA phantom. The QA phantom demonstrated also sufficient sensitivity for the detection of setup errors as small as 1 mm for the IMRT delivery. These results demonstrated that the prototype can accurately and efficiently verify the entire IG-IMRT process. This tool, in conjunction with image guidance

  6. Toxicity after post-prostatectomy image-guided intensity-modulated radiotherapy using Australian guidelines.

    Chin, Stephen; Aherne, Noel J; Last, Andrew; Assareh, Hassan; Shakespeare, Thomas P

    2017-12-01

    We evaluated single institution toxicity outcomes after post-prostatectomy radiotherapy (PPRT) via image-guided intensity-modulated radiation therapy (IG-IMRT) with implanted fiducial markers following national eviQ guidelines, for which late toxicity outcomes have not been published. Prospectively collected toxicity data were retrospectively reviewed for 293 men who underwent 64-66 Gy IG-IMRT to the prostate bed between 2007 and 2015. Median follow-up after PPRT was 39 months. Baseline grade ≥2 genitourinary (GU), gastrointestinal (GI) and sexual toxicities were 20.5%, 2.7% and 43.7%, respectively, reflecting ongoing toxicity after radical prostatectomy. Incidence of new (compared to baseline) acute grade ≥2 GU and GI toxicity was 5.8% and 10.6%, respectively. New late grade ≥2 GU, GI and sexual toxicity occurred in 19.1%, 4.7% and 20.2%, respectively. However, many patients also experienced improvements in toxicities. For this reason, prevalence of grade ≥2 GU, GI and sexual toxicities 4 years after PPRT was similar to or lower than baseline (21.7%, 2.6% and 17.4%, respectively). There were no grade ≥4 toxicities. Post-prostatectomy IG-IMRT using Australian contouring guidelines appears to have tolerable acute and late toxicity. The 4-year prevalence of grade ≥2 GU and GI toxicity was virtually unchanged compared to baseline, and sexual toxicity improved over baseline. This should reassure radiation oncologists following these guidelines. Late toxicity rates of surgery and PPRT are higher than following definitive IG-IMRT, and this should be taken into account if patients are considering surgery and likely to require PPRT. © 2017 The Royal Australian and New Zealand College of Radiologists.

  7. Long-term decision regret after post-prostatectomy image-guided intensity-modulated radiotherapy.

    Shakespeare, Thomas P; Chin, Stephen; Manuel, Lucy; Wen, Shelly; Hoffman, Matthew; Wilcox, Shea W; Aherne, Noel J

    2017-02-01

    Decision regret (DR) may occur when a patient believes their outcome would have been better if they had decided differently about their management. Although some studies investigate DR after treatment for localised prostate cancer, none report DR in patients undergoing surgery and post-prostatectomy radiotherapy. We evaluated DR in this group of patients overall, and for specific components of therapy. We surveyed 83 patients, with minimum 5 years follow-up, treated with radical prostatectomy (RP) and post-prostatectomy image-guided intensity-modulated radiotherapy (IG-IMRT) to 64-66 Gy following www.EviQ.org.au protocols. A validated questionnaire identified DR if men either indicated that they would have been better off had they chosen another treatment, or they wished they could change their mind about treatment. There was an 85.5% response rate, with median follow-up post-IMRT 78 months. Adjuvant IG-IMRT was used in 28% of patients, salvage in 72% and ADT in 48%. A total of 70% of patients remained disease-free. Overall, 16.9% of patients expressed DR for treatment, with fourfold more regret for the RP component of treatment compared to radiotherapy (16.9% vs 4.2%, P = 0.01). DR for androgen deprivation was 14.3%. Patients were regretful of surgery due to toxicity, not being adequately informed about radiotherapy as an alternative, positive margins and surgery costs (83%, 33%, 25% and 8% of regretful patients respectively). Toxicity caused DR in the three radiotherapy-regretful and four ADT-regretful patients. Patients were twice as regretful overall, and of surgery, for salvage vs adjuvant approaches (both 19.6% vs 10.0%). Decision regret after RP and post-prostatectomy IG-IMRT is uncommon, although patients regret RP more than post-operative IG-IMRT. This should reassure urologists referring patients for post-prostatectomy IG-IMRT, particularly in the immediate adjuvant setting. Other implications include appropriate patient selection for RP (and

  8. Introducing an on-line adaptive procedure for prostate image guided intensity modulate proton therapy.

    Zhang, M; Westerly, D C; Mackie, T R

    2011-08-07

    With on-line image guidance (IG), prostate shifts relative to the bony anatomy can be corrected by realigning the patient with respect to the treatment fields. In image guided intensity modulated proton therapy (IG-IMPT), because the proton range is more sensitive to the material it travels through, the realignment may introduce large dose variations. This effect is studied in this work and an on-line adaptive procedure is proposed to restore the planned dose to the target. A 2D anthropomorphic phantom was constructed from a real prostate patient's CT image. Two-field laterally opposing spot 3D-modulation and 24-field full arc distal edge tracking (DET) plans were generated with a prescription of 70 Gy to the planning target volume. For the simulated delivery, we considered two types of procedures: the non-adaptive procedure and the on-line adaptive procedure. In the non-adaptive procedure, only patient realignment to match the prostate location in the planning CT was performed. In the on-line adaptive procedure, on top of the patient realignment, the kinetic energy for each individual proton pencil beam was re-determined from the on-line CT image acquired after the realignment and subsequently used for delivery. Dose distributions were re-calculated for individual fractions for different plans and different delivery procedures. The results show, without adaptive, that both the 3D-modulation and the DET plans experienced delivered dose degradation by having large cold or hot spots in the prostate. The DET plan had worse dose degradation than the 3D-modulation plan. The adaptive procedure effectively restored the planned dose distribution in the DET plan, with delivered prostate D(98%), D(50%) and D(2%) values less than 1% from the prescription. In the 3D-modulation plan, in certain cases the adaptive procedure was not effective to reduce the delivered dose degradation and yield similar results as the non-adaptive procedure. In conclusion, based on this 2D phantom

  9. Image Guided Hypofractionated Postprostatectomy Intensity Modulated Radiation Therapy for Prostate Cancer

    Lewis, Stephen L.; Patel, Pretesh; Song, Haijun [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Freedland, Stephen J. [Surgery Section, Durham Veterans Administration, and Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California (United States); Bynum, Sigrun; Oh, Daniel; Palta, Manisha; Yoo, David; Oleson, James [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Salama, Joseph K., E-mail: joseph.salama@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2016-03-01

    Purpose: Hypofractionated radiation therapy (RT) has promising long-term biochemical relapse-free survival (bRFS) with comparable toxicity for definitive treatment of prostate cancer. However, data reporting outcomes after adjuvant and salvage postprostatectomy hypofractionated RT are sparse. Therefore, we report the toxicity and clinical outcomes after postprostatectomy hypofractionated RT. Methods and Materials: From a prospectively maintained database, men receiving image guided hypofractionated intensity modulated RT (HIMRT) with 2.5-Gy fractions constituted our study population. Androgen deprivation therapy was used at the discretion of the radiation oncologist. Acute toxicities were graded according to the Common Terminology Criteria for Adverse Events version 4.0. Late toxicities were scored using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale. Biochemical recurrence was defined as an increase of 0.1 in prostate-specific antigen (PSA) from posttreatment nadir or an increase in PSA despite treatment. The Kaplan-Meier method was used for the time-to-event outcomes. Results: Between April 2008 and April 2012, 56 men received postoperative HIMRT. The median follow-up time was 48 months (range, 21-67 months). Thirty percent had pre-RT PSA <0.1; the median pre-RT detectable PSA was 0.32 ng/mL. The median RT dose was 65 Gy (range, 57.5-65 Gy). Ten patients received neoadjuvant and concurrent hormone therapy. Posttreatment acute urinary toxicity was limited. There was no acute grade 3 toxicity. Late genitourinary (GU) toxicity of any grade was noted in 52% of patients, 40% of whom had pre-RT urinary incontinence. The 4-year actuarial rate of late grade 3 GU toxicity (exclusively gross hematuria) was 28% (95% confidence interval [CI], 16%-41%). Most grade 3 GU toxicity resolved; only 7% had persistent grade ≥3 toxicity at the last follow-up visit. Fourteen patients experienced biochemical recurrence at a

  10. Image-guided, intensity-modulated radiation therapy (IG-IMRT) for skull base chordoma and chondrosarcoma: preliminary outcomes.

    Sahgal, Arjun; Chan, Michael W; Atenafu, Eshetu G; Masson-Cote, Laurence; Bahl, Gaurav; Yu, Eugene; Millar, Barbara-Ann; Chung, Caroline; Catton, Charles; O'Sullivan, Brian; Irish, Jonathan C; Gilbert, Ralph; Zadeh, Gelareh; Cusimano, Michael; Gentili, Fred; Laperriere, Normand J

    2015-06-01

    We report our preliminary outcomes following high-dose image-guided intensity modulated radiotherapy (IG-IMRT) for skull base chordoma and chondrosarcoma. Forty-two consecutive IG-IMRT patients, with either skull base chordoma (n = 24) or chondrosarcoma (n = 18) treated between August 2001 and December 2012 were reviewed. The median follow-up was 36 months (range, 3-90 mo) in the chordoma cohort, and 67 months (range, 15-125) in the chondrosarcoma cohort. Initial surgery included biopsy (7% of patients), subtotal resection (57% of patients), and gross total resection (36% of patients). The median IG-IMRT total doses in the chondrosarcoma and chordoma cohorts were 70 Gy and 76 Gy, respectively, delivered with 2 Gy/fraction. For the chordoma and chondrosarcoma cohorts, the 5-year overall survival and local control rates were 85.6% and 65.3%, and 87.8% and 88.1%, respectively. In total, 10 patients progressed locally: 8 were chordoma patients and 2 chondrosarcoma patients. Both chondrosarcoma failures were in higher-grade tumors (grades 2 and 3). None of the 8 patients with grade 1 chondrosarcoma failed, with a median follow-up of 77 months (range, 34-125). There were 8 radiation-induced late effects-the most significant was a radiation-induced secondary malignancy occurring 6.7 years following IG-IMRT. Gross total resection and age were predictors of local control in the chordoma and chondrosarcoma patients, respectively. We report favorable survival, local control and adverse event rates following high dose IG-IMRT. Further follow-up is needed to confirm long-term efficacy. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Image-guided intensity-modulated radiotherapy of prostate cancer. Analysis of interfractional errors and acute toxicity

    Rudat, Volker; Nour, A.; Hammoud, M.; Alaradi, A.; Mohammed, A. [Saad Specialist Hospital, Department of Radiation Oncology, Al Khobar (Saudi Arabia)

    2016-02-15

    The aim of the study was to estimate interfractional deviations in patient and prostate position, the impact of the frequency of online verification on the treatment margins, and to assess acute radiation reactions of high-dose external beam image-guided intensity-modulated radiotherapy (IG-IMRT) of localized prostate cancer. IG-IMRT was performed by daily online verification of implanted fiducial prostate markers using a megavoltage electronic portal imaging device (EPID). A total of 1011 image-guided treatment fractions from 23 consecutive unselected prostate cancer patients were analyzed. The median total dose was 79.2 Gy (range 77.4-81.0 Gy). Acute radiation reactions were assessed weekly during radiotherapy using the Common Terminology Criteria for Adverse Events (CTCAE) v.4.03. A relevant combined patient set-up and prostate motion population random error of 4-5 mm was observed. Compared to daily IGRT, image guidance every other day required an expansion of the CTV-PTV (clinical target volume-planning target volume) margin of 8.1, 6.6, and 4.1 mm in the longitudinal, vertical, and lateral directions, thereby, increasing the PTV by approximately 30-40 %. No grade 3 or 4 acute radiation reactions were observed with daily IG-IMRT. A high dose with surprisingly low acute toxicity can be applied with daily IG-IMRT using implanted fiducial prostate markers. Daily image guidance is clearly superior to image guidance every other fraction concerning adequate target coverage with minimal margins. (orig.) [German] Ziel der Studie war es, die interfraktionelle Variabilitaet der Patientenlagerung und Prostataposition, den Einfluss der Bildgebungsfrequenz und die akuten Strahlenreaktionen bei einer hochdosierten bildgesteuerten intensitaetsmodulierten Strahlentherapie (IG-IMRT) des Prostatakarzinoms zu untersuchen. IG-IMRT wurde durch taegliche Verifikation von implantierten roentgendichten Prostatamarkern mittels Megavolt-Bildgebung (''electronic portal imaging

  12. Involved-Site Image-Guided Intensity Modulated Versus 3D Conformal Radiation Therapy in Early Stage Supradiaphragmatic Hodgkin Lymphoma

    Filippi, Andrea Riccardo, E-mail: andreariccardo.filippi@unito.it [Department of Oncology, University of Torino, Torino (Italy); Ciammella, Patrizia [Radiation Therapy Unit, Department of Oncology and Advanced Technology, ASMN Hospital IRCCS, Reggio Emilia (Italy); Piva, Cristina; Ragona, Riccardo [Department of Oncology, University of Torino, Torino (Italy); Botto, Barbara [Hematology, Città della Salute e della Scienza, Torino (Italy); Gavarotti, Paolo [Hematology, University of Torino and Città della Salute e della Scienza, Torino (Italy); Merli, Francesco [Hematology Unit, ASMN Hospital IRCCS, Reggio Emilia (Italy); Vitolo, Umberto [Hematology, Città della Salute e della Scienza, Torino (Italy); Iotti, Cinzia [Radiation Therapy Unit, Department of Oncology and Advanced Technology, ASMN Hospital IRCCS, Reggio Emilia (Italy); Ricardi, Umberto [Department of Oncology, University of Torino, Torino (Italy)

    2014-06-01

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows for margin reduction and highly conformal dose distribution, with consistent advantages in sparing of normal tissues. The purpose of this retrospective study was to compare involved-site IG-IMRT with involved-site 3D conformal RT (3D-CRT) in the treatment of early stage Hodgkin lymphoma (HL) involving the mediastinum, with efficacy and toxicity as primary clinical endpoints. Methods and Materials: We analyzed 90 stage IIA HL patients treated with either involved-site 3D-CRT or IG-IMRT between 2005 and 2012 in 2 different institutions. Inclusion criteria were favorable or unfavorable disease (according to European Organization for Research and Treatment of Cancer criteria), complete response after 3 to 4 cycles of an adriamycin- bleomycin-vinblastine-dacarbazine (ABVD) regimen plus 30 Gy as total radiation dose. Exclusion criteria were chemotherapy other than ABVD, partial response after ABVD, total radiation dose other than 30 Gy. Clinical endpoints were relapse-free survival (RFS) and acute toxicity. Results: Forty-nine patients were treated with 3D-CRT (54.4%) and 41 with IG-IMRT (45.6%). Median follow-up time was 54.2 months for 3D-CRT and 24.1 months for IG-IMRT. No differences in RFS were observed between the 2 groups, with 1 relapse each. Three-year RFS was 98.7% for 3D-CRT and 100% for IG-IMRT. Grade 2 toxicity events, mainly mucositis, were recorded in 32.7% of 3D-CRT patients (16 of 49) and in 9.8% of IG-IMRT patients (4 of 41). IG-IMRT was significantly associated with a lower incidence of grade 2 acute toxicity (P=.043). Conclusions: RFS rates at 3 years were extremely high in both groups, albeit the median follow-up time is different. Acute tolerance profiles were better for IG-IMRT than for 3D-CRT. Our preliminary results support the clinical safety and efficacy of advanced RT planning and delivery techniques in patients affected with early stage HL, achieving complete

  13. Clinical Experience With Image-Guided Radiotherapy in an Accelerated Partial Breast Intensity-Modulated Radiotherapy Protocol

    Leonard, Charles E.; Tallhamer, Michael M.S.; Johnson, Tim; Hunter, Kari C.M.D.; Howell, Kathryn; Kercher, Jane; Widener, Jodi; Kaske, Terese; Paul, Devchand; Sedlacek, Scot; Carter, Dennis L.

    2010-01-01

    Purpose: To explore the feasibility of fiducial markers for the use of image-guided radiotherapy (IGRT) in an accelerated partial breast intensity modulated radiotherapy protocol. Methods and Materials: Nineteen patients consented to an institutional review board approved protocol of accelerated partial breast intensity-modulated radiotherapy with fiducial marker placement and treatment with IGRT. Patients (1 patient with bilateral breast cancer; 20 total breasts) underwent ultrasound guided implantation of three 1.2- x 3-mm gold markers placed around the surgical cavity. For each patient, table shifts (inferior/superior, right/left lateral, and anterior/posterior) and minimum, maximum, mean error with standard deviation were recorded for each of the 10 BID treatments. The dose contribution of daily orthogonal films was also examined. Results: All IGRT patients underwent successful marker placement. In all, 200 IGRT treatment sessions were performed. The average vector displacement was 4 mm (range, 2-7 mm). The average superior/inferior shift was 2 mm (range, 0-5 mm), the average lateral shift was 2 mm (range, 1-4 mm), and the average anterior/posterior shift was 3 mm (range, 1 5 mm). Conclusions: This study shows that the use of IGRT can be successfully used in an accelerated partial breast intensity-modulated radiotherapy protocol. The authors believe that this technique has increased daily treatment accuracy and permitted reduction in the margin added to the clinical target volume to form the planning target volume.

  14. Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

    Wortel, Ruud C.; Incrocci, Luca; Pos, Floris J.; Lebesque, Joos V.; Witte, Marnix G.; van der Heide, Uulke A.; van Herk, Marcel; Heemsbergen, Wilma D.

    2015-01-01

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions

  15. Intra-fractional uncertainties in image-guided intensity-modulated radiotherapy (IMRT) of prostate cancer

    Polat, Buelent; Guenther, Iris; Wilbert, Juergen; Goebel, Joachim; Sweeney, Reinhart A.; Flentje, Michael; Guckenberger, Matthias

    2008-01-01

    To evaluate intra-fractional uncertainties during intensity-modulated radiotherapy (IMRT) of prostate cancer. During IMRT of 21 consecutive patients, kilovolt (kV) cone-beam computed tomography (CBCT) images were acquired prior to and immediately after treatment: a total of 252 treatment fractions with 504 CBCT studies were basis of this analysis. The prostate position in anterior-posterior (AP) direction was determined using contour matching; patient set-up based on the pelvic bony anatomy was evaluated using automatic image registration. Internal variability of the prostate position was the difference between absolute prostate and patient position errors. Intra-fractional changes of prostate position, patient position, rectal distension in AP direction and bladder volume were analyzed. With a median treatment time of 16 min, intra-fractional drifts of the prostate were > 5 mm in 12% of all fractions and a margin of 6 mm was calculated for compensation of this uncertainty. Mobility of the prostate was independent from the bony anatomy with poor correlation between absolute prostate motion and motion of the bony anatomy (R 2 = 0.24). A systematic increase of bladder filling by 41 ccm on average was observed; however, these changes did not influence the prostate position. Small variations of the prostate position occurred independently from intra-fractional changes of the rectal distension; a weak correlation between large internal prostate motion and changes of the rectal volume was observed (R 2 = 0.55). Clinically significant intra-fractional changes of the prostate position were observed and margins of 6 mm were calculated for this intra-fractional uncertainty. Repeated or continuous verification of the prostate position may allow further margin reduction. (orig.)

  16. Intra-fractional uncertainties in image-guided intensity-modulated radiotherapy (IMRT) of prostate cancer

    Polat, Buelent; Guenther, Iris; Wilbert, Juergen; Goebel, Joachim; Sweeney, Reinhart A.; Flentje, Michael; Guckenberger, Matthias [Wuerzburg Univ. (Germany). Dept. of Radiation Oncology

    2008-12-15

    To evaluate intra-fractional uncertainties during intensity-modulated radiotherapy (IMRT) of prostate cancer. During IMRT of 21 consecutive patients, kilovolt (kV) cone-beam computed tomography (CBCT) images were acquired prior to and immediately after treatment: a total of 252 treatment fractions with 504 CBCT studies were basis of this analysis. The prostate position in anterior-posterior (AP) direction was determined using contour matching; patient set-up based on the pelvic bony anatomy was evaluated using automatic image registration. Internal variability of the prostate position was the difference between absolute prostate and patient position errors. Intra-fractional changes of prostate position, patient position, rectal distension in AP direction and bladder volume were analyzed. With a median treatment time of 16 min, intra-fractional drifts of the prostate were > 5 mm in 12% of all fractions and a margin of 6 mm was calculated for compensation of this uncertainty. Mobility of the prostate was independent from the bony anatomy with poor correlation between absolute prostate motion and motion of the bony anatomy (R{sup 2} = 0.24). A systematic increase of bladder filling by 41 ccm on average was observed; however, these changes did not influence the prostate position. Small variations of the prostate position occurred independently from intra-fractional changes of the rectal distension; a weak correlation between large internal prostate motion and changes of the rectal volume was observed (R{sup 2} = 0.55). Clinically significant intra-fractional changes of the prostate position were observed and margins of 6 mm were calculated for this intra-fractional uncertainty. Repeated or continuous verification of the prostate position may allow further margin reduction. (orig.)

  17. Image-Guided Stereotactic Radiosurgery Using a Specially Designed High-Dose-Rate Linac

    Bayouth, John E.; Kaiser, Heather S.; Smith, Mark C.; Pennington, Edward C.; Anderson, Kathleen M. C.; Ryken, Timothy C.; Buatti, John M.

    2007-01-01

    Stereotactic radiosurgery and image-guided radiotherapy (IGRT) place enhanced demands on treatment delivery machines. In this study, we describe a high-dose-rate output accelerator as a part of our stereotactic IGRT delivery system. The linac is a Siemens Oncor without a flattening filter, and enables dose rates to reach 1000 monitor units (MUs) per minute. Even at this high-dose-rate, the linac dosimetry system remains robust; constancy, linearity, and beam energy remain within 1% for 3 to 1000 MU. Dose profiles for larger field sizes are not flat, but they are radially symmetric and, as such, able to be modeled by a treatment planning system. Target localization is performed via optical guidance utilizing a 3-dimensional (3D) ultrasound probe coupled to an array of 4 infrared light-emitting diodes. These diodes are identified by a fixed infrared camera system that determines diode position and, by extension, all objects imaged in the room coordinate system. This system provides sub-millimeter localization accuracy for cranial applications and better than 1.5 mm for extracranial applications. Because stereotactic IGRT can require significantly longer times for treatment delivery, the advantages of the high-dose-rate design and its direct impact on IGRT are discussed

  18. Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

    Lee, Larissa J. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States)

    2012-12-01

    Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure

  19. Image guided, adaptive, accelerated, high dose brachytherapy as model for advanced small volume radiotherapy

    Haie-Meder, Christine; Siebert, Frank-Andre; Poetter, Richard

    2011-01-01

    Brachytherapy has consistently provided a very conformal radiation therapy modality. Over the last two decades this has been associated with significant improvements in imaging for brachytherapy applications (prostate, gynecology), resulting in many positive advances in treatment planning, application techniques and clinical outcome. This is emphasized by the increased use of brachytherapy in Europe with gynecology as continuous basis and prostate and breast as more recently growing fields. Image guidance enables exact knowledge of the applicator together with improved visualization of tumor and target volumes as well as of organs at risk providing the basis for very individualized 3D and 4D treatment planning. In this commentary the most important recent developments in prostate, gynecological and breast brachytherapy are reviewed, with a focus on European recent and current research aiming at the definition of areas for important future research. Moreover the positive impact of GEC-ESTRO recommendations and the highlights of brachytherapy physics are discussed what altogether presents a full overview of modern image guided brachytherapy. An overview is finally provided on past and current international brachytherapy publications focusing on 'Radiotherapy and Oncology'. These data show tremendous increase in almost all research areas over the last three decades strongly influenced recently by translational research in regard to imaging and technology. In order to provide high level clinical evidence for future brachytherapy practice the strong need for comprehensive prospective clinical research addressing brachytherapy issues is high-lighted.

  20. Image-guided radiotherapy in near real time with intensity-modulated radiotherapy megavoltage treatment beam imaging.

    Mao, Weihua; Hsu, Annie; Riaz, Nadeem; Lee, Louis; Wiersma, Rodney; Luxton, Gary; King, Christopher; Xing, Lei; Solberg, Timothy

    2009-10-01

    To utilize image-guided radiotherapy (IGRT) in near real time by obtaining and evaluating the online positions of implanted fiducials from continuous electronic portal imaging device (EPID) imaging of prostate intensity-modulated radiotherapy (IMRT) delivery. Upon initial setup using two orthogonal images, the three-dimensional (3D) positions of all implanted fiducial markers are obtained, and their expected two-dimensional (2D) locations in the beam's-eye-view (BEV) projection are calculated for each treatment field. During IMRT beam delivery, EPID images of the megavoltage treatment beam are acquired in cine mode and subsequently analyzed to locate 2D locations of fiducials in the BEV. Simultaneously, 3D positions are estimated according to the current EPID image, information from the setup portal images, and images acquired at other gantry angles (the completed treatment fields). The measured 2D and 3D positions of each fiducial are compared with their expected 2D and 3D setup positions, respectively. Any displacements larger than a predefined tolerance may cause the treatment system to suspend the beam delivery and direct the therapists to reposition the patient. Phantom studies indicate that the accuracy of 2D BEV and 3D tracking are better than 1 mm and 1.4 mm, respectively. A total of 7330 images from prostate treatments were acquired and analyzed, showing a maximum 2D displacement of 6.7 mm and a maximum 3D displacement of 6.9 mm over 34 fractions. This EPID-based, real-time IGRT method can be implemented on any external beam machine with portal imaging capabilities without purchasing any additional equipment, and there is no extra dose delivered to the patient.

  1. Image-Guided Radiotherapy in Near Real Time With Intensity-Modulated Radiotherapy Megavoltage Treatment Beam Imaging

    Mao Weihua; Hsu, Annie; Riaz, Nadeem; Lee, Louis; Wiersma, Rodney; Luxton, Gary; King, Christopher; Xing Lei; Solberg, Timothy

    2009-01-01

    Purpose: To utilize image-guided radiotherapy (IGRT) in near real time by obtaining and evaluating the online positions of implanted fiducials from continuous electronic portal imaging device (EPID) imaging of prostate intensity-modulated radiotherapy (IMRT) delivery. Methods and Materials: Upon initial setup using two orthogonal images, the three-dimensional (3D) positions of all implanted fiducial markers are obtained, and their expected two-dimensional (2D) locations in the beam's-eye-view (BEV) projection are calculated for each treatment field. During IMRT beam delivery, EPID images of the megavoltage treatment beam are acquired in cine mode and subsequently analyzed to locate 2D locations of fiducials in the BEV. Simultaneously, 3D positions are estimated according to the current EPID image, information from the setup portal images, and images acquired at other gantry angles (the completed treatment fields). The measured 2D and 3D positions of each fiducial are compared with their expected 2D and 3D setup positions, respectively. Any displacements larger than a predefined tolerance may cause the treatment system to suspend the beam delivery and direct the therapists to reposition the patient. Results: Phantom studies indicate that the accuracy of 2D BEV and 3D tracking are better than 1 mm and 1.4 mm, respectively. A total of 7330 images from prostate treatments were acquired and analyzed, showing a maximum 2D displacement of 6.7 mm and a maximum 3D displacement of 6.9 mm over 34 fractions. Conclusions: This EPID-based, real-time IGRT method can be implemented on any external beam machine with portal imaging capabilities without purchasing any additional equipment, and there is no extra dose delivered to the patient.

  2. Multi-centre experience of implementing image-guided intensity-modulated radiotherapy using the TomoTherapy platform

    Dean, J.C.; Tudor, G.S.J.; Mott, J.H.; Dunlop, P.R.; Morris, S.L.; Harron, E.C.; Christian, J.A.; Sanghera, P.; Elsworthy, M.; Burnet, N.G.

    2013-01-01

    Use of image guided (IG) intensity modulated radiotherapy (IMRT) is increasing, and helical tomotherapy provides an effective, integrated solution. Practical experience of implementation, shared at a recent UK TomoTherapy Users' meeting, may help centres introducing these techniques using TomoTherapy or other platforms. Seven centres participated, with data shared from 6, varying from 2500 - 4800 new patients per year. Case selection of patients “most likely” to benefit from IG-IMRT was managed in all centres by multi-professional groups comprising clinical oncologists, physicists, treatment planners and radiographers. Radical treatments ranged from 94% to 100%. The proportions of tumour types varied substantially: head and neck: range 0%–100% (mean of centres 50%), prostate: 3%–96% (mean of centres 28%). Head and neck cases were considered most likely to benefit from IMRT, prostate cases from IGRT, or IG-IMRT if pelvic nodes were being treated. IMRT was also selected for complex target volumes, to avoid field junctions, for technical treatment difficulties, and retreatments. Across the centres, every patient was imaged every day, with positional correction before treatment. In one centre, for prostate patients including pelvic treatment, the pelvis was also imaged weekly. All centres had designed a ‘ramp up’ of patient numbers, which was similar in 5. One centre, treating 96% prostate patients, started with 3 and increased to 36 patients per day within 3 months. The variation in case mix implies wide applicability of IG-IMRT. Daily on-line IGRT with IMRT can be routinely implemented into busy departments

  3. Implementation of an image guided intensity-modulated protocol for post-prostatectomy radiotherapy: planning data and acute toxicity outcomes

    Chua, Benjamin; Min, Myo; Wood, Maree; Edwards, Sarah; Hoffmann, Matthew; Greenham, Stuart; Kovendy, Andrew; McKay, Michael J.; Shakespeare, Thomas P.

    2013-01-01

    There is substantial interest in implementation of image-guided intensity-modulated radiotherapy (IG-IMRT) in the post-prostatectomy setting. We describe our implementation of IG-IMRT, and examine how often published organ-at-risk (OAR) constraints were met. Furthermore, we evaluate the incidence of acute genitourinary and gastrointestinal toxicities when patients were treated according to our protocol. Patients were eligible if they received post-prostatectomy radiotherapy (PPRT). Planning data were collected prospectively, and toxicity assessments were collected before, during and after treatment. Seventy-five eligible patients received either 64Gy (19%) or 66Gy (81%) in a single phase to the prostate bed. Suggested rectal dose-constraints of V40Gy<60% and V60Gy<40% were met in 64 (85%) and 75 (100%) patients, respectively. IMRT-specific rectal dose-constraints of V40Gy<35% and V65Gy<17% were achieved in 5 (7%) and 57 (76%) of patients. Bladder dose-constraint (V50Gy<50%) was met in 58 (77%) patients. Two patients (3%) experienced new grade 3 genitourinary toxicity and one patient (1%) experienced new grade 3 gastrointestinal toxicity. All grade 3 toxicities had improved by 3-month review. Overall deterioration in urinary and gastrointestinal symptoms occurred in 33 (44%) and 35 (47%) of patients respectively. We report on our implementation of PPRT which takes into account nationally adopted guidelines, with a margin reduction supported by use of daily image guidance. Non-IMRT OAR constraints were met in most cases. IMRT-specific constraints were less often achieved despite margin reductions, suggesting the need for review of guidelines. Severe toxicity was rare, and most patients did not experience deterioration in urinary or bowel function attributable to radiotherapy.

  4. Implementation of an image guided intensity-modulated protocol for post-prostatectomy radiotherapy: planning data and acute toxicity outcomes.

    Chua, Benjamin; Min, Myo; Wood, Maree; Edwards, Sarah; Hoffmann, Matthew; Greenham, Stuart; Kovendy, Andrew; McKay, Michael J; Shakespeare, Thomas P

    2013-08-01

    There is substantial interest in implementation of image-guided intensity-modulated radiotherapy (IG-IMRT) in the post-prostatectomy setting. We describe our implementation of IG-IMRT, and examine how often published organ-at-risk (OAR) constraints were met. Furthermore, we evaluate the incidence of acute genitourinary and gastrointestinal toxicities when patients were treated according to our protocol. Patients were eligible if they received post-prostatectomy radiotherapy (PPRT). Planning data were collected prospectively, and toxicity assessments were collected before, during and after treatment. Seventy-five eligible patients received either 64 Gy (19%) or 66 Gy (81%) in a single phase to the prostate bed. Suggested rectal dose-constraints of V40Gy < 60% and V60Gy < 40% were met in 64 (85%) and 75 (100%) patients, respectively. IMRT-specific rectal dose-constraints of V40Gy < 35% and V65Gy < 17% were achieved in 5 (7%) and 57 (76%) of patients. Bladder dose-constraint (V50Gy < 50%) was met in 58 (77%) patients. Two patients (3%) experienced new grade 3 genitourinary toxicity and one patient (1%) experienced new grade 3 gastroinestinal toxicity. All grade 3 toxicities had improved by 3-month review. Overall deterioration in urinary and gastrointestinal symptoms occurred in 33 (44%) and 35 (47%) of patients respectively. We report on our implementation of PPRT which takes into account nationally adopted guidelines, with a margin reduction supported by use of daily image guidance. Non-IMRT OAR constraints were met in most cases. IMRT-specific constraints were less often achieved despite margin reductions, suggesting the need for review of guidelines. Severe toxicity was rare, and most patients did not experience deterioration in urinary or bowel function attributable to radiotherapy. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

  5. Automatic prostate localization on cone-beam CT scans for high precision image-guided radiotherapy

    Smitsmans, Monique H. P.; de Bois, Josien; Sonke, Jan-Jakob; Betgen, Anja; Zijp, Lambert J.; Jaffray, David A.; Lebesque, Joos V.; van Herk, Marcel

    2005-01-01

    PURPOSE: Previously, we developed an automatic three-dimensional gray-value registration (GR) method for fast prostate localization that could be used during online or offline image-guided radiotherapy. The method was tested on conventional computed tomography (CT) scans. In this study, the

  6. Concurrent image-guided intensity modulated radiotherapy and chemotherapy following neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma

    Shueng, Pei-Wei; Hsieh, Chen-Hsi; Shen, Bing-Jie; Wu, Le-Jung; Liao, Li-Jen; Hsiao, Chi-Huang; Lin, Yu-Chin; Cheng, Po-Wen; Lo, Wu-Chia; Jen, Yee-Min

    2011-01-01

    To evaluate the experience of induction chemotherapy followed by concurrent chemoradiationwith helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC). Between August 2006 and December 2009, 28 patients with pathological proven nonmetastatic NPC were enrolled. All patients were staged as IIB-IVB. Patients were first treated with 2 to 3 cycles of induction chemotherapy with EP-HDFL (Epirubicin, Cisplatin, 5-FU, and Leucovorin). After induction chemotherapy, weekly based PFL was administered concurrent with HT. Radiation consisted of 70 Gy to the planning target volumes of the primary tumor plus any positive nodal disease using 2 Gy per fraction. After completion of induction chemotherapy, the response rates for primary and nodal disease were 96.4% and 80.8%, respectively. With a median follow-up after 33 months (Range, 13-53 months), there have been 2 primary and 1 nodal relapse after completion of radiotherapy. The estimated 3-year progression-free rates for local, regional, locoregional and distant metastasis survival rate were 92.4%, 95.7%, 88.4%, and 78.0%, respectively. The estimated 3-year overall survival was 83.5%. Acute grade 3, 4 toxicities for xerostomia and dermatitis were only 3.6% and 10.7%, respectively. HT for locoregionally advanced NPC is feasible and effective in regard to locoregional control with high compliance, even after neoadjuvant chemotherapy. None of out-field or marginal failure noted in the current study confirms the potential benefits of treating NPC patients by image-guided radiation modality. A long-term follow-up study is needed to confirm these preliminary findings

  7. Image-guided intensity-modulated radiotherapy for prostate cancer: Dose constraints for the anterior rectal wall to minimize rectal toxicity

    Peterson, Jennifer L., E-mail: peterson.jennifer2@mayo.edu [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States); Buskirk, Steven J. [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States); Heckman, Michael G.; Diehl, Nancy N. [Section of Biostatistics, Mayo Clinic Florida, Jacksonville, FL (United States); Bernard, Johnny R. [Section of Biostatistics, Mayo Clinic Florida, Jacksonville, FL (United States); Department of Radiation Oncology, Southern Ohio Medical Center, Portsmouth, OH (United States); Tzou, Katherine S.; Casale, Henry E.; Bellefontaine, Louis P.; Serago, Christopher; Kim, Siyong; Vallow, Laura A.; Daugherty, Larry C.; Ko, Stephen J. [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States)

    2014-04-01

    Rectal adverse events (AEs) are a major concern with definitive radiotherapy (RT) treatment for prostate cancer. The anterior rectal wall is at the greatest risk of injury as it lies closest to the target volume and receives the highest dose of RT. This study evaluated the absolute volume of anterior rectal wall receiving a high dose to identify potential ideal dose constraints that can minimize rectal AEs. A total of 111 consecutive patients with Stage T1c to T3a N0 M0 prostate cancer who underwent image-guided intensity-modulated RT at our institution were included. AEs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The volume of anterior rectal wall receiving 5 to 80 Gy in 2.5-Gy increments was determined. Multivariable Cox regression models were used to identify cut points in these volumes that led to an increased risk of early and late rectal AEs. Early AEs occurred in most patients (88%); however, relatively few of them (13%) were grade ≥2. At 5 years, the cumulative incidence of late rectal AEs was 37%, with only 5% being grade ≥2. For almost all RT doses, we identified a threshold of irradiated absolute volume of anterior rectal wall above which there was at least a trend toward a significantly higher rate of AEs. Most strikingly, patients with more than 1.29, 0.73, or 0.45 cm{sup 3} of anterior rectal wall exposed to radiation doses of 67.5, 70, or 72.5 Gy, respectively, had a significantly increased risk of late AEs (relative risks [RR]: 2.18 to 2.72; p ≤ 0.041) and of grade ≥ 2 early AEs (RR: 6.36 to 6.48; p = 0.004). Our study provides evidence that definitive image-guided intensity-modulated radiotherapy (IG-IMRT) for prostate cancer is well tolerated and also identifies dose thresholds for the absolute volume of anterior rectal wall above which patients are at greater risk of early and late complications.

  8. Image-guided intensity-modulated radiotherapy for prostate cancer: Dose constraints for the anterior rectal wall to minimize rectal toxicity

    Peterson, Jennifer L.; Buskirk, Steven J.; Heckman, Michael G.; Diehl, Nancy N.; Bernard, Johnny R.; Tzou, Katherine S.; Casale, Henry E.; Bellefontaine, Louis P.; Serago, Christopher; Kim, Siyong; Vallow, Laura A.; Daugherty, Larry C.; Ko, Stephen J.

    2014-01-01

    Rectal adverse events (AEs) are a major concern with definitive radiotherapy (RT) treatment for prostate cancer. The anterior rectal wall is at the greatest risk of injury as it lies closest to the target volume and receives the highest dose of RT. This study evaluated the absolute volume of anterior rectal wall receiving a high dose to identify potential ideal dose constraints that can minimize rectal AEs. A total of 111 consecutive patients with Stage T1c to T3a N0 M0 prostate cancer who underwent image-guided intensity-modulated RT at our institution were included. AEs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The volume of anterior rectal wall receiving 5 to 80 Gy in 2.5-Gy increments was determined. Multivariable Cox regression models were used to identify cut points in these volumes that led to an increased risk of early and late rectal AEs. Early AEs occurred in most patients (88%); however, relatively few of them (13%) were grade ≥2. At 5 years, the cumulative incidence of late rectal AEs was 37%, with only 5% being grade ≥2. For almost all RT doses, we identified a threshold of irradiated absolute volume of anterior rectal wall above which there was at least a trend toward a significantly higher rate of AEs. Most strikingly, patients with more than 1.29, 0.73, or 0.45 cm 3 of anterior rectal wall exposed to radiation doses of 67.5, 70, or 72.5 Gy, respectively, had a significantly increased risk of late AEs (relative risks [RR]: 2.18 to 2.72; p ≤ 0.041) and of grade ≥ 2 early AEs (RR: 6.36 to 6.48; p = 0.004). Our study provides evidence that definitive image-guided intensity-modulated radiotherapy (IG-IMRT) for prostate cancer is well tolerated and also identifies dose thresholds for the absolute volume of anterior rectal wall above which patients are at greater risk of early and late complications

  9. A cost effective and high fidelity fluoroscopy simulator using the Image-Guided Surgery Toolkit (IGSTK)

    Gong, Ren Hui; Jenkins, Brad; Sze, Raymond W.; Yaniv, Ziv

    2014-03-01

    The skills required for obtaining informative x-ray fluoroscopy images are currently acquired while trainees provide clinical care. As a consequence, trainees and patients are exposed to higher doses of radiation. Use of simulation has the potential to reduce this radiation exposure by enabling trainees to improve their skills in a safe environment prior to treating patients. We describe a low cost, high fidelity, fluoroscopy simulation system. Our system enables operators to practice their skills using the clinical device and simulated x-rays of a virtual patient. The patient is represented using a set of temporal Computed Tomography (CT) images, corresponding to the underlying dynamic processes. Simulated x-ray images, digitally reconstructed radiographs (DRRs), are generated from the CTs using ray-casting with customizable machine specific imaging parameters. To establish the spatial relationship between the CT and the fluoroscopy device, the CT is virtually attached to a patient phantom and a web camera is used to track the phantom's pose. The camera is mounted on the fluoroscope's intensifier and the relationship between it and the x-ray source is obtained via calibration. To control image acquisition the operator moves the fluoroscope as in normal operation mode. Control of zoom, collimation and image save is done using a keypad mounted alongside the device's control panel. Implementation is based on the Image-Guided Surgery Toolkit (IGSTK), and the use of the graphics processing unit (GPU) for accelerated image generation. Our system was evaluated by 11 clinicians and was found to be sufficiently realistic for training purposes.

  10. High-volume image-guided injection for recalcitrant medial collateral ligament injuries of the knee

    Drumm, O.; Chan, O.; Malliaras, P.; Morrissey, D.; Maffulli, N.

    2014-01-01

    Aim: To evaluate the effectiveness of a novel injection technique in the management of recalcitrant medial collateral ligament (MCL) injuries of the knee. Materials and methods: The injection, comprising 10 ml local anaesthetic with 25–50 mg hydrocortisone, is directed beneath the periosteal attachment of the MCL. Twenty-eight patients who received the intervention were asked to complete a questionnaire, a visual analogue scale (VAS) and the International Knee Documentation Committee (IKDC) subjective knee form to quantify symptoms pre-injection and at follow-up. Data were assessed using descriptive statistics. Further analysis was conducted using the Wilcoxon signed-rank test and Fisher's exact test. Results: Sixty-eight percent (n = 19) of patients responded. Three patients were excluded according to the exclusion criteria. Of those studied, 37.5% (n = 6) were professional athletes. At follow-up, patients reported a mean improvement on the VAS of 75.5% (SD = 23.6). There was a significant improvement in IKDC scores (mean difference 42%, SD = 14.2) pre- and post-injection (Wilcoxon signed-rank test, p < 0.001). No residual symptoms were reported by 50% (n = 8) of patients, and a further 37.5% (n = 6) of patients had improved. Of those patients who played sport, two-thirds (n = 10) had returned to their previous level of sport at follow-up, including all of the professional athletes. Conclusion: Periosteal high-volume image-guided injection is a useful treatment for recalcitrant MCL injury. Results are encouraging, particularly amongst the professional athletes studied

  11. Preoperative intensity-modulated and image-guided radiotherapy with a simultaneous integrated boost in locally advanced rectal cancer: Report on late toxicity and outcome

    Engels, Benedikt; Platteaux, Nele; Van den Begin, Robbe; Gevaert, Thierry; Sermeus, Alexandra; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2014-01-01

    Background and purpose: The addition of chemotherapy to preoperative radiotherapy has been established as the standard of care for patients with cT3-4 rectal cancer. As an alternative strategy, we explored intensity-modulated and image-guided radiotherapy (IMRT–IGRT) with a simultaneous integrated boost (SIB) in a prospective phase II study. Here, we report outcome and late toxicity after a median follow-up of 54 months. Methods and materials: A total of 108 patients were treated preoperatively with IMRT–IGRT, delivering a dose of 46 Gy in fractions of 2 Gy. Patients (n = 57) displaying an anticipated circumferential resection margin (CRM) of less than 2 mm based on magnetic resonance imaging received a SIB to the tumor up to a total dose of 55.2 Gy. Results: The absolute incidence of grade ⩾3 late gastrointestinal and urinary toxicity was 9% and 4%, respectively, with a 13% rate of any grade ⩾3 late toxicity. The actuarial 5-year local control (LC), progression-free survival (PFS) and overall survival (OS) were 97%, 57%, and 68%. On multivariate analysis, R1 resection and pN2 disease were associated with significantly impaired OS. Conclusions: The use of preoperative IMRT–IGRT with a SIB resulted in a high 5-year LC rate and non-negligible late toxicity

  12. Intermediate-term results of image-guided brachytherapy and high-technology external beam radiotherapy in cervical cancer: Chiang Mai University experience.

    Tharavichitkul, Ekkasit; Chakrabandhu, Somvilai; Wanwilairat, Somsak; Tippanya, Damrongsak; Nobnop, Wannapha; Pukanhaphan, Nantaka; Galalae, Razvan M; Chitapanarux, Imjai

    2013-07-01

    To evaluate the outcomes of image-guided brachytherapy combined with 3D conformal or intensity modulated external beam radiotherapy (3D CRT/IMRT) in cervical cancer at Chiang Mai University. From 2008 to 2011, forty-seven patients with locally advanced cervical cancer were enrolled in this study. All patients received high-technology (3D CRT/IMRT) whole pelvic radiotherapy with a total dose of 45-46 Gy plus image-guided High-Dose-Rate intracavitary brachytherapy 6.5-7 Gy × 4 fractions to a High-Risk Clinical Target Volume (HR-CTV) according to GEC-ESTRO recommendations. The dose parameters of the HR-CTV for bladder, rectum and sigmoid colon were recorded, as well as toxicity profiles. In addition, the endpoints for local control, disease-free, metastasis-free survival and overall survival were calculated. At the median follow-up time of 26 months, the local control, disease-free survival, and overall survival rates were 97.9%, 85.1%, and 93.6%, respectively. The mean dose of HR-CTV, bladder, rectum and sigmoid were 93.1, 88.2, 69.6, and 72 Gy, respectively. In terms of late toxicity, the incidence of grade 3-4 bladder and rectum morbidity was 2.1% and 2.1%, respectively. A combination of image-guided brachytherapy and IMRT/3D CRT showed very promising results of local control, disease-free survival, metastasis-free survival and overall survival rates. It also caused a low incidence of grade 3-4 toxicity in treated study patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Half-Fan-Based Intensity-Weighted Region-of-Interest Imaging for Low-Dose Cone-Beam CT in Image-Guided Radiation Therapy.

    Yoo, Boyeol; Son, Kihong; Pua, Rizza; Kim, Jinsung; Solodov, Alexander; Cho, Seungryong

    2016-10-01

    With the increased use of computed tomography (CT) in clinics, dose reduction is the most important feature people seek when considering new CT techniques or applications. We developed an intensity-weighted region-of-interest (IWROI) imaging method in an exact half-fan geometry to reduce the imaging radiation dose to patients in cone-beam CT (CBCT) for image-guided radiation therapy (IGRT). While dose reduction is highly desirable, preserving the high-quality images of the ROI is also important for target localization in IGRT. An intensity-weighting (IW) filter made of copper was mounted in place of a bowtie filter on the X-ray tube unit of an on-board imager (OBI) system such that the filter can substantially reduce radiation exposure to the outer ROI. In addition to mounting the IW filter, the lead-blade collimation of the OBI was adjusted to produce an exact half-fan scanning geometry for a further reduction of the radiation dose. The chord-based rebinned backprojection-filtration (BPF) algorithm in circular CBCT was implemented for image reconstruction, and a humanoid pelvis phantom was used for the IWROI imaging experiment. The IWROI image of the phantom was successfully reconstructed after beam-quality correction, and it was registered to the reference image within an acceptable level of tolerance. Dosimetric measurements revealed that the dose is reduced by approximately 61% in the inner ROI and by 73% in the outer ROI compared to the conventional bowtie filter-based half-fan scan. The IWROI method substantially reduces the imaging radiation dose and provides reconstructed images with an acceptable level of quality for patient setup and target localization. The proposed half-fan-based IWROI imaging technique can add a valuable option to CBCT in IGRT applications.

  14. Present status and future of high-precision image guided adaptive brachytherapy for cervix carcinoma

    Poetter, Richard; Kirisits, Christian; Fidarova, Elena F.; Dimopoulos, Johan nes C. A.; Berger, Daniel; Tanderup, Kari; Lindegaard, Jacob C.

    2008-01-01

    Introduction. Image guided adaptive brachytherapy (IGABT) for cervical cancer, using mainly MRI, is an evolving method, increasingly replacing the 2D approach based on conventional radiography. During the complex 4D chain of this procedure image-assistance is provided for disease assessment, provisional treatment planning ('pre-planning'), applicator placement and reconstruction, as well as for contouring, definitive treatment planning and quality control of dose delivery. With IGABT changes of topography adjacent to the applicator, caused by tumour regression, oedema, organ changes and dilation are identified. Thus, the CTV for IGABT is primarily based on the tumour volume at the time of BT and takes into account both time and spatial domains. IGABT requires systematic concepts for target, OAR, biological modelling, DVH analysis, and dose-volume-adaptation. Methods and Results. This report focuses on the advantages and uncertainties, dose-effect relations and clinical results of the IGABT procedure addressing the current status and future perspectives. Uncertainties during the 4D chain of IGABT are mainly related to target contouring, applicator reconstruction, as well as to inter-fraction, intra-fraction and inter-application variability, as caused by tumour response and organ changes. Different from EBRT where set-up uncertainties are compensated by adding a margin to the CTV, no margins to the lateral and anterior-posterior directions can be used for IGABT. Discussion. By 3D treatment planning for IGABT significant improvement of the DVH parameters is achieved compared to 2D library plans. In small tumours the benefit is primarily obtained by a decrease of dose to nearby OAR while in large tumours the use of supplementary interstitial techniques and optimization may double the target volume that can be treated at a therapeutic dose level. The clinical impact of IGABT could recently be demonstrated by the establishment of some correlations between target- and

  15. Acute gastrointestinal and genitourinary toxicity of image-guided intensity modulated radiation therapy for prostate cancer using a daily water-filled endorectal balloon

    Deville, Curtiland; Both, Stefan; Bui, Viet; Hwang, Wei-Ting; Tan, Kay-See; Schaer, Mattia; Tochner, Zelig; Vapiwala, Neha

    2012-01-01

    Our purpose was to report acute gastrointestinal (GI) and genitourinary (GU) toxicity rates for prostate cancer patients undergoing image-guided intensity modulated radiation therapy (IG-IMRT) with a daily endorectal water-filled balloon (ERB H2O ), and assess associations with planning parameters and pretreatment clinical characteristics. The first 100 patients undergoing prostate and proximal seminal vesicle IG-IMRT with indexed-lumen 100 cc ERB H2O to 79.2 Gy in 1.8 Gy fractions at our institution from 12/2008- 12/2010 were assessed. Pretreatment characteristics, organ-at-risk dose volume histograms, and maximum GU and GI toxicities (CTCAE 3.0) were evaluated. Logistic regression models evaluated univariate association between toxicities and dosimetric parameters, and uni- and multivariate association between toxicities and pretreatment characteristics. Mean age was 68 (range 51–88). Thirty-two, 49, and 19 patients were low, intermediate, and high-risk, respectively; 40 received concurrent androgen deprivation. No grade 3 or greater toxicities were recorded. Maximum GI toxicity was grade 0, 1, and 2 in 69%, 23%, and 8%, respectively. Infield (defined as 1 cm above/below the CTV) rectal mean/median doses, D75, V30, and V40 and hemorrhoid history were associated with grade 2 GI toxicity (Ps < 0.05). Maximum acute GU toxicity was grade 0, 1, and 2 for 17%, 41%, and 42% of patients, respectively. Infield bladder V20 (P = 0.03) and pretreatment International Prostate Symptom Scale (IPSS) (P = 0.003) were associated with grade 2 GU toxicity. Prostate IG-IMRT using a daily ERB H2O shows low rates of acute GI toxicity compared to previous reports of air-filled ERB IMRT when using stringent infield rectum constraints and comparable GU toxicities

  16. Acute gastrointestinal and genitourinary toxicity of image-guided intensity modulated radiation therapy for prostate cancer using a daily water-filled endorectal balloon

    Deville Curtiland

    2012-05-01

    Full Text Available Abstract Background Our purpose was to report acute gastrointestinal (GI and genitourinary (GU toxicity rates for prostate cancer patients undergoing image-guided intensity modulated radiation therapy (IG-IMRT with a daily endorectal water-filled balloon (ERBH2O, and assess associations with planning parameters and pretreatment clinical characteristics. Methods The first 100 patients undergoing prostate and proximal seminal vesicle IG-IMRT with indexed-lumen 100 cc ERBH2O to 79.2 Gy in 1.8 Gy fractions at our institution from 12/2008- 12/2010 were assessed. Pretreatment characteristics, organ-at-risk dose volume histograms, and maximum GU and GI toxicities (CTCAE 3.0 were evaluated. Logistic regression models evaluated univariate association between toxicities and dosimetric parameters, and uni- and multivariate association between toxicities and pretreatment characteristics. Results Mean age was 68 (range 51–88. Thirty-two, 49, and 19 patients were low, intermediate, and high-risk, respectively; 40 received concurrent androgen deprivation. No grade 3 or greater toxicities were recorded. Maximum GI toxicity was grade 0, 1, and 2 in 69%, 23%, and 8%, respectively. Infield (defined as 1 cm above/below the CTV rectal mean/median doses, D75, V30, and V40 and hemorrhoid history were associated with grade 2 GI toxicity (Ps  Conclusion Prostate IG-IMRT using a daily ERBH2O shows low rates of acute GI toxicity compared to previous reports of air-filled ERB IMRT when using stringent infield rectum constraints and comparable GU toxicities.

  17. Image-guided intensity-modulated radiotherapy for patients with locally advanced gastric cancer: a clinical feasibility study.

    Badakhshi, Harun; Gruen, Arne; Graf, Reinhold; Boehmer, Dirk; Budach, Volker

    2014-01-01

    The aim of this study was to determine the medical and technical feasibility of intensity-modulated radiotherapy (IMRT) in high-risk nonmetastatic gastric cancer stage II and III after primary gastrectomy and D2 lymphadenectomy. A prospective nonrandomized phase II trial was performed on 25 consecutive patients with gastric cancer with high risk (T3-4, N1-3, G2-3, R0-1). The dose delivered was 45 Gy (1.80 Gy per fraction) in IMRT technique. Concurrent 5-fluorouracil-based chemotherapy at 225 mg/m(2) was administered as a continuous intravenous infusion. Primary endpoints were acute gastrointestinal toxicity (CTC 4.0) and technical feasibility of IMRT in regard to dose planning and radiation delivery. Early acute events were defined as clinical and chemical adverse effects of IMRT and concurrent chemotherapy during treatment. By definition, 90 days after the end of IMRT has been evaluated as acute-phase toxicity. No patient had grade 4 or higher acute adverse events. Clinical grade 3 toxicity occurred in two patients (8%) with diarrhea and in one case (4%) with nausea. Hematological changes with grade 3 occurred in three cases (12%) with hemoglobin decrease, in five cases (25%) as leukopenia, and in one case (4%) with thrombocytopenia. The mean dose for liver was 16 Gy and the percentage volume exceeding 30 Gy (V30) was 21%. Mean dose for right and left kidney was 9 and 13 Gy, respectively, and V20 was 9% and 13%, respectively. Heart received a median dose of 15 Gy and V40 was 17%. The mean dose to the bowel was 11 Gy and V40 was 6%. Spinal cord had at maximum 33 Gy in median. Specifics of dose distribution, including the coverage, for the target region were as follows: minimum was 33 Gy, maximum 48.6 Gy, and mean dose 44.6 Gy. The prescribed dose (45 Gy) covered 99% and 95% of planning target volume (OTV) in 66% and 92% of cases, respectively. Median PTV was 15.77 ml (range, 805-3,604 ml). The data support the practical feasibility of IMRT in adjuvant treatment in

  18. Automatic prostate localization on cone-beam CT scans for high precision image-guided radiotherapy

    Smitsmans, Monique H.P.; Bois, Josien de; Sonke, Jan-Jakob; Betgen, Anja; Zijp, Lambert J.; Jaffray, David A.; Lebesque, Joos V.; Herk, Marcel van

    2005-01-01

    Purpose: Previously, we developed an automatic three-dimensional gray-value registration (GR) method for fast prostate localization that could be used during online or offline image-guided radiotherapy. The method was tested on conventional computed tomography (CT) scans. In this study, the performance of the algorithm to localize the prostate on cone-beam CT (CBCT) scans acquired on the treatment machine was evaluated. Methods and Materials: Five to 17 CBCT scans of 32 prostate cancer patients (332 scans in total) were used. For 18 patients (190 CBCT scans), the CBCT scans were acquired with a collimated field of view (FOV) (craniocaudal). This procedure improved the image quality considerably. The prostate (i.e., prostate plus seminal vesicles) in each CBCT scan was registered to the prostate in the planning CT scan by automatic 3D gray-value registration (normal GR) starting from a registration on the bony anatomy. When these failed, registrations were repeated with a fixed rotation point locked at the prostate apex (fixed apex GR). Registrations were visually assessed in 3D by one observer with the help of an expansion (by 3.6 mm) of the delineated prostate contours of the planning CT scan. The percentage of successfully registered cases was determined from the combined normal and fixed apex GR assessment results. The error in gray-value registration for both registration methods was determined from the position of one clearly defined calcification in the prostate gland (9 patients, 71 successful registrations). Results: The percentage of successfully registered CBCT scans that were acquired with a collimated FOV was about 10% higher than for CBCT scans that were acquired with an uncollimated FOV. For CBCT scans that were acquired with a collimated FOV, the percentage of successfully registered cases improved from 65%, when only normal GR was applied, to 83% when the results of normal and fixed apex GR were combined. Gray-value registration mainly failed (or

  19. A highly effective in vivo photothermal nanoplatform with dual imaging-guided therapy of cancer based on the charge reversal complex of dye and iron oxide

    Chang, Y.; Li, X.; Kong, X.; Li, Y.; Liu, X.; Zhang, Y.; Tu, L.; Xue, B.; Wu, F.; Cao, D.; Zhao, H.; Zhang, H.

    2015-01-01

    To enhance the treatment efficiency of photothermal therapy (PTT) with very little light-associated side effect, we have constructed a highly effective PTT nanoplatform for fluorescence and MRI dual imaging-guided PTT of cancer, based on IR806 dye and iron oxide complex functionalized with

  20. Image guided prostate cancer treatments

    Bard, Robert L. [Bard Cancer Center, Biofoundation for Angiogenesis Research and Development, New York, NY (United States); Fuetterer, Jurgen J. [Radboud Univ. Nijmegen, Medical Centre (Netherlands). Dept. of Radiology; Sperling, Dan (ed.) [Sperling Prostate Center, Alpha 3TMRI, New York, NY (United States)

    2014-07-01

    Systematic overview of the application of ultrasound and MRI in the diagnosis and treatment of diseases of the lower urinary tract. Detailed information on image-guided therapies, including focused ultrasound, photodynamic therapy, and microwave and laser ablation. Numerous high-quality illustrations based on high-end equipment. Represents the state of the art in Non Invasive Imaging and Minimally Invasive Ablation Treatment (MIAT). Image-Guided Prostate Cancer Treatments is a comprehensive reference and practical guide on the technology and application of ultrasound and MRI in the male pelvis, with special attention to the prostate. The book is organized into three main sections, the first of which is devoted to general aspects of imaging and image-guided treatments. The second section provides a systematic overview of the application of ultrasound and MRI to the diagnosis and treatment of diseases of the lower urinary tract. Performance of the ultrasound and MRI studies is explained, and the normal and abnormal pathological anatomy is reviewed. Correlation with the ultrasound in the same plane is provided to assist in understanding the MRI sequences. Biopsy and interventional procedures, ultrasound-MRI fusion techniques, and image-guided therapies, including focused ultrasound, photodynamic therapy, microwave and laser ablation, are all fully covered. The third section focuses on securing treatment effectiveness and the use of follow-up imaging to ensure therapeutic success and detect tumor recurrence at an early stage, which is vital given that prompt focal treatment of recurrence is very successful. Here, particular attention is paid to the role of Doppler ultrasound and DCE-MRI technologies. This book, containing a wealth of high-quality illustrations based on high-end equipment, will acquaint beginners with the basics of prostate ultrasound and MRI, while more advanced practitioners will learn new skills, means of avoiding pitfalls, and ways of effectively

  1. Immobilization and positioning systems for treatment of patients with image-guided radiation therapy and intensity modulated radiation therapy)

    Hueso Bernad, M. Nuria; Suarez Dieguez, Raquel; Roures Ramos, M. Teresa; Broseta Tormos, M.Mercedes; Tirado Porcar, Miriam M; Del Castillo Arres, Jose; Franch Martinez, Silvia

    2009-01-01

    For adequate reproduction of daily patient positioning during treatment we use a 3-coordinate system alignment. The first set of axes would be the system of light (laser). - The second coordinate system is recognized by marks on the skin patient and / or immobilization systems. The third set of alignment refers to alignment of coordinates volume to try to locate the isocenter use Guided Radiotherapy Imaging when applied technologies with Intensity Modulated Radiotherapy treatment fields tend to be very small so it made individual protection and immobilization systems such as thermoplastic masks, vacuum sealed bags exterotaxicos conjugated systems and immobilization systems carbon fiber results by combining these immobilization and positioning systems can ensure effective treatment volume to be treated. There is no perfect immobilization system. However the choice of pool of qualified stun makes treatment more precise. (author)

  2. Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer

    Monroe, Alan T.; Peddada, Anuj V. [Dept. of Radiation Oncology, Penrose Cancer Center, Colorado Springs (United States); Pikaart, Dirk [Dept. of Gynecologic Oncology, Penrose Cancer Center, Colorado Springs (United States)

    2013-06-15

    Objective. To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients. Methods . Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique. Brachytherapy followed external radiation in 11 patients to a median dose of 18 Gy in 3 fractions. The median external beam dose delivered was 47.5 Gy in 25 fractions. Results. All 656 fractions were successfully imaged and treated. The median overall translational shift required for correction was 9.1 mm (standard deviation, 5.2 mm) relative to clinical set-up with skin tattoos. Shifts of 1 cm, 1.5 cm, and 2 cm or greater were performed in 43%, 14%, and 4% of patients, respectively. Acute grade 2 gastrointestinal (GI) toxicity occurred in eight patients (30%) and grade 3 toxicity occurred in one. At two years, there have been no local or regional failures and actuarial overall survival is 95%. Conclusion. Daily image guidance for high-risk endometrial cancer results in a low incidence of acute GI/genitourinary (GU) toxicity with uncompromised tumor control at two years. Vaginal cuff translations can be substantial and may possibly result in underdosing if not properly considered.

  3. Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer

    Monroe, Alan T.; Peddada, Anuj V.; Pikaart, Dirk

    2013-01-01

    Objective. To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients. Methods . Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique. Brachytherapy followed external radiation in 11 patients to a median dose of 18 Gy in 3 fractions. The median external beam dose delivered was 47.5 Gy in 25 fractions. Results. All 656 fractions were successfully imaged and treated. The median overall translational shift required for correction was 9.1 mm (standard deviation, 5.2 mm) relative to clinical set-up with skin tattoos. Shifts of 1 cm, 1.5 cm, and 2 cm or greater were performed in 43%, 14%, and 4% of patients, respectively. Acute grade 2 gastrointestinal (GI) toxicity occurred in eight patients (30%) and grade 3 toxicity occurred in one. At two years, there have been no local or regional failures and actuarial overall survival is 95%. Conclusion. Daily image guidance for high-risk endometrial cancer results in a low incidence of acute GI/genitourinary (GU) toxicity with uncompromised tumor control at two years. Vaginal cuff translations can be substantial and may possibly result in underdosing if not properly considered

  4. Impact of intensity-modulated and image-guided radiotherapy on elderly patients undergoing chemoradiation for locally advanced head and neck cancer

    Nguyen, N.P.; Chi, A.; Vock, J.

    2012-01-01

    Purpose: In this work, the treatment tolerance of elderly patients (≥ 70 years) undergoing intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) and chemotherapy for locally advanced head and neck cancer was assessed. Patients and methods: A retrospective review of 112 patients undergoing concurrent chemoradiation for locally advanced head and neck cancer was performed. Treatment toxicity, protocol violations, long-term complications, and survival were compared between 85 younger patients (< 70 years) and 27 older patients (≥ 70 years). Results: Grade 3-4 treatment toxicity was observed in 88.2% and 88.8% for younger and older patients, respectively. Mean weight loss and treatment break were 5.9 and 3.9 kg (p = 0.03) and 7.3 and 7.8 days (p = 0.8) for younger and older patients, respectively. Seven patients (8.2%) did not complete treatment in the younger group compared to 1 patient (3.7%) in the older group (p = 0.6). No significant differences in protocol violations and survival were found between the two groups. Conclusion: Compared to younger patients, elderly patients with locally advanced head and neck cancer tolerated chemoradiation with IMRT and IGRT well, and should not be denied curative treatment based solely on age. (orig.)

  5. FPGA-based High-Performance Collision Detection: An Enabling Technique for Image-Guided Robotic Surgery

    Zhaorui Zhang

    2016-08-01

    Full Text Available Collision detection, which refers to the computational problem of finding the relative placement or con-figuration of two or more objects, is an essential component of many applications in computer graphics and robotics. In image-guided robotic surgery, real-time collision detection is critical for preserving healthy anatomical structures during the surgical procedure. However, the computational complexity of the problem usually results in algorithms that operate at low speed. In this paper, we present a fast and accurate algorithm for collision detection between Oriented-Bounding-Boxes (OBBs that is suitable for real-time implementation. Our proposed Sweep and Prune algorithm can perform a preliminary filtering to reduce the number of objects that need to be tested by the classical Separating Axis Test algorithm, while the OBB pairs of interest are preserved. These OBB pairs are re-checked by the Separating Axis Test algorithm to obtain accurate overlapping status between them. To accelerate the execution, our Sweep and Prune algorithm is tailor-made for the proposed method. Meanwhile, a high performance scalable hardware architecture is proposed by analyzing the intrinsic parallelism of our algorithm, and is implemented on FPGA platform. Results show that our hardware design on the FPGA platform can achieve around 8X higher running speed than the software design on a CPU platform. As a result, the proposed algorithm can achieve a collision frame rate of 1 KHz, and fulfill the requirement for the medical surgery scenario of Robot Assisted Laparoscopy.

  6. A Filtering Approach for Image-Guided Surgery With a Highly Articulated Surgical Snake Robot.

    Tully, Stephen; Choset, Howie

    2016-02-01

    The objective of this paper is to introduce a probabilistic filtering approach to estimate the pose and internal shape of a highly flexible surgical snake robot during minimally invasive surgery. Our approach renders a depiction of the robot that is registered to preoperatively reconstructed organ models to produce a 3-D visualization that can be used for surgical feedback. Our filtering method estimates the robot shape using an extended Kalman filter that fuses magnetic tracker data with kinematic models that define the motion of the robot. Using Lie derivative analysis, we show that this estimation problem is observable, and thus, the shape and configuration of the robot can be successfully recovered with a sufficient number of magnetic tracker measurements. We validate this study with benchtop and in-vivo image-guidance experiments in which the surgical robot was driven along the epicardial surface of a porcine heart. This paper introduces a filtering approach for shape estimation that can be used for image guidance during minimally invasive surgery. The methods being introduced in this paper enable informative image guidance for highly articulated surgical robots, which benefits the advancement of robotic surgery.

  7. High-accuracy drilling with an image guided light weight robot: autonomous versus intuitive feed control.

    Tauscher, Sebastian; Fuchs, Alexander; Baier, Fabian; Kahrs, Lüder A; Ortmaier, Tobias

    2017-10-01

    Assistance of robotic systems in the operating room promises higher accuracy and, hence, demanding surgical interventions become realisable (e.g. the direct cochlear access). Additionally, an intuitive user interface is crucial for the use of robots in surgery. Torque sensors in the joints can be employed for intuitive interaction concepts. Regarding the accuracy, they lead to a lower structural stiffness and, thus, to an additional error source. The aim of this contribution is to examine, if an accuracy needed for demanding interventions can be achieved by such a system or not. Feasible accuracy results of the robot-assisted process depend on each work-flow step. This work focuses on the determination of the tool coordinate frame. A method for drill axis definition is implemented and analysed. Furthermore, a concept of admittance feed control is developed. This allows the user to control feeding along the planned path by applying a force to the robots structure. The accuracy is researched by drilling experiments with a PMMA phantom and artificial bone blocks. The described drill axis estimation process results in a high angular repeatability ([Formula: see text]). In the first set of drilling results, an accuracy of [Formula: see text] at entrance and [Formula: see text] at target point excluding imaging was achieved. With admittance feed control an accuracy of [Formula: see text] at target point was realised. In a third set twelve holes were drilled in artificial temporal bone phantoms including imaging. In this set-up an error of [Formula: see text] and [Formula: see text] was achieved. The results of conducted experiments show that accuracy requirements for demanding procedures such as the direct cochlear access can be fulfilled with compliant systems. Furthermore, it was shown that with the presented admittance feed control an accuracy of less then [Formula: see text] is achievable.

  8. Comparative evaluation of two dose optimization methods for image-guided, highly-conformal, tandem and ovoids cervix brachytherapy planning

    Ren, Jiyun; Menon, Geetha; Sloboda, Ron

    2013-04-01

    Although the Manchester system is still extensively used to prescribe dose in brachytherapy (BT) for locally advanced cervix cancer, many radiation oncology centers are transitioning to 3D image-guided BT, owing to the excellent anatomy definition offered by modern imaging modalities. As automatic dose optimization is highly desirable for 3D image-based BT, this study comparatively evaluates the performance of two optimization methods used in BT treatment planning—Nelder-Mead simplex (NMS) and simulated annealing (SA)—for a cervix BT computer simulation model incorporating a Manchester-style applicator. Eight model cases were constructed based on anatomical structure data (for high risk-clinical target volume (HR-CTV), bladder, rectum and sigmoid) obtained from measurements on fused MR-CT images for BT patients. D90 and V100 for HR-CTV, D2cc for organs at risk (OARs), dose to point A, conformation index and the sum of dwell times within the tandem and ovoids were calculated for optimized treatment plans designed to treat the HR-CTV in a highly conformal manner. Compared to the NMS algorithm, SA was found to be superior as it could perform optimization starting from a range of initial dwell times, while the performance of NMS was strongly dependent on their initial choice. SA-optimized plans also exhibited lower D2cc to OARs, especially the bladder and sigmoid, and reduced tandem dwell times. For cases with smaller HR-CTV having good separation from adjoining OARs, multiple SA-optimized solutions were found which differed markedly from each other and were associated with different choices for initial dwell times. Finally and importantly, the SA method yielded plans with lower dwell time variability compared with the NMS method.

  9. Use of deformed intensity distributions for on-line modification of image-guided IMRT to account for interfractional anatomic changes

    Mohan, Radhe; Zhang Xiaodong; Wang He; Kang Yixiu; Wang Xiaochun; Liu, Helen; Ang, K.; Kuban, Deborah; Dong Lei

    2005-01-01

    Purpose: Recent imaging studies have demonstrated that there can be significant changes in anatomy from day to day and over the course of radiotherapy as a result of daily positioning uncertainties and physiologic and clinical factors. There are a number of strategies to minimize such changes, reduce their impact, or correct for them. Measures to date have included improved immobilization of external and internal anatomy or adjustment of positions based on portal or ultrasound images. Perhaps the most accurate way is to use CT image-guided radiotherapy, for which the possibilities range from simple correction of setup based on daily CT images to on-line near real-time intensity modulated radiotherapy (IMRT) replanning. In addition, there are numerous intermediate possibilities. In this paper, we report the development of one such intermediate method that takes into account anatomic changes by deforming the intensity distributions of each beam based on deformations of anatomy as seen in the beam's-eye-view. Methods and materials: The intensity distribution deformations are computed based on anatomy deformations discerned from the changes in the current image relative to a reference image (e.g., the pretreatment CT scan). First, a reference IMRT plan is generated based on the reference CT image. A new CT image is acquired using an in-room CT for every fraction. The anatomic structure contours are obtained for the new image. (For this article, these contours were manually drawn. When image guided IMRT methods are implemented, anatomic structure contours on subsequent images will likely be obtained with automatic or semiautomatic means. This could be achieved by, for example, first deforming the original CT image to match today's image, and then using the same deformation transformation to map original contours to today's image.) The reference intensity distributions for each beam are then deformed so that the projected geometric relationship within the beam

  10. Effect of body mass index on shifts in ultrasound-based image-guided intensity-modulated radiation therapy for abdominal malignancies

    Choi, Mehee; Fuller, Clifton D.; Wang, Samuel J.; Siddiqi, Ather; Wong, Adrian; Thomas, Charles R.; Fuss, Martin

    2009-01-01

    Background and purpose: We investigated whether corrective shifts determined by daily ultrasound-based image-guidance correlate with body mass index (BMI) of patients treated with image-guided intensity-modulated radiation therapy (IG-IMRT) for abdominal malignancies. The utility of daily image-guidance, particularly for patients with BMI > 25.0, is examined. Materials and methods: Total 3162 ultrasound-directed shifts were performed in 86 patients. Direction and magnitude of shifts were correlated with pretreatment BMI. Bivariate statistical analysis and analysis of set-up correction data were performed using systematic and random error calculations. Results: Total 2040 daily alignments were performed. Average 3D vector of set-up correction for all patients was 12.1 mm/fraction. Directional and absolute shifts and 3D vector length were significantly different between BMI cohorts. 3D displacement averaged 4.9 mm/fraction and 6.8mm/fraction for BMI ≤ 25.0 and BMI > 25.0, respectively. Systematic error in all axes and 3D vector was significantly greater for BMI > 25.0. Differences in random error were not statistically significant. Conclusions: Set-up corrections derived from daily ultrasound-based IG-IMRT of abdominal tumors correlated with BMI. Daily image-guidance may improve precision of IMRT delivery with benefits assessed for the entire population, particularly patients with increased habitus. Requisite PTV margins suggested in the absence of daily image-guidance are significantly greater in patients with BMI > 25.0.

  11. A retrospective comparison of outcome and toxicity of preoperative image-guided intensity-modulated radiotherapy versus conventional pelvic radiotherapy for locally advanced rectal carcinoma

    Huang, Chun-Ming; Huang, Ming-Yii; Tsai, Hsiang-Lin; Huang, Ching-Wen; Ma, Cheng-Jen; Lin, Chih-Hung; Huang, Chih-Jen; Wang, Jaw-Yuan

    2017-01-01

    The aim of the study was to compare clinical outcomes and toxicity between 3D conformal radiotherapy (3DCRT) and image-guided intensity-modulated radiotherapy (IG-IMRT) administered through helical tomotherapy in locally advanced rectal cancer (LARC) patients receiving preoperative chemoradiotherapy. We reviewed 144 patients with Stage II–III rectal cancer receiving preoperative fluoropyrimidine-based chemoradiotherapy followed by radical resection. Tumor responses following chemoradiotherapy were evaluated using the Dworak tumor regression grade (TRG). Of the 144 patients, 45 received IG-IMRT and 99 received 3DCRT. A significant reduction in Grade 3 or 4 acute gastrointestinal toxicity (IG-IMRT, 6.7%; 3DCRT, 15.1%; P = 0.039) was observed by IG-IMRT. The pathologic complete response (pCR) rate did not differ between the IG-IMRT and the 3DCRT group (17.8% vs 15.1%, P = 0.52). Patients in the IG-IMRT group had the trend of favorable tumor regressions (TRG 3 or 4) compared with those in the 3DCRT group (66.7% vs 43.5%, P = 0.071). The median follow-up was 53 months (range, 18–95 months) in the 3DCRT group and 43 months (range, 17–69 months) in the IG-IMRT group. Four-year overall, disease-free, and local failure–free survival rates of the IG-IMRT and 3DCRT groups were 81.6% and 67.9% (P = 0.12), 53.8% and 51.8% (P = 0.51), and 88% and 75.1% (P = 0.031), respectively. LARC patients treated with preoperative IG-IMRT achieved lower acute gastrointestinal adverse effects and a higher local control rate than those treated with 3DCRT, but there was no prominent difference in distant metastasis rate and overall survival between two treatment modalities.

  12. Vaginal tolerance of CT based image-guided high-dose rate interstitial brachytherapy for gynecological malignancies

    Murakami, Naoya; Inaba, Koji; Morota, Madoka; Ito, Yoshinori; Itami, Jun; Kasamatsu, Takahiro; Sumi, Minako; Yoshimura, Ryoichi; Harada, Ken; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Yoshio, Kotaro

    2014-01-01

    Purpose of this study was to identify predictors of vaginal ulcer after CT based three-dimensional image-guided high-dose-rate interstitial brachytherapy (HDR-ISBT) for gynecologic malignancies. Records were reviewed for 44 female (14 with primary disease and 30 with recurrence) with gynecological malignancies treated with HDR-ISBT with or without external beam radiation therapy. The HDR-ISBT applicator insertion was performed with image guidance by trans-rectal ultrasound and CT. The median clinical target volume was 35.5 ml (2.4-142.1 ml) and the median delivered dose in equivalent dose in 2 Gy fractions (EQD 2 ) for target volume D 90 was 67.7 Gy (48.8-94.2 Gy, doses of external-beam radiation therapy and brachytherapy were combined). For re-irradiation patients, median EQD 2 of D 2cc for rectum and bladder, D 0.5cc , D 1cc , D 2cc , D 4cc , D 6cc and D 8cc for vaginal wall was 91.1 Gy, 100.9 Gy, 260.3 Gy, 212.3 Gy, 170.1 Gy, 117.1 Gy, 105.2 Gy, and 94.7 Gy, respectively. For those without prior radiation therapy, median EQD 2 of D 2cc for rectum and bladder, D 0.5cc , D 1cc , D 2cc , D 4cc , D 6cc and D 8cc for vaginal wall was 56.3 Gy, 54.3 Gy, 147.4 Gy, 126.2 Gy, 108.0 Gy, 103.5 Gy, 94.7 Gy, and 80.7 Gy, respectively. Among five patients with vaginal ulcer, three had prior pelvic radiation therapy in their initial treatment and three consequently suffered from fistula formation. On univariate analysis, re-irradiation and vaginal wall D 2cc in EQD 2 was the clinical predictors of vaginal ulcer (p = 0.035 and p = 0.025, respectively). The ROC analysis revealed that vaginal wall D 2cc is the best predictor of vaginal ulcer. The 2-year incidence rates of vaginal ulcer in the patients with vaginal wall D 2cc in EQD 2 equal to or less than 145 Gy and over 145 Gy were 3.7% and 23.5%, respectively, with a statistically significant difference (p = 0.026). Re-irradiation and vaginal D 2cc is a significant predictor of vaginal ulcer after HDR-ISBT for gynecologic

  13. Late Side Effects After Image Guided Intensity Modulated Radiation Therapy Compared to 3D-Conformal Radiation Therapy for Prostate Cancer: Results From 2 Prospective Cohorts

    Wortel, Ruud C.; Incrocci, Luca [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Pos, Floris J.; Heide, Uulke A. van der; Lebesque, Joos V. [Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Aluwini, Shafak [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Witte, Marnix G. [Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Heemsbergen, Wilma D., E-mail: w.heemsbergen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2016-06-01

    Purpose: Technical developments in the field of external beam radiation therapy (RT) enabled the clinical introduction of image guided intensity modulated radiation therapy (IG-IMRT), which improved target conformity and allowed reduction of safety margins. Whether this had an impact on late toxicity levels compared to previously applied three-dimensional conformal radiation therapy (3D-CRT) is currently unknown. We analyzed late side effects after treatment with IG-IMRT or 3D-CRT, evaluating 2 prospective cohorts of men treated for localized prostate cancer to investigate the hypothesized reductions in toxicity. Methods and Materials: Patients treated with 3D-CRT (n=189) or IG-IMRT (n=242) to 78 Gy in 39 fractions were recruited from 2 Dutch randomized trials with identical toxicity scoring protocols. Late toxicity (>90 days after treatment) was derived from self-assessment questionnaires and case report forms, according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG-EORTC) scoring criteria. Grade ≥2 endpoints included gastrointestinal (GI) rectal bleeding, increased stool frequency, discomfort, rectal incontinence, proctitis, and genitourinary (GU) obstruction, increased urinary frequency, nocturia, urinary incontinence, and dysuria. The Cox proportional hazards regression model was used to compare grade ≥2 toxicities between both techniques, adjusting for other modifying factors. Results: The 5-year cumulative incidence of grade ≥2 GI toxicity was 24.9% for IG-IMRT and 37.6% following 3D-CRT (adjusted hazard ratio [HR]: 0.59, P=.005), with significant reductions in proctitis (HR: 0.37, P=.047) and increased stool frequency (HR: 0.23, P<.001). GU grade ≥2 toxicity levels at 5 years were comparable with 46.2% and 36.4% following IG-IMRT and 3D-CRT, respectively (adjusted HR: 1.19, P=.33). Other strong predictors (P<.01) of grade ≥2 late toxicity were baseline complaints, acute toxicity, and age

  14. Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

    Wortel, Ruud C.; Incrocci, Luca [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Pos, Floris J.; Lebesque, Joos V.; Witte, Marnix G.; Heide, Uulke A. van der; Herk, Marcel van [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Heemsbergen, Wilma D., E-mail: w.heemsbergen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-03-15

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (n=215) and IG-IMRT (n=260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade ≥1, ≥2, and ≥3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P<.001) with IG-IMRT for anorectum, anal canal, and bladder. The mean dose to the anorectum was 34.4 Gy versus 47.3 Gy (P<.001), 23.6 Gy versus 44.6 Gy for the anal canal (P<.001), and 33.1 Gy versus 43.2 Gy for the bladder (P<.001). Significantly lower grade ≥2 toxicity was observed for proctitis, stool frequency ≥6/day, and urinary frequency ≥12/day. IG-IMRT resulted in significantly lower overall RTOG grade ≥2 GI toxicity (29% vs 49%, respectively, P=.002) and overall GU grade ≥2 toxicity (38% vs 48%, respectively, P=.009). Conclusions: A clinically meaningful reduction in dose to organs at risk and acute toxicity levels was observed in IG-IMRT patients, as a result of improved technique and tighter margins. Therefore reduced late toxicity levels can be expected as well; additional research is needed to quantify such reductions.

  15. [Accelerated partial breast irradiation with image-guided intensity-modulated radiotherapy following breast-conserving surgery - preliminary results of a phase II clinical study].

    Mészáros, Norbert; Major, Tibor; Stelczer, Gábor; Zaka, Zoltán; Mózsa, Emõke; Fodor, János; Polgár, Csaba

    2015-06-01

    The purpose of the study was to implement accelerated partial breast irradiation (APBI) by means of image-guided intensity-modulated radiotherapy (IG-IMRT) following breast-conserving surgery (BCS) for low-risk early invasive breast cancer. Between July 2011 and March 2014, 60 patients with low-risk early invasive (St I-II) breast cancer who underwent BCS were enrolled in our phase II prospective study. Postoperative APBI was given by means of step and shoot IG-IMRT using 4 to 5 fields to a total dose of 36.9 Gy (9×4.1 Gy) using a twice-a-day fractionation. Before each fraction, series of CT images were taken from the region of the target volume using a kV CT on-rail mounted in the treatment room. An image fusion software was used for automatic image registration of the planning and verification CT images. Patient set-up errors were detected in three directions (LAT, LONG, VERT), and inaccuracies were adjusted by automatic movements of the treatment table. Breast cancer related events, acute and late toxicities, and cosmetic results were registered and analysed. At a median follow-up of 24 months (range 12-44) neither locoregional nor distant failure was observed. Grade 1 (G1), G2 erythema, G1 oedema, and G1 and G2 pain occurred in 21 (35%), 2 (3.3%), 23 (38.3%), 6 (10%) and 2 (3.3%) patients, respectively. No G3-4 acute side effects were detected. Among late radiation side effects G1 pigmentation, G1 fibrosis, and G1 fat necrosis occurred in 5 (8.3%), 7 (11.7%), and 2 (3.3%) patients, respectively. No ≥G2 late toxicity was detected. Excellent and good cosmetic outcome was detected in 45 (75%) and 15 (25%) patients. IG-IMRT is a reproducible and feasible technique for the delivery of APBI following conservative surgery for the treatment of low-risk, early-stage invasive breast carcinoma. Preliminary results are promising, early radiation side effects are minimal, and cosmetic results are excellent.

  16. Late Side Effects After Image Guided Intensity Modulated Radiation Therapy Compared to 3D-Conformal Radiation Therapy for Prostate Cancer: Results From 2 Prospective Cohorts

    Wortel, Ruud C.; Incrocci, Luca; Pos, Floris J.; Heide, Uulke A. van der; Lebesque, Joos V.; Aluwini, Shafak; Witte, Marnix G.; Heemsbergen, Wilma D.

    2016-01-01

    Purpose: Technical developments in the field of external beam radiation therapy (RT) enabled the clinical introduction of image guided intensity modulated radiation therapy (IG-IMRT), which improved target conformity and allowed reduction of safety margins. Whether this had an impact on late toxicity levels compared to previously applied three-dimensional conformal radiation therapy (3D-CRT) is currently unknown. We analyzed late side effects after treatment with IG-IMRT or 3D-CRT, evaluating 2 prospective cohorts of men treated for localized prostate cancer to investigate the hypothesized reductions in toxicity. Methods and Materials: Patients treated with 3D-CRT (n=189) or IG-IMRT (n=242) to 78 Gy in 39 fractions were recruited from 2 Dutch randomized trials with identical toxicity scoring protocols. Late toxicity (>90 days after treatment) was derived from self-assessment questionnaires and case report forms, according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG-EORTC) scoring criteria. Grade ≥2 endpoints included gastrointestinal (GI) rectal bleeding, increased stool frequency, discomfort, rectal incontinence, proctitis, and genitourinary (GU) obstruction, increased urinary frequency, nocturia, urinary incontinence, and dysuria. The Cox proportional hazards regression model was used to compare grade ≥2 toxicities between both techniques, adjusting for other modifying factors. Results: The 5-year cumulative incidence of grade ≥2 GI toxicity was 24.9% for IG-IMRT and 37.6% following 3D-CRT (adjusted hazard ratio [HR]: 0.59, P=.005), with significant reductions in proctitis (HR: 0.37, P=.047) and increased stool frequency (HR: 0.23, P<.001). GU grade ≥2 toxicity levels at 5 years were comparable with 46.2% and 36.4% following IG-IMRT and 3D-CRT, respectively (adjusted HR: 1.19, P=.33). Other strong predictors (P<.01) of grade ≥2 late toxicity were baseline complaints, acute toxicity, and age

  17. Image-guided radiation therapy: physician's perspectives

    Gupta, T.; Anand Narayan, C.

    2012-01-01

    The evolution of radiotherapy has been ontogenetically linked to medical imaging. Over the years, major technological innovations have resulted in substantial improvements in radiotherapy planning, delivery, and verification. The increasing use of computed tomography imaging for target volume delineation coupled with availability of computer-controlled treatment planning and delivery systems have progressively led to conformation of radiation dose to the target tissues while sparing surrounding normal tissues. Recent advances in imaging technology coupled with improved treatment delivery allow near-simultaneous soft-tissue localization of tumor and repositioning of patient. The integration of various imaging modalities within the treatment room for guiding radiation delivery has vastly improved the management of geometric uncertainties in contemporary radiotherapy practice ushering in the paradigm of image-guided radiation therapy (IGRT). Image-guidance should be considered a necessary and natural corollary to high-precision radiotherapy that was long overdue. Image-guided radiation therapy not only provides accurate information on patient and tumor position on a quantitative scale, it also gives an opportunity to verify consistency of planned and actual treatment geometry including adaptation to daily variations resulting in improved dose delivery. The two main concerns with IGRT are resource-intensive nature of delivery and increasing dose from additional imaging. However, increasing the precision and accuracy of radiation delivery through IGRT is likely to reduce toxicity with potential for dose escalation and improved tumor control resulting in favourable therapeutic index. The radiation oncology community needs to leverage this technology to generate high-quality evidence to support widespread adoption of IGRT in contemporary radiotherapy practice. (author)

  18. Radiation resistivity of pure-silica core image guide

    Hayami, H.; Ishitani, T.; Kishihara, O.; Suzuki, K.

    1988-01-01

    Radiation resistivity of pure-silica core image guides were investigated in terms of incremental spectral loss and quality of pictures transmitted through the image guides. Radiation-induced spectral losses were measured so as to clarify the dependences of radiation resistivity on such parameters as core materials (OH and Cl contents), picture element dimensions, (core packing density and cladding thickness), number of picture elements and drawing conditions. As the results, an image guide with OH-and Cl-free pure-silica core, 30-45% in core packing density, and 1.8 ∼ 2.2 μm in cladding thickness showed the lowest loss. The parameters to design this image guide were almost the same as those to obtain a image guide with good picture quality. Radiation resistivity of the image guide was not dependent on drawing conditions and number of picture elements, indicating that the image guide has large allowable in production conditions and that reliable quality is constantly obtained in production. Radiation resistivity under high total doses was evaluated using the image guide with the lowest radiation-induced loss. Maximum usable lengths of the image guide for practical use under specific high total doses and maximum allowable total doses for the image guide in specific lengths were extrapolated. Picture quality in terms of radiation-induced degradation in color fidelity in the pictures transmitted through image guides was quantitatively evaluated in the chromaticity diagram based on the CIE standard colorimetric system and in the color specification charts according to three attributes of colors. The image guide with the least spectral incremental loss gives the least radiation-induced degradation in color fidelity in the pictures as well. (author)

  19. Implementation of image-guided intensity-modulated accelerated partial breast irradiation. Three-year results of a phase II clinical study

    Meszaros, Norbert; Major, Tibor; Stelczer, Gabor; Zaka, Zoltan; Takacsi-Nagy, Zoltan; Fodor, Janos; Polgar, Csaba [National Institute of Oncology, Center of Radiotherapy, Budapest (Hungary); Mozsa, Emoke [National Institute of Oncology, Center of Radiotherapy, Budapest (Hungary); Landesklinikum, Department of Radiooncology and Radiotherapy, Wiener Neustadt (Austria); Pukancsik, David [National Institute of Oncology, Department of Breast and Sarcoma Surgery, Budapest (Hungary)

    2017-01-15

    To report 3-year results of accelerated partial breast irradiation (APBI) using image-guided intensity-modulated radiotherapy (IG-IMRT) following breast conserving surgery (BCS) for low-risk early invasive breast cancer. Between July 2011 and March 2014, 60 patients with low-risk early invasive breast cancer underwent BCS and were enrolled in this phase II prospective study. The total dose was 36.9 Gy (9 fractions of 4.1 Gy, two fractions/day). Patient setup errors were detected in LAT, LONG and VERT directions. Local tumour control, survival results, early and late side effects and cosmetic outcome were assessed. At a median follow-up of 39 months, all patients were alive and neither locoregional nor distant failure occurred. One contralateral breast cancer and two new primary malignancies outside the breast were observed. No grade (G) 3-4 acute toxicity was detected. G1 and G2 erythema occurred in 21 (35%) and 2 (3.3%) patients, respectively; while G1 oedema was observed in 23 (38.8%) cases. G1 and G2 pain was reported by 6 (10%) and 2 (3.3%) patients, respectively. Among the late radiation side effects, G1 pigmentation or telangiectasia, G1 fibrosis and G1 asymptomatic fat necrosis occurred in 10 (16.7%), 7 (11.7%) and 3 (5%) patients, respectively. No ≥ G2 late toxicity was detected. Cosmetic outcome was excellent in 43 (71.7%) and good in 17 (28.3%) patients. IG-IMRT is a reproducible and feasible technique for delivery of external beam APBI following BCS for treatment of low-risk, early-stage invasive breast carcinoma. In order to avoid toxicity, image guidance performed before each radiation fraction is necessary to minimize the PTV. Three-year results are promising, early and late radiation side-effects are minimal, and cosmetic results are excellent to good. (orig.) [German] Evaluierung der 3-Jahres-Ergebnisse der Teilbrustbestrahlung (APBI) mittels bildgefuehrter intensitaetsmodulierter Strahlentherapie (IG-IMRT) nach brusterhaltender Operation (BCS

  20. An ultra-high field strength MR image-guided robotic needle delivery system for in-bore small animal interventions.

    Gravett, Matthew; Cepek, Jeremy; Fenster, Aaron

    2017-11-01

    The purpose of this study was to develop and validate an image-guided robotic needle delivery system for accurate and repeatable needle targeting procedures in mouse brains inside the 12 cm inner diameter gradient coil insert of a 9.4 T MR scanner. Many preclinical research techniques require the use of accurate needle deliveries to soft tissues, including brain tissue. Soft tissues are optimally visualized in MR images, which offer high-soft tissue contrast, as well as a range of unique imaging techniques, including functional, spectroscopy and thermal imaging, however, there are currently no solutions for delivering needles to small animal brains inside the bore of an ultra-high field MR scanner. This paper describes the mechatronic design, evaluation of MR compatibility, registration technique, mechanical calibration, the quantitative validation of the in-bore image-guided needle targeting accuracy and repeatability, and demonstrated the system's ability to deliver needles in situ. Our six degree-of-freedom, MR compatible, mechatronic system was designed to fit inside the bore of a 9.4 T MR scanner and is actuated using a combination of piezoelectric and hydraulic mechanisms. The MR compatibility and targeting accuracy of the needle delivery system are evaluated to ensure that the system is precisely calibrated to perform the needle targeting procedures. A semi-automated image registration is performed to link the robot coordinates to the MR coordinate system. Soft tissue targets can be accurately localized in MR images, followed by automatic alignment of the needle trajectory to the target. Intra-procedure visualization of the needle target location and the needle were confirmed through MR images after needle insertion. The effects of geometric distortions and signal noise were found to be below threshold that would have an impact on the accuracy of the system. The system was found to have negligible effect on the MR image signal noise and geometric distortion

  1. SU-E-T-296: Dosimetric Analysis of Small Animal Image-Guided Irradiator Using High Resolution Optical CT Imaging of 3D Dosimeters

    Na, Y; Qian, X; Wuu, C; Adamovics, J

    2015-01-01

    Purpose: To verify the dosimetric characteristics of a small animal image-guided irradiator using a high-resolution of optical CT imaging of 3D dosimeters. Methods: PRESAEGE 3D dosimeters were used to determine dosimetric characteristics of a small animal image-guided irradiator and compared with EBT2 films. Cylindrical PRESAGE dosimeters with 7cm height and 6cm diameter were placed along the central axis of the beam. The films were positioned between 6×6cm 2 cubed plastic water phantoms perpendicular to the beam direction with multiple depths. PRESAGE dosimeters and EBT2 films were then irradiated with the irradiator beams at 220kVp and 13mA. Each of irradiated PRESAGE dosimeters named PA1, PA2, PB1, and PB2, was independently scanned using a high-resolution single laser beam optical CT scanner. The transverse images were reconstructed with a 0.1mm high-resolution pixel. A commercial Epson Expression 10000XL flatbed scanner was used for readout of irradiated EBT2 films at a 0.4mm pixel resolution. PDD curves and beam profiles were measured for the irradiated PRESAGE dosimeters and EBT2 films. Results: The PDD agreements between the irradiated PRESAGE dosimeter PA1, PA2, PB1, PB2 and the EB2 films were 1.7, 2.3, 1.9, and 1.9% for the multiple depths at 1, 5, 10, 15, 20, 30, 40 and 50mm, respectively. The FWHM measurements for each PRESAEGE dosimeter and film agreed with 0.5, 1.1, 0.4, and 1.7%, respectively, at 30mm depth. Both PDD and FWHM measurements for the PRESAGE dosimeters and the films agreed overall within 2%. The 20%–80% penumbral widths of each PRESAGE dosimeter and the film at a given depth were respectively found to be 0.97, 0.91, 0.79, 0.88, and 0.37mm. Conclusion: Dosimetric characteristics of a small animal image-guided irradiator have been demonstrated with the measurements of PRESAGE dosimeter and EB2 film. With the high resolution and accuracy obtained from this 3D dosimetry system, precise targeting small animal irradiation can be achieved

  2. High intensity hadron accelerators

    Teng, L.C.

    1989-05-01

    This rapporteur report consists mainly of two parts. Part I is an abridged review of the status of all High Intensity Hadron Accelerator projects in the world in semi-tabulated form for quick reference and comparison. Part II is a brief discussion of the salient features of the different technologies involved. The discussion is based mainly on my personal experiences and opinions, tempered, I hope, by the discussions I participated in in the various parallel sessions of the workshop. In addition, appended at the end is my evaluation and expression of the merits of high intensity hadron accelerators as research facilities for nuclear and particle physics

  3. The planning target volume margins detected by cone-beam CT in head and neck cancer patients treated by image-guided intensity modulated radiotherapy

    Liu Jun; Chen Hong; Zhang Guoqiao; Chen Fei; Zhang Li

    2011-01-01

    Objective: To determine the planning target volume margins of head and neck cancers treated by image guided radiotherapy (IGRT). Methods: 464 sets cone beam computed tomography (CBCT) images before setup correction and 126 sets CBCT images after correction were obtained from 51 head and neck cancer patients treated by IGRT in our department. The systematic and random errors were evaluated by either online or offline correction through registering the CBCT images to the planning CT. The data was divided into 3 groups according to the online correction times. Results: The isocenter shift were 0.37 mm ± 2.37 mm, -0.43 mm ± 2.30 mm and 0.47 mm ± 2.65 mm in right-left (RL), anterior-posterior (AP) and superior-inferior (SI) directions respectively before correction, and it reduced to 0.08 mm ± 0.68 mm, -0.03 mm ± 0.74 mm and 0.03 mm ± 0.80 mm when evaluated by 126 sets corrected CBCT images. The planning target volume (PTV) margin from clinical target volume (CTV) before correction were: 6.41 mm, 6.15 mm and 7.10 mm based on two parameter model, and it reduced to 1.78 mm, 1.80 mm and 1.97 mm after correction. The PTV margins were 3.8 mm, 3.8 mm, 4.0 mm; 4.0 mm, 4.0 mm, 5.0 mm and 5.4 mm, 5.2 mm, 6.1 mm in RL, AP and SI respectively when online-correction times were more than 15 times, 11-15 times, 5-10 times. Conclusions: CBCT-based on online correction reduce the PTV margin for head and neck cancers treated by IGRT and ensure more precise dose delivery and less normal tissue complications. (authors)

  4. Image-guided and adaptive radiotherapy

    Louvel, G.; Chajon, E.; Henry, O.; Cazoulat, G.; Le Maitre, A.; Simon, A.; Bensadoun, R.J.; Crevoisier, R. de

    2012-01-01

    Image-guided radiotherapy (IGRT) aims to take into account anatomical variations occurring during irradiation by visualization of anatomical structures. It may consist of a rigid registration of the tumour by moving the patient, in case of prostatic irradiation for example. IGRT associated with intensity-modulated radiotherapy (IMRT) is strongly recommended when high-dose is delivered in the prostate, where it seems to reduce rectal and bladder toxicity. In case of significant anatomical deformations, as in head and neck tumours (tumour shrinking and decrease in volume of the salivary glands), re-planning appears to be necessary, corresponding to the adaptive radiotherapy. This should ideally be 'monitored' and possibly triggered based on a calculation of cumulative dose, session after session, compared to the initial planning dose, corresponding to the concept of dose-guided adaptive radiotherapy. The creation of 'planning libraries' based on predictable organ positions (as in cervical cancer) is another way of adaptive radiotherapy. All of these strategies still appear very complex and expensive and therefore require stringent validation before being routinely applied. (authors)

  5. Toxicity and dosimetric analysis of non-small cell lung cancer patients undergoing radiotherapy with 4DCT and image-guided intensity modulated radiotherapy: a regional centre's experience.

    Livingston, Gareth C; Last, Andrew J; Shakespeare, Thomas P; Dwyer, Patrick M; Westhuyzen, Justin; McKay, Michael J; Connors, Lisa; Leader, Stephanie; Greenham, Stuart

    2016-09-01

    For patients receiving radiotherapy for locally advance non-small cell lung cancer (NSCLC), the probability of experiencing severe radiation pneumonitis (RP) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy (IMRT) provides the ability to reduce planned doses to healthy organs at risk (OAR) and can potentially reduce treatment-related side effects. This study reports toxicity outcomes and provides a dosimetric comparison with three-dimensional conformal radiotherapy (3DCRT). Thirty curative NSCLC patients received radiotherapy using four-dimensional computed tomography and five-field IMRT. All were assessed for early and late toxicity using common terminology criteria for adverse events. All plans were subsequently re-planned using 3DCRT to the same standard as the clinical plans. Dosimetric parameters for lungs, oesophagus, heart and conformity were recorded for comparison between the two techniques. IMRT plans achieved improved high-dose conformity and reduced OAR doses including lung volumes irradiated to 5-20 Gy. One case each of oesophagitis and erythema (3%) were the only Grade 3 toxicities. Rates of Grade 2 oesophagitis were 40%. No cases of Grade 3 RP were recorded and Grade 2 RP rates were as low as 3%. IMRT provides a dosimetric benefit when compared to 3DCRT. While the clinical benefit appears to increase with increasing target size and increasing complexity, IMRT appears preferential to 3DCRT in the treatment of NSCLC.

  6. A Prospective Trial of Intensity Modulated Radiation Therapy (IMRT) Incorporating a Simultaneous Integrated Boost for Prostate Cancer: Long-term Outcomes Compared With Standard Image Guided IMRT

    Schild, Michael H. [Midwestern University, Glendale, Arizona (United States); Schild, Steven E., E-mail: sschild@mayo.edu [Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona (United States); Wong, William W.; Vora, Sujay A.; Keole, Sameer R.; Vargas, Carlos E.; Daniels, Thomas B.; Ezzell, Gary A. [Department of Radiation Oncology, Mayo Clinic Hospital, Phoenix, Arizona (United States); Nguyen, Ba D.; Roarke, Michael C. [Department of Radiology, Mayo Clinic, Scottsdale, Arizona (United States)

    2017-04-01

    Purpose: This report describes the long-term outcomes of a prospective trial of intensity modulated radiation therapy (IMRT), integrating a {sup 111}In capromab pendetide (ProstaScint) scan-directed simultaneous integrated boost (SIB) for localized prostate cancer. Methods and Materials: Seventy-one patients with T1N0M0 to T4N0M0 prostate cancer were enrolled, and their ProstaScint and pelvic computed tomography scans were coregistered for treatment planning. The entire prostate received 75.6 Gy in 42 fractions with IMRT, whereas regions of increased uptake on ProstaScint scans received 82 Gy as an SIB. Patients with intermediate- and high-risk disease also received 6 months and 12 months of adjuvant hormonal therapy, respectively. Results: The study enrolled 31 low-, 30 intermediate-, and 10 high-risk patients. The median follow-up was 120 months (range, 24-150 months). The 10-year biochemical control rates were 85% for the entire cohort and 84%, 84%, and 90% for patients with low-, intermediate-, and high-risk disease, respectively. The 10-year survival rate of the entire cohort was 69%. Pretreatment prostate-specific antigen level >10 ng/mL and boost volume of >10% of the prostate volume were significantly associated with poorer biochemical control and survival. The outcomes were compared with those of a cohort of 302 patients treated similarly but without the SIB and followed up for a median of 91 months (range, 6-138 months). The 5- and 10-year biochemical control rates were 86% and 61%, respectively, in patients without the SIB compared with 94% and 85%, respectively, in patients in this trial who received the SIB (P=.02). The cohort that received an SIB did not have increased toxicity. Conclusions: The described IMRT strategy, integrating multiple imaging modalities to administer 75.6 Gy to the entire prostate with a boost dose of 82 Gy, was feasible. The addition of the SIB was associated with greater biochemical control but not toxicity. Modern

  7. Portable Intraoperative Computed Tomography Scan in Image-Guided Surgery for Brain High-grade Gliomas: Analysis of Technical Feasibility and Impact on Extent of Tumor Resection.

    Barbagallo, Giuseppe M V; Palmucci, Stefano; Visocchi, Massimiliano; Paratore, Sabrina; Attinà, Giancarlo; Sortino, Giuseppe; Albanese, Vincenzo; Certo, Francesco

    2016-03-01

    Intraoperative magnetic resonance imaging is the gold standard among image-guided techniques for glioma surgery. Scant data are available on the role of intraoperative computed tomography (i-CT) in high-grade glioma (HGG) surgery. To verify the technical feasibility and usefulness of portable i-CT in image-guided surgical resection of HGGs. This is a retrospective series control analysis of prospectively collected data. Twenty-five patients (Group A) with HGGs underwent surgery using i-CT and 5-aminolevulinic acid (5-ALA) fluorescence. A second cohort of 25 patients (Group B) underwent 5-ALA fluorescence-guided surgery but without i-CT. We used a portable 8-slice CT scanner and, in both groups, neuronavigation. Extent of tumor resection (ETOR) and pre- and postoperative Karnofsky performance status (KPS) scores were measured; the impact of i-CT on overall survival (OS) and progression-free survival (PFS) was also analyzed. In 8 patients (32%) in Group A, i-CT revealed residual tumor, and in 4 of them it helped to also resect pathological tissue detached from the main tumor. EOTR in these 8 patients was 97.3% (96%-98.6%). In Group B, residual tumor was found in 6 patients, whose tumor's mean resection was 98% (93.5-99.7). The Student t test did not show statistically significant differences in EOTR in the 2 groups. The KPS score decreased from 67 to 69 after surgery in Group A and from 74 to 77 in Group B (P = .07 according to the Student t test). Groups A and B did not show statistically significant differences in OS and PFS (P = .61 and .46, respectively, by the log-rank test). No statistically significant differences in EOTR, KPS, PFS, and OS were observed in the 2 groups. However, i-CT helped to verify EOTR and to update the neuronavigator with real-time images, as well as to identify and resect pathological tissue in multifocal tumors. i-CT is a feasible and effective alternative to intraoperative magnetic resonance imaging. Portable i-CT can provide useful

  8. Endovascular image-guided interventions (EIGIs)

    Rudin, Stephen; Bednarek, Daniel R.; Hoffmann, Kenneth R.

    2008-01-01

    Minimally invasive interventions are rapidly replacing invasive surgical procedures for the most prevalent human disease conditions. X-ray image-guided interventions carried out using the insertion and navigation of catheters through the vasculature are increasing in number and sophistication. In this article, we offer our vision for the future of this dynamic field of endovascular image-guided interventions in the form of predictions about (1) improvements in high-resolution detectors for more accurate guidance, (2) the implementation of high-resolution region of interest computed tomography for evaluation and planning, (3) the implementation of dose tracking systems to control patient radiation risk, (4) the development of increasingly sophisticated interventional devices, (5) the use of quantitative treatment planning with patient-specific computer fluid dynamic simulations, and (6) the new expanding role of the medical physicist. We discuss how we envision our predictions will come to fruition and result in the universal goal of improved patient care.

  9. Image-Guided Cancer Nanomedicine

    Dong-Hyun Kim

    2018-01-01

    Full Text Available Multifunctional nanoparticles with superior imaging properties and therapeutic effects have been extensively developed for the nanomedicine. However, tumor-intrinsic barriers and tumor heterogeneity have resulted in low in vivo therapeutic efficacy. The poor in vivo targeting efficiency in passive and active targeting of nano-therapeutics along with the toxicity of nanoparticles has been a major problem in nanomedicine. Recently, image-guided nanomedicine, which can deliver nanoparticles locally using non-invasive imaging and interventional oncology techniques, has been paid attention as a new opportunity of nanomedicine. This short review will discuss the existing challenges in nanomedicine and describe the prospects for future image-guided nanomedicine.

  10. Image guided percutaneous splenic interventions

    Kang, Mandeep; Kalra, Naveen; Gulati, Madhu; Lal, Anupam; Kochhar, Rohit; Rajwanshi, Arvind

    2007-01-01

    Aim: The objective of this study is to evaluate the efficacy and safety of image-guided percutaneous splenic interventions as diagnostic or therapeutic procedures. Materials and methods: We performed a retrospective review of our interventional records from July 2001 to June 2006. Ninety-five image-guided percutaneous splenic interventions were performed after informed consent in 89 patients: 64 men and 25 women who ranged in age from 5 months to 71 years (mean, 38.4 years) under ultrasound (n = 93) or CT (n = 2) guidance. The procedures performed were fine needle aspiration biopsy of focal splenic lesions (n = 78) and aspiration (n = 10) or percutaneous catheter drainage of a splenic abscess (n = 7). Results: Splenic fine needle aspiration biopsy was successful in 62 (83.78%) of 74 patients with benign lesions diagnosed in 43 (58.1%) and malignancy in 19 (25.67%) patients. The most common pathologies included tuberculosis (26 patients, 35.13%) and lymphoma (14 patients, 18.91%). Therapeutic aspiration or pigtail catheter drainage was successful in all (100%) patients. There were no major complications. Conclusions: Image-guided splenic fine needle aspiration biopsy is a safe and accurate technique that can provide a definitive diagnosis in most patients with focal lesions in the spleen. This study also suggests that image-guided percutaneous aspiration or catheter drainage of splenic abscesses is a safe and effective alternative to surgery

  11. A feasibility study for image guided radiotherapy using low dose, high speed, cone beam X-ray volumetric imaging

    Sykes, Jonathan R.; Amer, Ali; Czajka, Jadwiga; Moore, Christopher J.

    2005-01-01

    Background and purpose: Image Guidance of patient set-up for radiotherapy can be achieved by acquiring X-ray volumetric images (XVI) with Elekta Synergy and registering these to the planning CT scan. This enables full 3D registration of structures from similar 3D imaging modalities and offers superior image quality, rotational set-up information and a large field of view. This study uses the head section of the Rando phantom to demonstrate a new paradigm of faster, lower dose XVI that still allows registration to high precision. Materials and methods: One high exposure XVI scan and one low exposure XVI scan were performed with a Rando Head Phantom. The second scan was used to simulate ultra low dose, fast acquisition, full and half scans by discarding a large number of projections before reconstruction. Dose measurements were performed using Thermo Luminescent Dosimeters (TLD) and an ion chamber. The reconstructed XVI scans were automatically registered with a helical CT scan of the Rando Head using the volumetric, grey-level, cross-correlation algorithm implemented in the Syntegra software package (Philips Medical Systems). Reproducibility of the registration process was investigated. Results: In both XVI scans the body surface, bone-tissue and tissue air interfaces were clearly visible. Although the subjective image quality of the low dose cone beam scan was reduced, registration of both cone beam scans with the planning CT scan agreed within 0.1 mm and 0.1 deg. Dose to the patient was reduced from 28 mGy to less than 1 mGy and the equivalent scan speed reduced to one minute or less. Conclusions: Automatic 3D registration of high speed, ultra low dose XVI scans with the planning CT scan can be used for precision 3D patient set-up verification/image guidance on a daily basis with out loss of accuracy when compared to higher dose XVI scans

  12. Image-guided spinal injection procedures in open high-field MRI with vertical field orientation: feasibility and technical features

    Streitparth, F.; Walter, T.; Wonneberger, U.; Wagner, M.; Hermann, K.G.; Hamm, B.; Teichgraeber, U. [Charite, Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Chopra, S. [Charite-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Department of General, Visceral, and Transplantation Surgery, Berlin (Germany); Wichlas, F. [Charite-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Center for Musculoskeletal Surgery, Berlin (Germany)

    2010-02-15

    We prospectively evaluated the feasibility and technical features of MR-guided lumbosacral injection procedures in open high-field MRI at 1.0 T. In a CuSO{sub 4}.5H{sub 2}O phantom and five human cadaveric spines, fluoroscopy sequences (proton-density-weighted turbo spin-echo (PDw TSE), T1w TSE, T2w TSE; balanced steady-state free precession (bSSFP), T1w gradient echo (GE), T2w GE) were evaluated using two MRI-compatible 20-G Chiba-type needles. Artefacts were analysed by varying needle orientation to B{sub 0}, frequency-encoding direction and slice orientation. Image quality was described using the contrast-to-noise ratio (CNR). Subsequently, a total of 183 MR-guided nerve root (107), facet (53) and sacroiliac joint (23) injections were performed in 53 patients. In vitro, PDw TSE sequence yielded the best needle-tissue contrasts (CNR = 45, 18, 15, 9, and 8 for needle vs. fat, muscle, root, bone and sclerosis, respectively) and optimal artefact sizes (width and tip shift less than 5 mm). In vivo, PDw TSE sequence was sufficient in all cases. The acquisition time of 2 s facilitated near-real-time MRI guidance. Drug delivery was technically successful in 100% (107/107), 87% (46/53) and 87% (20/23) of nerve root, facet and sacroiliac joint injections, respectively. No major complications occurred. The mean procedure time was 29 min (range 19-67 min). MR-guided spinal injections in open high-field MRI are feasible and accurate using fast TSE sequence designs. (orig.)

  13. Highly Specific and Sensitive Fluorescent Nanoprobes for Image-Guided Resection of Sub-Millimeter Peritoneal Tumors.

    Colby, Aaron H; Berry, Samantha M; Moran, Ann M; Pasion, Kristine Amber; Liu, Rong; Colson, Yolonda L; Ruiz-Opazo, Nelson; Grinstaff, Mark W; Herrera, Victoria L M

    2017-02-28

    A current challenge in the treatment of peritoneal carcinomatosis is the inability to detect, visualize, and resect small or microscopic tumors of pancreatic, ovarian, or mesothelial origin. In these diseases, the completeness of primary tumor resection is directly correlated with patient survival, and hence, identifying small sub-millimeter tumors (i.e., disseminated disease) is critical. Thus, new imaging techniques and probes are needed to improve cytoreductive surgery and patient outcomes. Highly fluorescent rhodamine-labeled expansile nanoparticles (HFR-eNPs) are described for use as a visual aid during cytoreductive surgery of pancreatic carcinomatosis. The covalent incorporation of rhodamine into ∼30 nm eNPs increases the fluorescent signal compared to free rhodamine, thereby affording a brighter and more effective probe than would be achieved by a single rhodamine molecule. Using the intraperitoneal route of administration, HFR-eNPs localize to regions of large (∼1 cm), sub-centimeter, and sub-millimeter intraperitoneal tumor in three different animal models, including pancreatic, mesothelioma, and ovarian carcinoma. Tumoral localization of the HFR-eNPs depends on both the material property (i.e., eNP polymer) as well as the surface chemistry (anionic surfactant vs PEGylated noncharged surfactant). In a rat model of pancreatic carcinomatosis, HFR-eNP identification of tumor is validated against gold-standard histopathological analysis to reveal that HFR-eNPs possess high specificity (99%) and sensitivity (92%) for tumors, in particular, sub-centimeter and microscopic sub-millimeter tumors, with an overall accuracy of 95%. Finally, as a proof-of-concept, HFR-eNPs are used to guide the resection of pancreatic tumors in a rat model of peritoneal carcinomatosis.

  14. MRI screening-detected breast lesions in high-risk young women: the value of targeted second-look ultrasound and imaging-guided biopsy.

    Peter, P; Dhillon, R; Bose, S; Bourke, A

    2016-10-01

    To analyse the value of targeted second-look ultrasound and imaging-guided biopsy in high-risk young women eligible for screening magnetic resonance imaging (MRI) in a tertiary referral centre in Perth, Western Australia. A retrospective analysis of eligible high-risk young women who underwent screening breast MRI and targeted second-look ultrasound between June 2012 and June 2014 was performed with review of data. Over a 2-year period, 139 women underwent high-risk screening MRI. Of these, 30 women (with a total of 45 lesions) were recalled for targeted second-look ultrasound. Thirty-four MRI-detected lesions were identified on targeted ultrasound with 19 of them proceeding to ultrasound-guided biopsy, while the remaining 15 lesions were considered benign on ultrasound, were not biopsied, and were stable on follow-up imaging 12 months later. One lesion proceeded to an MRI-guided biopsy to confirm a benign result. Of the 11 lesions not seen on ultrasound, nine underwent MRI biopsy, one proceeded directly to hook wire localisation and excision, and one did not return for biopsy and was lost to follow-up. The overall biopsy rate was 14.4%. The cancer detection rate was 1.4%. The results of this study indicate that targeted second-look ultrasound and ultrasound-guided biopsy is a cost-effective and time-efficient approach for MRI-detected lesions in young women at high risk of developing breast cancer. MRI-guided biopsy should be considered for ultrasonographically occult suspicious lesions as there is a low, but definite, risk of cancer. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. Compton scattering at high intensities

    Heinzl, Thomas, E-mail: thomas.heinzl@plymouth.ac.u [University of Plymouth, School of Mathematics and Statistics, Drake Circus, Plymouth PL4 8AA (United Kingdom)

    2009-12-01

    High-intensity Compton scattering takes place when an electron beam is brought into collision with a high power laser. We briefly review the main intensity signatures using the formalism of strong-field quantum electrodynamics.

  16. Study protocol: a double blind randomised control trial of high volume image guided injections in Achilles and patellar tendinopathy in a young active population.

    Barker-Davies, Robert M; Nicol, Alastair; McCurdie, I; Watson, James; Baker, Polly; Wheeler, Patrick; Fong, Daniel; Lewis, Mark; Bennett, Alexander N

    2017-05-22

    Chronic tendinopathy is a significant problem particularly in active populations limiting sporting and occupational performance. The prevalence of patellar tendinopathy in some sports is near 50% and the incidence of lower limb tendinopathy is 1.4% p.a. in the UK Military. Management includes isometric, eccentric, heavy slow resistance exercises and extracorporeal shockwave therapy (ESWT). Often these treatments are inadequate yet there is no good evidence for injection therapies and success rates from surgery can be as low as 50%. High Volume Image Guided Injection (HVIGI) proposes to strip away the neovascularity and disrupt the nerve ingrowth seen in chronic cases and has shown promising results in case series. This study aims to investigate the efficacy of HVIGI in a randomised controlled trial (RCT). RCT comparing 40ml HVIGI, with or without corticosteroid, with a 3ml local anaesthetic sham-control injection. Ninety-six participants will be recruited. male, 18-55 years old, chronic Achilles or patellar tendinopathy of at least 6 months, failed conservative management including ESWT, and Ultrasound (US) evidence of neovascularisation, tendon thickening and echogenic changes. Outcome measures will be recorded at baseline, 6 weeks, 3, 6 and 12 months. Primary outcome measures include The Victoria Institute of Sport Assessments for Achilles and patellar tendinopathy (VISA-A and VISA-P) and VAS pain. Secondary outcome measures include Modified Ohberg score, maximum tendon diameter and assessment of hypoechoic appearance on US, and Functional Activity Assessment. Despite previous interventional trials and reviews there is still insufficient evidence to guide injectable therapy for chronic tendinopathy that has failed conservative treatment. The scant evidence available suggests HVIGI has the greatest potential however there is no level one RCT evidence to support this. Investigating the efficacy of HVIGI against control in a RCT and separating the effect of HVIGI

  17. Prostate cancer treated with image-guided helical TomoTherapy {sup registered} and image-guided LINAC-IMRT. Correlation between high-dose bladder volume, margin reduction, and genitourinary toxicity

    Drozdz, Sonia; Wendt, Thomas G. [University Hospital Jena, Friedrich-Schiller-University Jena, Department of Radiation Oncology, Jena (Germany); Schwedas, Michael; Salz, Henning [University Hospital Jena, Friedrich-Schiller-University Jena, Department of Radiation Oncology, Section of Medical Physics, Jena (Germany); Foller, Susan [University Hospital Jena, Friedrich-Schiller-University Jena, Department of Urology, Jena (Germany)

    2016-04-15

    We compared different image-guidance (IG) strategies for prostate cancer with high-precision IG intensity-modulated radiation therapy (IMRT) using TomoTherapy {sup registered} (Accuray Inc., Madison, WI, USA) and linear accelerator (LINAC)-IMRT and their impact on planning target volume (PTV) margin reduction. Follow-up data showed reduced bladder toxicity in TomoTherapy patients compared to LINAC-IMRT. The purpose of this study was to quantify whether the treatment delivery technique and decreased margins affect reductions in bladder toxicity. Setup corrections from 30 patients treated with helical TomoTherapy and 30 treated with a LINAC were analyzed. These data were used to simulate three IG protocols based on setup error correction and a limited number of imaging sessions. For all patients, gastrointestinal (GI) and genitourinary (GU) toxicity was documented and correlated with the treatment delivery technique. For fiducial marker (FM)-based RT, a margin reduction of up to 3.1, 3.0, and 4.8 mm in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions, respectively, could be achieved with calculation of a setup correction from the first three fractions and IG every second day. Although the bladder volume was treated with mean doses of 35 Gy in the TomoTherapy group vs. 22 Gy in the LINAC group, we observed less GU toxicity after TomoTherapy. Intraprostate FMs allow for small safety margins, help decrease imaging frequency after setup correction, and minimize the dose to bladder and rectum, resulting in lower GU toxicity. In addition, IMRT delivered with TomoTherapy helps to avoid hotspots in the bladder neck, a critical anatomic structure associated with post-RT urinary toxicity. (orig.) [German] Wir haben im Rahmen der Prostatakarzinombehandlung verschiedene bildgefuehrte (IG) Strategien der hochpraezisen intensitaetsmodulierten Radiotherapie (IMRT) unter Einsatz der Tomotherapie (TomoTherapy {sup registered}, Accuray Inc., Madison

  18. High intensity circular proton accelerators

    Craddock, M.K.

    1987-12-01

    Circular machines suitable for the acceleration of high intensity proton beams include cyclotrons, FFAG accelerators, and strong-focusing synchrotrons. This paper discusses considerations affecting the design of such machines for high intensity, especially space charge effects and the role of beam brightness in multistage accelerators. Current plans for building a new generation of high intensity 'kaon factories' are reviewed. 47 refs

  19. The technical feasibility of an image-guided intensity-modulated radiotherapy (IG-IMRT) to perform a hypofractionated schedule in terms of toxicity and local control for patients with locally advanced or recurrent pancreatic cancer

    Son, Seok Hyun; Song, Jin Ho; Choi, Byung Ock; Kang, Young-nam; Lee, Myung Ah; Kang, Ki Mun; Jang, Hong Seok

    2012-01-01

    The purpose of this study was to evaluate the technical feasibility of an image-guided intensity modulated radiotherapy (IG-IMRT) using involved-field technique to perform a hypofractionated schedule for patients with locally advanced or recurrent pancreatic cancer. From May 2009 to November 2011, 12 patients with locally advanced or locally recurrent pancreatic cancer received hypofractionated CCRT using TomoTherapy Hi-Art with concurrent and sequential chemotherapy at Seoul St. Mary’s Hospital, the Catholic University of Korea. The total dose delivered was 45 Gy in 15 fractions or 50 Gy in 20 fractions. The target volume did not include the uninvolved regional lymph nodes. Treatment planning and delivery were performed using the IG-IMRT technique. The follow-up duration was a median of 31.1 months (range: 5.7-36.3 months). Grade 2 or worse acute toxicities developed in 7 patients (58%). Grade 3 or worse gastrointestinal and hematologic toxicity occurred in 0% and 17% of patients, respectively. In the response evaluation, the rates of partial response and stable disease were 58% and 42%, respectively. The rate of local failure was 8% and no regional failure was observed. Distant failure was the main cause of treatment failure. The progression-free survival and overall survival durations were 7.6 and 12.1 months, respectively. The involved-field technique and IG-IMRT delivered via a hypofractionated schedule are feasible for patients with locally advanced or recurrent pancreatic cancer

  20. Radiation therapy technology innovations applied to the treatment of head and neck patients: - Clinical results of Intensity Modulated Radiotherapy (IMRT), - Contribution of Image Guided Radiotherapy (IGRT) in the management of head and neck patients treated with IMRT

    Graff-Cailleaud, Pierre

    2011-01-01

    Numerous and exciting technological innovations were recently developed in radiotherapy. We aimed to assess benefits in two specific fields. 1) Clinical results of Intensity Modulated Radiotherapy (IMRT) applied to the treatment of Head and Neck (H and N) patients. The first study was a long-term mono-centric prospective registration of all H and N patients treated with IMRT in our institution. Locoregional control was excellent and toxicities limited. Recurrences were in-field. Dosimetric recommendations (parotids mean dose) were established. The second study assessed the impact of IMRT on health-related quality of life for H and N patients through a multicentric matched-pair comparison with conventional radiotherapy. Outstanding benefits were observed particularly in the fields of salivary dysfunction and oral discomfort. 2) Contribution of Image Guided Radiotherapy (IGRT) in the management of H and N patients treated with IMRT. The first study was a monitoring of delivered dose, using 3D dose recalculation from Megavoltage Cone-Beam CT (CBCT), as a quality assurance measure of a panel of H and N IMRT patients aligned with IGRT. Dosimetric consequences of anatomical changes were assessed. Contribution of color-coded MVCBCT dose-difference maps was studied. The aim of the second study was to quantify the inherent relative mobility between anatomic regions of the H and N area and to assess the dosimetric impact of several different matching procedures. Recommendations for the use of CBCT images in a daily practice were established. (author) [fr

  1. Dosimetric feasibility of magnetic resonance imaging-guided tri-cobalt 60 preoperative intensity modulated radiation therapy for soft tissue sarcomas of the extremity.

    Kishan, Amar U; Cao, Minsong; Mikaeilian, Argin G; Low, Daniel A; Kupelian, Patrick A; Steinberg, Michael L; Kamrava, Mitchell

    2015-01-01

    The purpose of this study was to investigate the dosimetric differences of delivering preoperative intensity modulated radiation therapy (IMRT) to patients with soft tissue sarcomas of the extremity (ESTS) with a teletherapy system equipped with 3 rotating (60)Co sources and a built-in magnetic resonance imaging and with standard linear accelerator (LINAC)-based IMRT. The primary study population consisted of 9 patients treated with preoperative radiation for ESTS between 2008 and 2014 with LINAC-based static field IMRT. LINAC plans were designed to deliver 50 Gy in 25 fractions to 95% of the planning target volume (PTV). Tri-(60)Co system IMRT plans were designed with ViewRay system software. Tri-(60)Co-based IMRT plans achieved equivalent target coverage and dosimetry for organs at risk (long bone, skin, and skin corridor) compared with LINAC-based IMRT plans. The maximum and minimum PTV doses, heterogeneity indices, and ratio of the dose to 50% of the volume were equivalent for both planning systems. One LINAC plan violated the maximum bone dose constraint, whereas none of the tri-(60)Co plans did. Using a tri-(60)Co system, we were able to achieve equivalent dosimetry to the PTV and organs at risk for patients with ESTS compared with LINAC-based IMRT plans. The tri-(60)Co system may be advantageous over current treatment platforms by allowing PTV reduction and by elimination of the additional radiation dose associated with daily image guidance, but this needs to be evaluated prospectively. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  2. Functional Image-Guided Radiotherapy Planning in Respiratory-Gated Intensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease

    Kimura, Tomoki, E-mail: tkkimura@hiroshima-u.ac.jp [Department of Radiation Oncology, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima City (Japan); Nishibuchi, Ikuno; Murakami, Yuji; Kenjo, Masahiro; Kaneyasu, Yuko; Nagata, Yasushi [Department of Radiation Oncology, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima City (Japan)

    2012-03-15

    Purpose: To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD). Methods and Materials: Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values of less than than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung. Two respiratory-gated radiotherapy plans (70 Gy/35 fractions) were designed and compared in each patient as follows: Plan A was an anatomical IMRT or VMAT plan based on the total lung; Plan F was a functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (percentage of total lung volume irradiated with {>=}20 Gy [V20], and mean dose of total lung [MLD]) of the two plans were compared. Results: V20 was lower in Plan F than in Plan A (mean 1.5%, p = 0.025 in IMRT, mean 1.6%, p = 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p = 0.083 in IMRT, mean 0.5 Gy, p = 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses. Conclusions: Functional IGRT planning based on LAA in respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.

  3. Image-guided radiotherapy for effective radiotherapy delivery

    Karlsson, Ulf Lennart

    2016-01-01

    Image-guided radiotherapy (IGRT) is a new radiotherapy technology that combines the rapid dose fall off associated with intensity-modulated radiotherapy (IMRT) and daily tumor imaging allowing for high precision tumor dose delivery and effective sparing of surrounding normal organs. The new radiation technology requires close collaboration between radiologists, nuclear medicine specialists, and radiation oncologists to avoid marginal miss. Modern diagnostic imaging such as positron emission tomography (PET) scans, positron emission tomography with Computed Tomograpgy (PET-CT), and magnetic resonance imaging (MRI) allows the radiation oncologist to target the positive tumor with high accuracy. As the tumor is well visualized during radiation treatment, the margins required to avoid geographic miss can be safely reduced , thus sparing the normal organs from excessive radiation. When the tumor is located close to critical radiosensitive structures such as the spinal cord, IGRT can deliver a high dose of radiatio...

  4. Interim report of image-guided conformal high-dose-rate brachytherapy for patients with unfavorable prostate cancer: the William Beaumont Phase II dose-escalating trial

    Martinez, Alvaro A.; Kestin, Larry L.; Stromberg, Jannifer S.; Gonzalez, Jose A.; Wallace, Michelle; Gustafson, Gary S.; Edmundson, Gregory K.; Spencer, William; Vicini, Frank A.

    2000-01-01

    Purpose: We analyzed our institution's experience treating patients with unfavorable prostate cancer in a prospective Phase II dose-escalating trial of external beam radiation therapy (EBRT) integrated with conformal high-dose-rate (HDR) brachytherapy boosts. This interim report discusses treatment outcome and prognostic factors using this treatment approach. Methods and Materials: From November 1991 through February 1998, 142 patients with unfavorable prostate cancer were prospectively treated in a dose-escalating trial with pelvic EBRT in combination with outpatient HDR brachytherapy at William Beaumont Hospital. Patients with any of the following characteristics were eligible: pretreatment prostate-specific antigen (PSA) ≥ 10.0 ng/ml, Gleason score ≥ 7, or clinical stage T2b or higher. All patients received pelvic EBRT to a median total dose of 46.0 Gy. Pelvic EBRT was integrated with ultrasound-guided transperineal conformal interstitial iridium-192 HDR implants. From 1991 to 1995, 58 patients underwent three conformal interstitial HDR implants during the first, second, and third weeks of pelvic EBRT. After October 1995, 84 patients received two interstitial implants during the first and third weeks of pelvic EBRT. The dose delivered via interstitial brachytherapy was escalated from 5.50 Gy to 6.50 Gy for each implant in those patients receiving three implants, and subsequently, from 8.25 Gy to 9.50 Gy per fraction in those patients receiving two implants. To improve implant quality and reduce operator dependency, an on-line, image-guided interactive dose optimization program was utilized during each HDR implant. No patient received hormonal therapy unless treatment failure was documented. The median follow-up was 2.1 years (range: 0.2-7.2 years). Biochemical failure was defined according to the American Society for Therapeutic Radiology and Oncology Consensus Panel definition. Results: The pretreatment PSA level was ≥ 10.0 ng/ml in 51% of patients. The

  5. Single Vocal Cord Irradiation: Image Guided Intensity Modulated Hypofractionated Radiation Therapy for T1a Glottic Cancer: Early Clinical Results

    Al-Mamgani, Abrahim, E-mail: a.almamgani@nki.nl [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Kwa, Stefan L.S.; Tans, Lisa; Moring, Michael; Fransen, Dennie; Mehilal, Robert; Verduijn, Gerda M. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Baatenburg de Jong, Rob J. [Department of Otolaryngology and Head and Neck Surgery – Erasmus MC, University Medical Center Rotterdam, Rotterdam (Netherlands); Heijmen, Ben J.M.; Levendag, Peter C. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands)

    2015-10-01

    Purpose: To report, from a retrospective analysis of prospectively collected data, on the feasibility, outcome, toxicity, and voice-handicap index (VHI) of patients with T1a glottic cancer treated by a novel intensity modulated radiation therapy technique developed at our institution to treat only the involved vocal cord: single vocal cord irradiation (SVCI). Methods and Materials: Thirty patients with T1a glottic cancer were treated by means of SVCI. Dose prescription was set to 16 × 3.63 Gy (total dose 58.08 Gy). The clinical target volume was the entire vocal cord. Setup verification was done by means of an online correction protocol using cone beam computed tomography. Data for voice quality assessment were collected prospectively at baseline, end of treatment, and 4, 6, and 12 weeks and 6, 12, and 18 months after treatment using VHI questionnaires. Results: After a median follow-up of 30 months (range, 7-50 months), the 2-year local control and overall survival rates were 100% and 90% because no single local recurrence was reported and 3 patients died because of comorbidity. All patients have completed the intended treatment schedule; no treatment interruptions and no grade 3 acute toxicity were reported. Grade 2 acute dermatitis or dysphagia was reported in only 5 patients (17%). No serious late toxicity was reported; only 1 patient developed temporary grade 2 laryngeal edema, and responded to a short-course of corticosteroid. The VHI improved significantly, from 33.5 at baseline to 9.5 and 10 at 6 weeks and 18 months, respectively (P<.001). The control group, treated to the whole larynx, had comparable local control rates (92.2% vs 100%, P=.24) but more acute toxicity (66% vs 17%, P<.0001) and higher VHI scores (23.8 and 16.7 at 6 weeks and 18 months, respectively, P<.0001). Conclusion: Single vocal cord irradiation is feasible and resulted in maximal local control rate at 2 years. The deterioration in VHI scores was slight and temporary and

  6. High intensity focused ultrasound treatment of small renal masses: Clinical effectiveness and technological advances

    Nabi, G.; Goodman, C.; Melzer, A.

    2010-01-01

    The review summarises the technological advances in the application of high-intensity focused ultrasound for small renal masses presumed to be cancer including the systematic review of its clinical application. Current progress in the area of magnetic resonance image guided ultrasound ablation is also appraised. Specifically, organ tracking and real time monitoring of temperature changes during the treatment are discussed. Finally, areas of future research interest are outlined. PMID:21116349

  7. High intensity focused ultrasound treatment of small renal masses: Clinical effectiveness and technological advances

    Nabi, G.; Goodman, C.; Melzer, A.

    2010-01-01

    The review summarises the technological advances in the application of high-intensity focused ultrasound for small renal masses presumed to be cancer including the systematic review of its clinical application. Current progress in the area of magnetic resonance image guided ultrasound ablation is also appraised. Specifically, organ tracking and real time monitoring of temperature changes during the treatment are discussed. Finally, areas of future research interest are outlined.

  8. Dose escalation by image-guided intensity-modulated radiotherapy leads to an increase in pain relief for spinal metastases: a comparison study with a regimen of 30 Gy in 10 fractions.

    He, Jinlan; Xiao, Jianghong; Peng, Xingchen; Duan, Baofeng; Li, Yan; Ai, Ping; Yao, Min; Chen, Nianyong

    2017-12-22

    Under the existing condition that the optimum radiotherapy regimen for spinal metastases is controversial, this study investigates the benefits of dose escalation by image-guided intensity-modulated radiotherapy (IG-IMRT) with 60-66 Gy in 20-30 fractions for spinal metastases. In the dose-escalation group, each D50 of planning gross tumor volume (PGTV) was above 60 Gy and each Dmax of spinal cord planning organ at risk volume (PRV) was below 48 Gy. The median biological effective dose (BED) of Dmax of spinal cord was lower in the dose-escalation group compared with that in the 30-Gy group (69.70 Gy vs. 83.16 Gy, p pain responses were better in the dose-escalation group than those in the 30-Gy group ( p = 0.005 and p = 0.024), and the complete pain relief rates were respectively 73.69% and 34.29% ( p = 0.006), 73.69% and 41.38% ( p = 0.028) in two compared groups. In the dose-escalation group, there is a trend of a longer duration of pain relief, a longer overall survival and a lower incidence of acute radiation toxicities. No late radiation toxicities were observed in both groups. Dosimetric parameters and clinical outcomes, including pain response, duration of pain relief, radiation toxicities and overall survival, were compared among twenty-five metastatic spinal lesions irradiated with the dose-escalation regimen and among forty-four lesions treated with the 30-Gy regimen. Conventionally-fractionated IG-IMRT for spinal metastases could escalate dose to the vertebral lesions while sparing the spinal cord, achieving a better pain relief without increasing radiation complications.

  9. Definitive Upfront Stereotactic Ablative Radiotherapy Combined with Image-Guided, Intensity Modulated Radiotherapy (IG-IMRT or IG-IMRT Alone for Locally Advanced Non-Small Cell Lung Cancer.

    Alexander Chi

    Full Text Available Image-guided (IG intensity-modulated radiotherapy (IMRT enables maximal tumor margin reduction for the sparing of organs at risk (OARs when used to treat locally advanced non-small cell lung cancer (NSCLC with definitive chemo-radiation. It also allows for the incorporation of stereotactic ablative radiotherapy (SABR into the treatment regimen. Here, we describe our initial experience in combining definitive upfront SABR to the primary lesion with chemo-radiation delivered with conventionally fractionated IG-IMRT to the remaining regional disease; along with clinical outcome following chemo-radiation with conventionally fractionated IG-IMRT alone in the treatment of locally advanced NSCLC.The clinical outcome of 29 patients with locally advanced NSCLC who underwent conventionally fractionated IG-IMRT, or definitive upfront SABR followed by IG-IMRT combined with chemotherapy (induction, concurrent, or both was retrospectively reviewed.After a median follow up of 23.7 months, the median overall survival (OS and progression-free survival (PFS were 19.8 and 11.3 months, respectively. The 2 year local, regional, and distant control was 60%, 62%, and 38%, respectively. No local failure was observed in 3 patients following SABR + IG-IMRT while 6/26 patients failed locally following IG-IMRT alone. SABR + IG-IMRT was well tolerated. No ≥ grade 3 radiation-related toxicity was observed.Definitive upfront SABR followed by IG-IMRT in selected patients with locally advanced NSCLC warrants further investigation in future clinical trials, while chemo-radiation with IG-IMRT alone was well tolerated.

  10. Encouraging Early Clinical Outcomes With Helical Tomotherapy–Based Image-Guided Intensity-Modulated Radiation Therapy for Residual, Recurrent, and/or Progressive Benign/Low-Grade Intracranial Tumors: A Comprehensive Evaluation

    Gupta, Tejpal; Wadasadawala, Tabassum; Master, Zubin; Phurailatpam, Reena; Pai-Shetty, Rajershi; Jalali, Rakesh

    2012-01-01

    Purpose: To report early clinical outcomes of helical tomotherapy (HT)-based image-guided intensity-modulated radiation therapy (IMRT) in brain tumors of varying shape, size, and location. Materials and Methods: Patients with residual, recurrent, and/or progressive low-grade intracranial and skull-base tumors were treated on a prospective protocol of HT-based IMRT and followed clinicoradiologically. Standardized metrics were used for plan evaluation and outcome analysis. Results: Twenty-seven patients with 30 lesions were treated to a median radiotherapy dose of 54 Gy in 30 fractions. All HT plans resulted in excellent target volume coverage with steep dose-gradients. The mean (standard deviation) dose homogeneity index and conformity index was 0.07 (0.05) and 0.71 (0.08) respectively. At first response assessment, 20 of 30 lesions were stable, whereas 9 showed partial regression. One patient with a recurrent clival chordoma though neurologically stable showed imaging-defined progression, whereas another patient with stable disease on serial imaging had sustained neurologic worsening. With a median follow-up of 19 months (interquartile range, 11–26 months), the 2-year clinicoradiological progression-free survival and overall survival was 93.3% and 100% respectively. Conclusions: Careful selection of radiotherapy technique is warranted for benign/low-grade brain tumors to achieve durable local control with minimum long-term morbidity. Large or complex-shaped tumors benefit most from IMRT. Our early clinical experience of HT-based IMRT for brain tumors has been encouraging.

  11. Encouraging Early Clinical Outcomes With Helical Tomotherapy-Based Image-Guided Intensity-Modulated Radiation Therapy for Residual, Recurrent, and/or Progressive Benign/Low-Grade Intracranial Tumors: A Comprehensive Evaluation

    Gupta, Tejpal [Department of Radiation Oncology, ACTREC/TMH, Tata Memorial Centre, Kharghar, Navi Mumbai (India); Wadasadawala, Tabassum; Master, Zubin; Phurailatpam, Reena; Pai-Shetty, Rajershi; Jalali, Rakesh [Department of Radiation Oncology, ACTREC/TMH, Tata Memorial Centre, Kharghar, Navi Mumbai (India)

    2012-02-01

    Purpose: To report early clinical outcomes of helical tomotherapy (HT)-based image-guided intensity-modulated radiation therapy (IMRT) in brain tumors of varying shape, size, and location. Materials and Methods: Patients with residual, recurrent, and/or progressive low-grade intracranial and skull-base tumors were treated on a prospective protocol of HT-based IMRT and followed clinicoradiologically. Standardized metrics were used for plan evaluation and outcome analysis. Results: Twenty-seven patients with 30 lesions were treated to a median radiotherapy dose of 54 Gy in 30 fractions. All HT plans resulted in excellent target volume coverage with steep dose-gradients. The mean (standard deviation) dose homogeneity index and conformity index was 0.07 (0.05) and 0.71 (0.08) respectively. At first response assessment, 20 of 30 lesions were stable, whereas 9 showed partial regression. One patient with a recurrent clival chordoma though neurologically stable showed imaging-defined progression, whereas another patient with stable disease on serial imaging had sustained neurologic worsening. With a median follow-up of 19 months (interquartile range, 11-26 months), the 2-year clinicoradiological progression-free survival and overall survival was 93.3% and 100% respectively. Conclusions: Careful selection of radiotherapy technique is warranted for benign/low-grade brain tumors to achieve durable local control with minimum long-term morbidity. Large or complex-shaped tumors benefit most from IMRT. Our early clinical experience of HT-based IMRT for brain tumors has been encouraging.

  12. Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

    Wu, T.-H.; Liang, C.-H.; Wu, J.-K.; Lien, C.-Y.; Yang, B.-H.; Huang, Y.-H.; Lee, J. J. S.

    2009-07-01

    Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18F-fluorodeoxyglucose (18F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

  13. A fast inverse treatment planning strategy facilitating optimized catheter selection in image-guided high-dose-rate interstitial gynecologic brachytherapy.

    Guthier, Christian V; Damato, Antonio L; Hesser, Juergen W; Viswanathan, Akila N; Cormack, Robert A

    2017-12-01

    Interstitial high-dose rate (HDR) brachytherapy is an important therapeutic strategy for the treatment of locally advanced gynecologic (GYN) cancers. The outcome of this therapy is determined by the quality of dose distribution achieved. This paper focuses on a novel yet simple heuristic for catheter selection for GYN HDR brachytherapy and their comparison against state of the art optimization strategies. The proposed technique is intended to act as a decision-supporting tool to select a favorable needle configuration. The presented heuristic for catheter optimization is based on a shrinkage-type algorithm (SACO). It is compared against state of the art planning in a retrospective study of 20 patients who previously received image-guided interstitial HDR brachytherapy using a Syed Neblett template. From those plans, template orientation and position are estimated via a rigid registration of the template with the actual catheter trajectories. All potential straight trajectories intersecting the contoured clinical target volume (CTV) are considered for catheter optimization. Retrospectively generated plans and clinical plans are compared with respect to dosimetric performance and optimization time. All plans were generated with one single run of the optimizer lasting 0.6-97.4 s. Compared to manual optimization, SACO yields a statistically significant (P ≤ 0.05) improved target coverage while at the same time fulfilling all dosimetric constraints for organs at risk (OARs). Comparing inverse planning strategies, dosimetric evaluation for SACO and "hybrid inverse planning and optimization" (HIPO), as gold standard, shows no statistically significant difference (P > 0.05). However, SACO provides the potential to reduce the number of used catheters without compromising plan quality. The proposed heuristic for needle selection provides fast catheter selection with optimization times suited for intraoperative treatment planning. Compared to manual optimization, the

  14. Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

    Wu, T-H; Liang, C-H; Wu, J-K; Lien, C-Y; Yang, B-H; Lee, J J S; Huang, Y-H

    2009-01-01

    Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18 F-fluorodeoxyglucose ( 18 F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

  15. Phase 1/2 Study of the Addition of Cisplatin to Adjuvant Chemotherapy With Image Guided High-Precision Radiation Therapy for Completely Resected Gastric Cancer

    Goody, Rebecca B. [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); MacKay, Helen [Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Pitcher, Bethany [Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Oza, Amit; Siu, Lillian L. [Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Kim, John; Wong, Rebecca K.S. [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Chen, Eric [Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Swallow, Carol [Department of Surgical Oncology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario (Canada); Knox, Jennifer [Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Kassam, Zahra [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Stronach Regional Cancer Centre, Newmarket, Ontario (Canada); Cummings, Bernard [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Feld, Ron; Hedley, David; Liu, Geoffrey; Krzyzanowska, Monika K. [Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Dinniwell, Robert; Brade, Anthony M.; Dawson, Laura A. [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Pintilie, Melania [Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); and others

    2016-12-01

    Purpose: Locoregional recurrence is common after surgery for gastric cancer. Adjuvant therapy improves outcomes but with toxicity. This phase 1/2 study investigated infusional 5-fluorouracil (5-FU) in combination with biweekly cisplatin delivered concurrently with image guided high-precision radiation therapy. Methods and Materials: Eligible patients had completely resected stage IB to IV (Union for International Cancer Control TNM 6th edition) nonmetastatic gastric adenocarcinoma. Treatment constituted 12 weeks of infusional 5-FU (200 mg/m{sup 2}/day) with cisplatin added in a standard 3 + 3 dose escalation protocol (0, 20, 30, and 40 mg/m{sup 2}) during weeks 1, 3, 5, and 7, and an additional week 9 dose in the final cohort. Radiation therapy (45 Gy in 25 fractions) was delivered during weeks 3 to 7. Maximum tolerated dose (MTD) was determined in phase 1 and confirmed in phase 2. Results: Among the 55 patients (median age, 54 years; range 28-77 years; 55% male), the median follow-up time was 3.0 years (range, 0.3-5.3 years). Five patients in phase 1 experienced dose-limiting toxicity, and MTD was determined as 4 cycles of 40 mg/m{sup 2} cisplatin. Twenty-seven patients were treated at MTD. Acute grade 3 to 4 toxicity rate was 37.0% at MTD and 29.1% across all dose levels. No treatment-related deaths occurred. Fourteen patients experienced recurrent disease. The 2-year overall survival (OS) and relapse-free survival were 85% and 74%, respectively. Median OS has not been reached. Quality of life (QOL) was impaired during treatment, but most scores recovered by 4 weeks. Conclusion: Cisplatin can be safely delivered with 5-FU–based chemoradiation therapy. Acute toxicity was acceptable, and patient-reported QOL showed the regimen was tolerable. Outcomes are encouraging and justify further study of this regimen.

  16. First Clinical Release of an Online, Adaptive, Aperture-Based Image-Guided Radiotherapy Strategy in Intensity-Modulated Radiotherapy to Correct for Inter- and Intrafractional Rotations of the Prostate

    Deutschmann, Heinz; Kametriser, Gerhard; Steininger, Philipp; Scherer, Philipp; Schöller, Helmut; Gaisberger, Christoph; Mooslechner, Michaela; Mitterlechner, Bernhard; Weichenberger, Harald; Fastner, Gert; Wurstbauer, Karl; Jeschke, Stephan; Forstner, Rosemarie; Sedlmayer, Felix

    2012-01-01

    Purpose: We developed and evaluated a correction strategy for prostate rotations using direct adaptation of segments in intensity-modulated radiotherapy (IMRT). Method and Materials: Implanted fiducials (four gold markers) were used to determine interfractional translations, rotations, and dilations of the prostate. We used hybrid imaging: The markers were automatically detected in two pretreatment planar X-ray projections; their actual position in three-dimensional space was reconstructed from these images at first. The structure set comprising prostate, seminal vesicles, and adjacent rectum wall was transformed accordingly in 6 degrees of freedom. Shapes of IMRT segments were geometrically adapted in a class solution forward-planning approach, derived within seconds on-site and treated immediately. Intrafractional movements were followed in MV electronic portal images captured on the fly. Results: In 31 of 39 patients, for 833 of 1013 fractions (supine, flat couch, knee support, comfortably full bladder, empty rectum, no intraprostatic marker migrations >2 mm of more than one marker), the online aperture adaptation allowed safe reduction of margins clinical target volume–planning target volume (prostate) down to 5 mm when only interfractional corrections were applied: Dominant L-R rotations were found to be 5.3° (mean of means), standard deviation of means ±4.9°, maximum at 30.7°. Three-dimensional vector translations relative to skin markings were 9.3 ± 4.4 mm (maximum, 23.6 mm). Intrafractional movements in 7.7 ± 1.5 min (maximum, 15.1 min) between kV imaging and last beam’s electronic portal images showed further L-R rotations of 2.5° ± 2.3° (maximum, 26.9°), and three-dimensional vector translations of 3.0 ±3.7 mm (maximum, 10.2 mm). Addressing intrafractional errors could further reduce margins to 3 mm. Conclusion: We demonstrated the clinical feasibility of an online adaptive image-guided, intensity-modulated prostate protocol on a standard

  17. First clinical release of an online, adaptive, aperture-based image-guided radiotherapy strategy in intensity-modulated radiotherapy to correct for inter- and intrafractional rotations of the prostate.

    Deutschmann, Heinz; Kametriser, Gerhard; Steininger, Philipp; Scherer, Philipp; Schöller, Helmut; Gaisberger, Christoph; Mooslechner, Michaela; Mitterlechner, Bernhard; Weichenberger, Harald; Fastner, Gert; Wurstbauer, Karl; Jeschke, Stephan; Forstner, Rosemarie; Sedlmayer, Felix

    2012-08-01

    We developed and evaluated a correction strategy for prostate rotations using direct adaptation of segments in intensity-modulated radiotherapy (IMRT). Implanted fiducials (four gold markers) were used to determine interfractional translations, rotations, and dilations of the prostate. We used hybrid imaging: The markers were automatically detected in two pretreatment planar X-ray projections; their actual position in three-dimensional space was reconstructed from these images at first. The structure set comprising prostate, seminal vesicles, and adjacent rectum wall was transformed accordingly in 6 degrees of freedom. Shapes of IMRT segments were geometrically adapted in a class solution forward-planning approach, derived within seconds on-site and treated immediately. Intrafractional movements were followed in MV electronic portal images captured on the fly. In 31 of 39 patients, for 833 of 1013 fractions (supine, flat couch, knee support, comfortably full bladder, empty rectum, no intraprostatic marker migrations >2 mm of more than one marker), the online aperture adaptation allowed safe reduction of margins clinical target volume-planning target volume (prostate) down to 5 mm when only interfractional corrections were applied: Dominant L-R rotations were found to be 5.3° (mean of means), standard deviation of means ±4.9°, maximum at 30.7°. Three-dimensional vector translations relative to skin markings were 9.3 ± 4.4 mm (maximum, 23.6 mm). Intrafractional movements in 7.7 ± 1.5 min (maximum, 15.1 min) between kV imaging and last beam's electronic portal images showed further L-R rotations of 2.5° ± 2.3° (maximum, 26.9°), and three-dimensional vector translations of 3.0 ±3.7 mm (maximum, 10.2 mm). Addressing intrafractional errors could further reduce margins to 3 mm. We demonstrated the clinical feasibility of an online adaptive image-guided, intensity-modulated prostate protocol on a standard linear accelerator to correct 6 degrees of freedom of

  18. A Highly Efficient and Photostable Photosensitizer with Near-Infrared Aggregation-Induced Emission for Image-Guided Photodynamic Anticancer Therapy.

    Wu, Wenbo; Mao, Duo; Hu, Fang; Xu, Shidang; Chen, Chao; Zhang, Chong-Jing; Cheng, Xiamin; Yuan, Youyong; Ding, Dan; Kong, Deling; Liu, Bin

    2017-09-01

    Photodynamic therapy (PDT), which relies on photosensitizers (PS) and light to generate reactive oxygen species to kill cancer cells or bacteria, has attracted much attention in recent years. PSs with both bright emission and efficient singlet oxygen generation have also been used for image-guided PDT. However, simultaneously achieving effective 1 O 2 generation, long wavelength absorption, and stable near-infrared (NIR) emission with low dark toxicity in a single PS remains challenging. In addition, it is well known that when traditional PSs are made into nanoparticles, they encounter quenched fluorescence and reduced 1 O 2 production. In this contribution, these challenging issues have been successfully addressed through designing the first photostable photosensitizer with aggregation-induced NIR emission and very effective 1 O 2 generation in aggregate state. The yielded nanoparticles show very effective 1 O 2 generation, bright NIR fluorescence centered at 820 nm, excellent photostability, good biocompatibility, and negligible dark in vivo toxicity. Both in vitro and in vivo experiments prove that the nanoparticles are excellent candidates for image-guided photodynamic anticancer therapy. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Bladder accumulated dose in image-guided high-dose-rate brachytherapy for locally advanced cervical cancer and its relation to urinary toxicity

    Zakariaee, Roja; Hamarneh, Ghassan; Brown, Colin J.; Gaudet, Marc; Aquino-Parsons, Christina; Spadinger, Ingrid

    2016-12-01

    The purpose of this study was to estimate locally accumulated dose to the bladder in multi-fraction high-dose-date (HDR) image-guided intracavitary brachytherapy (IG-ICBT) for cervical cancer, and study the locally-accumulated dose parameters as predictors of late urinary toxicity. A retrospective study of 60 cervical cancer patients who received five HDR IG-ICBT sessions was performed. The bladder outer and inner surfaces were segmented for all sessions and a bladder-wall contour point-set was created in MATLAB. The bladder-wall point-sets for each patient were registered using a deformable point-set registration toolbox called coherent point drift (CPD), and the fraction doses were accumulated. Various dosimetric and volumetric parameters were calculated using the registered doses, including r{{\\text{D}}n \\text{c{{\\text{m}}\\text{3}}}} (minimum dose to the most exposed n-cm3 volume of bladder wall), r V n Gy (wall volume receiving at least m Gy), and r\\text{EQD}{{2}n \\text{c{{\\text{m}}\\text{3}}}} (minimum equivalent biologically weighted dose to the most exposed n-cm3 of bladder wall), where n  =  1/2/5/10 and m  =  3/5/10. Minimum dose to contiguous 1 and 2 cm3 hot-spot volumes was also calculated. The unregistered dose volume histogram (DVH)-summed equivalent of r{{\\text{D}}n \\text{c{{\\text{m}}3}}} and r\\text{EQD}{{2}n \\text{c{{\\text{m}}3}}} parameters (i.e. s{{\\text{D}}n \\text{c{{\\text{m}}\\text{3}}}} and s\\text{EQD}{{2}n \\text{c{{\\text{m}}3}}} ) were determined for comparison. Late urinary toxicity was assessed using the LENT-SOMA scale, with toxicity Grade 0-1 categorized as Controls and Grade 2-4 as Cases. A two-sample t-test was used to identify the differences between the means of Control and Case groups for all parameters. A binomial logistic regression was also performed between the registered dose parameters and toxicity grouping. Seventeen patients were in the Case and 43 patients in the Control group. Contiguous

  20. Hydrogel Spacer Prospective Multicenter Randomized Controlled Pivotal Trial: Dosimetric and Clinical Effects of Perirectal Spacer Application in Men Undergoing Prostate Image Guided Intensity Modulated Radiation Therapy

    Mariados, Neil, E-mail: nmariados@ampofny.com [Associated Medical Professionals of New York, Syracuse, New York (United States); Sylvester, John [21st Century Oncology, East Bradenton, Florida (United States); Shah, Dhiren [Western New York Urology Associates, Cancer Care of WNY, Cheektowaga, New York (United States); Karsh, Lawrence [The Urology Center of Colorado, Denver, Colorado (United States); Hudes, Richard [Chesapeake Urology Research Associates, The Prostate Center, Owings Mills, Maryland (United States); Beyer, David [Arizona Oncology Services Foundation, Phoenix, Arizona (United States); Kurtzman, Steven [Urological Surgeons of Northern California, Campbell, California (United States); Bogart, Jeffrey [The Research Foundation of State University of New York, SUNY Upstate Medical University, Syracuse, New York (United States); Hsi, R. Alex [Peninsula Cancer Center, Poulsbo, Washington (United States); Kos, Michael [Urology Nevada, Reno, Nevada (United States); Ellis, Rodney [University Hospitals Case Medical Center, Cleveland, Ohio (United States); Logsdon, Mark [Sutter Health Sacramento Sierra Region, Sutter Institute for Medical Research, Sacramento, California (United States); Zimberg, Shawn [Advanced Radiation Centers of New York, Lake Success, New York (United States); Forsythe, Kevin [Oregon Urology Institute, Springfield, Oregon (United States); Zhang, Hong [University of Rochester, Rochester, New York (United States); Soffen, Edward [CentraState Medical Center, Freehold, New Jersey (United States); Francke, Patrick [Carolina Regional Cancer Center, 21st Century Oncology, Myrtle Beach, South Carolina (United States); Mantz, Constantine [21st Century Oncology, Fort Meyers, Florida (United States); Rossi, Peter [Emory University, Atlanta, Georgia (United States); DeWeese, Theodore [The Johns Hopkins University, Baltimore, Maryland (United States); and others

    2015-08-01

    Purpose: Perirectal spacing, whereby biomaterials are placed between the prostate and rectum, shows promise in reducing rectal dose during prostate cancer radiation therapy. A prospective multicenter randomized controlled pivotal trial was performed to assess outcomes following absorbable spacer (SpaceOAR system) implantation. Methods and Materials: Overall, 222 patients with clinical stage T1 or T2 prostate cancer underwent computed tomography (CT) and magnetic resonance imaging (MRI) scans for treatment planning, followed with fiducial marker placement, and were randomized to receive spacer injection or no injection (control). Patients received postprocedure CT and MRI planning scans and underwent image guided intensity modulated radiation therapy (79.2 Gy in 1.8-Gy fractions). Spacer safety and impact on rectal irradiation, toxicity, and quality of life were assessed throughout 15 months. Results: Spacer application was rated as “easy” or “very easy” 98.7% of the time, with a 99% hydrogel placement success rate. Perirectal spaces were 12.6 ± 3.9 mm and 1.6 ± 2.0 mm in the spacer and control groups, respectively. There were no device-related adverse events, rectal perforations, serious bleeding, or infections within either group. Pre-to postspacer plans had a significant reduction in mean rectal V70 (12.4% to 3.3%, P<.0001). Overall acute rectal adverse event rates were similar between groups, with fewer spacer patients experiencing rectal pain (P=.02). A significant reduction in late (3-15 months) rectal toxicity severity in the spacer group was observed (P=.04), with a 2.0% and 7.0% late rectal toxicity incidence in the spacer and control groups, respectively. There was no late rectal toxicity greater than grade 1 in the spacer group. At 15 months 11.6% and 21.4% of spacer and control patients, respectively, experienced 10-point declines in bowel quality of life. MRI scans at 12 months verified spacer absorption. Conclusions: Spacer

  1. High-intensity laser physics

    Mohideen, U.

    1993-01-01

    This thesis is a study of the effect of high intensity lasers on atoms, free electrons and the generation of X-rays from solid density plasmas. The laser produced 50 milli Joule 180 femto sec pulses at 5 Hz. This translates to a maximum intensity of 5 x 10 18 W/cm 2 . At such high fields the AC stark shifts of atoms placed at the focus is much greater than the ionization energy. The characteristics of multiphoton ionization of atoms in intense laser fields was studied by angle resolved photoelectron spectroscopy. Free electrons placed in high intensity laser fields lead to harmonic generation. This phenomenon of Nonlinear Compton Scattering was theoretically investigated. Also, when these high intensity pulses are focused on solids a hot plasma is created. This plasma is a bright source of a short X-ray pulse. The pulse-width of X-rays from these solid density plasmas was measured by time-resolved X-ray spectroscopy

  2. Image-guided robotic surgery.

    Marescaux, Jacques; Solerc, Luc

    2004-06-01

    Medical image processing leads to an improvement in patient care by guiding the surgical gesture. Three-dimensional models of patients that are generated from computed tomographic scans or magnetic resonance imaging allow improved surgical planning and surgical simulation that offers the opportunity for a surgeon to train the surgical gesture before performing it for real. These two preoperative steps can be used intra-operatively because of the development of augmented reality, which consists of superimposing the preoperative three-dimensional model of the patient onto the real intraoperative view. Augmented reality provides the surgeon with a view of the patient in transparency and can also guide the surgeon, thanks to the real-time tracking of surgical tools during the procedure. When adapted to robotic surgery, this tool tracking enables visual serving with the ability to automatically position and control surgical robotic arms in three dimensions. It is also now possible to filter physiologic movements such as breathing or the heart beat. In the future, by combining augmented reality and robotics, these image-guided robotic systems will enable automation of the surgical procedure, which will be the next revolution in surgery.

  3. The utility of high-resolution intraoperative MRI in endoscopic transsphenoidal surgery for pituitary macroadenomas: early experience in the Advanced Multimodality Image Guided Operating suite

    Zaidi, Hasan A.; De Los Reyes, Kenneth; Barkhoudarian, Garni; Litvack, Zachary N.; Bi, Wenya Linda; Rincon-Torroella, Jordina; Mukundan, Srinivasan; Dunn, Ian F.; Laws, Edward R.

    2016-01-01

    Objective Endoscopic skull base surgery has become increasingly popular among the skull base surgery community, with improved illumination and angled visualization potentially improving tumor resection rates. Intraoperative MRI (iMRI) is used to detect residual disease during the course of the resection. This study is an investigation of the utility of 3-T iMRI in combination with transnasal endoscopy with regard to gross-total resection (GTR) of pituitary macroadenomas. Methods The authors retrospectively reviewed all endoscopic transsphenoidal operations performed in the Advanced Multimodality Image Guided Operating (AMIGO) suite from November 2011 to December 2014. Inclusion criteria were patients harboring presumed pituitary macroadenomas with optic nerve or chiasmal compression and visual loss, operated on by a single surgeon. Results Of the 27 patients who underwent transsphenoidal resection in the AMIGO suite, 20 patients met the inclusion criteria. The endoscope alone, without the use of iMRI, would have correctly predicted 13 (65%) of 20 cases. Gross-total resection was achieved in 12 patients (60%) prior to MRI. Intraoperative MRI helped convert 1 STR and 4 NTRs to GTRs, increasing the number of GTRs from 12 (60%) to 16 (80%). Conclusions Despite advances in visualization provided by the endoscope, the incidence of residual disease can potentially place the patient at risk for additional surgery. The authors found that iMRI can be useful in detecting unexpected residual tumor. The cost-effectiveness of this tool is yet to be determined. PMID:26926058

  4. SU-E-J-47: Development of a High-Precision, Image-Guided Radiotherapy, Multi- Purpose Radiation Isocenter Quality-Assurance Calibration and Checking System

    Liu, C; Yan, G; Helmig, R; Lebron, S; Kahler, D

    2014-01-01

    Purpose: To develop a system that can define the radiation isocenter and correlate this information with couch coordinates, laser alignment, optical distance indicator (ODI) settings, optical tracking system (OTS) calibrations, and mechanical isocenter walkout. Methods: Our team developed a multi-adapter, multi-purpose quality assurance (QA) and calibration device that uses an electronic portal imaging device (EPID) and in-house image-processing software to define the radiation isocenter, thereby allowing linear accelerator (Linac) components to be verified and calibrated. Motivated by the concept that each Linac component related to patient setup for image-guided radiotherapy based on cone-beam CT should be calibrated with respect to the radiation isocenter, we designed multiple concentric adapters of various materials and shapes to meet the needs of MV and KV radiation isocenter definition, laser alignment, and OTS calibration. The phantom's ability to accurately define the radiation isocenter was validated on 4 Elekta Linacs using a commercial ball bearing (BB) phantom as a reference. Radiation isocenter walkout and the accuracy of couch coordinates, ODI, and OTS were then quantified with the device. Results: The device was able to define the radiation isocenter within 0.3 mm. Radiation isocenter walkout was within ±1 mm at 4 cardinal angles. By switching adapters, we identified that the accuracy of the couch position digital readout, ODI, OTS, and mechanical isocenter walkout was within sub-mm. Conclusion: This multi-adapter, multi-purpose isocenter phantom can be used to accurately define the radiation isocenter and represents a potential paradigm shift in Linac QA. Moreover, multiple concentric adapters allowed for sub-mm accuracy for the other relevant components. This intuitive and user-friendly design is currently patent pending

  5. High Intensity Source Laboratory (HISL)

    1992-01-01

    The High Intensity Source Laboratory (HISL) is a laboratory facility operated for the US Department of Energy (DOE) by EG ampersand G, Energy Measurements (EG ampersand G/EM). This document is intended as an overview -- primarily for external users -- of the general purposes and capabilities of HISL; numerous technical details are beyond its scope. Moreover, systems at HISL are added, deleted, and modified to suit current needs, and upgraded with continuing development. Consequently, interested parties are invited to contact the HISL manager for detailed, current, technical, and administrative information. The HISL develops and operates pulsed radiation sources with energies, intensities, and pulse widths appropriate for several applications. Principal among these are development, characterization, and calibration of various high-bandwidth radiation detectors and diagnostic systems. Hardness/vulnerability of electronic or other sensitive components to radiation is also tested. In this connection, source development generally focuses on attending (1) the highest possible intensities with (2) reasonably short pulse widths and (3) comprehensive output characterization

  6. LHC Report: reaching high intensity

    Jan Uythoven

    2015-01-01

    After both beams having been ramped to their full energy of 6.5 TeV, the last two weeks saw the beam commissioning process advancing on many fronts. An important milestone was achieved when operators succeeded in circulating a nominal-intensity bunch. During the operation, some sudden beam losses resulted in beam dumps at top energy, a problem that needed to be understood and resolved.   In 2015 the LHC will be circulating around 2800 bunches in each beam and each bunch will contain just over 1 x 1011 protons. Until a few days ago commissioning was taking place with single bunches of 5 x 109 protons. The first nominal bunch with an intensity of 1 x 1011 protons was injected on Tuesday, 21 April. In order to circulate such a high-intensity bunch safely, the whole protection system must be working correctly: collimators, which protect the aperture, are set at preliminary values known as coarse settings; all kicker magnets for injecting and extracting the beams are commissioned with beam an...

  7. Prospective Study Delivering Simultaneous Integrated High-dose Tumor Boost (≤70 Gy) With Image Guided Adaptive Radiation Therapy for Radical Treatment of Localized Muscle-Invasive Bladder Cancer

    Hafeez, Shaista, E-mail: Shaista.Hafeez@icr.ac.uk [The Institute of Cancer Research, London (United Kingdom); The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); Warren-Oseni, Karole [The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); McNair, Helen A.; Hansen, Vibeke N.; Jones, Kelly; Tan, Melissa; Khan, Attia [The Institute of Cancer Research, London (United Kingdom); The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); Harris, Victoria; McDonald, Fiona; Lalondrelle, Susan; Mohammed, Kabir; Thomas, Karen; Thompson, Alan; Kumar, Pardeep [The Royal Marsden National Health Service Foundation Trust, London (United Kingdom); Dearnaley, David; Horwich, Alan; Huddart, Robert [The Institute of Cancer Research, London (United Kingdom); The Royal Marsden National Health Service Foundation Trust, London (United Kingdom)

    2016-04-01

    Purpose: Image guided adaptive radiation therapy offers individualized solutions to improve target coverage and reduce normal tissue irradiation, allowing the opportunity to increase the radiation tumor dose and spare normal bladder tissue. Methods and Materials: A library of 3 intensity modulated radiation therapy plans were created (small, medium, and large) from planning computed tomography (CT) scans performed at 30 and 60 minutes; treating the whole bladder to 52 Gy and the tumor to 70 Gy in 32 fractions. A “plan of the day” approach was used for treatment delivery. A post-treatment cone beam CT (CBCT) scan was acquired weekly to assess intrafraction filling and coverage. Results: A total of 18 patients completed treatment to 70 Gy. The plan and treatment for 1 patient was to 68 Gy. Also, 1 patient's plan was to 70 Gy but the patient was treated to a total dose of 65.6 Gy because dose-limiting toxicity occurred before dose escalation. A total of 734 CBCT scans were evaluated. Small, medium, and large plans were used in 36%, 48%, and 16% of cases, respectively. The mean ± standard deviation rate of intrafraction filling at the start of treatment (ie, week 1) was 4.0 ± 4.8 mL/min (range 0.1-19.4) and at end of radiation therapy (ie, week 5 or 6) was 1.1 ± 1.6 mL/min (range 0.01-7.5; P=.002). The mean D{sub 98} (dose received by 98% volume) of the tumor boost and bladder as assessed on the post-treatment CBCT scan was 97.07% ± 2.10% (range 89.0%-104%) and 99.97% ± 2.62% (range 96.4%-112.0%). At a median follow-up period of 19 months (range 4-33), no muscle-invasive recurrences had developed. Two patients experienced late toxicity (both grade 3 cystitis) at 5.3 months (now resolved) and 18 months after radiation therapy. Conclusions: Image guided adaptive radiation therapy using intensity modulated radiation therapy to deliver a simultaneous integrated tumor boost to 70 Gy is feasible, with acceptable toxicity, and will be

  8. The efficacy of Elekta Synergy image-guided radiotherapy

    Takamatsu, Shigeyuki; Takanaka, Tsuyoshi; Kumano, Tomoyasu

    2008-01-01

    We evaluated the efficacy of Elekta Synergy image-guided radiotherapy (IGRT) system equipped with cone beam CT (CBCT) for high accuracy radiation therapy. In cases set up with body marking who had large set up error could be adjusted by this system within 1 mm error. IGRT with CBCT correction provided precise set up. Elekta Synergy IGRT system is useful for high accuracy set up and will facilitate novel precise radiotherapy techniques. (author)

  9. A Single-Institution Experience in Percutaneous Image-Guided Biopsy of Malignant Pleural Mesothelioma

    Welch, B. T.; Eiken, P. W.; Atwell, T. D.; Peikert, T.; Yi, E. S.; Nichols, F.; Schmit, G. D.

    2017-01-01

    PurposeMesothelioma has been considered a difficult pathologic diagnosis to achieve via image-guided core needle biopsy. The purpose of this study was to assess the diagnostic sensitivity of percutaneous image-guided biopsy for diagnosis of pleural mesothelioma.Materials and MethodsRetrospective review was performed to identify patients with a confirmed diagnosis of pleural mesothelioma and who underwent image-guided needle biopsy between January 1, 2002, and January 1, 2016. Thirty-two patients with pleural mesothelioma were identified and included for analysis in 33 image-guided biopsy procedures. Patient, procedural, and pathologic characteristics were recorded. Complications were characterized via standardized nomenclature [Common Terminology for Clinically Adverse Events (CTCAE)].ResultsPercutaneous image-guided biopsy was associated with an overall sensitivity of 81%. No CTCAE clinically significant complications were observed. No image-guided procedures were complicated by pneumothorax or necessitated chest tube placement. No patients had tumor seeding of the biopsy tract.ConclusionPercutaneous image-guided biopsy can achieve high sensitivity for pathologic diagnosis of pleural mesothelioma with a low procedural complication rate, potentially obviating need for surgical biopsy.

  10. A Single-Institution Experience in Percutaneous Image-Guided Biopsy of Malignant Pleural Mesothelioma

    Welch, B. T., E-mail: Welch.brian@mayo.edu; Eiken, P. W.; Atwell, T. D. [Mayo Clinic, Department of Radiology (United States); Peikert, T. [Mayo Clinic, Department of Pulmonary and Critical Care Medicine (United States); Yi, E. S. [Mayo Clinic, Department of Pathology (United States); Nichols, F. [Mayo Clinic, Department of Thoracic Surgery (United States); Schmit, G. D. [Mayo Clinic, Department of Radiology (United States)

    2017-06-15

    PurposeMesothelioma has been considered a difficult pathologic diagnosis to achieve via image-guided core needle biopsy. The purpose of this study was to assess the diagnostic sensitivity of percutaneous image-guided biopsy for diagnosis of pleural mesothelioma.Materials and MethodsRetrospective review was performed to identify patients with a confirmed diagnosis of pleural mesothelioma and who underwent image-guided needle biopsy between January 1, 2002, and January 1, 2016. Thirty-two patients with pleural mesothelioma were identified and included for analysis in 33 image-guided biopsy procedures. Patient, procedural, and pathologic characteristics were recorded. Complications were characterized via standardized nomenclature [Common Terminology for Clinically Adverse Events (CTCAE)].ResultsPercutaneous image-guided biopsy was associated with an overall sensitivity of 81%. No CTCAE clinically significant complications were observed. No image-guided procedures were complicated by pneumothorax or necessitated chest tube placement. No patients had tumor seeding of the biopsy tract.ConclusionPercutaneous image-guided biopsy can achieve high sensitivity for pathologic diagnosis of pleural mesothelioma with a low procedural complication rate, potentially obviating need for surgical biopsy.

  11. Quality assurance for image-guided radiotherapy

    Marinello, Ginette

    2008-01-01

    The topics discussed include, among others, the following: Quality assurance program; Image guided radiotherapy; Commissioning and quality assurance; Check of agreement between visual and displayed scales; quality controls: electronic portal imaging device (EPID), MV-kV and kV-kV, cone-beam CT (CBCT), patient doses. (P.A.)

  12. Different styles of image-guided radiotherapy

    van Herk, Marcel

    2007-01-01

    To account for geometric uncertainties during radiotherapy, safety margins are applied. In many cases, these margins overlap organs at risk, thereby limiting dose escalation. The aim of image-guided radiotherapy is to improve the accuracy by imaging tumors and critical structures on the machine just

  13. High-frequency, high-intensity photoionization

    Reiss, H. R.

    1996-02-01

    Two analytical methods for computing ionization by high-frequency fields are compared. Predicted ionization rates compare well, but energy predictions for the onset of ionization differ radically. The difference is shown to arise from the use of a transformation in one of the methods that alters the zero from which energy is measured. This alteration leads to an apparent energy threshold for ionization that can, especially in the stabilization regime, differ strongly from the laboratory measurement. It is concluded that channel closings in intense-field ionization can occur at high as well as low frequencies. It is also found that the stabilization phenomenon at high frequencies, very prominent for hydrogen, is absent in a short-range potential.

  14. Trilogy Image-Guided Stereotactic Radiosurgery

    Huntzinger, Calvin; Friedman, William; Bova, Frank; Fox, Timothy; Bouchet, Lionel; Boeh, Lester M.B.A.

    2007-01-01

    Full integration of advanced imaging, noninvasive immobilization, positioning, and motion-management methods into radiosurgery have resulted in fundamental changes in therapeutic strategies and approaches that are leading us to the treatment room of the future. With the introduction of image-guided radiosurgery (IGRS) systems, such as Trilogy TM , physicians have for the first time a practical means of routinely identifying and treating very small lesions throughout the body. Using new imaging processes such as positron emission tomography/computed tomography (PET/CT) scans, clinics may be able to detect these lesions and then eradicate them with image-guided stereotactic radiosurgery treatments. Thus, there is promise that cancer could be turned into a chronic disease, managed through a series of checkups, and Trilogy treatments when metastatic lesions reappear

  15. Issues in image-guided therapy.

    Haigron , Pascal; Luo , Limin ,; Coatrieux , Jean-Louis

    2009-01-01

    International audience; Medical robotics, computer- assisted surgery (CAS), image-guided therapy (IGT), and the like emerged more than 20 years ago, and many advances have been made since. Conferences and workshops have been organized; scientific contributions, position papers, and patents have been published; new academic societies have been launched; and companies were created all over the world to propose methods, devices, and systems in the area. Researchers in robotics, computer vision a...

  16. MR image-guided portal verification for brain treatment field

    Yin Fangfang; Gao Qinghuai; Xie Huchen; Nelson, Diana F.; Yu Yan; Kwok, W. Edmund; Totterman, Saara; Schell, Michael C.; Rubin, Philip

    1998-01-01

    Purpose: To investigate a method for the generation of digitally reconstructed radiographs directly from MR images (DRR-MRI) to guide a computerized portal verification procedure. Methods and Materials: Several major steps were developed to perform an MR image-guided portal verification procedure. Initially, a wavelet-based multiresolution adaptive thresholding method was used to segment the skin slice-by-slice in MR brain axial images. Some selected anatomical structures, such as target volume and critical organs, were then manually identified and were reassigned to relatively higher intensities. Interslice information was interpolated with a directional method to achieve comparable display resolution in three dimensions. Next, a ray-tracing method was used to generate a DRR-MRI image at the planned treatment position, and the ray tracing was simply performed on summation of voxels along the ray. The skin and its relative positions were also projected to the DRR-MRI and were used to guide the search of similar features in the portal image. A Canny edge detector was used to enhance the brain contour in both portal and simulation images. The skin in the brain portal image was then extracted using a knowledge-based searching technique. Finally, a Chamfer matching technique was used to correlate features between DRR-MRI and portal image. Results: The MR image-guided portal verification method was evaluated using a brain phantom case and a clinical patient case. Both DRR-CT and DRR-MRI were generated using CT and MR phantom images with the same beam orientation and then compared. The matching result indicated that the maximum deviation of internal structures was less than 1 mm. The segmented results for brain MR slice images indicated that a wavelet-based image segmentation technique provided a reasonable estimation for the brain skin. For the clinical patient case with a given portal field, the MR image-guided verification method provided an excellent match between

  17. High Retention and Safety of Percutaneously Implanted Endovascular Embolization Coils as Fiducial Markers for Image-Guided Stereotactic Ablative Radiotherapy of Pulmonary Tumors

    Hong, Julian C.; Yu Yao; Rao, Aarti K.; Dieterich, Sonja; Maxim, Peter G.; Le, Quynh-Thu; Diehn, Maximilian; Sze, Daniel Y.; Kothary, Nishita; Loo, Billy W.

    2011-01-01

    Purpose: To compare the retention rates of two types of implanted fiducial markers for stereotactic ablative radiotherapy (SABR) of pulmonary tumors, smooth cylindrical gold 'seed' markers ('seeds') and platinum endovascular embolization coils ('coils'), and to compare the complication rates associated with the respective implantation procedures. Methods and Materials: We retrospectively analyzed the retention of percutaneously implanted markers in 54 consecutive patients between January 2004 and June 2009. A total of 270 markers (129 seeds, 141 coils) were implanted in or around 60 pulmonary tumors over 59 procedures. Markers were implanted using a percutaneous approach under computed tomography (CT) guidance. Postimplantation and follow-up imaging studies were analyzed to score marker retention relative to the number of markers implanted. Markers remaining near the tumor were scored as retained. Markers in a distant location (e.g., pleural space) were scored as lost. CT imaging artifacts near markers were quantified on radiation therapy planning scans. Results: Immediately after implantation, 140 of 141 coils (99.3%) were retained, compared to 110 of 129 seeds (85.3%); the difference was highly significant (p < 0.0001). Of the total number of lost markers, 45% were reported lost during implantation, but 55% were lost immediately afterwards. No additional markers were lost on longer-term follow-up. Implanted lesions were peripherally located for both seeds (mean distance, 0.33 cm from pleural surface) and coils (0.34 cm) (p = 0.96). Incidences of all pneumothorax (including asymptomatic) and pneumothorax requiring chest tube placement were lower in implantation of coils (23% and 3%, respectively) vs. seeds (54% and 29%, respectively; p = 0.02 and 0.01). The degree of CT artifact was similar between marker types. Conclusions: Retention of CT-guided percutaneously implanted coils is significantly better than that of seed markers. Furthermore, implanting coils is at

  18. Compact instrument for fluorescence image-guided surgery

    Wang, Xinghua; Bhaumik, Srabani; Li, Qing; Staudinger, V. Paul; Yazdanfar, Siavash

    2010-03-01

    Fluorescence image-guided surgery (FIGS) is an emerging technique in oncology, neurology, and cardiology. To adapt intraoperative imaging for various surgical applications, increasingly flexible and compact FIGS instruments are necessary. We present a compact, portable FIGS system and demonstrate its use in cardiovascular mapping in a preclinical model of myocardial ischemia. Our system uses fiber optic delivery of laser diode excitation, custom optics with high collection efficiency, and compact consumer-grade cameras as a low-cost and compact alternative to open surgical FIGS systems. Dramatic size and weight reduction increases flexibility and access, and allows for handheld use or unobtrusive positioning over the surgical field.

  19. Image-guided procedures in brain biopsy.

    Fujita, K; Yanaka, K; Meguro, K; Narushima, K; Iguchi, M; Nakai, Y; Nose, T

    1999-07-01

    Image-guided procedures, such as computed tomography (CT)-guided stereotactic and ultrasound-guided methods, can assist neurosurgeons in localizing the relevant pathology. The characteristics of image-guided procedures are important for their appropriate use, especially in brain biopsy. This study reviewed the results of various image-guided brain biopsies to ascertain the advantages and disadvantages. Brain biopsies assisted by CT-guided stereotactic, ultrasound-guided, Neuronavigator-guided, and the combination of ultrasound and Neuronavigator-guided procedures were carried out in seven, eight, one, and three patients, respectively. Four patients underwent open biopsy without a guiding system. Twenty of 23 patients had a satisfactory diagnosis after the initial biopsy. Three patients failed to have a definitive diagnosis after the initial procedure, one due to insufficient volume sampling after CT-guided procedure, and two due to localization failure by ultrasound because the lesions were nonechogenic. All patients who underwent biopsy using the combination of ultrasound and Neuronavigator-guided methods had a satisfactory result. The CT-guided procedure provided an efficient method of approaching any intracranial target and was appropriate for the diagnosis of hypodense lesions, but tissue sampling was sometimes not sufficient to achieve a satisfactory diagnosis. The ultrasound-guided procedure was suitable for the investigation of hyperdense lesions, but was difficult to localize nonechogenic lesions. The combination of ultrasound and Neuronavigator methods improved the diagnostic accuracy even in nonechogenic lesions such as malignant lymphoma. Therefore, it is essential to choose the most appropriate guiding method for brain biopsy according to the radiological nature of the lesions.

  20. Image-guided positioning and tracking.

    Ruan, Dan; Kupelian, Patrick; Low, Daniel A

    2011-01-01

    Radiation therapy aims at maximizing tumor control while minimizing normal tissue complication. The introduction of stereotactic treatment explores the volume effect and achieves dose escalation to tumor target with small margins. The use of ablative irradiation dose and sharp dose gradients requires accurate tumor definition and alignment between patient and treatment geometry. Patient geometry variation during treatment may significantly compromise the conformality of delivered dose and must be managed properly. Setup error and interfraction/intrafraction motion are incorporated in the target definition process by expanding the clinical target volume to planning target volume, whereas the alignment between patient and treatment geometry is obtained with an adaptive control process, by taking immediate actions in response to closely monitored patient geometry. This article focuses on the monitoring and adaptive response aspect of the problem. The term "image" in "image guidance" will be used in a most general sense, to be inclusive of some important point-based monitoring systems that can be considered as degenerate cases of imaging. Image-guided motion adaptive control, as a comprehensive system, involves a hierarchy of decisions, each of which balances simplicity versus flexibility and accuracy versus robustness. Patient specifics and machine specifics at the treatment facility also need to be incorporated into the decision-making process. Identifying operation bottlenecks from a system perspective and making informed compromises are crucial in the proper selection of image-guidance modality, the motion management mechanism, and the respective operation modes. Not intended as an exhaustive exposition, this article focuses on discussing the major issues and development principles for image-guided motion management systems. We hope these information and methodologies will facilitate conscientious practitioners to adopt image-guided motion management systems

  1. Automated dental implantation using image-guided robotics: registration results.

    Sun, Xiaoyan; McKenzie, Frederic D; Bawab, Sebastian; Li, Jiang; Yoon, Yongki; Huang, Jen-K

    2011-09-01

    One of the most important factors affecting the outcome of dental implantation is the accurate insertion of the implant into the patient's jaw bone, which requires a high degree of anatomical accuracy. With the accuracy and stability of robots, image-guided robotics is expected to provide more reliable and successful outcomes for dental implantation. Here, we proposed the use of a robot for drilling the implant site in preparation for the insertion of the implant. An image-guided robotic system for automated dental implantation is described in this paper. Patient-specific 3D models are reconstructed from preoperative Cone-beam CT images, and implantation planning is performed with these virtual models. A two-step registration procedure is applied to transform the preoperative plan of the implant insertion into intra-operative operations of the robot with the help of a Coordinate Measurement Machine (CMM). Experiments are carried out with a phantom that is generated from the patient-specific 3D model. Fiducial Registration Error (FRE) and Target Registration Error (TRE) values are calculated to evaluate the accuracy of the registration procedure. FRE values are less than 0.30 mm. Final TRE values after the two-step registration are 1.42 ± 0.70 mm (N = 5). The registration results of an automated dental implantation system using image-guided robotics are reported in this paper. Phantom experiments show that the practice of robot in the dental implantation is feasible and the system accuracy is comparable to other similar systems for dental implantation.

  2. High intensity radiation imaging system

    Barrett, H.H.

    1976-01-01

    A nuclear imaging system is described for mapping a spatially distributed source of high energy nuclear particles from a living organ which has selectively absorbed a radioactive compound in which the nuclear energy is spatially coded by a zone plate positioned between the source and a spatial detector, and a half tone screen is positioned between the source and the zone plate to increase the definition of the image

  3. High Intensity Exercise in Multiple Sclerosis

    Wens, Inez; Dalgas, Ulrik; Vandenabeele, Frank

    2015-01-01

    Introduction Low-to-moderate intensity exercise improves muscle contractile properties and endurance capacity in multiple sclerosis (MS). The impact of high intensity exercise remains unknown. Methods Thirty-four MS patients were randomized into a sedentary control group (SED, n = 11) and 2...... exercise groups that performed 12 weeks of a high intensity interval (HITR, n = 12) or high intensity continuous cardiovascular training (HCTR, n = 11), both in combination with resistance training. M.vastus lateralis fiber cross sectional area (CSA) and proportion, knee-flexor/extensor strength, body...... composition, maximal endurance capacity and self-reported physical activity levels were assessed before and after 12 weeks. Results Compared to SED, 12 weeks of high intensity exercise increased mean fiber CSA (HITR: +21±7%, HCTR: +23±5%). Furthermore, fiber type I CSA increased in HCTR (+29±6%), whereas type...

  4. INNOLAB- image guided surgery and therapy lab

    Fritzsche Holger

    2017-09-01

    Full Text Available Incremental innovation, something better or cheaper or more effective, is the standard innovation process for medical product development. Disruptive innovation is often not recognized as disruptive, because it very often starts as a simple and easy alternative to existing products with much reduced features and bad performance. Innovation is the invention multiplied with a commercial use, or in other words something that eventually provides a value to a clinical user or patient. To create such innovation not a technology push (technology delivered from a technical need perspective but rather a pull (by learning and working with the clinical users is required. Medical technology students need to understand that only through proper observation, procedure know-how and subsequent analysis and evaluation, clinically relevant and affordable innovation can be generated and possibly subsequently used for entrepreneurial ventures. The dedicated laboratory for innovation, research and entrepreneurship- INNOLAB ego.-INKUBATOR IGT (Image Guided Therapies is financed by the state of Sachsen-Anhalt as part of the European ego.-INKUBATOR program with (EFRE funds at the university clinic operated by the technical chair for catheter technologies and image guided surgeries. It forms a network node between medicine, research and economics. It teaches students to lead innovation processes, technology transfer to the user and is designed to stimulate the start-up intentions.

  5. Strategies for Biologic Image-Guided Dose Escalation: A Review

    Sovik, Aste; Malinen, Eirik; Olsen, Dag Rune

    2009-01-01

    There is increasing interest in how to incorporate functional and molecular information obtained by noninvasive, three-dimensional tumor imaging into radiotherapy. The key issues are to identify radioresistant regions that can be targeted for dose escalation, and to develop radiation dose prescription and delivery strategies providing optimal treatment for the individual patient. In the present work, we review the proposed strategies for biologic image-guided dose escalation with intensity-modulated radiation therapy. Biologic imaging modalities and the derived images are discussed, as are methods for target volume delineation. Different dose escalation strategies and techniques for treatment delivery and treatment plan evaluation are also addressed. Furthermore, we consider the need for response monitoring during treatment. We conclude with a summary of the current status of biologic image-based dose escalation and of areas where further work is needed for this strategy to become incorporated into clinical practice

  6. High intensity proton accelerator program

    Kaneko, Yoshihiko; Mizumoto, Motoharu; Nishida, Takahiko

    1991-06-01

    Industrial applications of proton accelerators to the incineration of the long-lived nuclides contained in the spent fuels have long been investigated. Department of Reactor Engineering of Japan Atomic Energy Research Institute (JAERI) has formulated the Accelerator Program through the investigations on the required performances of the accelerator and its development strategies and also the research plan using the accelerator. Outline of the Program is described in the present report. The target of the Program is the construction of the Engineering Test Accelerators (ETA) of the type of a linear accelerator with the energy 1.5 GeV and the proton current ∼10 mA. It is decided that the construction of the Basic Technology Accelerator (BTA) is necessary as an intermediate step, aiming at obtaining the required technical basis and human resources. The Basic Technology Accelerator with the energy of 10 MeV and with the current of ∼10 mA is composed of the ion source, RFQ and DTL, of which system forms the mock-up of the injector of ETA. Development of the high-β structure which constitutes the main acceleration part of ETA is also scheduled. This report covers the basic parameters of the Basic Technology Accelerator (BTA), development steps of the element and system technologies of the high current accelerators and rough sketch of ETA which can be prospected at present. (J.P.N.)

  7. High Intensity Polarized Electron Sources

    Poelker, Benard; Adderley, Philip; Brittian, Joshua; Clark, J.; Grames, Joseph; Hansknecht, John; McCarter, James; Stutzman, Marcy; Suleiman, Riad; Surles-law, Kenneth

    2008-01-01

    During the 1990s, at numerous facilities world wide, extensive RandD devoted to constructing reliable GaAs photoguns helped ensure successful accelerator-based nuclear and high-energy physics programs using spin polarized electron beams. Today, polarized electron source technology is considered mature, with most GaAs photoguns meeting accelerator and experiment beam specifications in a relatively trouble-free manner. Proposals for new collider facilities however, require electron beams with parameters beyond today's state-of-the-art and serve to renew interest in conducting polarized electron source RandD. And at CEBAF/Jefferson Lab, there is an immediate pressing need to prepare for new experiments that require considerably more beam current than before. One experiment in particular?Q-weak, a parity violation experiment that will look for physics beyond the Standard Model?requires 180 uA average current at polarization >80% for a duration of one year, with run-averaged helicity correlate

  8. Commissioning an image-guided localization system for radiotherapy

    Phillips, Mark H.; Singer, Karen; Miller, Elizabeth; Stelzer, Keith

    2000-01-01

    Purpose: To describe the design and commissioning of a system for the treatment of classes of tumors that require highly accurate target localization during a course of fractionated external-beam therapy. This system uses image-guided localization techniques in the linac vault to position patients being treated for cranial tumors using stereotactic radiotherapy, conformal radiotherapy, and intensity-modulated radiation therapy techniques. Design constraints included flexibility in the use of treatment-planning software, accuracy and precision of repeat localization, limits on the time and human resources needed to use the system, and ease of use. Methods and Materials: A commercially marketed, stereotactic radiotherapy system, based on a system designed at the University of Florida, Gainesville, was adapted for use at the University of Washington Medical Center. A stereo pair of cameras in the linac vault were used to detect the position and orientation of an array of fiducial markers that are attached to a patient's biteblock. The system was modified to allow the use of either a treatment-planning system designed for stereotactic treatments, or a general, three-dimensional radiation therapy planning program. Measurements of the precision and accuracy of the target localization, dose delivery, and patient positioning were made using a number of different jigs and devices. Procedures were developed for the safe and accurate clinical use of the system. Results: The accuracy of the target localization is comparable to that of other treatment-planning systems. Gantry sag, which cannot be improved, was measured to be 1.7 mm, which had the effect of broadening the dose distribution, as confirmed by a comparison of measurement and calculation. The accuracy of positioning a target point in the radiation field was 1.0 ± 0.2 mm. The calibration procedure using the room-based lasers had an accuracy of 0.76 mm, and using a floor-based radiosurgery system it was 0.73 mm

  9. Image-Guided Spinal Ablation: A Review

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Garnon, Julien, E-mail: julien.garnon@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: roberto-luigi.cazzato@chru-strasbourg.fr; Edalat, Faramarz, E-mail: faramarz.edalat@gmail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [Strasbourg University Hospital (France)

    2016-09-15

    The image-guided thermal ablation procedures can be used to treat a variety of benign and malignant spinal tumours. Small size osteoid osteoma can be treated with laser or radiofrequency. Larger tumours (osteoblastoma, aneurysmal bone cyst and metastasis) can be addressed with radiofrequency or cryoablation. Results on the literature of spinal microwave ablation are scarce, and thus it should be used with caution. A distinct advantage of cryoablation is the ability to monitor the ice-ball by intermittent CT or MRI. The different thermal insulation, temperature and electrophysiological monitoring techniques should be applied. Cautious pre-procedural planning and intermittent intra-procedural monitoring of the ablation zone can help reduce neural complications. Tumour histology, patient clinical-functional status and life-expectancy should define the most efficient and least disabling treatment option.

  10. MO-DE-202-03: Image-Guided Surgery and Interventions in the Advanced Multimodality Image-Guided Operating (AMIGO) Suite

    Kapur, T. [Brigham & Women’s Hospital (United States)

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  11. MO-DE-202-03: Image-Guided Surgery and Interventions in the Advanced Multimodality Image-Guided Operating (AMIGO) Suite

    Kapur, T.

    2016-01-01

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  12. Incidence of Secondary Cancer Development After High-Dose Intensity-Modulated Radiotherapy and Image-Guided Brachytherapy for the Treatment of Localized Prostate Cancer

    Zelefsky, Michael J.; Housman, Douglas M.; Pei Xin; Alicikus, Zumre; Magsanoc, Juan Martin; Dauer, Lawrence T.; St Germain, Jean; Yamada, Yoshiya; Kollmeier, Marisa; Cox, Brett; Zhang Zhigang

    2012-01-01

    Purpose: To report the incidence and excess risk of second malignancy (SM) development compared with the general population after external beam radiotherapy (EBRT) and brachytherapy to treat prostate cancer. Methods and Materials: Between 1998 and 2001, 1,310 patients with localized prostate cancer were treated with EBRT (n = 897) or brachytherapy (n = 413). We compared the incidence of SMs in our patients with that of the general population extracted from the National Cancer Institute’s Surveillance, Epidemiology, and End Results data set combined with the 2000 census data. Results: The 10-year likelihood of SM development was 25% after EBRT and 15% after brachytherapy (p = .02). The corresponding 10-year likelihood for in-field SM development in these groups was 4.9% and 1.6% (p = .24). Multivariate analysis showed that EBRT vs. brachytherapy and older age were the only significant predictors for the development of all SMs (p = .037 and p = .030), with a trend for older patients to develop a SM. The increased incidence of SM for EBRT patients was explained by the greater incidence of skin cancer outside the radiation field compared with that after brachytherapy (10.6% and 3.3%, respectively, p = .004). For the EBRT group, the 5- and 10-year mortality rate was 1.96% and 5.1% from out-of field cancer, respectively; for in-field SM, the corresponding mortality rates were 0.1% and 0.7%. Among the brachytherapy group, the 5- and 10-year mortality rate related to out-of field SM was 0.8% and 2.7%, respectively. Our observed SM rates after prostate RT were not significantly different from the cancer incidence rates in the general population. Conclusions: Using modern sophisticated treatment techniques, we report low rates of in-field bladder and rectal SM risks after prostate cancer RT. Furthermore, the likelihood of mortality secondary to a SM was unusual. The greater rate of SM observed with EBRT vs. brachytherapy was related to a small, but significantly increased, number of skin cancers in the EBRT patients compared with that of the general population.

  13. Image-guided drug delivery: preclinical applications and clinical translation

    Ojha, Tarun; Rizzo, Larissa; Storm, Gerrit; Kiessling, Fabian; Lammers, Twan Gerardus Gertudis Maria

    2015-01-01

    Image-guided drug delivery refers to the combination of drug targeting and imaging. Preclinically, image-guided drug delivery can be used for several different purposes, including for monitoring biodistribution, target site accumulation, off-target localization, drug release and drug efficacy.

  14. Photoproduction at high energy and high intensity

    2002-01-01

    The photon beam used for this programme is tagged and provides a large flux up to very high energies (150-200 GeV). It is also hadron-free, since it is obtained by a two-step conversion method. A spectrometer is designed to exploit this beam and to perform a programme of photoproduction with a high level of sensitivity (5-50 events/picobarn).\\\\ \\\\ Priority will be given to the study of processes exhibiting the point-like behaviour of the photon, especially deep inelastic Compton scattering. The spectrometer has two magnets. Charged tracks are measured by MWPC's located only in field-free regions. Three calorimeters provide a large coverage for identifying and measuring electrons and photons. An iron filter downstream identifies muons. Most of the equipment is existing and recuperated from previous experiments.

  15. Stimulated Raman backscattering at high laser intensities

    Skoric, M M [Vinca Inst. of Nuclear Sciences, Belgrade (Yugoslavia); Tajima, Toshiki; Sasaki, Akira; Maluckov, A; Jovanovic, M

    1998-03-01

    Signatures of Stimulated Raman backscattering of a short-pulse high-intensity laser interacting with an underdense plasma are discussed. We introduce a nonlinear three-wave interaction model that accounts for laser pump depletion and relativistic detuning. A mechanism is revealed based on a generic route to chaos, that predicts a progressive increase of the backscatter complexity with a growing laser intensity. Importance of kinetic effects is outlined and demonstrated in fluid-hybrid and particle simulations. As an application, we show that spectral anomalies of the backscatter, predicted by the above model, are consistent with recent sub-picosecond, high-intensity laser gas-target measurements at Livermore and elsewhere. Finally, a recently proposed scheme for generation of ultra-short, low-prepulse laser pulses by Raman backscattering in a thin foil target, is shown. (author)

  16. Image-guided diagnosis of prostate cancer can increase detection of tumors

    In the largest prospective study to date of image-guided technology for identifying suspicious regions of the prostate to biopsy, researchers compared the ability of this technology to detect high-risk prostate cancer with that of the current standard of

  17. Microencapsulation of indocyanine green for potential applications in image-guided drug delivery.

    Zhu, Zhiqiang; Si, Ting; Xu, Ronald X

    2015-02-07

    We present a novel process to encapsulate indocyanine green (ICG) in liposomal droplets at high concentration for potential applications in image-guided drug delivery. The microencapsulation process follows two consecutive steps of droplet formation by liquid-driven coaxial flow focusing (LDCFF) and solvent removal by oil phase dewetting. These biocompatible lipid vesicles may have important applications in drug delivery and fluorescence imaging.

  18. Cryogenic semiconductor high-intensity radiation monitors

    Palmieri, V.G.; Bell, W.H.; Borer, K.; Casagrande, L.; Da Via, C.; Devine, S.R.H.; Dezillie, B.; Esposito, A.; Granata, V.; Hauler, F.; Jungermann, L.; Li, Z.; Lourenco, C.; Niinikoski, T.O.; Shea, V. O'; Ruggiero, G.; Sonderegger, P.

    2003-01-01

    This paper describes a novel technique to monitor high-intensity particle beams by means of a semiconductor detector. It consists of cooling a semiconductor detector down to cryogenic temperature to suppress the thermally generated leakage current and to precisely measure the integrated ionization signal. It will be shown that such a device provides very good linearity and a dynamic range wider than is possible with existing techniques. Moreover, thanks to the Lazarus effect, extreme radiation hardness can be achieved providing in turn absolute intensity measurements against precise calibration of the device at low beam flux

  19. Very high intensity reaction chamber design

    Devaney, J.J.

    1975-09-01

    The problem of achieving very high intensity irradiation by light in minimal regions was studied. Three types of irradiation chamber are suggested: the common laser-reaction chamber, the folded concentric or near-concentric resonator, and the asymmetric confocal resonator. In all designs the ratio of high-intensity illuminated volume to other volume is highly dependent (to the 3 / 2 power) on the power and fluence tolerances of optical elements, primarily mirrors. Optimization of energy coupling is discussed for the common cavity. For the concentric cavities, optimization for both coherent and incoherent beams is treated. Formulae and numerical examples give the size of chambers, aspect ratios, maximum pass number, image sizes, fluences, and the like. Similarly for the asymmetric confocal chamber, formulae and numerical examples for fluences, dimensions, losses, and totally contained pass numbers are given

  20. Development of high intensity proton accelerator

    Mizumoto, M.; Kusano, J.; Hasegawa, K.; Ouchi, N.; Oguri, H.; Kinsho, M.; Touchi, Y.; Honda, Y.; Mukugi, K.; Ino, H.; Noda, F.; Akaoka, N.; Kaneko, H.; Chishiro, E.; Fechner, B.

    1997-01-01

    The high-intensity proton linear accelerator with an energy of 1.5 GeV and an average current of 5.33mA has been proposed for the Neutron Science Project (NSP) at JAERI. the NSP is aiming at exploring nuclear technologies for nuclear waste transmutation based on a proton induced spallation neutrons. The proposed accelerators facilities will be also used in the various basic research fields such as condensed matter physics in combination with a high intensity proton storage ring. The R and D work has been carried out for the components of the front-end of the proton accelerator. For the high energy portion above 100 MeV, superconducting (SC) accelerator linac has been designed and developed as a major option. (Author) 7 refs

  1. Concept for a new high resolution high intensity diffractometer

    Stuhr, U [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1997-09-01

    A concept of a new time-of-flight powder-diffractometer for a thermal neutral beam tube at SINQ is presented. The design of the instrument optimises the contradictory conditions of high intensity and high resolution. The high intensity is achieved by using many neutron pulses simultaneously. By analysing the time-angle-pattern of the detected neutrons an assignment of the neutrons to a single pulse is possible. (author) 3 figs., tab., refs.

  2. Gamma Imaging-Guided Minimally Invasive Breast Biopsy: Initial Clinical Experience.

    Brem, Rachel F; Mehta, Anita K; Rapelyea, Jocelyn A; Akin, Esma A; Bazoberry, Adriana M; Velasco, Christel D

    2018-03-01

    The purpose of this study was to evaluate our initial experience with gamma imaging-guided vacuum-assisted breast biopsy in women with abnormal findings. A retrospective review of patients undergoing breast-specific gamma imaging (BSGI), also known as molecular breast imaging (MBI), between April 2011 and October 2015 found 117 nonpalpable mammographically and sonographically occult lesions for which gamma imaging-guided biopsies were recommended. Biopsy was performed with a 9-gauge vacuum-assisted device with subsequent placement of a titanium biopsy site marker. Medical records and pathologic findings were evaluated. Of the 117 biopsies recommended, 104 were successful and 13 were canceled. Of the 104 performed biopsies, 32 (30.8%) had abnormal pathologic findings. Of those 32 biopsies, nine (28.1%) found invasive cancers, six (18.8%) found ductal carcinoma in situ (DCIS), and 17 (53.1%) found high-risk lesions. Of the 17 high-risk lesions, there were three (17.6%) lobular carcinomas in situ, five (29.4%) atypical ductal hyperplasias, two (11.8%) atypical lobular hyperplasias, one (5.9%) flat epithelial atypia, and six (35.3%) papillomas. Two cases of atypical ductal hyperplasia were upgraded to DCIS at surgery. The overall cancer detection rate for gamma imaging-guided biopsy was 16.3%. In this study, gamma imaging-guided biopsy had a positive predictive value of total successful biopsies of 16.3% for cancer and 30.8% for cancer and high-risk lesions. Gamma imaging-guided biopsy is a viable approach to sampling BSGI-MBI-detected lesions without sonographic or mammographic correlate. Our results compare favorably to those reported for MRI-guided biopsy.

  3. Feasibility and effectiveness of image-guided percutaneous biopsy of the urinary bladder.

    Butros, Selim Reha; McCarthy, Colin James; Karaosmanoğlu, Ali Devrim; Shenoy-Bhangle, Anuradha S; Arellano, Ronald S

    2015-08-01

    To evaluate the indications, technique, results, and complications of image-guided percutaneous biopsy of the urinary bladder. This retrospective study included 15 patients (10 male, 5 female) who underwent image-guided percutaneous biopsy of the urinary bladder between January 1999 and December 2013. The medical records, imaging studies, procedural details, and long-term follow-up of each patient were reviewed in detail to assess the feasibility of percutaneous bladder biopsy. Ten patients had focal bladder masses and 5 patients had asymmetric or diffuse bladder wall thickening. Eleven patients had either negative or unsatisfactory cystoscopies prior to the biopsy. Percutaneous biopsies were performed under computed tomography guidance in 12 patients and ultrasound in 3 patients. All procedures were technically successful and there were no procedural complications. Malignancy was confirmed in 8 patients, among whom 6 had transitional cell carcinoma, 1 cervical cancer, and 1 prostate cancer metastasis. Seven patients had a benign diagnosis, including 3 that were later confirmed by pathology following surgery and 2 patients with a false-negative result. The overall sensitivity was 80% and accuracy was 87%. Image-guided percutaneous biopsy of the urinary bladder is a safe and technically feasible procedure with a high sensitivity and accuracy rate. Although image-guided bladder biopsy is an uncommon procedure, it should be considered in selected cases when more traditional methods of tissue sampling are either not possible or fail to identify abnormalities detected by cross-sectional imaging.

  4. Evaluation of Image-Guided Positioning for Frameless Intracranial Radiosurgery

    Lamba, Michael; Breneman, John C.; Warnick, Ronald E.

    2009-01-01

    Purpose: The standard for target alignment and immobilization in intracranial radiosurgery is frame-based alignment and rigid immobilization using a stereotactic head ring. Recent improvements in image-guidance systems have introduced the possibility of image-guided radiosurgery with nonrigid immobilization. We present data on the alignment accuracy and patient stability of a frameless image-guided system. Methods and Materials: Isocenter alignment errors were measured for in vitro studies in an anthropomorphic phantom for both frame-based stereotactic and frameless image-guided alignment. Subsequently, in vivo studies assessed differences between frame-based and image-guided alignment in patients who underwent frame-based intracranial radiosurgery. Finally, intratreatment target stability was determined by image-guided alignment performed before and after image-guided mask immobilized radiosurgery. Results: In vitro hidden target localization errors were comparable for the framed (0.7 ± 0.5 mm) and image-guided (0.6 ± 0.2 mm) techniques. The in vivo differences in alignment were 0.9 ± 0.5 mm (anteroposterior), -0.2 ± 0.4 mm (superoinferior), and 0.3 ± 0.5 mm (lateral). For in vivo stability tests, the mean distance differed between the pre- and post-treatment positions with mask-immobilized radiosurgery by 0.5 ± 0.3 mm. Conclusion: Frame-based and image-guided alignment accuracy in vitro was comparable for the system tested. In vivo tests showed a consistent trend in the difference of alignment in the anteroposterior direction, possibly due to torque to the ring and mounting system with frame-based localization. The mask system as used appeared adequate for patient immobilization.

  5. Radiation resistivity of pure silica core image guides for industrial fiberscopes

    Okamoto, Shinichi; Ohnishi, Tokuhiro; Kanazawa, Tamotsu; Tsuji, Yukio; Hayami, Hiroyuki; Ishitani, Tadayoshi; Akutsu, Takeji; Suzuki, Koichi.

    1991-01-01

    Industrial fiberscopes incorporating pure silica core image guides have been extensively used for remote visual inspection in radiation fields including nuclear power plants, owing to their superior radiation resistivity. The authors have been intensively conducting R and D on improving radiation resistivity of pure silica core image guides. This paper reports the results of experiments to compare the effects of core materials on radiation resistivity and to investigate the dependence of radiation resistivity on total dose, does rate, and support pipe material. The results confirmed the superior radiation resistivity of the core material containing fluorine at any irradiation condition and indicated the existence of a critical dose rate at which radiation-induced deterioration was stabilized. No difference in radiation resistivity attributable to support layer material was observed. (author)

  6. Development of a high intensity proton accelerator

    Mizumoto, Motoharu; Kusano, Joichi; Hasegawa, Kazuo; Ito, Nobuo; Oguri, Hidetomo; Touchi, Yutaka; Mukugi, Ken; Ino, Hiroshi

    1997-01-01

    The high-intensity proton linear accelerator with a beam power of 15 MW has been proposed for various engineering tests for the nuclear waste transmutation system as one of the research plans in the Neutron Science Research Program (NSRP) in JAERI. High intensity proton beam and secondary particle beams such as neutron, pion, muon and unstable radio isotope (RI) beam generated from the proton spallation reaction will be utilized at these facilities in each research field. The R and D work has been carried out for the components of the front-end part of the proton accelerator; ion source, RFQ, DTL and RF source. In the beam test, the current of 70 mA with a duty factor of 7% has been accelerated from the RFQ at the energy of 2 MeV. A hot test model of the DTL for the high power and high duty operation was fabricated and tested. For the high energy portion above 100 MeV, superconducting accelerating cavity is studied as a main option. The superconducting linac is expected to have several favourable characteristics for high intensity accelerator such as short accelerator length, large bore radius resulting in low beam losses and cost effectiveness for construction and operation. A test stand with equipment of cryogenics system, vacuum system, RF system and cavity processing and cleaning is prepared to test the physics issues and fabrication process. The proposed plan for accelerator design and construction will compose of two consecutive stages. The first stage will be completed in about 7 years with the beam power of 1.5 MW. As the second stage gradual upgrading of the beam power will be made up to 15 MW. 7 refs., 3 figs., 4 tabs

  7. The utilization of high-intensity lasers

    Fabre, E.

    1988-01-01

    The 1988 progress report of the laboratory for the Utilization of High-Intensity Lasers (Polytechnic School, France), is presented. The research program is focused on the laser-plasma physics, on the generation of high pressures by means of laser shock heating, on the laser spectroscopy and on the laser implosions. Numerical simulation codes are developed. Concerning the atomic physics, the investigations on dense plasmas and the x-laser research developments are carried out. The research activities of the laboratory teams, the published papers, the national and international cooperations, are given [fr

  8. MO-DE-202-01: Image-Guided Focused Ultrasound Surgery and Therapy

    Farahani, K. [National Cancer Institute (United States)

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  9. MO-DE-202-01: Image-Guided Focused Ultrasound Surgery and Therapy

    Farahani, K.

    2016-01-01

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  10. Beam halo in high-intensity beams

    Wangler, T.P.

    1993-01-01

    In space-charge dominated beams the nonlinear space-charge forces produce a filamentation pattern, which in projection to the 2-D phase spaces results in a 2-component beam consisting of an inner core and a diffuse outer halo. The beam-halo is of concern for a next generation of cw, high-power proton linacs that could be applied to intense neutron generators for nuclear materials processing. The author describes what has been learned about beam halo and the evolution of space-charge dominated beams using numerical simulations of initial laminar beams in uniform linear focusing channels. Initial results are presented from a study of beam entropy for an intense space-charge dominated beam

  11. Percutaneous image-guided needle biopsy in children - summary of our experience with 57 children

    Sklair-Levy, M.; Lebensart, P.D.; Applbaum, Y.H.; Bar-Ziv, J.; Libson, E.; Ramu, N.; Freeman, A.; Gozal, D.; Gross, E.; Sherman, Y.

    2001-01-01

    Background: Percutaneous image-guided needle biopsy in children has been slower to gain acceptance than in adults where it is regarded as the standard clinical practice in screening suspicious masses. Objectives: To report our experience with percutaneous image-guided needle biopsy in the pediatric population and assess its clinical use, efficacy and limitations. Material and methods: Sixty-nine percutaneous image-guided needle biopsies were performed in 57 children. The age of the children ranged from 4 days to 14 years (mean 5.6 years). We used 16- to-20-gauge cutting-edge needles. Sixty-two biopsies were core-needle biopsies and 7 fine-needle aspiration biopsies. Results: There were 50 malignant lesions, 10 benign lesions and 2 infectious lesions. In 55 (88.7 %) lesions the needle biopsy was diagnostic. In 7 (11.3 %) the biopsy was non-diagnostic and the diagnosis was made by surgery. Core-needle biopsy was diagnostic in 47 of 50 (94 %) of the malignant solid tumors. In 3 out of 5 children with lymphoma, an accurate diagnosis was obtained with needle aspiration. Seven children underwent a repeated core-needle biopsy, (5 for Wilms' tumor and 2 for neuroblastoma) that was diagnostic in all cases. All the biopsies were performed without complications. Conclusion: Percutaneous image-guided needle biopsy is a simple, minimally invasive, safe and accurate method for the evaluation of children with suspicious masses. These data suggest that image-guided needle biopsy is an excellent tool for diagnosing solid tumors in the pediatric population. Negative studies should be considered nondiagnostic and followed by excisional surgical biopsies when clinical suspicion of malignancy is high. (orig.)

  12. Moderate and high intensity pulsed electric fields

    Timmermans, Rian Adriana Hendrika

    2018-01-01

    Pulsed Electric Field (PEF) processing has gained a lot of interest the last decades as mild processing technology as alternative to thermal pasteurisation, and is suitable for preservation of liquid food products such as fruit juices. PEF conditions typically applied at industrial scale for pasteurisation are high intensity pulsed electric fields aiming for minimal heat load, with an electric field strength (E) in the range of 15 − 20 kV/cm and pulse width (τ) between 2 − 20 μs. Alternativel...

  13. Physics of high intensity nanosecond electron source

    Herrera-Gomez, A.; Spicer, W.E.

    1993-08-01

    A new high-intensity, short-time electron source is now being used at the Stanford Linear Accelerator Center (SLAC). Using a GaAs negative affinity semiconductor in the construction of the cathode, it is possible to fulfill operation requirements such as peak currents of tens of amperes, peak widths of the order of nanoseconds, hundreds of hours of operation stability, and electron spin polarization. The cathode is illuminated with high intensity laser pulses, and photoemitted electrons constitute the yield. Because of the high currents, some nonlinear effects are present. Very noticeable is the so-called Charge Limit (CL) effect, which consists of a limit on the total charge in each pulse-that is, the total bunch charge stops increasing as the light pulse total energy increases. In this paper, we explain the mechanism of the CL and how it is caused by the photovoltaic effect. Our treatment is based on the Three-Step model of photoemission. We relate the CL to the characteristics of the surface and bulk of the semiconductor, such as doping, band bending, surface vacuum level, and density of surface states. We also discuss possible ways to prevent the Char's Level effect

  14. Real-time Fluorescence Image-Guided Oncologic Surgery

    Mondal, Suman B.; Gao, Shengkui; Zhu, Nan; Liang, Rongguang; Gruev, Viktor; Achilefu, Samuel

    2014-01-01

    Medical imaging plays a critical role in cancer diagnosis and planning. Many of these patients rely on surgical intervention for curative outcomes. This requires a careful identification of the primary and microscopic tumors, and the complete removal of cancer. Although there have been efforts to adapt traditional imaging modalities for intraoperative image guidance, they suffer from several constraints such as large hardware footprint, high operation cost, and disruption of the surgical workflow. Because of the ease of image acquisition, relatively low cost devices and intuitive operation, optical imaging methods have received tremendous interests for use in real-time image-guided surgery. To improve imaging depth under low interference by tissue autofluorescence, many of these applications utilize light in the near-infra red (NIR) wavelengths, which is invisible to human eyes. With the availability of a wide selection of tumor-avid contrast agents, advancements in imaging sensors, electronic and optical designs, surgeons are able to combine different attributes of NIR optical imaging techniques to improve treatment outcomes. The emergence of diverse commercial and experimental image guidance systems, which are in various stages of clinical translation, attests to the potential high impact of intraoperative optical imaging methods to improve speed of oncologic surgery with high accuracy and minimal margin positivity. PMID:25287689

  15. A small animal image guided irradiation system study using 3D dosimeters

    Qian, Xin; Wuu, Cheng-Shie; Admovics, John

    2015-01-01

    In a high resolution image-guided small animal irradiation platform, a cone beam computed tomography (CBCT) is integrated with an irradiation unit for precise targeting. Precise quality assurance is essential for both imaging and irradiation components. The conventional commissioning techniques with films face major challenges due to alignment uncertainty and labour intensive film preparation and scanning. In addition, due to the novel design of this platform the mouse stage rotation for CBCT imaging is perpendicular to the gantry rotation for irradiation. Because these two rotations are associated with different mechanical systems, discrepancy between rotation isocenters exists. In order to deliver x-ray precisely, it is essential to verify coincidence of the imaging and the irradiation isocenters. A 3D PRESAGE dosimeter can provide an excellent tool for checking dosimetry and verifying coincidence of irradiation and imaging coordinates in one system. Dosimetric measurements were performed to obtain beam profiles and percent depth dose (PDD). Isocentricity and coincidence of the mouse stage and gantry rotations were evaluated with starshots acquired using PRESAGE dosimeters. A single PRESAGE dosimeter can provide 3 -D information in both geometric and dosimetric uncertainty, which is crucial for translational studies

  16. High intensity discharge device containing oxytrihalides

    Lapatovich, W.P.; Keeffe, W.M.; Liebermann, R.W.; Maya, J.

    1987-06-09

    A fill composition for a high intensity discharge device including mercury, niobium oxytrihalide, and a molecular stabilization agent is provided. The molar ratio of niobium oxytrihalide to the molecular stabilization agent in the fill is in the range of from about 5:1 to about 7.5:1. Niobium oxytrihalide is present in the fill in sufficient amount to produce, by dissociation in the discharge, atomic niobium, niobium oxide, NbO, and niobium dioxide, NbO[sub 2], with the molar ratio of niobium-containing vapor species to mercury in the fill being in the range of from about 0.01:1 to about 0.50:1; and mercury pressure of about 1 to about 50 atmospheres at lamp operating temperature. There is also provided a high intensity discharge device comprising a sealed light-transmissive arc tube; the arc tube including the above-described fill; and an energizing means for producing an electric discharge within the arc tube. 7 figs.

  17. Concept for quantifying the dose from image guided radiotherapy

    Schneider, Uwe; Hälg, Roger; Besserer, Jürgen

    2015-01-01

    Radiographic image guidance is routinely used for patient positioning in radiotherapy. All radiographic guidance techniques can give a significant radiation dose to the patient. The dose from diagnostic imaging is usually managed by using effective dose minimization. In contrast, image-guided radiotherapy adds the imaging dose to an already high level of therapeutic radiation which cannot be easily managed using effective dose. The purpose of this work is the development of a concept of IGRT dose quantification which allows a comparison of imaging dose with commonly accepted variations of therapeutic dose. It is assumed that dose variations of the treatment beam which are accepted in the spirit of the ALARA convention can also be applied to the additional imaging dose. Therefore we propose three dose categories: Category I: The imaging dose is lower than a 2 % variation of the therapy dose. Category II: The imaging dose is larger than in category I, but lower than the therapy dose variations between different treatment techniques. Category III: The imaging dose is larger than in Category II. For various treatment techniques dose measurements are used to define the dose categories. The imaging devices were categorized according to the measured dose. Planar kV-kV imaging is a category I imaging procedure. kV-MV imaging is located at the edge between category I and II and is for increasing fraction size safely a category I imaging technique. MV-MV imaging is for all imaging technologies a category II procedure. MV fan beam CT for localization is a category I technology. Low dose protocols for kV CBCT are located between category I and II and are for increasing fraction size a category I imaging technique. All other investigated Pelvis-CBCT protocols are category II procedures. Fan beam CT scout views are category I technology. Live imaging modalities are category III for conventional fractionation, but category II for stereotactic treatments. Dose from radiotherapy

  18. A dual-targeting upconversion nanoplatform for two-color fluorescence imaging-guided photodynamic therapy.

    Wang, Xu; Yang, Cheng-Xiong; Chen, Jia-Tong; Yan, Xiu-Ping

    2014-04-01

    The targetability of a theranostic probe is one of the keys to assuring its theranostic efficiency. Here we show the design and fabrication of a dual-targeting upconversion nanoplatform for two-color fluorescence imaging-guided photodynamic therapy (PDT). The nanoplatform was prepared from 3-aminophenylboronic acid functionalized upconversion nanocrystals (APBA-UCNPs) and hyaluronated fullerene (HAC60) via a specific diol-borate condensation. The two specific ligands of aminophenylboronic acid and hyaluronic acid provide synergistic targeting effects, high targetability, and hence a dramatically elevated uptake of the nanoplatform by cancer cells. The high generation yield of (1)O2 due to multiplexed Förster resonance energy transfer between APBA-UCNPs (donor) and HAC60 (acceptor) allows effective therapy. The present nanoplatform shows great potential for highly selective tumor-targeted imaging-guided PDT.

  19. High-intensity deuteron linear accelerator (FMIT)

    Jameson, R.A.

    1979-01-01

    For fusion reactors to become operational, one of the many problems to be solved is to find materials able to withstand the intense bombardment of 14-MeV neutrons released by the fusion process. The development of alloys less likely to become damaged by this neutron bombardment will require years of work, making it desirable to begin studies in parallel with other aspects of fusion power generators. The Fusion Materials Irradiation Test (FMIT) Facility, to be built at the Hanford Engineering Development Laboratory (HEDL), Richland, Washington, will provide a high neutron flux and a neutron energy spectrum representative of fusion reactor conditions in volumes adequate to screen and qualify samples of candidate fusion reactor materials. FMIT's design goal is to provide an irradiation test volume of 10 cm 3 at a neutron flux of 10 15 n/cm 2 -s, and 500 cm 3 at a flux of 10 14 n/cm 2 -s. This will not allow testing of actual components, but samples in the most intense flux region can be subjected to accelerated life testing, accumulating in one year the total number of neutrons seen by a fusion reactor in 10 to 20 years of operation

  20. IMRT for Image-Guided Single Vocal Cord Irradiation

    Osman, Sarah O.S.; Astreinidou, Eleftheria; Boer, Hans C.J. de; Keskin-Cambay, Fatma; Breedveld, Sebastiaan; Voet, Peter; Al-Mamgani, Abrahim; Heijmen, Ben J.M.; Levendag, Peter C.

    2012-01-01

    Purpose: We have been developing an image-guided single vocal cord irradiation technique to treat patients with stage T1a glottic carcinoma. In the present study, we compared the dose coverage to the affected vocal cord and the dose delivered to the organs at risk using conventional, intensity-modulated radiotherapy (IMRT) coplanar, and IMRT non-coplanar techniques. Methods and Materials: For 10 patients, conventional treatment plans using two laterally opposed wedged 6-MV photon beams were calculated in XiO (Elekta-CMS treatment planning system). An in-house IMRT/beam angle optimization algorithm was used to obtain the coplanar and non-coplanar optimized beam angles. Using these angles, the IMRT plans were generated in Monaco (IMRT treatment planning system, Elekta-CMS) with the implemented Monte Carlo dose calculation algorithm. The organs at risk included the contralateral vocal cord, arytenoids, swallowing muscles, carotid arteries, and spinal cord. The prescription dose was 66 Gy in 33 fractions. Results: For the conventional plans and coplanar and non-coplanar IMRT plans, the population-averaged mean dose ± standard deviation to the planning target volume was 67 ± 1 Gy. The contralateral vocal cord dose was reduced from 66 ± 1 Gy in the conventional plans to 39 ± 8 Gy and 36 ± 6 Gy in the coplanar and non-coplanar IMRT plans, respectively. IMRT consistently reduced the doses to the other organs at risk. Conclusions: Single vocal cord irradiation with IMRT resulted in good target coverage and provided significant sparing of the critical structures. This has the potential to improve the quality-of-life outcomes after RT and maintain the same local control rates.

  1. IMRT for Image-Guided Single Vocal Cord Irradiation

    Osman, Sarah O.S., E-mail: s.osman@erasmusmc.nl [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Astreinidou, Eleftheria; Boer, Hans C.J. de; Keskin-Cambay, Fatma; Breedveld, Sebastiaan; Voet, Peter; Al-Mamgani, Abrahim; Heijmen, Ben J.M.; Levendag, Peter C. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-02-01

    Purpose: We have been developing an image-guided single vocal cord irradiation technique to treat patients with stage T1a glottic carcinoma. In the present study, we compared the dose coverage to the affected vocal cord and the dose delivered to the organs at risk using conventional, intensity-modulated radiotherapy (IMRT) coplanar, and IMRT non-coplanar techniques. Methods and Materials: For 10 patients, conventional treatment plans using two laterally opposed wedged 6-MV photon beams were calculated in XiO (Elekta-CMS treatment planning system). An in-house IMRT/beam angle optimization algorithm was used to obtain the coplanar and non-coplanar optimized beam angles. Using these angles, the IMRT plans were generated in Monaco (IMRT treatment planning system, Elekta-CMS) with the implemented Monte Carlo dose calculation algorithm. The organs at risk included the contralateral vocal cord, arytenoids, swallowing muscles, carotid arteries, and spinal cord. The prescription dose was 66 Gy in 33 fractions. Results: For the conventional plans and coplanar and non-coplanar IMRT plans, the population-averaged mean dose {+-} standard deviation to the planning target volume was 67 {+-} 1 Gy. The contralateral vocal cord dose was reduced from 66 {+-} 1 Gy in the conventional plans to 39 {+-} 8 Gy and 36 {+-} 6 Gy in the coplanar and non-coplanar IMRT plans, respectively. IMRT consistently reduced the doses to the other organs at risk. Conclusions: Single vocal cord irradiation with IMRT resulted in good target coverage and provided significant sparing of the critical structures. This has the potential to improve the quality-of-life outcomes after RT and maintain the same local control rates.

  2. Image-guided radiofrequency ablation of renal cell carcinoma

    Boss, Andreas; Clasen, Stephan; Pereira, Philippe L.; Kuczyk, Markus; Schick, Fritz

    2007-01-01

    The incidence of renal cell carcinoma is rising with the increased number of incidental detection of small tumours. During the past few years, percutaneous imaging-guided radiofrequency ablation has evolved as a minimally invasive treatment of small unresectable renal tumours offering reduced patient morbidity and overall health care costs. In radiofrequency ablation, thermal energy is deposited into a targeted tumour by means of a radiofrequency applicator. In recent studies, radiofrequency ablation was shown to be an effective and safe modality for local destruction of renal cell carcinoma. Radiofrequency applicator navigation can be performed via ultrasound, computed tomography or magnetic resonance guidance; however, ultrasound seems less favourable because of the absence of monitoring capabilities during ablation. On-line monitoring of treatment outcome can only be performed with magnetic resonance imaging giving the possibility of eventual applicator repositioning to ablate visible residual tumour tissue. Long-term follow-up is crucial to assess completeness of tumour ablation. New developments in ablation technology and radiological equipment will further increase the indication field for radiofrequency ablation of renal cell carcinoma. Altogether, radiofrequency ablation seems to be a promising new modality for the minimally invasive treatment of renal cell carcinoma, which was demonstrated to exhibit high short-term effectiveness. (orig.)

  3. Synthesis of multifunctional gold nanoparticles for image guided therapy

    Laurent, Gautier

    2014-01-01

    The original properties of nanoparticles make them extremely attractive in the field of oncology. In fast, gold nanoparticles coated by macrocyclic ligands allow imaging and therapy with only one object. Therefore, multifunctional platforms are very promising for image-guided therapy, winch constitutes an important step towards personalization of treatment. This consists of stimulating the therapeutic activity of the nanoparticles when their accumulation is high within the tumor zone and low in healthy tissues. A higher selectivity of the treatment is therefore expected. Biodistribution study by SPECT/CT has shown free circulation, renal elimination and a moderate retention by the liver of the nanoparticles. However, this retention is not due to the opsonisation processes. The MRI study of rats' brain carrying a gliosarcoma has shown an accumulation of nanoparticles Au-at-FADOTAGA-Gd in the tumor. Moreover, the co-labeling of these nanoparticles by Ge and 64Cts2+ was successfully performed. As a result, PET/MRI images, a much researched combination but rarely achieved, were acquired on the same animal alter intravenous injection of the co-labeled nanoparticles. The radiosensitizing character of nanoparticles Au-at-TADOTAGA was confirmed by the follow up of tumor growth alter a treatment by MRT (microbeam irradiation) 15 minutes after intratumoral injection of nanoparticles. The therapeutic gain of this treatment has been validated by MRT 24 hours after intravenous injection of nanoparticles to rats carrying gliosarcoma (radioresistant tumor in radiosensitive organ). (author)

  4. Production of high intensity radioactive beams

    Nitschke, J.M.

    1990-04-01

    The production of radioactive nuclear beams world-wide is reviewed. The projectile fragmentation and the ISOL approaches are discussed in detail, and the luminosity parameter is used throughout to compare different production methods. In the ISOL approach a thin and a thick target option are distinguished. The role of storage rings in radioactive beam research is evaluated. It is concluded that radioactive beams produced by the projectile fragmentation and the ISOL methods have complementary characteristics and can serve to answer different scientific questions. The decision which kind of facility to build has to depend on the significance and breadth of these questions. Finally a facility for producing a high intensity radioactive beams near the Coulomb barrier is proposed, with an expected luminosity of ∼10 39 cm -2 s -1 , which would yield radioactive beams in excess of 10 11 s -1 . 9 refs., 3 figs., 7 tabs

  5. A High Intensity Hadron Facility, AGS II

    Lee, Y.Y.; Lowenstein, D.I.

    1988-01-01

    We have present one of several possibilities for the evolution of the AGS complex into a high intensity hadron facility. One could consider other alternatives, such as using the AGS as the Collector and constructing a new 9-30 GeV machine. We believe the most responsible scenario must minimize the cost and downtime to the ongoing physics program. With a stepwise approach, starting with the Booster, the physics program can evolve without a single major commitment in funds. At each step an evaluation of the funds versus physics merit can be made. As a final aside, each upgrade at the AGS and Booster is presently being implemented to support an interleaved operation of both protons and ions. 1 fig., 6 tabs

  6. High intensity proton accelerator controls network upgrade

    Krempaska, R.; Bertrand, A.; Lendzian, F.; Lutz, H.

    2012-01-01

    The High Intensity Proton Accelerator (HIPA) control system network is spread through a vast area in PSI and it was grown historically in an unorganized way. The miscellaneous network hardware infrastructure and the lack of the documentation and components overview could no longer guarantee the reliability of the control system and the facility operation. Therefore, a new network, based on modern network topology, PSI standard hardware with monitoring and detailed documentation and overview was needed. The number of active components has been reduced from 25 to 9 Cisco Catalyst 24- or 48-port switches. They are the same type as other PSI switches, thus a replacement emergency stock is not an issue anymore. We would like to present how we successfully achieved this goal and the advantages of the clean and well documented network infrastructure. (authors)

  7. Image-guided pleural biopsy: diagnostic yield and complications

    Benamore, R.E.; Scott, K.; Richards, C.J.; Entwisle, J.J.

    2006-01-01

    Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following biopsy, presence of pleura in the biopsy, and adequacy of tissue for histological diagnosis. Results: A total of 82 patients underwent 85 image-guided pleural biopsies over a 4-year period. 80 cases were performed under CT and five under US guidance. The rate of new pneumothorax detected by chest radiography was 4.7%. No patient required a chest drain or blood transfusion to treat complications. In 10 (12%) cases, there was inadequate tissue to reach a confident histological diagnosis and in eight (9%) of these, no pleura was present. Assuming all suspicious and inadequate biopsies are treated as benign, which is the worst case scenario, image-guided pleural biopsy has a sensitivity and specificity of 76% and 100%, respectively, for the diagnosis of malignant disease. Conclusions: Image-guided pleural biopsy is a safe procedure with few associated complications and has a higher sensitivity than previously published series for reverse cutting needle biopsy in the diagnosis of malignant pleural disease

  8. Image-guided pleural biopsy: diagnostic yield and complications

    Benamore, R.E. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom)]. E-mail: rachelbenamore@doctors.org.uk; Scott, K. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom); Richards, C.J. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom); Entwisle, J.J. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom)

    2006-08-15

    Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following biopsy, presence of pleura in the biopsy, and adequacy of tissue for histological diagnosis. Results: A total of 82 patients underwent 85 image-guided pleural biopsies over a 4-year period. 80 cases were performed under CT and five under US guidance. The rate of new pneumothorax detected by chest radiography was 4.7%. No patient required a chest drain or blood transfusion to treat complications. In 10 (12%) cases, there was inadequate tissue to reach a confident histological diagnosis and in eight (9%) of these, no pleura was present. Assuming all suspicious and inadequate biopsies are treated as benign, which is the worst case scenario, image-guided pleural biopsy has a sensitivity and specificity of 76% and 100%, respectively, for the diagnosis of malignant disease. Conclusions: Image-guided pleural biopsy is a safe procedure with few associated complications and has a higher sensitivity than previously published series for reverse cutting needle biopsy in the diagnosis of malignant pleural disease.

  9. High Intensity High Charge State ECR Ion Sources

    Leitner, Daniela

    2005-01-01

    The next-generation heavy ion beam accelerators such as the proposed Rare Isotope Accelerator (RIA), the Radioactive Ion Beam Factory at RIKEN, the GSI upgrade project, the LHC-upgrade, and IMP in Lanzhou require a great variety of high charge state ion beams with a magnitude higher beam intensity than currently achievable. High performance Electron Cyclotron Resonance (ECR) ion sources can provide the flexibility since they can routinely produce beams from hydrogen to uranium. Over the last three decades, ECR ion sources have continued improving the available ion beam intensities by increasing the magnetic fields and ECR heating frequencies to enhance the confinement and the plasma density. With advances in superconducting magnet technology, a new generation of high field superconducting sources is now emerging, designed to meet the requirements of these next generation accelerator projects. The talk will briefly review the field of high performance ECR ion sources and the latest developments for high intens...

  10. Applications of High Intensity Proton Accelerators

    Raja, Rajendran; Mishra, Shekhar

    2010-06-01

    Superconducting radiofrequency linac development at Fermilab / S. D. Holmes -- Rare muon decay experiments / Y. Kuno -- Rare kaon decays / D. Bryman -- Muon collider / R. B. Palmer -- Neutrino factories / S. Geer -- ADS and its potential / J.-P. Revol -- ADS history in the USA / R. L. Sheffield and E. J. Pitcher -- Accelerator driven transmutation of waste: high power accelerator for the European ADS demonstrator / J. L. Biarrotte and T. Junquera -- Myrrha, technology development for the realisation of ADS in EU: current status & prospects for realisation / R. Fernandez ... [et al.] -- High intensity proton beam production with cyclotrons / J. Grillenberger and M. Seidel -- FFAG for high intensity proton accelerator / Y. Mori -- Kaon yields for 2 to 8 GeV proton beams / K. K. Gudima, N. V. Mokhov and S. I. Striganov -- Pion yield studies for proton driver beams of 2-8 GeV kinetic energy for stopped muon and low-energy muon decay experiments / S. I. Striganov -- J-Parc accelerator status and future plans / H. Kobayashi -- Simulation and verification of DPA in materials / N. V. Mokhov, I. L. Rakhno and S. I. Striganov -- Performance and operational experience of the CNGS facility / E. Gschwendtner -- Particle physics enabled with super-conducting RF technology - summary of working group 1 / D. Jaffe and R. Tschirhart -- Proton beam requirements for a neutrino factory and muon collider / M. S. Zisman -- Proton bunching options / R. B. Palmer -- CW SRF H linac as a proton driver for muon colliders and neutrino factories / M. Popovic, C. M. Ankenbrandt and R. P. Johnson -- Rapid cycling synchrotron option for Project X / W. Chou -- Linac-based proton driver for a neutrino factory / R. Garoby ... [et al.] -- Pion production for neutrino factories and muon colliders / N. V. Mokhov ... [et al.] -- Proton bunch compression strategies / V. Lebedev -- Accelerator test facility for muon collider and neutrino factory R&D / V. Shiltsev -- The superconducting RF linac for muon

  11. Minimally Invasive Spinal Surgery with Intraoperative Image-Guided Navigation

    Terrence T. Kim

    2016-01-01

    Full Text Available We present our perioperative minimally invasive spine surgery technique using intraoperative computed tomography image-guided navigation for the treatment of various lumbar spine pathologies. We present an illustrative case of a patient undergoing minimally invasive percutaneous posterior spinal fusion assisted by the O-arm system with navigation. We discuss the literature and the advantages of the technique over fluoroscopic imaging methods: lower occupational radiation exposure for operative room personnel, reduced need for postoperative imaging, and decreased revision rates. Most importantly, we demonstrate that use of intraoperative cone beam CT image-guided navigation has been reported to increase accuracy.

  12. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

    Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

    2017-08-01

    To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

  13. ''High intensity per bunch'' working group

    2001-01-01

    Third Generation Light Sources are supposed to store high intensity beams not only in many tightly spaced bunches (multibunch operation), but also in few bunch or even single lunch modes of operation, required for example for time structure experiments. Single bunch instabilities, driven by short-range wake fields, however spoil the beam quality, both longitudinally and transversely. Straightforward ways of handling them, by pushing up the chromaticity (ζ = ΔQ/(Δp/p)) for example, enabled to raise the charge per bunch, but to the detriment of beam lifetime. In addition, since the impedance of the vacuum chamber deteriorates with the installation of new insertion devices, the current thresholds tend to dope down continuously. The goal of this Working Group was then to review these limitations in the existing storage rings, where a large number of beam measurements have been performed to characterise them, and to discuss different strategies which are used against them. About 15 different laboratories reported on the present performance of storage rings, experiences gained in high charge per bunch, and on simulation results and theoretical studies. More than 25 presentations addressed the critical issues and stimulated the discussion. Four main topics came out: - Observation and experimental data; - Impedance studies and tracking codes; - Theoretical investigations; - Cures and feedback. (author)

  14. High intensity neutrino oscillation facilities in Europe

    Edgecock, T.R.; Davenne, T.; Densham, C.; Fitton, M.; Kelliher, D.; Loveridge, P.; Machida, S.; Prior, C.; Rogers, C.; Rooney, M.; Thomason, J.; Wilcox, D.; Wildner, E.; Efthymiopoulos, I.; Garoby, R.; Gilardoni, S.; Hansen, C.; Benedetto, E.; Jensen, E.; Kosmicki, A.; Martini, M.; Osborne, J.; Prior, G.; Stora, T.; Melo-Mendonca, T.; Vlachoudis, V.; Waaijer, C.; Cupial, P.; Chancé, A.; Longhin, A.; Payet, J.; Zito, M.; Baussan, E.; Bobeth, C.; Bouquerel, E.; Dracos, M.; Gaudiot, G.; Lepers, B.; Osswald, F.; Poussot, P.; Vassilopoulos, N.; Wurtz, J.; Zeter, V.; Bielski, J.; Kozien, M.; Lacny, L.; Skoczen, B.; Szybinski, B.; Ustrzycka, A.; Wroblewski, A.; Marie-Jeanne, M.; Balint, P.; Fourel, C.; Giraud, J.; Jacob, J.; Lamy, T.; Latrasse, L.; Sortais, P.; Thuillier, T.; Mitrofanov, S.; Loiselet, M.; Keutgen, Th.; Delbar, Th.; Debray, F.; Trophine, C.; Veys, S.; Daversin, C.; Zorin, V.; Izotov, I.; Skalyga, V.; Burt, G.; Dexter, A.C.; Kravchuk, V.L.; Marchi, T.; Cinausero, M.; Gramegna, F.; De Angelis, G.; Prete, G.; Collazuol, G.; Laveder, M.; Mazzocco, M.; Mezzetto, M.; Signorini, C.; Vardaci, E.; Di Nitto, A.; Brondi, A.; La Rana, G.; Migliozzi, P.; Moro, R.; Palladino, V.; Gelli, N.; Berkovits, D.; Hass, M.; Hirsh, T.Y.; Schaumann, M.; Stahl, A.; Wehner, J.; Bross, A.; Kopp, J.; Neuffer, D.; Wands, R.; Bayes, R.; Laing, A.; Soler, P.; Agarwalla, S.K.; Cervera Villanueva, A.; Donini, A.; Ghosh, T.; Gómez Cadenas, J.J.; Hernández, P.; Martín-Albo, J.; Mena, O.; Burguet-Castell, J.; Agostino, L.; Buizza-Avanzini, M.; Marafini, M.; Patzak, T.; Tonazzo, A.; Duchesneau, D.; Mosca, L.; Bogomilov, M.; Karadzhov, Y.; Matev, R.; Tsenov, R.; Akhmedov, E.; Blennow, M.; Lindner, M.; Schwetz, T.; Fernández Martinez, E.; Maltoni, M.; Menéndez, J.; Giunti, C.; González García, M. C.; Salvado, J.; Coloma, P.; Huber, P.; Li, T.; López-Pavón, J.; Orme, C.; Pascoli, S.; Meloni, D.; Tang, J.; Winter, W.; Ohlsson, T.; Zhang, H.; Scotto-Lavina, L.; Terranova, F.; Bonesini, M.; Tortora, L.; Alekou, A.; Aslaninejad, M.; Bontoiu, C.; Kurup, A.; Jenner, L.J.; Long, K.; Pasternak, J.; Pozimski, J.; Back, J.J.; Harrison, P.; Beard, K.; Bogacz, A.; Berg, J.S.; Stratakis, D.; Witte, H.; Snopok, P.; Bliss, N.; Cordwell, M.; Moss, A.; Pattalwar, S.; Apollonio, M.

    2013-02-20

    The EUROnu project has studied three possible options for future, high intensity neutrino oscillation facilities in Europe. The first is a Super Beam, in which the neutrinos come from the decay of pions created by bombarding targets with a 4 MW proton beam from the CERN High Power Superconducting Proton Linac. The far detector for this facility is the 500 kt MEMPHYS water Cherenkov, located in the Fr\\'ejus tunnel. The second facility is the Neutrino Factory, in which the neutrinos come from the decay of {\\mu}+ and {\\mu}- beams in a storage ring. The far detector in this case is a 100 kt Magnetised Iron Neutrino Detector at a baseline of 2000 km. The third option is a Beta Beam, in which the neutrinos come from the decay of beta emitting isotopes, in particular 6He and 18Ne, also stored in a ring. The far detector is also the MEMPHYS detector in the Fr\\'ejus tunnel. EUROnu has undertaken conceptual designs of these facilities and studied the performance of the detectors. Based on this, it has determined the ph...

  15. High repetition rate intense ion beam source

    Hammer, D.A.; Glidden, S.C.; Noonan, B.

    1992-01-01

    This final report describes a ≤ 150kV, 40kA, 100ns high repetition rate pulsed power system and intense ion beam source which is now in operation at Cornell University. Operation of the Magnetically-controlled Anode Plasma (MAP) ion diode at > 100Hz (burst mode for up to 10 pulse bursts) provides an initial look at repetition rate limitations of both the ion diode and beam diagnostics. The pulsed power systems are capable of ≥ 1kHz operation (up to 10 pulse bursts), but ion diode operation was limited to ∼100Hz because of diagnostic limitations. By varying MAP diode operating parameters, ion beams can be extracted at a few 10s of keV or at up to 150keV, the corresponding accelerating gap impedance ranging from about 1Ω to about 10Ω. The ability to make hundreds of test pulses per day at an average repetition rate of about 2 pulses per minute permits statistical analysis of diode operation as a function of various parameters. Most diode components have now survived more than 10 4 pulses, and the design and construction of the various pulsed power components of the MAP diode which have enabled us to reach this point are discussed. A high speed data acquisition system and companion analysis software capable of acquiring pulse data at 1ms intervals (in bursts of up to 10 pulses) and processing it in ≤ min is described

  16. MR image-guided portal verification for brain treatment field

    Yin, F.-F.; Gao, Q.H.; Xie, H.; Nelson, D.F.; Yu, Y.; Kwok, W.E.; Totterman, S.; Schell, M.C.; Rubin, P.

    1996-01-01

    and marrow information within the skull. Next, a ray-tracing method is used to generate a projection (pseudo-portal) image at the planned treatment position. In this situation, the ray-tracing is simply performed on pixels rather than attenuation coefficients. The skull and its relative positions are also projected to the pseudo-portal image and are used as 'hint' for the search of similar features in the portal images. A Canny edge detector is applied to the region of treatment field and is used to enhance brain contour and skull. The skull in the brain is then identified using a snake technique which is guided by the ''hint'', the projected features from MR images. Finally, a Chamfer matching technique is used to correlate features between the MR projection and portal images. Results: MR image-guided portal verification technique is evaluated using a clinical patient case who has an astrocytoma brain tumor and is treated by radiation therapy. The segmented results for brain MR slice images indicate that a wavelet-based image segmentation technique provides a reasonable estimation for the brain skull. Compared to the brain portal image, the method developed in this study for the generation of brain projection images provides skull structure about 3 mm differences. However, overall matching results are within 2 mm compared to the results between portal and simulation images. In addition, tumor volume can be accurately visualized in the projection image and be mapped over to portal images for treatment verification with this approach. Conclusions: A method for MR image-guided portal verification of brain treatment field is being developed. Although the projection image from MR images dose not have the similar radiographic appearance as portal images, it provides certain essential anatomical features (landmarks and gross tumor) as well as their relative locations to be used as references for computerized portal verification

  17. High Intensity Organic Light-emitting Diodes

    Qi, Xiangfei

    This thesis is dedicated to the fabrication, modeling, and characterization to achieve high efficiency organic light-emitting diodes (OLEDs) for illumination applications. Compared to conventional lighting sources, OLEDs enabled the direct conversion of electrical energy into light emission and have intrigued the world's lighting designers with the long-lasting, highly efficient illumination. We begin with a brief overview of organic technology, from basic organic semiconductor physics, to its application in optoelectronics, i.e. light-emitting diodes, photovoltaics, photodetectors and thin-film transistors. Due to the importance of phosphorescent materials, we will focus on the photophysics of metal complexes that is central to high efficiency OLED technology, followed by a transient study to examine the radiative decay dynamics in a series of phosphorescent platinum binuclear complexes. The major theme of this thesis is the design and optimization of a novel architecture where individual red, green and blue phosphorescent OLEDs are vertically stacked and electrically interconnected by the compound charge generation layers. We modeled carrier generation from the metal-oxide/doped organic interface based on a thermally assisted tunneling mechanism. The model provides insights to the optimization of a stacked OLED from both electrical and optical point of view. To realize the high intensity white lighting source, the efficient removal of heat is of a particular concern, especially in large-area devices. A fundamental transfer matrix analysis is introduced to predict the thermal properties in the devices. The analysis employs Laplace transforms to determine the response of the system to the combined effects of conduction, convection, and radiation. This perspective of constructing transmission matrices greatly facilitates the calculation of transient coupled heat transfer in a general multi-layer composite. It converts differential equations to algebraic forms, and

  18. 'J-KAREN' - high intensity, high contrast laser

    Kiriyama, Hiromitsu; Mori, Michiaki; Nakai, Yoshiki; Okada, Hajime; Sasao, Hajime; Sagisaka, Akito; Ochi, Yoshihiro; Tanaka, Momoko; Kondo, Kiminori; Tateno, Ryo; Sugiyama, Akira; Daido, Hiroyuki; Koike, Masato; Kawanishi, Syunichi; Shimomura, Takuya; Tanoue, Manabu; Wakai, Daisuke; Kondo, Shuji; Kanazawa, Shuhei

    2010-01-01

    We report on the high intensity, high contrast double chirped-pulse amplification (CPA) Ti:sapphire laser system (named J-KAREN). By use of an optical parametric chirped-pulse amplification (OPCPA) preamplifier that is seeded by a cleaned high-energy pulse, a background amplified spontaneous emission (ASE) level of 10 -10 relative to the peak main femtosecond pulse on the picosecond timescales demonstrated with an output energy of 1.7 J and a pulse duration of 30 fs, corresponding to a peak power of 60TW at a 10 Hz repetition rate. This system which uses a cryogenically-cooled Ti:sapphire final amplifier generates focused peak intensity in excess of 10 20 W/cm 2 at a 10 Hz repetition rate. (author)

  19. The Role of Seminal Vesicle Motion in Target Margin Assessment for Online Image-Guided Radiotherapy for Prostate Cancer

    Liang Jian; Wu Qiuwen; Yan Di

    2009-01-01

    Purpose: For patients with intermediate- and high-risk prostate cancer, the seminal vesicles (SVs) are included in the clinical target volume (CTV). The purposes of this study are to investigate interfraction motion characteristics of the SVs and determine proper margins for online computed tomography image guidance. Methods and Materials: Twenty-four patients, each with 16 daily helical computed tomography scans, were included in this study. A binary image mask was used for image registration to determine daily organ motion. Two online image-guided radiotherapy strategies (prostate only and prostate + SVs) were simulated in a hypofractionated scheme. Three margin designs were studied for both three-dimensional conformal radiotherapy and intensity-modulated radiotherapy (IMRT). In prostate-only guidance, Margin A was uniformly applied to the whole CTV, and Margin B was applied to the SVs with a fixed 3-mm prostate margin. In prostate plus SV guidance, Margin C was uniformly applied to the CTV. The minimum margins were sought to satisfy the criterion that minimum cumulative CTV dose be more than those of the planning target volume in the plan for greater than 95% of patients. Results: The prostate and SVs move significantly more in the anterior-posterior and superior-inferior than right-left directions. The anterior-posterior motion of the prostate and SVs correlated (R 2 = 0.7). The SVs move significantly more than the prostate. The minimum margins found were 2.5 mm for three-dimensional conformal radiotherapy and 4.5, 4.5, and 3.0 mm for Margins A, B, and C for IMRT, respectively. Margins for IMRT were larger, but the irradiated volume and doses to critical structures were smaller. Minimum margins of 4.5 mm to the SVs and 3 mm to the prostate are recommended for IMRT with prostate-only guidance. Conclusions: The SVs move independently from the prostate gland, and additional margins are necessary for image-guided radiotherapy

  20. Tissue feature-based intra-fractional motion tracking for stereoscopic x-ray image guided radiotherapy

    Xie, Yaoqin; Xing, Lei; Gu, Jia; Liu, Wu

    2013-06-01

    Real-time knowledge of tumor position during radiation therapy is essential to overcome the adverse effect of intra-fractional organ motion. The goal of this work is to develop a tumor tracking strategy by effectively utilizing the inherent image features of stereoscopic x-ray images acquired during dose delivery. In stereoscopic x-ray image guided radiation delivery, two orthogonal x-ray images are acquired either simultaneously or sequentially. The essence of markerless tumor tracking is the reliable identification of inherent points with distinct tissue features on each projection image and their association between two images. The identification of the feature points on a planar x-ray image is realized by searching for points with high intensity gradient. The feature points are associated by using the scale invariance features transform descriptor. The performance of the proposed technique is evaluated by using images of a motion phantom and four archived clinical cases acquired using either a CyberKnife equipped with a stereoscopic x-ray imaging system, or a LINAC equipped with an onboard kV imager and an electronic portal imaging device. In the phantom study, the results obtained using the proposed method agree with the measurements to within 2 mm in all three directions. In the clinical study, the mean error is 0.48 ± 0.46 mm for four patient data with 144 sequential images. In this work, a tissue feature-based tracking method for stereoscopic x-ray image guided radiation therapy is developed. The technique avoids the invasive procedure of fiducial implantation and may greatly facilitate the clinical workflow.

  1. Tissue feature-based intra-fractional motion tracking for stereoscopic x-ray image guided radiotherapy

    Xie Yaoqin; Gu Jia; Xing Lei; Liu Wu

    2013-01-01

    Real-time knowledge of tumor position during radiation therapy is essential to overcome the adverse effect of intra-fractional organ motion. The goal of this work is to develop a tumor tracking strategy by effectively utilizing the inherent image features of stereoscopic x-ray images acquired during dose delivery. In stereoscopic x-ray image guided radiation delivery, two orthogonal x-ray images are acquired either simultaneously or sequentially. The essence of markerless tumor tracking is the reliable identification of inherent points with distinct tissue features on each projection image and their association between two images. The identification of the feature points on a planar x-ray image is realized by searching for points with high intensity gradient. The feature points are associated by using the scale invariance features transform descriptor. The performance of the proposed technique is evaluated by using images of a motion phantom and four archived clinical cases acquired using either a CyberKnife equipped with a stereoscopic x-ray imaging system, or a LINAC equipped with an onboard kV imager and an electronic portal imaging device. In the phantom study, the results obtained using the proposed method agree with the measurements to within 2 mm in all three directions. In the clinical study, the mean error is 0.48 ± 0.46 mm for four patient data with 144 sequential images. In this work, a tissue feature-based tracking method for stereoscopic x-ray image guided radiation therapy is developed. The technique avoids the invasive procedure of fiducial implantation and may greatly facilitate the clinical workflow. (paper)

  2. Radiologists' leading position in image-guided therapy

    Helmberger, Thomas; Martí-Bonmatí, Luis; Pereira, Philippe; Gillams, Alice; Martínez, Jose; Lammer, Johannes; Malagari, Katarina; Gangi, Afshin; de Baere, Thierry; Adam, E. Jane; Rasch, Coen; Budach, Volker; Reekers, Jim A.

    2013-01-01

    Image-guided diagnostic and therapeutic procedures are related to, or performed under, some kind of imaging. Such imaging may be direct inspection (as in open surgery) or indirect inspection as in endoscopy or laparoscopy. Common to all these techniques is the transformation of optical and visible

  3. High-intensity laser application in Orthodontics

    Eduardo Franzotti Sant’Anna

    Full Text Available ABSTRACT Introduction: In dental practice, low-level laser therapy (LLLT and high-intensity laser therapy (HILT are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. Objective: The aim of this study is to discuss HILT applications in orthodontic treatment. Methods: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Conclusion: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.

  4. In vivo 808 nm image-guided photodynamic therapy based on an upconversion theranostic nanoplatform

    Liu, Xiaomin; Que, Ivo; Kong, Xianggui; Zhang, Youlin; Tu, Langping; Chang, Yulei; Wang, Tong Tong; Chan, Alan; Löwik, Clemens W. G. M.; Zhang, Hong

    2015-09-01

    A new strategy for efficient in vivo image-guided photodynamic therapy (PDT) has been demonstrated utilizing a ligand-exchange constructed upconversion-C60 nanophotosensitizer. This theranostic platform is superior to the currently reported nanophotosensitizers in (i) directly bonding photosensitizer C60 to the surface of upconversion nanoparticles (UCNPs) by a smart ligand-exchange strategy, which greatly shortened the energy transfer distance and enhanced the 1O2 production, resulting in the improvement of the therapeutic effect; (ii) realizing in vivo NIR 808 nm image-guided PDT with both excitation (980 nm) and emission (808 nm) light falling in the biological window of tissues, which minimized auto-fluorescence, reduced light scatting and improved the imaging contrast and depth, and thus guaranteed noninvasive diagnostic accuracy. In vivo and ex vivo tests demonstrated its favorable bio-distribution, tumor-selectivity and high therapeutic efficacy. Owing to the effective ligand exchange strategy and the excellent intrinsic photophysical properties of C60, 1O2 production yield was improved, suggesting that a low 980 nm irradiation dosage (351 J cm-2) and a short treatment time (15 min) were sufficient to perform NIR (980 nm) to NIR (808 nm) image-guided PDT. Our work enriches the understanding of UCNP-based PDT nanophotosensitizers and highlights their potential use in future NIR image-guided noninvasive deep cancer therapy.A new strategy for efficient in vivo image-guided photodynamic therapy (PDT) has been demonstrated utilizing a ligand-exchange constructed upconversion-C60 nanophotosensitizer. This theranostic platform is superior to the currently reported nanophotosensitizers in (i) directly bonding photosensitizer C60 to the surface of upconversion nanoparticles (UCNPs) by a smart ligand-exchange strategy, which greatly shortened the energy transfer distance and enhanced the 1O2 production, resulting in the improvement of the therapeutic effect; (ii

  5. Physics of intense, high energy radiation effects.

    Hjalmarson, Harold Paul; Hartman, E. Frederick; Magyar, Rudolph J.; Crozier, Paul Stewart

    2011-02-01

    This document summarizes the work done in our three-year LDRD project titled 'Physics of Intense, High Energy Radiation Effects.' This LDRD is focused on electrical effects of ionizing radiation at high dose-rates. One major thrust throughout the project has been the radiation-induced conductivity (RIC) produced by the ionizing radiation. Another important consideration has been the electrical effect of dose-enhanced radiation. This transient effect can produce an electromagnetic pulse (EMP). The unifying theme of the project has been the dielectric function. This quantity contains much of the physics covered in this project. For example, the work on transient electrical effects in radiation-induced conductivity (RIC) has been a key focus for the work on the EMP effects. This physics in contained in the dielectric function, which can also be expressed as a conductivity. The transient defects created during a radiation event are also contained, in principle. The energy loss lead the hot electrons and holes is given by the stopping power of ionizing radiation. This information is given by the inverse dielectric function. Finally, the short time atomistic phenomena caused by ionizing radiation can also be considered to be contained within the dielectric function. During the LDRD, meetings about the work were held every week. These discussions involved theorists, experimentalists and engineers. These discussions branched out into the work done in other projects. For example, the work on EMP effects had influence on another project focused on such phenomena in gases. Furthermore, the physics of radiation detectors and radiation dosimeters was often discussed, and these discussions had impact on related projects. Some LDRD-related documents are now stored on a sharepoint site (https://sharepoint.sandia.gov/sites/LDRD-REMS/default.aspx). In the remainder of this document the work is described in catergories but there is much overlap between the atomistic

  6. Physics of intense, high energy radiation effects

    Hjalmarson, Harold Paul; Hartman, E. Frederick; Magyar, Rudolph J.; Crozier, Paul Stewart

    2011-01-01

    This document summarizes the work done in our three-year LDRD project titled 'Physics of Intense, High Energy Radiation Effects.' This LDRD is focused on electrical effects of ionizing radiation at high dose-rates. One major thrust throughout the project has been the radiation-induced conductivity (RIC) produced by the ionizing radiation. Another important consideration has been the electrical effect of dose-enhanced radiation. This transient effect can produce an electromagnetic pulse (EMP). The unifying theme of the project has been the dielectric function. This quantity contains much of the physics covered in this project. For example, the work on transient electrical effects in radiation-induced conductivity (RIC) has been a key focus for the work on the EMP effects. This physics in contained in the dielectric function, which can also be expressed as a conductivity. The transient defects created during a radiation event are also contained, in principle. The energy loss lead the hot electrons and holes is given by the stopping power of ionizing radiation. This information is given by the inverse dielectric function. Finally, the short time atomistic phenomena caused by ionizing radiation can also be considered to be contained within the dielectric function. During the LDRD, meetings about the work were held every week. These discussions involved theorists, experimentalists and engineers. These discussions branched out into the work done in other projects. For example, the work on EMP effects had influence on another project focused on such phenomena in gases. Furthermore, the physics of radiation detectors and radiation dosimeters was often discussed, and these discussions had impact on related projects. Some LDRD-related documents are now stored on a sharepoint site (https://sharepoint.sandia.gov/sites/LDRD-REMS/default.aspx). In the remainder of this document the work is described in catergories but there is much overlap between the atomistic calculations, the

  7. High intensity neutrino oscillation facilities in Europe

    T. R. Edgecock

    2013-02-01

    Full Text Available The EUROnu project has studied three possible options for future, high intensity neutrino oscillation facilities in Europe. The first is a Super Beam, in which the neutrinos come from the decay of pions created by bombarding targets with a 4 MW proton beam from the CERN High Power Superconducting Proton Linac. The far detector for this facility is the 500 kt MEMPHYS water Cherenkov, located in the Fréjus tunnel. The second facility is the Neutrino Factory, in which the neutrinos come from the decay of μ^{+} and μ^{-} beams in a storage ring. The far detector in this case is a 100 kt magnetized iron neutrino detector at a baseline of 2000 km. The third option is a Beta Beam, in which the neutrinos come from the decay of beta emitting isotopes, in particular ^{6}He and ^{18}Ne, also stored in a ring. The far detector is also the MEMPHYS detector in the Fréjus tunnel. EUROnu has undertaken conceptual designs of these facilities and studied the performance of the detectors. Based on this, it has determined the physics reach of each facility, in particular for the measurement of CP violation in the lepton sector, and estimated the cost of construction. These have demonstrated that the best facility to build is the Neutrino Factory. However, if a powerful proton driver is constructed for another purpose or if the MEMPHYS detector is built for astroparticle physics, the Super Beam also becomes very attractive.

  8. Testicular Doses in Image-Guided Radiotherapy of Prostate Cancer

    Deng Jun; Chen Zhe; Yu, James B.; Roberts, Kenneth B.; Peschel, Richard E.; Nath, Ravinder

    2012-01-01

    Purpose: To investigate testicular doses contributed by kilovoltage cone-beam computed tomography (kVCBCT) during image-guided radiotherapy (IGRT) of prostate cancer. Methods and Materials: An EGS4 Monte Carlo code was used to calculate three-dimensional dose distributions from kVCBCT on 3 prostate cancer patients. Absorbed doses to various organs were compared between intensity-modulated radiotherapy (IMRT) treatments and kVCBCT scans. The impact of CBCT scanning mode, kilovoltage peak energy (kVp), and CBCT field span on dose deposition to testes and other organs was investigated. Results: In comparison with one 10-MV IMRT treatment, a 125-kV half-fan CBCT scan delivered 3.4, 3.8, 4.1, and 5.7 cGy to the prostate, rectum, bladder, and femoral heads, respectively, accounting for 1.7%, 3.2%, 3.2%, and 8.4% of megavoltage photon dose contributions. However, the testes received 2.9 cGy from the same CBCT scan, a threefold increase as compared with 0.7 cGy received during IMRT. With the same kVp, full-fan mode deposited much less dose to organs than half-fan mode, ranging from 9% less for prostate to 69% less for testes, except for rectum, where full-fan mode delivered 34% more dose. As photon beam energy increased from 60 to 125 kV, kVCBCT-contributed doses increased exponentially for all organs, irrespective of scanning mode. Reducing CBCT field span from 30 to 10 cm in the superior–inferior direction cut testicular doses from 5.7 to 0.2 cGy in half-fan mode and from 1.5 to 0.1 cGy in full-fan mode. Conclusions: Compared with IMRT, kVCBCT-contributed doses to the prostate, rectum, bladder, and femoral heads are clinically insignificant, whereas dose to the testes is threefold more. Full-fan CBCT usually deposits much less dose to organs (except for rectum) than half-fan mode in prostate patients. Kilovoltage CBCT–contributed doses increase exponentially with photon beam energy. Reducing CBCT field significantly cuts doses to testes and other organs.

  9. Testicular Doses in Image-Guided Radiotherapy of Prostate Cancer

    Deng Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, CT (United States); Chen Zhe; Yu, James B.; Roberts, Kenneth B.; Peschel, Richard E.; Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, CT (United States)

    2012-01-01

    Purpose: To investigate testicular doses contributed by kilovoltage cone-beam computed tomography (kVCBCT) during image-guided radiotherapy (IGRT) of prostate cancer. Methods and Materials: An EGS4 Monte Carlo code was used to calculate three-dimensional dose distributions from kVCBCT on 3 prostate cancer patients. Absorbed doses to various organs were compared between intensity-modulated radiotherapy (IMRT) treatments and kVCBCT scans. The impact of CBCT scanning mode, kilovoltage peak energy (kVp), and CBCT field span on dose deposition to testes and other organs was investigated. Results: In comparison with one 10-MV IMRT treatment, a 125-kV half-fan CBCT scan delivered 3.4, 3.8, 4.1, and 5.7 cGy to the prostate, rectum, bladder, and femoral heads, respectively, accounting for 1.7%, 3.2%, 3.2%, and 8.4% of megavoltage photon dose contributions. However, the testes received 2.9 cGy from the same CBCT scan, a threefold increase as compared with 0.7 cGy received during IMRT. With the same kVp, full-fan mode deposited much less dose to organs than half-fan mode, ranging from 9% less for prostate to 69% less for testes, except for rectum, where full-fan mode delivered 34% more dose. As photon beam energy increased from 60 to 125 kV, kVCBCT-contributed doses increased exponentially for all organs, irrespective of scanning mode. Reducing CBCT field span from 30 to 10 cm in the superior-inferior direction cut testicular doses from 5.7 to 0.2 cGy in half-fan mode and from 1.5 to 0.1 cGy in full-fan mode. Conclusions: Compared with IMRT, kVCBCT-contributed doses to the prostate, rectum, bladder, and femoral heads are clinically insignificant, whereas dose to the testes is threefold more. Full-fan CBCT usually deposits much less dose to organs (except for rectum) than half-fan mode in prostate patients. Kilovoltage CBCT-contributed doses increase exponentially with photon beam energy. Reducing CBCT field significantly cuts doses to testes and other organs.

  10. Wet high-intensity magnetic separation

    Levin, J.; Shanks, R.I.

    1980-01-01

    Miscellaneous laboratory tests (most of them on cyanide residues) were undertaken to supplement on-site pilot-plant work on wet high intensity magnetic separation (WHIMS). Initially, the main concern was with blockage of the matrix, and consideration was given to the use of a reverse-flushing system. The laboratory tests on this system were encouraging, but they were not of sufficiently long duration to be conclusive. The velocity of the pulp through the matrix is important, because it determines the capacity of the separator and the recovery obtainable. Of almost equal importance is the magnetic load, which affects the velocity of the pulp and the recovery. Typically, a recovery of 51 per cent of the uranium was reduced to one of 40 per cent as the magnetic load was increased from 25 to 100 g/l, while the pulp velocity decreased from 62 to 36 mm/s. There was some indication that, for the same pulp velocity, lower recoveries are obtained when free-fall feeding is used. Some benefit was observed in the application of WHIMS to coarsely ground ore; from a Blyvooruitzicht rod-mill product, 25 per cent of the total uranium was recovered when only 29 per cent of the rod-mill product (the finest portion) was treated. A similar recovery was made from 43 per cent of the rod-mill product from Stilfontein; a second stage of treatment after regrinding raised the overall recovery of uranium to 76,4 per cent. Recoveries of 55 and 42 per cent of the uranium were obtained in tests on two flotation tailings from Free State Geduld. In a determination of the mass magnetic susceptibilities of the constituents in a typical concentrate obtained by WHIMS, it was found that some 20 per cent of the magnetic product had a susceptibility of less than 5,4 X 10 -6 e.m.u. but contained 38 per cent of the uranium recovered by WHIMS. A few tests were conducted on different types of matrix. A matrix of spaced horizontal rods is recommended for possible future consideration [af

  11. Performances of BNL high-intensity synchrotrons

    Weng, W.T.

    1998-03-01

    The AGS proton synchrotron was completed in 1960 with initial intensity in the 10 to the 10th power proton per pulse (ppp) range. Over the years, through many upgrades and improvements, the AGS now reached an intensity record of 6.3 x 10 13 ppp, the highest world intensity record for a proton synchrotron on a single pulse basis. At the same time, the Booster reached 2.2 x 10 13 ppp surpassing the design goal of 1.5 x 10 13 ppp due to the introduction of second harmonic cavity during injection. The intensity limitation caused by space charge tune spread and its relationship to injection energy at 50 MeV, 200 MeV, and 1,500 MeV will be presented as well as many critical accelerator manipulations. BNL currently participates in the design of an accumulator ring for the SNS project at Oak Ridge. The status on the issues of halo formation, beam losses and collimation are also presented

  12. Exposure Risks Among Children Undergoing Radiation Therapy: Considerations in the Era of Image Guided Radiation Therapy

    Hess, Clayton B.; Thompson, Holly M.; Benedict, Stanley H.; Seibert, J. Anthony; Wong, Kenneth; Vaughan, Andrew T.; Chen, Allen M.

    2016-01-01

    Recent improvements in toxicity profiles of pediatric oncology patients are attributable, in part, to advances in the field of radiation oncology such as intensity modulated radiation (IMRT) and proton therapy (IMPT). While IMRT and IMPT deliver highly conformal dose to targeted volumes, they commonly demand the addition of 2- or 3-dimensional imaging for precise positioning—a technique known as image guided radiation therapy (IGRT). In this manuscript we address strategies to further minimize exposure risk in children by reducing effective IGRT dose. Portal X rays and cone beam computed tomography (CBCT) are commonly used to verify patient position during IGRT and, because their relative radiation exposure is far less than the radiation absorbed from therapeutic treatment beams, their sometimes significant contribution to cumulative risk can be easily overlooked. Optimizing the conformality of IMRT/IMPT while simultaneously ignoring IGRT dose may result in organs at risk being exposed to a greater proportion of radiation from IGRT than from therapeutic beams. Over a treatment course, cumulative central-axis CBCT effective dose can approach or supersede the amount of radiation absorbed from a single treatment fraction, a theoretical increase of 3% to 5% in mutagenic risk. In select scenarios, this may result in the underprediction of acute and late toxicity risk (such as azoospermia, ovarian dysfunction, or increased lifetime mutagenic risk) in radiation-sensitive organs and patients. Although dependent on variables such as patient age, gender, weight, body habitus, anatomic location, and dose-toxicity thresholds, modifying IGRT use and acquisition parameters such as frequency, imaging modality, beam energy, current, voltage, rotational degree, collimation, field size, reconstruction algorithm, and documentation can reduce exposure, avoid unnecessary toxicity, and achieve doses as low as reasonably achievable, promoting a culture and practice of “gentle IGRT.”

  13. Exposure Risks Among Children Undergoing Radiation Therapy: Considerations in the Era of Image Guided Radiation Therapy

    Hess, Clayton B. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Thompson, Holly M. [Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California (United States); Benedict, Stanley H. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Seibert, J. Anthony [Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California (United States); Wong, Kenneth [Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California (United States); Vaughan, Andrew T. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Chen, Allen M., E-mail: allenmchen@yahoo.com [Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California (United States)

    2016-04-01

    Recent improvements in toxicity profiles of pediatric oncology patients are attributable, in part, to advances in the field of radiation oncology such as intensity modulated radiation (IMRT) and proton therapy (IMPT). While IMRT and IMPT deliver highly conformal dose to targeted volumes, they commonly demand the addition of 2- or 3-dimensional imaging for precise positioning—a technique known as image guided radiation therapy (IGRT). In this manuscript we address strategies to further minimize exposure risk in children by reducing effective IGRT dose. Portal X rays and cone beam computed tomography (CBCT) are commonly used to verify patient position during IGRT and, because their relative radiation exposure is far less than the radiation absorbed from therapeutic treatment beams, their sometimes significant contribution to cumulative risk can be easily overlooked. Optimizing the conformality of IMRT/IMPT while simultaneously ignoring IGRT dose may result in organs at risk being exposed to a greater proportion of radiation from IGRT than from therapeutic beams. Over a treatment course, cumulative central-axis CBCT effective dose can approach or supersede the amount of radiation absorbed from a single treatment fraction, a theoretical increase of 3% to 5% in mutagenic risk. In select scenarios, this may result in the underprediction of acute and late toxicity risk (such as azoospermia, ovarian dysfunction, or increased lifetime mutagenic risk) in radiation-sensitive organs and patients. Although dependent on variables such as patient age, gender, weight, body habitus, anatomic location, and dose-toxicity thresholds, modifying IGRT use and acquisition parameters such as frequency, imaging modality, beam energy, current, voltage, rotational degree, collimation, field size, reconstruction algorithm, and documentation can reduce exposure, avoid unnecessary toxicity, and achieve doses as low as reasonably achievable, promoting a culture and practice of “gentle IGRT.”.

  14. Teleconsultation in image guided dental implantology

    Truppe, M.; Kawana, H.; Schicho, K.; Ewers, R.

    2008-01-01

    Telemedicine encourages the separation of highly knowledge-based, diagnosis/consultation-oriented activities from skill centered activities such as surgical patient treatment. Teleconsultation is defined as consultation, evaluation and management services provided to patients via telecommunication systems with out face-to-face interaction between patient and health-care provider. The increasing clinical relevance of computer assisted navigation technology promoted new perspectives in telemedicine utilizing live sensor data to enhance remote visualization. Any digital content, i.e. digital images from imaging modalities (most frequently Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) as well as navigation data (e.g. intraoperative coordinates of surgical instruments relatively to preplanned pathways and target-points at the patient, implant positions, etc.), can be transferred without any loss of information. This means that remote experts can be involved in surgical interventions or preoperative planning sessions while being supplied with identical information as the 'local' staff. Examples from computer assisted dental implantology are given as well as a case study.

  15. High intensity hadron facility, AGS II

    Lee, Y.Y.; Lowenstein, D.I.

    1989-01-01

    There is a large and growing community of particle and nuclear physicists around the world who are actively lobbying for the construction of an accelerator that could provide 1-2 orders of magnitude increase in proton intensity above that of the present AGS. There have been a series of proposals from Canada, Europe, Japan, and the USA. They can all be characterized as machines varying in energy from 12-60 GeV and intensities of 30-100 μA. The community of physicists using the AGS are in a unique position however. The AGS is the only machine available that can provide the beams to execute the physics program that this large international community is interested in. The BNL approach to the communities interests involves a stepwise intensity upgrade program. At present the AGS slow extracted beam current is 1 μA. With the completion of the Booster in 1990 and the associated AGS modifications, the current will rise to 4-5 μA. With the subsequent addition of the Stretcher which is under design, the current will rise to 8-10 μA and approximately 100% duty factor. The possibility of a further enhancement to a current level of 40-50 μA CW is now being examined. 2 figures, 6 tables

  16. Exploring high-intensity QED at ELI

    Heinzl, T. [Plymouth Univ., School of Mathematics and Statistics, Drake Circus, PL4 8AA (United Kingdom); Ilderton, A. [School of Mathematics, Hamilton Building, Trinity College, Dublin (Ireland)

    2009-11-15

    We give a non-technical overview of quantum electrodynamics (QED) effects arising in the presence of ultra-strong electromagnetic fields highlighting the new prospects provided by a realisation of the ELI laser facility. Vacuum polarization is a genuine QED process describing the probability amplitude of a propagating photon fluctuating into a virtual electron-positron pair. It has measurable effects such as the Lamb shift and charge screening at short distances. Nonlinear Compton scattering that consists of processes of the type: e + ngamma{sub L} -> e' + gamma (where n counting the number of laser photons involved) is an intensity dependent effect that is accessible to experimental observation

  17. High-intensity-laser-electron scattering

    Meyerhofer, D.D.

    1997-01-01

    In the field of an intense laser, photon-electron scattering becomes nonlinear when the oscillatory energy of the electron approaches its rest mass. The electron wave function is dressed by the field with a concomitant increase in the effective electron mass. When the photon energy in the electron rest frame is comparable to the electron rest mass, multiphoton Compton scattering occurs. When the photon energy is significantly lower than the electron rest mass, the electron acquires momentum from the photon field and emits harmonics. This paper reviews nonlinear photon-electron scattering processes and results from two recent experiments where they have been observed

  18. Effect of image-guided hypofractionated stereotactic radiotherapy on peripheral non-small-cell lung cancer

    Wang SW

    2016-08-01

    Full Text Available Shu-wen Wang,1 Juan Ren,1 Yan-li Yan,2 Chao-fan Xue,2 Li Tan,2 Xiao-wei Ma2 1Department of Radiotherapy, First Affiliated Hospital of Xian Jiaotong University, 2Medical School of Xian Jiaotong University, Xi’an, Shaanxi, People’s Republic of China Abstract: The objective of this study was to compare the effects of image-guided hypofractionated radiotherapy and conventional fractionated radiotherapy on non-small-cell lung cancer (NSCLC. Fifty stage- and age-matched cases with NSCLC were randomly divided into two groups (A and B. There were 23 cases in group A and 27 cases in group B. Image-guided radiotherapy (IGRT and stereotactic radiotherapy were conjugately applied to the patients in group A. Group A patients underwent hypofractionated radiotherapy (6–8 Gy/time three times per week, with a total dose of 64–66 Gy; group B received conventional fractionated radiotherapy, with a total dose of 68–70 Gy five times per week. In group A, 1-year and 2-year local failure survival rate and 1-year local failure-free survival rate were significantly higher than in group B (P<0.05. The local failure rate (P<0.05 and distant metastasis rate (P>0.05 were lower in group A than in group B. The overall survival rate of group A was significantly higher than that of group B (P=0.03, and the survival rate at 1 year was 87% vs 63%, (P<0.05. The median survival time of group A was longer than that of group B. There was no significant difference in the incidence of complications between the two groups (P>0.05. Compared with conventional fractionated radiation therapy, image-guided hypofractionated stereotactic radiotherapy in NSCLC received better treatment efficacy and showed good tolerability. Keywords: non-small-cell lung cancer, hypofractionated radiotherapy, stereotactic radiotherapy, segmentation, intensity-modulated radiotherapy, image-guided radiation therapy technology

  19. Image-guided regularization level set evolution for MR image segmentation and bias field correction.

    Wang, Lingfeng; Pan, Chunhong

    2014-01-01

    Magnetic resonance (MR) image segmentation is a crucial step in surgical and treatment planning. In this paper, we propose a level-set-based segmentation method for MR images with intensity inhomogeneous problem. To tackle the initialization sensitivity problem, we propose a new image-guided regularization to restrict the level set function. The maximum a posteriori inference is adopted to unify segmentation and bias field correction within a single framework. Under this framework, both the contour prior and the bias field prior are fully used. As a result, the image intensity inhomogeneity can be well solved. Extensive experiments are provided to evaluate the proposed method, showing significant improvements in both segmentation and bias field correction accuracies as compared with other state-of-the-art approaches. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Shielding for high energy, high intensity electron accelerator installation

    Warawas, C.; Chongkum, S.

    1997-03-01

    The utilization of electron accelerators (eBA) is gradually increased in Thailand. For instance, a 30-40 MeV eBA are used for tumor and cancer therapy in the hospitals, and a high current eBA in for gemstone colonization. In the near future, an application of eBA in industries will be grown up in a few directions, e.g., flue gases treatment from the coal fire-power plants, plastic processing, rubber vulcanization and food preservation. It is the major roles of Office of Atomic Energy for Peace (OAEP) to promote the peaceful uses of nuclear energy and to regulate the public safety and protection of the environment. By taking into account of radiation safety aspect, high energy electrons are not only harmful to human bodies, but the radioactive nuclides can be occurred. This report presents a literature review by following the National Committee on Radiation Protection and Measurements (NCRP) report No.31. This reviews for parametric calculation and shielding design of the high energy (up to 100 MeV), high intensity electron accelerator installation

  1. Development of high intensity beam handling system, 4

    Yamanoi, Yutaka; Tanaka, Kazuhiro; Minakawa, Michifumi

    1992-01-01

    We have constructed the new counter experimental hall at the KEK 12 GeV Proton Synchrotron (KEK-PS) in order to handle high intensity primary proton beams of up to 1x10 3 pps (protons per second), which is one order of magnitude greater than the present beam intensity of the KEK-PS, 1x10 12 pps. New technologies for handling high-intensity beams have, then, been developed and employed in the construction of the new hall. A part of our R/D work on handling high intensity beams will be reported. (author)

  2. MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery

    Siewerdsen, J. [Johns Hopkins University (United States)

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  3. MO-DE-202-04: Multimodality Image-Guided Surgery and Intervention: For the Rest of Us

    Shekhar, R. [Children’s National Health System (United States)

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  4. MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery

    Siewerdsen, J.

    2016-01-01

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  5. MO-DE-202-04: Multimodality Image-Guided Surgery and Intervention: For the Rest of Us

    Shekhar, R.

    2016-01-01

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  6. Current External Beam Radiation Therapy Quality Assurance Guidance: Does It Meet the Challenges of Emerging Image-Guided Technologies?

    Palta, Jatinder R.; Liu, Chihray; Li, Jonathan G.

    2008-01-01

    The traditional prescriptive quality assurance (QA) programs that attempt to ensure the safety and reliability of traditional external beam radiation therapy are limited in their applicability to such advanced radiation therapy techniques as three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, inverse treatment planning, stereotactic radiosurgery/radiotherapy, and image-guided radiation therapy. The conventional QA paradigm, illustrated by the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 40 (TG-40) report, consists of developing a consensus menu of tests and device performance specifications from a generic process model that is assumed to apply to all clinical applications of the device. The complexity, variation in practice patterns, and level of automation of high-technology radiotherapy renders this 'one-size-fits-all' prescriptive QA paradigm ineffective or cost prohibitive if the high-probability error pathways of all possible clinical applications of the device are to be covered. The current approaches to developing comprehensive prescriptive QA protocols can be prohibitively time consuming and cost ineffective and may sometimes fail to adequately safeguard patients. It therefore is important to evaluate more formal error mitigation and process analysis methods of industrial engineering to more optimally focus available QA resources on process components that have a significant likelihood of compromising patient safety or treatment outcomes

  7. High-intensity sources for light ions

    Leung, K.N.

    1995-10-01

    The use of the multicusp plasma generator as a source of light ions is described. By employing radio-frequency induction discharge, the performance of the multicusp source is greatly improved, both in lifetime and in high brightness H + and H - beam production. A new technique for generating multiply-charged ions in this type of ion source is also presented

  8. Image-guided breast biopsy: state-of-the-art

    O' Flynn, E.A.M., E-mail: lizoflynn@doctors.org.u [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom); Wilson, A.R.M.; Michell, M.J. [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom)

    2010-04-15

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues.

  9. High intensity positron program at LLNL

    Asoka-Kumar, P.; Howell, R.; Stoeffl, W.; Carter, D.

    1999-01-01

    Lawrence Livermore National Laboratory (LLNL) is the home of the world's highest current beam of keV positrons. The potential for establishing a national center for materials analysis using positron annihilation techniques around this capability is being actively pursued. The high LLNL beam current will enable investigations in several new areas. We are developing a positron microprobe that will produce a pulsed, focused positron beam for 3-dimensional scans of defect size and concentration with submicron resolution. Below we summarize the important design features of this microprobe. Several experimental end stations will be available that can utilize the high current beam with a time distribution determined by the electron linac pulse structure, quasi-continuous, or bunched at 20 MHz, and can operate in an electrostatic or (and) magnetostatic environment. Some of the planned early experiments are: two-dimensional angular correlation of annihilation radiation of thin films and buried interfaces, positron diffraction holography, positron induced desorption, and positron induced Auger spectroscopy

  10. High intensity positron program at LLNL

    Asoka-Kumar, P.; Howell, R.H.; Stoeffl, W.

    1998-01-01

    Lawrence Livermore National Laboratory (LLNL) is the home of the world's highest current beam of keV positrons. The potential for establishing a national center for materials analysis using positron annihilation techniques around this capability is being actively pursued. The high LLNL beam current will enable investigations in several new areas. We are developing a positron microprobe that will produce a pulsed, focused positron beam for 3-dimensional scans of defect size and concentration with submicron resolution. Below we summarize the important design features of this microprobe. Several experimental end stations will be available that can utilize the high current beam with a time distribution determined by the electron linac pulse structure, quasi-continuous, or bunched at 20 MHz, and can operate in an electrostatic or (and) magnetostatic environment. Some of the planned early experiments are: two-dimensional angular correlation of annihilation radiation of thin films and buried interfaces, positron diffraction holography, positron induced desorption, and positron induced Auger spectra

  11. High intensity TOF spectrometer for cold neutrons

    Maayouf, R.M.; Abd El-Kawy, A.; Habib, N.; Adib, M.; Hamouda, I.

    1984-01-01

    This work presents a neutron time-of-flight (TOF) spectrometer developed specially for total neutron cross-section measurements at neutron energies below 5 MeV and sample's temperature varying from the liquid nitrogen one and up to 500 0 K. The spectrometer is equipped by remote control unit, designed especially, in order to move the sample in and out of the beam during the experimental measurements. The spectrometer has proved to be useful for transmission measurements at neutron energies below 5 MeV. It has a reasonable energy resolution (4.4%) and high effect to background ratio (11.1) at 5 MeV

  12. High intensity positron program at LLNL

    Asoka-Kumar, P.; Howell, R.; Stoeffl, W.; Carter, D.

    1999-01-01

    Lawrence Livermore National Laboratory (LLNL) is the home of the world close-quote s highest current beam of keV positrons. The potential for establishing a national center for materials analysis using positron annihilation techniques around this capability is being actively pursued. The high LLNL beam current will enable investigations in several new areas. We are developing a positron microprobe that will produce a pulsed, focused positron beam for 3-dimensional scans of defect size and concentration with submicron resolution. Below we summarize the important design features of this microprobe. Several experimental end stations will be available that can utilize the high current beam with a time distribution determined by the electron linac pulse structure, quasi-continuous, or bunched at 20 MHz, and can operate in an electrostatic or (and) magnetostatic environment. Some of the planned early experiments are: two-dimensional angular correlation of annihilation radiation of thin films and buried interfaces, positron diffraction holography, positron induced desorption, and positron induced Auger spectroscopy. copyright 1999 American Institute of Physics

  13. SALIVARY CORTISOL RESPONSES AND PERCEIVED EXERTION DURING HIGH INTENSITY AND LOW INTENSITY BOUTS OF RESISTANCE EXERCISE

    Alison D. Egan

    2004-03-01

    Full Text Available The purpose of this study was to measure the salivary cortisol response to different intensities of resistance exercise. In addition, we wanted to determine the reliability of the session rating of perceived exertion (RPE scale to monitor resistance exercise intensity. Subjects (8 men, 9 women completed 2 trials of acute resistance training bouts in a counterbalanced design. The high intensity resistance exercise protocol consisted of six, ten-repetition sets using 75% of one repetition maximum (RM on a Smith machine squat and bench press exercise (12 sets total. The low intensity resistance exercise protocol consisted of three, ten-repetition sets at 30% of 1RM of the same exercises as the high intensity protocol. Both exercise bouts were performed with 2 minutes of rest between each exercise and sessions were repeated to test reliability of the measures. The order of the exercise bouts was randomized with least 72 hours between each session. Saliva samples were obtained immediately before, immediately after and 30 mins following each resistance exercise bout. RPE measures were obtained using Borg's CR-10 scale following each set. Also, the session RPE for the entire exercise session was obtained 30 minutes following completion of the session. There was a significant 97% increase in the level of salivary cortisol immediately following the high intensity exercise session (P<0.05. There was also a significant difference in salivary cortisol of 145% between the low intensity and high intensity exercise session immediately post-exercise (P<0.05. The low intensity exercise did not result in any significant changes in cortisol levels. There was also a significant difference between the session RPE values for the different intensity levels (high intensity 7.1 vs. low intensity 1.9 (P<0.05. The intraclass correlation coefficient for the session RPE measure was 0.95. It was concluded that the session RPE method is a valid and reliable method of

  14. Precise image-guided irradiation of small animals: a flexible non-profit platform

    Tillner, Falk; Thute, Prasad; Löck, Steffen; Dietrich, Antje; Fursov, Andriy; Haase, Robert; Lukas, Mathias; Krause, Mechthild; Baumann, Michael; Bütof, Rebecca; Enghardt, Wolfgang; Rimarzig, Bernd; Sobiella, Manfred

    2016-01-01

    Preclinical in vivo studies using small animals are essential to develop new therapeutic options in radiation oncology. Of particular interest are orthotopic tumour models, which better reflect the clinical situation in terms of growth patterns and microenvironmental parameters of the tumour as well as the interplay of tumours with the surrounding normal tissues. Such orthotopic models increase the technical demands and the complexity of preclinical studies as local irradiation with therapeutically relevant doses requires image-guided target localisation and accurate beam application. Moreover, advanced imaging techniques are needed for monitoring treatment outcome. We present a novel small animal image-guided radiation therapy (SAIGRT) system, which allows for precise and accurate, conformal irradiation and x-ray imaging of small animals. High accuracy is achieved by its robust construction, the precise movement of its components and a fast high-resolution flat-panel detector. Field forming and x-ray imaging is accomplished close to the animal resulting in a small penumbra and a high image quality. Feasibility for irradiating orthotopic models has been proven using lung tumour and glioblastoma models in mice. The SAIGRT system provides a flexible, non-profit academic research platform which can be adapted to specific experimental needs and therefore enables systematic preclinical trials in multicentre research networks. (paper)

  15. SU-E-J-03: Characterization of the Precision and Accuracy of a New, Preclinical, MRI-Guided Focused Ultrasound System for Image-Guided Interventions in Small-Bore, High-Field Magnets

    Ellens, N; Farahani, K

    2015-01-01

    Purpose: MRI-guided focused ultrasound (MRgFUS) has many potential and realized applications including controlled heating and localized drug delivery. The development of many of these applications requires extensive preclinical work, much of it in small animal models. The goal of this study is to characterize the spatial targeting accuracy and reproducibility of a preclinical high field MRgFUS system for thermal ablation and drug delivery applications. Methods: The RK300 (FUS Instruments, Toronto, Canada) is a motorized, 2-axis FUS positioning system suitable for small bore (72 mm), high-field MRI systems. The accuracy of the system was assessed in three ways. First, the precision of the system was assessed by sonicating regular grids of 5 mm squares on polystyrene plates and comparing the resulting focal dimples to the intended pattern, thereby assessing the reproducibility and precision of the motion control alone. Second, the targeting accuracy was assessed by imaging a polystyrene plate with randomly drilled holes and replicating the hole pattern by sonicating the observed hole locations on intact polystyrene plates and comparing the results. Third, the practicallyrealizable accuracy and precision were assessed by comparing the locations of transcranial, FUS-induced blood-brain-barrier disruption (BBBD) (observed through Gadolinium enhancement) to the intended targets in a retrospective analysis of animals sonicated for other experiments. Results: The evenly-spaced grids indicated that the precision was 0.11 +/− 0.05 mm. When image-guidance was included by targeting random locations, the accuracy was 0.5 +/− 0.2 mm. The effective accuracy in the four rodent brains assessed was 0.8 +/− 0.6 mm. In all cases, the error appeared normally distributed (p<0.05) in both orthogonal axes, though the left/right error was systematically greater than the superior/inferior error. Conclusions: The targeting accuracy of this device is sub-millimeter, suitable for many

  16. SU-E-J-03: Characterization of the Precision and Accuracy of a New, Preclinical, MRI-Guided Focused Ultrasound System for Image-Guided Interventions in Small-Bore, High-Field Magnets

    Ellens, N [Johns Hopkins University, Baltimore, Maryland (United States); Farahani, K [National Cancer Institute, Bethesda, MD (United States)

    2015-06-15

    Purpose: MRI-guided focused ultrasound (MRgFUS) has many potential and realized applications including controlled heating and localized drug delivery. The development of many of these applications requires extensive preclinical work, much of it in small animal models. The goal of this study is to characterize the spatial targeting accuracy and reproducibility of a preclinical high field MRgFUS system for thermal ablation and drug delivery applications. Methods: The RK300 (FUS Instruments, Toronto, Canada) is a motorized, 2-axis FUS positioning system suitable for small bore (72 mm), high-field MRI systems. The accuracy of the system was assessed in three ways. First, the precision of the system was assessed by sonicating regular grids of 5 mm squares on polystyrene plates and comparing the resulting focal dimples to the intended pattern, thereby assessing the reproducibility and precision of the motion control alone. Second, the targeting accuracy was assessed by imaging a polystyrene plate with randomly drilled holes and replicating the hole pattern by sonicating the observed hole locations on intact polystyrene plates and comparing the results. Third, the practicallyrealizable accuracy and precision were assessed by comparing the locations of transcranial, FUS-induced blood-brain-barrier disruption (BBBD) (observed through Gadolinium enhancement) to the intended targets in a retrospective analysis of animals sonicated for other experiments. Results: The evenly-spaced grids indicated that the precision was 0.11 +/− 0.05 mm. When image-guidance was included by targeting random locations, the accuracy was 0.5 +/− 0.2 mm. The effective accuracy in the four rodent brains assessed was 0.8 +/− 0.6 mm. In all cases, the error appeared normally distributed (p<0.05) in both orthogonal axes, though the left/right error was systematically greater than the superior/inferior error. Conclusions: The targeting accuracy of this device is sub-millimeter, suitable for many

  17. Usefulness of automated biopsy guns in image-guided biopsy

    Lee, Jung Hyung; Rhee, Chang Soo; Lee, Sung Moon; Kim, Hong; Woo, Sung Ku; Suh, Soo Jhi

    1994-01-01

    To evaluate the usefulness of automated biopsy guns in image-guided biopsy of lung, liver, pancreas and other organs. Using automated biopsy devices, 160 biopsies of variable anatomic sites were performed: Biopsies were performed under ultrasonographic(US) guidance in 95 and computed tomographic (CT) guidance in 65. We retrospectively analyzed histologic results and complications. Specimens were adequate for histopathologic diagnosis in 143 of the 160 patients(89.4%)-Diagnostic tissue was obtained in 130 (81.3%), suggestive tissue obtained in 13(8.1%), and non-diagnostic tissue was obtained in 14(8.7%). Inadequate tissue was obtained in only 3(1.9%). There was no statistically significant difference between US-guided and CT-guided percutaneous biopsy. There was no occurrence of significant complication. We have experienced mild complications in only 5 patients-2 hematuria and 2 hematochezia in transrectal prostatic biopsy, and 1 minimal pneumothorax in CT-guided percutaneous lung biopsy. All of them were resolved spontaneously. The image-guided biopsy using the automated biopsy gun was a simple, safe and accurate method of obtaining adequate specimen for the histopathologic diagnosis

  18. Usefulness of automated biopsy guns in image-guided biopsy

    Lee, Jung Hyung; Rhee, Chang Soo; Lee, Sung Moon; Kim, Hong; Woo, Sung Ku; Suh, Soo Jhi [School of Medicine, Keimyung University, Daegu (Korea, Republic of)

    1994-12-15

    To evaluate the usefulness of automated biopsy guns in image-guided biopsy of lung, liver, pancreas and other organs. Using automated biopsy devices, 160 biopsies of variable anatomic sites were performed: Biopsies were performed under ultrasonographic(US) guidance in 95 and computed tomographic (CT) guidance in 65. We retrospectively analyzed histologic results and complications. Specimens were adequate for histopathologic diagnosis in 143 of the 160 patients(89.4%)-Diagnostic tissue was obtained in 130 (81.3%), suggestive tissue obtained in 13(8.1%), and non-diagnostic tissue was obtained in 14(8.7%). Inadequate tissue was obtained in only 3(1.9%). There was no statistically significant difference between US-guided and CT-guided percutaneous biopsy. There was no occurrence of significant complication. We have experienced mild complications in only 5 patients-2 hematuria and 2 hematochezia in transrectal prostatic biopsy, and 1 minimal pneumothorax in CT-guided percutaneous lung biopsy. All of them were resolved spontaneously. The image-guided biopsy using the automated biopsy gun was a simple, safe and accurate method of obtaining adequate specimen for the histopathologic diagnosis.

  19. ELECTRON CLOUD EFFECTS IN HIGH INTENSITY PROTON ACCELERATORS

    Wei, J.; Macek, R.J.

    2002-01-01

    One of the primary concerns in the design and operation of high-intensity proton synchrotrons and accumulators is the electron cloud and associated beam loss and instabilities. Electron-cloud effects are observed at high-intensity proton machines like the Los Alamos National Laboratory's PSR and CERN's SPS, and investigated experimentally and theoretically. In the design of next-generation high-intensity proton accelerators like the Spallation Neutron Source ring, emphasis is made in minimizing electron production and in enhancing Landau damping. This paper reviews the present understanding of the electron-cloud effects and presents mitigation measures

  20. ELECTRON CLOUD EFFECTS IN HIGH INTENSITY PROTON ACCELERATORS.

    WEI,J.; MACEK,R.J.

    2002-04-14

    One of the primary concerns in the design and operation of high-intensity proton synchrotrons and accumulators is the electron cloud and associated beam loss and instabilities. Electron-cloud effects are observed at high-intensity proton machines like the Los Alamos National Laboratory's PSR and CERN's SPS, and investigated experimentally and theoretically. In the design of next-generation high-intensity proton accelerators like the Spallation Neutron Source ring, emphasis is made in minimizing electron production and in enhancing Landau damping. This paper reviews the present understanding of the electron-cloud effects and presents mitigation measures.

  1. Smart human serum albumin-indocyanine green nanoparticles generated by programmed assembly for dual-modal imaging-guided cancer synergistic phototherapy.

    Sheng, Zonghai; Hu, Dehong; Zheng, Mingbin; Zhao, Pengfei; Liu, Huilong; Gao, Duyang; Gong, Ping; Gao, Guanhui; Zhang, Pengfei; Ma, Yifan; Cai, Lintao

    2014-12-23

    Phototherapy, including photodynamic therapy (PDT) and photothermal therapy (PTT), is a light-activated local treatment modality that is under intensive preclinical and clinical investigations for cancer. To enhance the treatment efficiency of phototherapy and reduce the light-associated side effects, it is highly desirable to improve drug accumulation and precision guided phototherapy for efficient conversion of the absorbed light energy to reactive oxygen species (ROS) and local hyperthermia. In the present study, a programmed assembly strategy was developed for the preparation of human serum albumin (HSA)-indocyanine green (ICG) nanoparticles (HSA-ICG NPs) by intermolecular disulfide conjugations. This study indicated that HSA-ICG NPs had a high accumulation with tumor-to-normal tissue ratio of 36.12±5.12 at 24 h and a long-term retention with more than 7 days in 4T1 tumor-bearing mice, where the tumor and its margin, normal tissue were clearly identified via ICG-based in vivo near-infrared (NIR) fluorescence and photoacoustic dual-modal imaging and spectrum-resolved technology. Meanwhile, HSA-ICG NPs efficiently induced ROS and local hyperthermia simultaneously for synergetic PDT/PTT treatments under a single NIR laser irradiation. After an intravenous injection of HSA-ICG NPs followed by imaging-guided precision phototherapy (808 nm, 0.8 W/cm2 for 5 min), the tumor was completely suppressed, no tumor recurrence and treatments-induced toxicity were observed. The results suggest that HSA-ICG NPs generated by programmed assembly as smart theranostic nanoplatforms are highly potential for imaging-guided cancer phototherapy with PDT/PTT synergistic effects.

  2. Apparatus for controlled mixing in a high intensity mixer

    Crocker, Z.; Gupta, V.P.

    1982-01-01

    An apparatus and a process is disclosed for controlled mixing of a mixable material in a high intensity mixer. The system enables instantaneous, precise and continual monitoring of a batch in a high intensity mixer which heretofore could not be achieved. The process comprises the steps of feeding a batch of material into a high intensity mixer, agitating the batch in the mixer, monitoring batch temperature separately from mixer temperature and discharging the batch from the mixer when the batch temperature reaches a final predetermined level. The apparatus includes means for monitoring batch temperature in a high intensity mixer separately from mixer temperature, and means responsive to the batch temperature to discharge the batch when the batch temperature reaches a final predetermined level

  3. Feasibility of high-intensity training in asthma

    Tønnesen, Louise Lindhardt; Sørensen, E D; Hostrup, Morten

    2018-01-01

    Background: High-intensity interval training is an effective and popular training regime but its feasibility in untrained adults with asthma is insufficiently described. Objective: The randomized controlled trial 'EFFORT Asthma' explored the effects of behavioural interventions including high......-intensity interval training on clinical outcomes in nonobese sedentary adults with asthma. In this article we present a sub analysis of data aiming to evaluate if patients' pre-intervention levels of asthma control, FEV1, airway inflammation and airway hyperresponsiveness (AHR) predicted their training response...... to the high-intensity interval training program, measured as increase in maximal oxygen consumption (VO2max). Design: We used data from the EFFORT Asthma Study. Of the 36 patients randomized to the 8-week exercise intervention consisting of high-intensity training three times per week, 29 patients (45...

  4. High-intensity interval training evokes larger serum BDNF levels compared with intense continuous exercise.

    Saucedo Marquez, Cinthia Maria; Vanaudenaerde, Bart; Troosters, Thierry; Wenderoth, Nicole

    2015-12-15

    Exercise can have a positive effect on the brain by activating brain-derived neurotrophic factor (BDNF)-related processes. In healthy humans there appears to be a linear relationship between exercise intensity and the positive short-term effect of acute exercise on BDNF levels (i.e., the highest BDNF levels are reported after high-intensity exercise protocols). Here we performed two experiments to test the effectiveness of two high-intensity exercise protocols, both known to improve cardiovascular health, to determine whether they have a similar efficacy in affecting BDNF levels. Participants performed a continuous exercise (CON) protocol at 70% of maximal work rate and a high-intensity interval-training (HIT) protocol at 90% of maximal work rate for periods of 1 min alternating with 1 min of rest (both protocols lasted 20 min). We observed similar BDNF kinetics in both protocols, with maximal BDNF concentrations being reached toward the end of training (experiment 1). We then showed that both exercise protocols significantly increase BDNF levels compared with a rest condition (CON P = 0.04; HIT P exercise are slightly more effective than continuous high-intensity exercise for elevating serum BDNF. Additionally, 73% of the participants preferred the HIT protocol (P = 0.02). Therefore, we suggest that the HIT protocol might represent an effective and preferred intervention for elevating BDNF levels and potentially promoting brain health. Copyright © 2015 the American Physiological Society.

  5. Case Study on Justification: High Intensity Discharge Lamps. Annex II

    2016-01-01

    High intensity discharge lamps produce bright white light of a high intensity in an energy efficient manner. These lamps are typically used in large numbers in public and professional settings such as shops, warehouses, hotels and offices. They are also used in outdoor applications to illuminate streets, buildings, statues, flags and gardens and further as architectural lighting. They also have applications associated with film projection in cinemas, manufacture of semiconductors, fluorescence endoscopy and microscopy, schlieren photography, hologram projection, ultraviolet curing, sky beamers and car headlights. Some types of high intensity discharge lamp, as well as certain other consumer products for lighting, contain radioactive substances for functional reasons. The radionuclides that are typically incorporated into high intensity discharge lamps are 85 Kr and 232 Th. Given the wide range of uses, specific decisions on justification may be required for different applications. A small number of safety assessments for high intensity discharge lamps have been carried out and published. No published decisions at the national level specifically addressing the justification of the use of high intensity discharge lamps have been identified

  6. Integration of intraoperative stereovision imaging for brain shift visualization during image-guided cranial procedures

    Schaewe, Timothy J.; Fan, Xiaoyao; Ji, Songbai; Roberts, David W.; Paulsen, Keith D.; Simon, David A.

    2014-03-01

    Dartmouth and Medtronic Navigation have established an academic-industrial partnership to develop, validate, and evaluate a multi-modality neurosurgical image-guidance platform for brain tumor resection surgery that is capable of updating the spatial relationships between preoperative images and the current surgical field. A stereovision system has been developed and optimized for intraoperative use through integration with a surgical microscope and an image-guided surgery system. The microscope optics and stereovision CCD sensors are localized relative to the surgical field using optical tracking and can efficiently acquire stereo image pairs from which a localized 3D profile of the exposed surface is reconstructed. This paper reports the first demonstration of intraoperative acquisition, reconstruction and visualization of 3D stereovision surface data in the context of an industry-standard image-guided surgery system. The integrated system is capable of computing and presenting a stereovision-based update of the exposed cortical surface in less than one minute. Alternative methods for visualization of high-resolution, texture-mapped stereovision surface data are also investigated with the objective of determining the technical feasibility of direct incorporation of intraoperative stereo imaging into future iterations of Medtronic's navigation platform.

  7. Anser EMT: the first open-source electromagnetic tracking platform for image-guided interventions.

    Jaeger, Herman Alexander; Franz, Alfred Michael; O'Donoghue, Kilian; Seitel, Alexander; Trauzettel, Fabian; Maier-Hein, Lena; Cantillon-Murphy, Pádraig

    2017-06-01

    Electromagnetic tracking is the gold standard for instrument tracking and navigation in the clinical setting without line of sight. Whilst clinical platforms exist for interventional bronchoscopy and neurosurgical navigation, the limited flexibility and high costs of electromagnetic tracking (EMT) systems for research investigations mitigate against a better understanding of the technology's characterisation and limitations. The Anser project provides an open-source implementation for EMT with particular application to image-guided interventions. This work provides implementation schematics for our previously reported EMT system which relies on low-cost acquisition and demodulation techniques using both National Instruments and Arduino hardware alongside MATLAB support code. The system performance is objectively compared to other commercial tracking platforms using the Hummel assessment protocol. Positional accuracy of 1.14 mm and angular rotation accuracy of [Formula: see text] are reported. Like other EMT platforms, Anser is susceptible to tracking errors due to eddy current and ferromagnetic distortion. The system is compatible with commercially available EMT sensors as well as the Open Network Interface for image-guided therapy (OpenIGTLink) for easy communication with visualisation and medical imaging toolkits such as MITK and 3D Slicer. By providing an open-source platform for research investigations, we believe that novel and collaborative approaches can overcome the limitations of current EMT technology.

  8. Image-guided biopsy in patients with suspected ovarian carcinoma: a safe and effective technique?

    Griffin, Nyree; Grant, Lee A.; Freeman, Susan J.; Berman, Laurence H.; Sala, Evis; Jimenez-Linan, Mercedes; Earl, Helena; Ahmed, Ahmed Ashour; Crawford, Robin; Brenton, James

    2009-01-01

    In patients with suspected advanced ovarian carcinoma, a precise histological diagnosis is required before commencing neo-adjuvant chemotherapy. This study aims to determine the diagnostic accuracy and complication rate of percutaneous biopsies performed under ultrasound or computed tomography guidance. Between 2002 to 2007, 60 consecutive image-guided percutaneous biopsies were performed in patients with suspected ovarian cancer. The following variables were recorded: tissue biopsied, imaging technique, experience of operator, biopsy needle gauge, number of passes, complications, and final histology. Forty-seven patients had omental biopsies, 12 pelvic mass biopsies, and 1 para-aortic lymph node biopsy. Thirty-five biopsies were performed under ultrasound, 25 under computed tomography guidance. Biopsy needle gauges ranged from 14-20 swg with two to five passes for each patient. There were no complications. Histology was obtained in 52 (87%) patients. Percutaneous image-guided biopsy of peritoneal disease or pelvic mass is safe with high diagnostic accuracy. The large-gauge biopsy needle is as safe as the small gauge needle, but has the added value of obtaining tissue samples for immunohistochemistry and genomic studies. (orig.)

  9. Image-guided therapy and minimally invasive surgery in children: a merging future

    Shlomovitz, Eran; Amaral, Joao G.; Chait, Peter G.

    2006-01-01

    Minimally invasive image-guided therapy for children, also known as pediatric interventional radiology (PIR), is a new and exciting field of medicine. Two key elements that helped the rapid evolution and dissemination of this specialty were the creation of devices appropriate for the pediatric population and the development of more cost-effective and minimally invasive techniques. Despite its clear advantages to children, many questions are raised regarding who should be performing these procedures. Unfortunately, this is a gray zone with no clear answer. Surgeons fear that interventional radiologists will take over additional aspects of the surgical/procedural spectrum. Interventional radiologists, on the other hand, struggle to avoid becoming highly specialized technicians rather than physicians who are responsible for complete care of their patients. In this article, we briefly discuss some of the current aspects of minimally invasive image-guided therapy in children and innovations that are expected to be incorporated into clinical practice in the near future. Then, we approach the current interspecialty battles over the control of this field and suggest some solutions to these issues. Finally, we propose the development of a generation of physicians with both surgical and imaging skills. (orig.)

  10. Multimodal scanning laser ophthalmoscopy for image guided treatment of age-related macular degeneration

    Hammer, Daniel X.; Ferguson, R. D.; Patel, Ankit H.; Iftimia, Nicusor V.; Mujat, Mircea; Husain, Deeba

    2009-02-01

    Subretinal neovascular membranes (SRNM) are a deleterious complication of laser eye injury and retinal diseases such as age-related macular degeneration (AMD), choroiditis, and myopic retinopathy. Photodynamic therapy (PDT) and anti-vascular endothelial growth factor (VEGF) drugs are approved treatment methods. PDT acts by selective dye accumulation, activation by laser light, and disruption and clotting of the new leaky vessels. However, PDT surgery is currently not image-guided, nor does it proceed in an efficient or automated manner. This may contribute to the high rate of re-treatment. We have developed a multimodal scanning laser ophthalmoscope (SLO) for automated diagnosis and image-guided treatment of SRNMs associated with AMD. The system combines line scanning laser ophthalmoscopy (LSLO), fluorescein angiography (FA), indocyanine green angiography (ICGA), PDT laser delivery, and retinal tracking in a compact, efficient platform. This paper describes the system hardware and software design, performance characterization, and automated patient imaging and treatment session procedures and algorithms. Also, we present initial imaging and tracking measurements on normal subjects and automated lesion demarcation and sizing analysis of previously acquired angiograms. Future pre-clinical testing includes line scanning angiography and PDT treatment of AMD subjects. The automated acquisition procedure, enhanced and expedited data post-processing, and innovative image visualization and interpretation tools provided by the multimodal retinal imager may eventually aid in the diagnosis, treatment, and prognosis of AMD and other retinal diseases.

  11. Reliability of the Bony Anatomy in Image-Guided Stereotactic Radiotherapy of Brain Metastases

    Guckenberger, Matthias; Baier, Kurt; Guenther, Iris; Richter, Anne; Wilbert, Juergen; Sauer, Otto; Vordermark, Dirk; Flentje, Michael

    2007-01-01

    Purpose: To evaluate whether the position of brain metastases remains stable between planning and treatment in cranial stereotactic radiotherapy (SRT). Methods and Materials: Eighteen patients with 20 brain metastases were treated with single-fraction (17 lesions) or hypofractionated (3 lesions) image-guided SRT. Median time interval between planning and treatment was 8 days. Before treatment a cone-beam CT (CBCT) and a conventional CT after application of i.v. contrast were acquired. Setup errors using automatic bone registration (CBCT) and manual soft-tissue registration of the brain metastases (conventional CT) were compared. Results: Tumor size was not significantly different between planning and treatment. The three-dimensional setup error (mean ± SD) was 4.0 ± 2.1 mm and 3.5 ± 2.2 mm according to the bony anatomy and the lesion itself, respectively. A highly significant correlation between automatic bone match and soft-tissue registration was seen in all three directions (r ≥ 0.88). The three-dimensional distance between the isocenter according to bone match and soft-tissue registration was 1.7 ± 0.7 mm, maximum 2.8 mm. Treatment of intracranial pressure with steroids did not influence the position of the lesion relative to the bony anatomy. Conclusion: With a time interval of approximately 1 week between planning and treatment, the bony anatomy of the skull proved to be an excellent surrogate for the target position in image-guided SRT

  12. Generation of intense high-order vortex harmonics.

    Zhang, Xiaomei; Shen, Baifei; Shi, Yin; Wang, Xiaofeng; Zhang, Lingang; Wang, Wenpeng; Xu, Jiancai; Yi, Longqiong; Xu, Zhizhan

    2015-05-01

    This Letter presents for the first time a scheme to generate intense high-order optical vortices that carry orbital angular momentum in the extreme ultraviolet region based on relativistic harmonics from the surface of a solid target. In the three-dimensional particle-in-cell simulation, the high-order harmonics of the high-order vortex mode is generated in both reflected and transmitted light beams when a linearly polarized Laguerre-Gaussian laser pulse impinges on a solid foil. The azimuthal mode of the harmonics scales with its order. The intensity of the high-order vortex harmonics is close to the relativistic region, with the pulse duration down to attosecond scale. The obtained intense vortex beam possesses the combined properties of fine transversal structure due to the high-order mode and the fine longitudinal structure due to the short wavelength of the high-order harmonics. In addition to the application in high-resolution detection in both spatial and temporal scales, it also presents new opportunities in the intense vortex required fields, such as the inner shell ionization process and high energy twisted photons generation by Thomson scattering of such an intense vortex beam off relativistic electrons.

  13. Role of image-guided patient repositioning and online planning in localized prostate cancer IMRT

    Lerma, Fritz A.; Liu, Bei; Wang, Zhendong; Yi, Byongyong; Amin, Pradip; Liu, Sandy; Feng Yuanming; Yu, Cedric X.

    2009-01-01

    Purpose: To determine the expected benefit of image-guided online replanning over image-guided repositioning of localized prostate cancer intensity-modulated radiotherapy (IMRT). Materials and methods: On 10 to 11 CT scans of each of 10 early-stage prostate cancer patients, the prostate, bladder and rectum are manually segmented. Using a 3-mm PTV margin expansion from the CTV, an IMRT plan is made on the first CT scan of each patient. Online repositioning is simulated by recalculating the IMRT plan from the initial CT scan on the subsequent CT scans of each patient. For online replanning, IMRT is replanned twice on all CT scans, using 0-mm and 3-mm margins. The doses from subsequent CT images of each patient are then deformed to the initial CT anatomy using a mesh-based thin-plate B-spline deformation method and are accumulated for DVH and isodose review. Results: Paired t-tests show that online replanning with 3-mm margins significantly increases the prostate volume receiving the prescribed dose over replanning with 0-mm margins (p-value 0.004); gives marginally better target coverage than repositioning with 3-mm margins(p-value 0.06-0.343), and reduces variations in target coverage over repositioning. Fractional volumes of rectum and bladder receiving 75%, 80%, 85%, 90%, and 95% (V75, V80, V85, V90, and V95) of the prescription dose are evaluated. V90 and V95 values for the rectum are 1.6% and 0.7 % for 3-mm margin replanning and 1% and 0.4 % for 0-mm margin replanning, with p-values of 0.010-0.011. No significant differences between repositioning and replanning with 3-mm margins are found for both the rectum and the bladder. Conclusions: Image-guided replanning using 3-mm margins reduces target coverage variations, and maintains comparable rectum and bladder sparing to patient repositioning in localized prostate cancer IMRT. Marginal reductions in doses to rectum and bladder are possible when planning margins are eliminated in the online replanning scenario

  14. Preoperative imaging as the basis for image-guided neurosurgery

    Winkler, D.; Strauss, G.; Hesse, S.; Sabri, O.; Goldammer, A.; Meixensberger, J.; Hund-Georgiadis, M.; Richter, A.; Kahn, T.

    2004-01-01

    With the progressive development of soft- and hardware, the acceptance of image-guided neurosurgery has increased dramatically. Additional image data are required to analyze the nature and the dimensions of pathological processes and the surrounding tissue. In this context, fMRI, SPECT, PET, as well as special modalities of CT and MR imaging, are routinely used. Secondary post-processing options are used to detect intracerebral lesions as well as adjacent functional eloquent regions in the parenchymatous organ pre- and intraoperatively. The integration of different image information guarantees the precise planning and realization of surgical maneuvers. The segmentation of interesting structures and risk structures, as well as their implementation in the neuronavigation systems, help to avoid additional intraoperative traumatization and offer a higher level of safety and precision. In this article the value and limitations of presurgical imaging will be discussed. (orig.) [de

  15. Fast-MICP for frameless image-guided surgery

    Lee, Jiann-Der; Huang, Chung-Hsien; Wang, Sheng-Ta; Lin, Chung-Wei; Lee, Shin-Tseng

    2010-01-01

    Purpose: In image-guided surgery (IGS) systems, image-to-physical registration is critical for reliable anatomical information mapping and spatial guidance. Conventional stereotactic frame-based or fiducial-based approaches provide accurate registration but are not patient-friendly. This study proposes a frameless cranial IGS system that uses computer vision techniques to replace the frame or fiducials with the natural features of the patient. Methods: To perform a cranial surgery with the proposed system, the facial surface of the patient is first reconstructed by stereo vision. Accuracy is ensured by capturing parallel-line patterns projected from a calibrated LCD projector. Meanwhile, another facial surface is reconstructed from preoperative computed tomography (CT) images of the patient. The proposed iterative closest point (ICP)-based algorithm [fast marker-added ICP (Fast-MICP)] is then used to register the two facial data sets, which transfers the anatomical information from the CT images to the physical space. Results: Experimental results reveal that the Fast-MICP algorithm reduces the computational cost of marker-added ICP (J.-D. Lee et al., ''A coarse-to-fine surface registration algorithm for frameless brain surgery,'' in Proceedings of International Conference of the IEEE Engineering in Medicine and Biology Society, 2007, pp. 836-839) to 10% and achieves comparable registration accuracy, which is under 3 mm target registration error (TRE). Moreover, two types of optical-based spatial digitizing devices can be integrated for further surgical navigation. Anatomical information or image-guided surgical landmarks can be projected onto the patient to obtain an immersive augmented reality environment. Conclusion: The proposed frameless IGS system with stereo vision obtains TRE of less than 3 mm. The proposed Fast-MICP registration algorithm reduces registration time by 90% without compromising accuracy.

  16. Fast-MICP for frameless image-guided surgery

    Lee, Jiann-Der; Huang, Chung-Hsien; Wang, Sheng-Ta; Lin, Chung-Wei; Lee, Shin-Tseng [Department of Electrical Engineering, Chang Gung University, Tao-Yuan 333, Taiwan (China); Department of Medical Mechatronics, Chang Gung University, Tao-Yuan 333, Taiwan (China); Department of Neurosurgery and Medical Augmented Reality Research Center, Chang Gung Memorial Hospital, No. 199, Tunghwa Rd., Taipei 105, Taiwan (China)

    2010-09-15

    Purpose: In image-guided surgery (IGS) systems, image-to-physical registration is critical for reliable anatomical information mapping and spatial guidance. Conventional stereotactic frame-based or fiducial-based approaches provide accurate registration but are not patient-friendly. This study proposes a frameless cranial IGS system that uses computer vision techniques to replace the frame or fiducials with the natural features of the patient. Methods: To perform a cranial surgery with the proposed system, the facial surface of the patient is first reconstructed by stereo vision. Accuracy is ensured by capturing parallel-line patterns projected from a calibrated LCD projector. Meanwhile, another facial surface is reconstructed from preoperative computed tomography (CT) images of the patient. The proposed iterative closest point (ICP)-based algorithm [fast marker-added ICP (Fast-MICP)] is then used to register the two facial data sets, which transfers the anatomical information from the CT images to the physical space. Results: Experimental results reveal that the Fast-MICP algorithm reduces the computational cost of marker-added ICP (J.-D. Lee et al., ''A coarse-to-fine surface registration algorithm for frameless brain surgery,'' in Proceedings of International Conference of the IEEE Engineering in Medicine and Biology Society, 2007, pp. 836-839) to 10% and achieves comparable registration accuracy, which is under 3 mm target registration error (TRE). Moreover, two types of optical-based spatial digitizing devices can be integrated for further surgical navigation. Anatomical information or image-guided surgical landmarks can be projected onto the patient to obtain an immersive augmented reality environment. Conclusion: The proposed frameless IGS system with stereo vision obtains TRE of less than 3 mm. The proposed Fast-MICP registration algorithm reduces registration time by 90% without compromising accuracy.

  17. Radiologists' leading position in image-guided therapy.

    Helmberger, Thomas; Martí-Bonmatí, Luis; Pereira, Philippe; Gillams, Alice; Martínez, Jose; Lammer, Johannes; Malagari, Katarina; Gangi, Afshin; de Baere, Thierry; Adam, E Jane; Rasch, Coen; Budach, Volker; Reekers, Jim A

    2013-02-01

    Image-guided diagnostic and therapeutic procedures are related to, or performed under, some kind of imaging. Such imaging may be direct inspection (as in open surgery) or indirect inspection as in endoscopy or laparoscopy. Common to all these techniques is the transformation of optical and visible information to a monitor or the eye of the operator. Image-guided therapy (IGT) differs by using processed imaging data acquired before, during and after a wide range of different imaging techniques. This means that the planning, performing and monitoring, as well as the control of the therapeutic procedure, are based and dependent on the "virtual reality" provided by imaging investigations. Since most of such imaging involves radiology in the broadest sense, there is a need to characterise IGT in more detail. In this paper, the technical, medico-legal and medico-political issues will be discussed. The focus will be put on state-of-the-art imaging, technical developments, methodological and legal requisites concerning radiation protection and licensing, speciality-specific limitations and crossing specialty borders, definition of technical and quality standards, and finally to the issue of awareness of IGT within the medical and public community. The specialty-specific knowledge should confer radiologists with a significant role in the overall responsibility for the imaging-related processes in various non-radiological specialties. These processes may encompass purchase, servicing, quality management, radiation protection and documentation, also taking responsibility for the definition and compliance with the legal requirements regarding all radiological imaging performed by non-radiologists.

  18. MR-Guided High-Intensity Focused Ultrasound Ablation of Breast Cancer with a Dedicated Breast Platform

    Merckel, Laura G.; Bartels, Lambertus W.; Köhler, Max O.; Bongard, H. J. G. Desirée van den; Deckers, Roel; Mali, Willem P. Th. M.; Binkert, Christoph A.; Moonen, Chrit T.; Gilhuijs, Kenneth G. A.; Bosch, Maurice A. A. J. van den

    2013-01-01

    Optimizing the treatment of breast cancer remains a major topic of interest. In current clinical practice, breast-conserving therapy is the standard of care for patients with localized breast cancer. Technological developments have fueled interest in less invasive breast cancer treatment. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a completely noninvasive ablation technique. Focused beams of ultrasound are used for ablation of the target lesion without disrupting the skin and subcutaneous tissues in the beam path. MRI is an excellent imaging method for tumor targeting, treatment monitoring, and evaluation of treatment results. The combination of HIFU and MR imaging offers an opportunity for image-guided ablation of breast cancer. Previous studies of MR-HIFU in breast cancer patients reported a limited efficacy, which hampered the clinical translation of this technique. These prior studies were performed without an MR-HIFU system specifically developed for breast cancer treatment. In this article, a novel and dedicated MR-HIFU breast platform is presented. This system has been designed for safe and effective MR-HIFU ablation of breast cancer. Furthermore, both clinical and technical challenges are discussed, which have to be solved before MR-HIFU ablation of breast cancer can be implemented in routine clinical practice.

  19. Pulsed system for obtaining microdosimetric data with high intensity beams

    Zaider, M.; Dicello, J.F.; Hiebert, R.D.

    1977-01-01

    The use of heavy particle accelerators for radiation therapy requires high intensity beams in order to produce useful dose rates. The 800-MeV proton beam at LAMPF passes through different production targets to generate secondary pion beams. Conventional microdosimetric techniques are not applicable under these conditions because exceedingly high count rates result in detector damage, gas breakdown, and saturation effects in the electronics. We describe a new microdosimetric system developed at the Pion Biomedical Channel of LAMPF. The accelerator provides a variable low intensity pulse once every ten high intensity macropulses. The voltage on the detector is pulsed in coincidence with the low intensity pulse so that we were able to operate the detector under optimum data-taking conditions. A low noise two-stage preamplifier was built in connection with the pulsed mode operation. A comparison is made between data obtained in pulsed (high intensity beam) and unpulsed (low intensity beam) modes. The spectra obtained by the two methods agree within the experimental uncertainties

  20. High-Power, High-Intensity Laser Propagation and Interactions

    2014-03-10

    intensity as the weighting function. The full refractive index associated with the laser plasma interaction having a parabolic density variation ...radiation in turn enhances the electron density wave further amplifying the radiation. Considering spatial variations in the z direction only the FEL...effL/ at the entrance to the wiggler where effL is the effective interaction length. This requirement can be expressed by the following inequality

  1. Light-intensity and high-intensity interval training improve cardiometabolic health in rats.

    Batacan, Romeo B; Duncan, Mitch J; Dalbo, Vincent J; Connolly, Kylie J; Fenning, Andrew S

    2016-09-01

    Physical activity has the potential to reduce cardiometabolic risk factors but evaluation of different intensities of physical activity and the mechanisms behind their health effects still need to be fully established. This study examined the effects of sedentary behaviour, light-intensity training, and high-intensity interval training on biometric indices, glucose and lipid metabolism, inflammatory and oxidative stress markers, and vascular and cardiac function in adult rats. Rats (12 weeks old) were randomly assigned to 1 of 4 groups: control (CTL; no exercise), sedentary (SED; no exercise and housed in small cages to reduce activity), light-intensity trained (LIT; four 30-min exercise bouts/day at 8 m/min separated by 2-h rest period, 5 days/week), and high-intensity interval trained (HIIT, four 2.5-min work bouts/day at 50 m/min separated by 3-min rest periods, 5 days/week). After 12 weeks of intervention, SED had greater visceral fat accumulation (p HIIT demonstrated beneficial changes in body weight, visceral and epididymal fat weight, glucose regulation, low-density lipoprotein cholesterol, total cholesterol, and mesenteric vessel contractile response compared with the CTL group (p HIIT had significant improvements in systolic blood pressure and endothelium-independent vasodilation to aorta and mesenteric artery compared with the CTL group (p HIIT induce health benefits by improving traditional cardiometabolic risk factors. LIT improves cardiac health while HIIT promotes improvements in vascular health.

  2. P-West High Intensity Secondary Beam Area Design Report

    Cox, A.; Currier, R.; Eartly, D.; Guthke, A.; Johnson, G.; Lee, D.; Dram, R.; Villegas, E.; Rest, J.; Tilles, E.; Vander Arend, P.

    1977-03-01

    This report gives the initial design parameters of a 1000 GeV High Intensity Superconducting Secondary Beam Laboratory to be situated in the Proton Area downstream of the existing Proton West experimental station. The area will provide Fermilab with a major capability for experimentation with pion and antiproton beams of intensities and of energies available at no other laboratory and with an electron beam with excellent spot size, intensity, and purity at energies far above that available at electron machines. Detailed beam design, area layouts, and cost estimates are presented, along with the design considerations.

  3. Ultra-High Intensity Proton Accelerators and their Applications

    Weng, W. T.

    1997-01-01

    The science and technology of proton accelerators have progressed considerably in the past three decades. Three to four orders of magnitude increase in both peak intensity and average flux have made it possible to construct high intensity proton accelerators for modern applications, such as: spallation neutron sources, kaon factory, accelerator production of tritium, energy amplifier and muon collider drivers. The accelerator design focus switched over from intensity for synchrotrons, to brightness for colliders to halos for spallation sources. An overview of this tremendous progress in both accelerator science and technology is presented, with special emphasis on the new challenges of accelerator physics issues such as: H(-) injection, halo formation and reduction of losses

  4. Measurements of acoustic pressure at high amplitudes and intensities

    Crum, L A; Bailey, M R; Kaczkowski, P; McAteer, J A; Pishchalnikov, Y A; Sapozhnikov, O A

    2004-01-01

    In our research group, we desire measurements of the large pressure amplitudes generated by the shock waves used in shock wave lithotripsy (SWL) and the large acoustic intensities used in High Intensity Focused Ultrasound (HIFU). Conventional piezoelectric or PVDF hydrophones can not be used for such measurements as they are damaged either by cavitation, in SWL applications, or heat, in HIFU applications. In order to circumvent these difficulties, we have utilized optical fiber hydrophones in SWL that do not cavitate, and small glass probes and a scattering technique for measurements of large HIFU intensities. Descriptions of these techniques will be given as well as some typical data

  5. Photon-photon scattering at the high-intensity frontier

    Gies, Holger; Karbstein, Felix; Kohlfürst, Christian; Seegert, Nico

    2018-04-01

    The tremendous progress in high-intensity laser technology and the establishment of dedicated high-field laboratories in recent years have paved the way towards a first observation of quantum vacuum nonlinearities at the high-intensity frontier. We advocate a particularly prospective scenario, where three synchronized high-intensity laser pulses are brought into collision, giving rise to signal photons, whose frequency and propagation direction differ from the driving laser pulses, thus providing various means to achieve an excellent signal to background separation. Based on the theoretical concept of vacuum emission, we employ an efficient numerical algorithm which allows us to model the collision of focused high-intensity laser pulses in unprecedented detail. We provide accurate predictions for the numbers of signal photons accessible in experiment. Our study is the first to predict the precise angular spread of the signal photons, and paves the way for a first verification of quantum vacuum nonlinearity in a well-controlled laboratory experiment at one of the many high-intensity laser facilities currently coming online.

  6. Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases

    Boda-Heggemann, Judit; Wenz, Frederik; Lohr, Frank; Frauenfeld, Anian; Weiss, Christel; Simeonova, Anna; Neumaier, Christian; Siebenlist, Kerstin; Attenberger, Ulrike; Heußel, Claus Peter; Schneider, Frank

    2014-01-01

    Stereotactic Ablative RadioTherapy (SABR) of lung tumors/metastases has been shown to be an effective treatment modality with low toxicity. Outcome and toxicity were retrospectively evaluated in a unique single-institution cohort treated with intensity-modulated image-guided breath-hold SABR (igSABR) without external immobilization. The dose–response relationship is analyzed based on Biologically Equivalent Dose (BED). 50 lesions in 43 patients with primary NSCLC (n = 27) or lung-metastases of various primaries (n = 16) were consecutively treated with igSABR with Active-Breathing-Coordinator (ABC®) and repeat-breath-hold cone-beam-CT. After an initial dose-finding/-escalation period, 5x12 Gy for peripheral lesions and single doses of 5 Gy to varying dose levels for central lesions were applied. Overall-survival (OS), progression-free-survival (PFS), progression pattern, local control (LC) and toxicity were analyzed. The median BED2 was 83 Gy. 12 lesions were treated with a BED2 of <80 Gy, and 38 lesions with a BED2 of >80 Gy. Median follow-up was 15 months. Actuarial 1- and 2-year OS were 67% and 43%; respectively. Cause of death was non-disease-related in 27%. Actuarial 1- and 2-year PFS was 42% and 28%. Progression site was predominantly distant. Actuarial 1- and 2 year LC was 90% and 85%. LC showed a trend for a correlation to BED2 (p = 0.1167). Pneumonitis requiring conservative treatment occurred in 23%. Intensity-modulated breath-hold igSABR results in high LC-rates and low toxicity in this unfavorable patient cohort with inoperable lung tumors or metastases. A BED2 of <80 Gy was associated with reduced local control

  7. Biologic targets identified from dynamic 18FDG-PET and implications for image-guided therapy

    Rusten, Espen; Malinen, Eirik; Roedal, Jan; Bruland, Oeyvind S.

    2013-01-01

    Purpose: The outcome of biologic image-guided radiotherapy depends on the definition of the biologic target. The purpose of the current work was to extract hyper perfused and hypermetabolic regions from dynamic positron emission tomography (D-PET) images, to dose escalate either region and to discuss implications of such image guided strategies. Methods: Eleven patients with soft tissue sarcomas were investigated with D-PET. The images were analyzed using a two-compartment model producing parametric maps of perfusion and metabolic rate. The two image series were segmented and exported to a treatment planning system, and biological target volumes BTV per and BTV met (perfusion and metabolism, respectively) were generated. Dice's similarity coefficient was used to compare the two biologic targets. Intensity-modulated radiation therapy (IMRT) plans were generated for a dose painting by contours regime, where planning target volume (PTV) was planned to 60 Gy and BTV to 70 Gy. Thus, two separate plans were created for each patient with dose escalation of either BTV per or BTV met . Results: BTV per was somewhat smaller than BTV met (209 ±170 cm 3 against 243 ±143 cm 3 , respectively; population-based mean and s.d.). Dice's coefficient depended on the applied margin, and was 0.72 ±0.10 for a margin of 10 mm. Boosting BTV per resulted in mean dose of 69 ±1.0 Gy to this region, while BTV met received 67 ±3.2 Gy. Boosting BTV met gave smaller dose differences between the respective non-boost DVHs (such as D 98 ). Conclusions: Dose escalation of one of the BTVs results in a partial dose escalation of the other BTV as well. If tumor aggressiveness is equally pronounced in hyper perfused and hypermetabolic regions, this should be taken into account in the treatment planning

  8. Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

    Sachin Logani

    2011-01-01

    Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.

  9. Measurement of high-power microwave pulse under intense ...

    Abstract. KALI-1000 pulse power system has been used to generate single pulse nanosecond duration high-power microwaves (HPM) from a virtual cathode oscillator. (VIRCATOR) device. HPM power measurements were carried out using a transmitting– receiving system in the presence of intense high frequency (a few ...

  10. Simulation study of the high intensity S-Band photoinjector

    Zhu, Xiongwei; Nakajima, Kazuhisa [High Energy Accelerator Research Organization, Tsukuba, Ibaraki (Japan)

    2001-10-01

    In this paper, we report the results of simulation study of the high intensity S-Band photoinjector. The aim of the simulation study is to transport high bunch charge with low emittance evolution. The simulation result shows that 7nC bunch with rms emittance 22.3 {pi} mm mrad can be outputted at the exit of photoinjector. (author)

  11. Simulation study of the high intensity S-Band photoinjector

    Zhu, Xiongwei; Nakajima, Kazuhisa

    2001-01-01

    In this paper, we report the results of simulation study of the high intensity S-Band photoinjector. The aim of the simulation study is to transport high bunch charge with low emittance evolution. The simulation result shows that 7nC bunch with rms emittance 22.3 π mm mrad can be outputted at the exit of photoinjector. (author)

  12. High Intensity Interval Training for Maximizing Health Outcomes.

    Karlsen, Trine; Aamot, Inger-Lise; Haykowsky, Mark; Rognmo, Øivind

    Regular physical activity and exercise training are important actions to improve cardiorespiratory fitness and maintain health throughout life. There is solid evidence that exercise is an effective preventative strategy against at least 25 medical conditions, including cardiovascular disease, stroke, hypertension, colon and breast cancer, and type 2 diabetes. Traditionally, endurance exercise training (ET) to improve health related outcomes has consisted of low- to moderate ET intensity. However, a growing body of evidence suggests that higher exercise intensities may be superior to moderate intensity for maximizing health outcomes. The primary objective of this review is to discuss how aerobic high-intensity interval training (HIIT) as compared to moderate continuous training may maximize outcomes, and to provide practical advices for successful clinical and home-based HIIT. Copyright © 2017. Published by Elsevier Inc.

  13. Multifunctional nanoparticles as a tissue adhesive and an injectable marker for image-guided procedures

    Shin, Kwangsoo; Choi, Jin Woo; Ko, Giho; Baik, Seungmin; Kim, Dokyoon; Park, Ok Kyu; Lee, Kyoungbun; Cho, Hye Rim; Han, Sang Ihn; Lee, Soo Hong; Lee, Dong Jun; Lee, Nohyun; Kim, Hyo-Cheol; Hyeon, Taeghwan

    2017-07-01

    Tissue adhesives have emerged as an alternative to sutures and staples for wound closure and reconnection of injured tissues after surgery or trauma. Owing to their convenience and effectiveness, these adhesives have received growing attention particularly in minimally invasive procedures. For safe and accurate applications, tissue adhesives should be detectable via clinical imaging modalities and be highly biocompatible for intracorporeal procedures. However, few adhesives meet all these requirements. Herein, we show that biocompatible tantalum oxide/silica core/shell nanoparticles (TSNs) exhibit not only high contrast effects for real-time imaging but also strong adhesive properties. Furthermore, the biocompatible TSNs cause much less cellular toxicity and less inflammation than a clinically used, imageable tissue adhesive (that is, a mixture of cyanoacrylate and Lipiodol). Because of their multifunctional imaging and adhesive property, the TSNs are successfully applied as a hemostatic adhesive for minimally invasive procedures and as an immobilized marker for image-guided procedures.

  14. In vivo quantification of fluorescent molecular markers in real-time by ratio Imaging for diagnostic screening and image-guided surgery

    Bogaards, A.; Sterenborg, H. J. C. M.; Trachtenberg, J.; Wilson, B. C.; Lilge, L.

    2007-01-01

    Future applications of "molecular diagnostic screening" and "molecular image-guided surgery" will demand images of molecular markers with high resolution and high throughput (similar to >= 30 frames/second). MRI, SPECT, PET, optical fluorescence tomography, hyper-spectral fluorescence imaging, and

  15. Multi-institutional MicroCT image comparison of image-guided small animal irradiators

    Johnstone, Chris D.; Lindsay, Patricia; E Graves, Edward; Wong, Eugene; Perez, Jessica R.; Poirier, Yannick; Ben-Bouchta, Youssef; Kanesalingam, Thilakshan; Chen, Haijian; E Rubinstein, Ashley; Sheng, Ke; Bazalova-Carter, Magdalena

    2017-07-01

    To recommend imaging protocols and establish tolerance levels for microCT image quality assurance (QA) performed on conformal image-guided small animal irradiators. A fully automated QA software SAPA (small animal phantom analyzer) for image analysis of the commercial Shelley micro-CT MCTP 610 phantom was developed, in which quantitative analyses of CT number linearity, signal-to-noise ratio (SNR), uniformity and noise, geometric accuracy, spatial resolution by means of modulation transfer function (MTF), and CT contrast were performed. Phantom microCT scans from eleven institutions acquired with four image-guided small animal irradiator units (including the commercial PXi X-RAD SmART and Xstrahl SARRP systems) with varying parameters used for routine small animal imaging were analyzed. Multi-institutional data sets were compared using SAPA, based on which tolerance levels for each QA test were established and imaging protocols for QA were recommended. By analyzing microCT data from 11 institutions, we established image QA tolerance levels for all image quality tests. CT number linearity set to R 2  >  0.990 was acceptable in microCT data acquired at all but three institutions. Acceptable SNR  >  36 and noise levels  1.5 lp mm-1 for MTF  =  0.2) was obtained at all but four institutions due to their large image voxel size used (>0.275 mm). Ten of the eleven institutions passed the set QA tolerance for geometric accuracy (2000 HU for 30 mgI ml-1). We recommend performing imaging QA with 70 kVp, 1.5 mA, 120 s imaging time, 0.20 mm voxel size, and a frame rate of 5 fps for the PXi X-RAD SmART. For the Xstrahl SARRP, we recommend using 60 kVp, 1.0 mA, 240 s imaging time, 0.20 mm voxel size, and 6 fps. These imaging protocols should result in high quality images that pass the set tolerance levels on all systems. Average SAPA computation time for complete QA analysis for a 0.20 mm voxel, 400 slice Shelley phantom microCT data set

  16. Ion source and injection line for high intensity medical cyclotron

    Jia, XianLu; Guan, Fengping; Yao, Hongjuan; Zhang, TianJue; Yang, Jianjun; Song, Guofang; Ge, Tao; Qin, Jiuchang

    2014-02-01

    A 14 MeV high intensity compact cyclotron, CYCIAE-14, was built at China Institute of Atomic Energy (CIAE). An injection system based on the external H- ion source was used on CYCIAE-14 so as to provide high intensity beam, while most positron emission tomography cyclotrons adopt internal ion source. A beam intensity of 100 μA/14 MeV was extracted from the cyclotron with a small multi-cusp H- ion source (CIAE-CH-I type) and a short injection line, which the H- ion source of 3 mA/25 keV H- beam with emittance of 0.3π mm mrad and the injection line of with only 1.2 m from the extraction of ion source to the medial plane of the cyclotron. To increase the extracted beam intensity of the cyclotron, a new ion source (CIAE-CH-II type) of 9.1 mA was used, with maximum of 500 μA was achieved from the cyclotron. The design and test results of the ion source and injection line optimized for high intensity acceleration will be given in this paper.

  17. Fluorescent supramolecular micelles for imaging-guided cancer therapy

    Sun, Mengmeng; Yin, Wenyan; Dong, Xinghua; Yang, Wantai; Zhao, Yuliang; Yin, Meizhen

    2016-02-01

    A novel smart fluorescent drug delivery system composed of a perylene diimide (PDI) core and block copolymer poly(d,l-lactide)-b-poly(ethyl ethylene phosphate) is developed and named as PDI-star-(PLA-b-PEEP)8. The biodegradable PDI-star-(PLA-b-PEEP)8 is a unimolecular micelle and can self-assemble into supramolecular micelles, called as fluorescent supramolecular micelles (FSMs), in aqueous media. An insoluble drug camptothecin (CPT) can be effectively loaded into the FSMs and exhibits pH-responsive release. Moreover, the FSMs with good biocompatibility can also be employed as a remarkable fluorescent probe for cell labelling because the maximum emission of PDI is beneficial for bio-imaging. The flow cytometry and confocal laser scanning microscopy analysis demonstrate that the micelles are easily endocytosed by cancer cells. In vitro and in vivo tumor growth-inhibitory studies reveal a better therapeutic effect of FSMs after CPT encapsulation when compared with the free CPT drug. The multifunctional FSM nanomedicine platform as a nanovehicle has great potential for fluorescence imaging-guided cancer therapy.A novel smart fluorescent drug delivery system composed of a perylene diimide (PDI) core and block copolymer poly(d,l-lactide)-b-poly(ethyl ethylene phosphate) is developed and named as PDI-star-(PLA-b-PEEP)8. The biodegradable PDI-star-(PLA-b-PEEP)8 is a unimolecular micelle and can self-assemble into supramolecular micelles, called as fluorescent supramolecular micelles (FSMs), in aqueous media. An insoluble drug camptothecin (CPT) can be effectively loaded into the FSMs and exhibits pH-responsive release. Moreover, the FSMs with good biocompatibility can also be employed as a remarkable fluorescent probe for cell labelling because the maximum emission of PDI is beneficial for bio-imaging. The flow cytometry and confocal laser scanning microscopy analysis demonstrate that the micelles are easily endocytosed by cancer cells. In vitro and in vivo tumor growth

  18. Half-integer resonance crossing in high-intensity rings

    A. V. Fedotov

    2002-02-01

    Full Text Available A detailed study of the influence of space charge on the crossing of second-order resonances is presented and associated with the space-charge limit of high-intensity rings. Two-dimensional simulation studies are compared with envelope models, which agree in the finding of an increased intensity limit due to the coherent frequency shift. This result is also found for realistic bunched beams with multiturn injection painting. Characteristic features such as the influence of tune splitting, structure resonances, and the role of envelope instabilities are discussed in detail. The theoretical limits are found to be in good agreement with the performance of high-intensity proton machines.

  19. High signal intensity of fat on fast spin echo imaging

    Ogura, Akio; Yamazaki, Masaru; Hongoh, Takaharu; Inoue, Hiroshi; Ishikuro, Akihiro

    2000-01-01

    The fast spin echo (FSE) technique of producing T 2 -weighted images in greatly reduced imaging times has recently been used for routine clinical study. FSE images show contrast that is very similar in most tissues to that of conventional SE images. However, fat shows a high signal intensity that is influenced by j-coupling and the magnetization transfer effect. The purpose of this study was to assess whether the higher signal intensity of fat is different among MRI systems and to examine the effects of j-coupling and magnetization transfer on the high signal intensity of fat on FSE. The contrast in signal intensity between fat and water was measured for various echo train lengths (ETL) with and without multislicing on FSE using a contrast phantom. Measurements were obtained with four different MRI systems. In addition, the effective T 2 values of fat were calculated for the above conditions. Results indicated that contrast for fat and water was reduced with increased ETL and by using multislicing and was different among the four MRI systems. The effective T 2 values of fat were extended for increased ETL and were not dependent on multislicing. They also differed among the four MRI systems. The extent of effective T 2 values was affected by j-coupling. In this study, it was indicated that the degree of the high signal intensity of fat on FSE differed for different MRI systems. In addition, the reasons for the high signal intensity of fat on FSE were related to the effects of j-coupling and magnetization transfer. (author)

  20. Early Outcomes From Three Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    Mendenhall, Nancy P.; Li Zuofeng; Hoppe, Bradford S.; Marcus, Robert B.; Mendenhall, William M.; Nichols, R. Charles; Morris, Christopher G.; Williams, Christopher R.; Costa, Joseph; Henderson, Randal

    2012-01-01

    Purpose: To report early outcomes with image-guided proton therapy for prostate cancer. Methods and Materials: We accrued 211 prostate cancer patients on prospective Institutional Review Board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low–risk disease, dose escalation from 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel followed by androgen deprivation for high-risk disease. Minimum follow-up was 2 years. Results: One intermediate-risk patient and 2 high-risk patients had disease progression. Pretreatment genitourinary (GU) symptom management was required in 38% of patients. A cumulative 88 (42%) patients required posttreatment GU symptom management. Four transient Grade 3 GU toxicities occurred, all among patients requiring pretreatment GU symptom management. Multivariate analysis showed correlation between posttreatment GU 2+ symptoms and pretreatment GU symptom management (p < 0.0001) and age (p = 0.0048). Only 1 Grade 3+ gastrointestinal (GI) symptom occurred. The prevalence of Grade 2+ GI symptoms was 0 (0%), 10 (5%), 12 (6%), and 8 (4%) at 6, 12, 18, and 24 months, with a cumulative incidence of 20 (10%) patients at 2 years after proton therapy. Univariate and multivariate analyses showed significant correlation between Grade 2+ rectal bleeding and proctitis and the percentage of rectal wall (rectum) receiving doses ranging from 40 CGE (10 CGE) to 80 CGE. Conclusions: Early outcomes with image-guided proton therapy suggest high efficacy and minimal toxicity with only 1.9% Grade 3 GU symptoms and <0.5% Grade 3 GI toxicities.

  1. Early Outcomes From Three Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    Mendenhall, Nancy P., E-mail: menden@shands.ufl.edu [University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Li Zuofeng; Hoppe, Bradford S.; Marcus, Robert B.; Mendenhall, William M.; Nichols, R. Charles; Morris, Christopher G. [University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Williams, Christopher R.; Costa, Joseph [Division of Urology, College of Medicine, University of Florida, Jacksonville, FL (United States); Henderson, Randal [University of Florida Proton Therapy Institute, Jacksonville, FL (United States)

    2012-01-01

    Purpose: To report early outcomes with image-guided proton therapy for prostate cancer. Methods and Materials: We accrued 211 prostate cancer patients on prospective Institutional Review Board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, dose escalation from 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel followed by androgen deprivation for high-risk disease. Minimum follow-up was 2 years. Results: One intermediate-risk patient and 2 high-risk patients had disease progression. Pretreatment genitourinary (GU) symptom management was required in 38% of patients. A cumulative 88 (42%) patients required posttreatment GU symptom management. Four transient Grade 3 GU toxicities occurred, all among patients requiring pretreatment GU symptom management. Multivariate analysis showed correlation between posttreatment GU 2+ symptoms and pretreatment GU symptom management (p < 0.0001) and age (p = 0.0048). Only 1 Grade 3+ gastrointestinal (GI) symptom occurred. The prevalence of Grade 2+ GI symptoms was 0 (0%), 10 (5%), 12 (6%), and 8 (4%) at 6, 12, 18, and 24 months, with a cumulative incidence of 20 (10%) patients at 2 years after proton therapy. Univariate and multivariate analyses showed significant correlation between Grade 2+ rectal bleeding and proctitis and the percentage of rectal wall (rectum) receiving doses ranging from 40 CGE (10 CGE) to 80 CGE. Conclusions: Early outcomes with image-guided proton therapy suggest high efficacy and minimal toxicity with only 1.9% Grade 3 GU symptoms and <0.5% Grade 3 GI toxicities.

  2. Site-specific induction of lymphatic malformations in a rat model for image-guided therapy

    Short, Robert F.; Shiels, William E. [Ohio State University College of Medicine and Public Health, Department of Radiology, The Children' s Radiological Institute, Children' s Hospital, Columbus, OH (United States); Sferra, Thomas J. [Ohio State University College of Medicine and Public Health, Department of Gastroenterology, The Columbus Children' s Research Institute, Children' s Hospital, Columbus, OH (United States); Nicol, Kathleen K. [Ohio State University College of Medicine and Public Health, Department of Pathology, Children' s Hospital, Columbus, OH (United States); Schofield, Minka; Wiet, Gregory J. [Ohio State University College of Medicine and Public Health, Department of Otolaryngology, Children' s Hospital, Columbus, OH (United States)

    2007-06-15

    Lymphatic malformation is a common benign mass in children and adults and is representative of a derangement in lymphangiogenesis. These lesions have high recurrence rates and significant morbidity associated with surgery. Several sclerotherapy regimens have been developed clinically to treat lymphatic malformations; however, an animal model has not been developed that is adequate to test the efficacy of image-guided therapeutic interventions. To develop an animal model suitable for evaluation of percutaneous treatments of lymphatic malformations. Male Harlan Sprague-Dawley rats (n = 9) received two US-guided injections of Incomplete Freund's Adjuvant (IFA) over a 2-week period. All nine rats were injected twice into the peritoneum (IP); a subgroup (n = 3) received additional injections into the neck. Three animals that received IP injections of saline were used as controls. The injection sites were monitored for the development of lesions by high-resolution ultrasonography at 2-week intervals for 100 days. High-resolution (4.7 Tesla) magnetic resonance imaging was then performed on two animals noted to have developed masses. The rats were sacrificed and histologic examination of the identified lesions was performed, including immunohistochemical staining for vascular (CD31) and lymphatic (Flt-4 and Prox-1) endothelium. All animals injected with IFA developed cystic lesions. The three animals injected at dual sites were noted to have both microcystic and macrocystic malformations in the neck and microcystic plaque-like lesions in the peritoneum. The macrocystic malformations ({>=}5 mm) in the neck were detected by ultrasonography and grossly later during necropsy. Histopathologic analysis revealed the cystic spaces to be lined by lymphatic endothelium supported by a connective tissue stroma. Control animals did not exhibit detectable lesions with either ultrasonography or necropsy. This model represents a promising tool for translational development of image-guided

  3. Site-specific induction of lymphatic malformations in a rat model for image-guided therapy

    Short, Robert F.; Shiels, William E.; Sferra, Thomas J.; Nicol, Kathleen K.; Schofield, Minka; Wiet, Gregory J.

    2007-01-01

    Lymphatic malformation is a common benign mass in children and adults and is representative of a derangement in lymphangiogenesis. These lesions have high recurrence rates and significant morbidity associated with surgery. Several sclerotherapy regimens have been developed clinically to treat lymphatic malformations; however, an animal model has not been developed that is adequate to test the efficacy of image-guided therapeutic interventions. To develop an animal model suitable for evaluation of percutaneous treatments of lymphatic malformations. Male Harlan Sprague-Dawley rats (n = 9) received two US-guided injections of Incomplete Freund's Adjuvant (IFA) over a 2-week period. All nine rats were injected twice into the peritoneum (IP); a subgroup (n = 3) received additional injections into the neck. Three animals that received IP injections of saline were used as controls. The injection sites were monitored for the development of lesions by high-resolution ultrasonography at 2-week intervals for 100 days. High-resolution (4.7 Tesla) magnetic resonance imaging was then performed on two animals noted to have developed masses. The rats were sacrificed and histologic examination of the identified lesions was performed, including immunohistochemical staining for vascular (CD31) and lymphatic (Flt-4 and Prox-1) endothelium. All animals injected with IFA developed cystic lesions. The three animals injected at dual sites were noted to have both microcystic and macrocystic malformations in the neck and microcystic plaque-like lesions in the peritoneum. The macrocystic malformations (≥5 mm) in the neck were detected by ultrasonography and grossly later during necropsy. Histopathologic analysis revealed the cystic spaces to be lined by lymphatic endothelium supported by a connective tissue stroma. Control animals did not exhibit detectable lesions with either ultrasonography or necropsy. This model represents a promising tool for translational development of image-guided

  4. Production of High-Intensity, Highly Charged Ions

    Gammino, S.

    2013-12-16

    In the past three decades, the development of nuclear physics facilities for fundamental and applied science purposes has required an increasing current of multicharged ion beams. Multiple ionization implies the formation of dense and energetic plasmas, which, in turn, requires specific plasma trapping configurations. Two types of ion source have been able to produce very high charge states in a reliable and reproducible way: electron beam ion sources (EBIS) and electron cyclotron resonance ion sources (ECRIS). Multiple ionization is also obtained in laser-generated plasmas (laser ion sources (LIS)), where the high-energy electrons and the extremely high electron density allow step-by-step ionization, but the reproducibility is poor. This chapter discusses the atomic physics background at the basis of the production of highly charged ions and describes the scientific and technological features of the most advanced ion sources. Particular attention is paid to ECRIS and the latest developments, since they now r...

  5. Nonlinear behavior in high-intensity discharge lamps

    Baumann, Bernd; Schwieger, Joerg; Wolff, Marcus; Manders, Freddy; Suijker, Jos

    2016-06-01

    The light flicker problem of high intensity discharge lamps is studied numerically and experimentally. It is shown that in some respects the systems behave very similar to the forced Duffing oscillator with a softening spring. In particular, the jump phenomenon and hysteresis are observed in the simulations and in the experiments.

  6. Influence of high intensity ultrasound with different probe diameter ...

    The main goal of this research is to analyze the influence of ultrasonic probe diameters (7 and 10 mm) of high-intensity ultrasound with constant frequency (30 kHz) on the degree of homogenization (variance) of cow milk. Influence of different probe diameters on the physical properties of cow milk was also tested. Changes ...

  7. Intense neutron source: high-voltage power supply specifications

    Riedel, A.A.

    1980-08-01

    This report explains the need for and sets forth the electrical, mechanical and safety specifications for a high-voltage power supply to be used with the intense neutron source. It contains sufficient information for a supplier to bid on such a power supply

  8. Evidence based exercise - clinical benefits of high intensity interval training.

    Shiraev, Tim; Barclay, Gabriella

    2012-12-01

    Aerobic exercise has a marked impact on cardiovascular disease risk. Benefits include improved serum lipid profiles, blood pressure and inflammatory markers as well as reduced risk of stroke, acute coronary syndrome and overall cardiovascular mortality. Most exercise programs prescribed for fat reduction involve continuous, moderate aerobic exercise, as per Australian Heart Foundation clinical guidelines. This article describes the benefits of exercise for patients with cardiovascular and metabolic disease and details the numerous benefits of high intensity interval training (HIIT) in particular. Aerobic exercise has numerous benefits for high-risk populations and such benefits, especially weight loss, are amplified with HIIT. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery (either no or low intensity exercise). HIT is associated with increased patient compliance and improved cardiovascular and metabolic outcomes and is suitable for implementation in both healthy and 'at risk' populations. Importantly, as some types of exercise are contraindicated in certain patient populations and HIIT is a complex concept for those unfamiliar to exercise, some patients may require specific assessment or instruction before commencing a HIIT program.

  9. Reuse Recycler: High Intensity Proton Stacking at Fermilab

    Adamson, P. [Fermilab

    2016-07-17

    After a successful career as an antiproton storage and cooling ring, Recycler has been converted to a high intensity proton stacker for the Main Injector. We discuss the commissioning and operation of the Recycler in this new role, and the progress towards the 700 kW design goal.

  10. The high intensity approximation applied to multiphoton ionization

    Brandi, H.S.; Davidovich, L.; Zagury, N.

    1980-08-01

    It is shown that the most commonly used high intensity approximations as applied to ionization by strong electromagnetic fields are related. The applicability of the steepest descent method in these approximations, and the relation between them and first-order perturbation theory, are also discussed. (Author) [pt

  11. Drift tube suspension for high intensity linear accelerators

    Clark, D.C.; Frank, J.A.; Liska, D.J.; Potter, R.C.; Schamaun, R.G.

    1982-01-01

    The disclosure relates to a drift tube suspension for high intensity linear accelerators. The system comprises a series of box-sections girders independently adjustably mounted on a linear accelerator. A plurality of drift tube holding stems are individually adjustably mounted on each girder

  12. Annotated bibliography on high-intensity linear accelerators

    Jameson, R.A.; Roybal, E.U.

    1978-01-01

    A technical bibliography covering subjects important to the design of high-intensity beam transport systems and linear accelerators is presented. Space charge and emittance growth are stressed. Subject and author concordances provide cross-reference to detailed citations, which include an abstract and notes on the material. The bibliography resides in a computer database that can be searched for key words and phrases

  13. High-intensity exercise and recovery during short-term ...

    to power athletes and other individuals wishing to improve performance in ... effect of creatine supplementation on physical performance. It has been reported that ... high-intensity work performance.1,2,5,16,31,36 Such activities as resistance ...

  14. High-Intensity Interval Training for Improving Postprandial Hyperglycemia

    Little, Jonathan P.; Francois, Monique E.

    2014-01-01

    High-intensity interval training (HIIT) has garnered attention in recent years as a time-efficient exercise option for improving cardiovascular and metabolic health. New research demonstrates that HIIT may be particularly effective for improving postprandial hyperglycemia in individuals with, or at risk for, type 2 diabetes (T2D). These findings…

  15. Annotated bibliography on high-intensity linear accelerators. [240 citations

    Jameson, R.A.; Roybal, E.U.

    1978-01-01

    A technical bibliography covering subjects important to the design of high-intensity beam transport systems and linear accelerators is presented. Space charge and emittance growth are stressed. Subject and author concordances provide cross-reference to detailed citations, which include an abstract and notes on the material. The bibliography resides in a computer database that can be searched for key words and phrases.

  16. Nonlinear behavior in high-intensity discharge lamps

    Baumann, Bernd; Schwieger, Joerg; Wolff, Marcus; Manders, Freddy; Suijker, Jos

    2016-01-01

    The light flicker problem of high intensity discharge lamps is studied numerically and experimentally. It is shown that in some respects the systems behave very similar to the forced Duffing oscillator with a softening spring. In particular, the jump phenomenon and hysteresis are observed in the

  17. Tolerable Beam Loss at High-Intensity Machines

    Krivosheev, Oleg E.; Mokhov, Nikolai V.

    2000-01-01

    Tolerable beam losses are estimated for high-intensity ring accelerators with proton energy of 3 to 16 GeV. Dependence on beam energy, lattice and magnet geometry is studied via full Monte Carlo MARS14 simulations in lattice elements, shielding, tunnel and surrounding dirt with realistic geometry, materials and magnetic fields

  18. Drift tube suspension for high intensity linear accelerators

    Liska, Donald J.; Schamaun, Roger G.; Clark, Donald C.; Potter, R. Christopher; Frank, Joseph A.

    1982-01-01

    The disclosure relates to a drift tube suspension for high intensity linear accelerators. The system comprises a series of box-sections girders independently adjustably mounted on a linear accelerator. A plurality of drift tube holding stems are individually adjustably mounted on each girder.

  19. High-intensity exercise and recovery during short-term ...

    Objective. To determine the effect of short-term creatine supplementation plus a protein-carbohydrate formula on high-intensity exercise performance and recovery. Design. A repeated-measures, experimental study, employing a randomised, double-blind, placebo-controlled, group comparison design was used.

  20. Image guided placement of temporary anchorage devices for tooth movement

    Bahl-Palomo, L.; Bissada, N. [Case Western Reserve Univ. School of Dental Medicine, Dept. of Periodontics, Cleveland, OH (United States); Palomo, J.M.; Hans, M.G. [Case Western Reserve Univ. School of Dental Medicine, Dept. of Orthodontics, Cleveland, OH (United States)

    2007-06-15

    The aim of this project is to develop an image guided protocol for placement of a temporary anchorage device without surgically reflecting a mucoperiosteal flap. Eighteen orthodontic cases were selected for skeletal anchorage from the department of orthodontics at Case University. CBCT images of the subjects were taken using the Hitachi CB MercuRay system set at 15 mA, 120 kVp. CBCT images evaluated the ideal location for TAD placement in three dimensions. Horizontal and vertical linear measurements were taken from fixed dental landmarks to clearly define the location for placement. Transverse slices were used to evaluate the thickness of the buccal plate. Using the transverse view, the angle of insertion was determined such that the maximum buccal plate surface area would contact the screw. TADs were placed in the optimum location, with the most appropriate angle of insertion using a closed approach and with minimal local anesthesia and without flap elevation. Results: All TADs were placed without anatomic encroachment and enabled fixed orthodontic anchorage. (orig.)

  1. Quantifying attention shifts in augmented reality image-guided neurosurgery.

    Léger, Étienne; Drouin, Simon; Collins, D Louis; Popa, Tiberiu; Kersten-Oertel, Marta

    2017-10-01

    Image-guided surgery (IGS) has allowed for more minimally invasive procedures, leading to better patient outcomes, reduced risk of infection, less pain, shorter hospital stays and faster recoveries. One drawback that has emerged with IGS is that the surgeon must shift their attention from the patient to the monitor for guidance. Yet both cognitive and motor tasks are negatively affected with attention shifts. Augmented reality (AR), which merges the realworld surgical scene with preoperative virtual patient images and plans, has been proposed as a solution to this drawback. In this work, we studied the impact of two different types of AR IGS set-ups (mobile AR and desktop AR) and traditional navigation on attention shifts for the specific task of craniotomy planning. We found a significant difference in terms of the time taken to perform the task and attention shifts between traditional navigation, but no significant difference between the different AR set-ups. With mobile AR, however, users felt that the system was easier to use and that their performance was better. These results suggest that regardless of where the AR visualisation is shown to the surgeon, AR may reduce attention shifts, leading to more streamlined and focused procedures.

  2. Image-Guided percutaneous biopsies with a biopsy gun

    Lee, Kyung Hwan; Lim, Hyo Keun; Kim, Eun Ah; Yun, Ku Sub; Bae, Sang Hoo; Shin, Hyung Sik [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1994-07-15

    We report the results of image-guided percutaneous biopsies with a biopsy gun and evaluate the clinical usefulness. One hundred and five biopsies under ultrasonographic or fluoroscopic guidance were performed. Various anatomic sites were targeted(liver; 50, chest; 22, kidney; 12, pancreas; 8, intraperitoeum; 7, retroperitoneum; ). Obtained tissue was diagnostic in 98 of the 105 biopsies(93%). In each instance, representative core tissue specimens were obtained. Evaluation of the core tissue by pathologist revealed consistent, uniform specimens that contained significant crush artifact in no case. Five biopsies yielded inadequate tissue which were too small for histopathologic interpretation or were composed of necrotic debris. Two biopsies yielded adequate tissues, but tissues were not of the target. The diagnoses were malignancy in 77 biopsies and benign disease in 21 biopsies. No complications other than mild, localized discomfort were encountered except a transient hemoptysis and pneumothorax which was observed in two patients. Cutting biopsy with a biopsy gun provided sufficient amount of target tissue for an accurate diagnosis of malignant and benign disease. It was a safe and useful procedure for percutaneous biopsy.

  3. Ultrasonic image analysis and image-guided interventions.

    Noble, J Alison; Navab, Nassir; Becher, H

    2011-08-06

    The fields of medical image analysis and computer-aided interventions deal with reducing the large volume of digital images (X-ray, computed tomography, magnetic resonance imaging (MRI), positron emission tomography and ultrasound (US)) to more meaningful clinical information using software algorithms. US is a core imaging modality employed in these areas, both in its own right and used in conjunction with the other imaging modalities. It is receiving increased interest owing to the recent introduction of three-dimensional US, significant improvements in US image quality, and better understanding of how to design algorithms which exploit the unique strengths and properties of this real-time imaging modality. This article reviews the current state of art in US image analysis and its application in image-guided interventions. The article concludes by giving a perspective from clinical cardiology which is one of the most advanced areas of clinical application of US image analysis and describing some probable future trends in this important area of ultrasonic imaging research.

  4. Image guided placement of temporary anchorage devices for tooth movement

    Bahl-Palomo, L.; Bissada, N.; Palomo, J.M.; Hans, M.G.

    2007-01-01

    The aim of this project is to develop an image guided protocol for placement of a temporary anchorage device without surgically reflecting a mucoperiosteal flap. Eighteen orthodontic cases were selected for skeletal anchorage from the department of orthodontics at Case University. CBCT images of the subjects were taken using the Hitachi CB MercuRay system set at 15 mA, 120 kVp. CBCT images evaluated the ideal location for TAD placement in three dimensions. Horizontal and vertical linear measurements were taken from fixed dental landmarks to clearly define the location for placement. Transverse slices were used to evaluate the thickness of the buccal plate. Using the transverse view, the angle of insertion was determined such that the maximum buccal plate surface area would contact the screw. TADs were placed in the optimum location, with the most appropriate angle of insertion using a closed approach and with minimal local anesthesia and without flap elevation. Results: All TADs were placed without anatomic encroachment and enabled fixed orthodontic anchorage. (orig.)

  5. Image-guided robotic radiosurgery for spinal metastases

    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

  6. A new fiducial marker for Image-guided radiotherapy of prostate cancer: Clinical experience

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Hoejkjaer Larsen, Erik; Fabrin, Knud; Fisker, Rune V. (Dept. of Medical Physics, Oncology, Aalborg Hospital (Denmark))

    2008-08-15

    Background. A new fiducial marker for image guided radiotherapy (IGRT) based on a removable prostate stent made of Ni Ti has been developed during two previous clinical feasibility studies. The marker is currently being evaluated for IGRT treatment in a third clinical study. Method. The new marker is used to co-register MR and planning CT scans with high accuracy in the region around the prostate. The co-registered MR-CT volumes are used for delineation of GTV before planning. In each treatment session the IGRT system is used to position the patient before treatment. The IGRT system use a stereo pair of kV images matched to corresponding Digital Reconstructed Radiograms (DRR) from the planning CT scan. The match is done using mutual gray scale information. The pair of DRR's for positioning is created in the IGRT system with a threshold in the Look Up Table (LUT). The resulting match provides the necessary shift in couch coordinates to position the stent with an accuracy of 1-2 mm within the planned position. Results. At the present time 39 patients have received the new marker. Of the 39 one has migrated to the bladder. Deviations of more than 5 mm between CTV outlined on CT and MR are seen in several cases and in anterior-posterior (AP), left-right (LR) and cranial-caudal (CC) directions. Intra-fraction translation movements up to +/- 3 mm are seen as well. As the stent is also clearly visible on images taken with high voltage x-rays using electronic portal images devices (EPID), the positioning has been verified independently of the IGRT system. Discussion. The preliminary result of an on going clinical study of a Ni Ti prostate stent, potentially a new fiducial marker for image guided radiotherapy, looks promising. The risk of migration appears to be much lower compared to previous designs

  7. A new fiducial marker for Image-guided radiotherapy of prostate cancer: clinical experience.

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Højkjaer Larsen, Erik; Fabrin, Knud; Fisker, Rune V

    2008-01-01

    A new fiducial marker for image guided radiotherapy (IGRT) based on a removable prostate stent made of Ni Ti has been developed during two previous clinical feasibility studies. The marker is currently being evaluated for IGRT treatment in a third clinical study. The new marker is used to co-register MR and planning CT scans with high accuracy in the region around the prostate. The co-registered MR-CT volumes are used for delineation of GTV before planning. In each treatment session the IGRT system is used to position the patient before treatment. The IGRT system use a stereo pair of kV images matched to corresponding Digital Reconstructed Radiograms (DRR) from the planning CT scan. The match is done using mutual gray scale information. The pair of DRR's for positioning is created in the IGRT system with a threshold in the Look Up Table (LUT). The resulting match provides the necessary shift in couch coordinates to position the stent with an accuracy of 1-2 mm within the planned position. At the present time 39 patients have received the new marker. Of the 39 one has migrated to the bladder. Deviations of more than 5 mm between CTV outlined on CT and MR are seen in several cases and in anterior-posterior (AP), left-right (LR) and cranial-caudal (CC) directions. Intra-fraction translation movements up to +/- 3 mm are seen as well. As the stent is also clearly visible on images taken with high voltage x-rays using electronic portal images devices (EPID), the positioning has been verified independently of the IGRT system. The preliminary result of an on going clinical study of a Ni Ti prostate stent, potentially a new fiducial marker for image guided radiotherapy, looks promising. The risk of migration appears to be much lower compared to previous designs.

  8. Initial Results With Image-guided Cochlear Implant Programming in Children.

    Noble, Jack H; Hedley-Williams, Andrea J; Sunderhaus, Linsey; Dawant, Benoit M; Labadie, Robert F; Camarata, Stephen M; Gifford, René H

    2016-02-01

    Image-guided cochlear implant (CI) programming can improve hearing outcomes for pediatric CI recipients. CIs have been highly successful for children with severe-to-profound hearing loss, offering potential for mainstreamed education and auditory-oral communication. Despite this, a significant number of recipients still experience poor speech understanding, language delay, and, even among the best performers, restoration to normal auditory fidelity is rare. Although significant research efforts have been devoted to improving stimulation strategies, few developments have led to significant hearing improvement over the past two decades. Recently introduced techniques for image-guided CI programming (IGCIP) permit creating patient-customized CI programs by making it possible, for the first time, to estimate the position of implanted CI electrodes relative to the nerves they stimulate using CT images. This approach permits identification of electrodes with high levels of stimulation overlap and to deactivate them from a patient's map. Previous studies have shown that IGCIP can significantly improve hearing outcomes for adults with CIs. The IGCIP technique was tested for 21 ears of 18 pediatric CI recipients. Participants had long-term experience with their CI (5 mo to 13 yr) and ranged in age from 5 to 17 years old. Speech understanding was assessed after approximately 4 weeks of experience with the IGCIP map. Using a two-tailed Wilcoxon signed-rank test, statistically significant improvement (p < 0.05) was observed for word and sentence recognition in quiet and noise, as well as pediatric self-reported quality-of-life (QOL) measures. Our results indicate that image guidance significantly improves hearing and QOL outcomes for pediatric CI recipients.

  9. A new fiducial marker for Image-guided radiotherapy of prostate cancer: Clinical experience

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Hoejkjaer Larsen, Erik; Fabrin, Knud; Fisker, Rune V.

    2008-01-01

    Background. A new fiducial marker for image guided radiotherapy (IGRT) based on a removable prostate stent made of Ni Ti has been developed during two previous clinical feasibility studies. The marker is currently being evaluated for IGRT treatment in a third clinical study. Method. The new marker is used to co-register MR and planning CT scans with high accuracy in the region around the prostate. The co-registered MR-CT volumes are used for delineation of GTV before planning. In each treatment session the IGRT system is used to position the patient before treatment. The IGRT system use a stereo pair of kV images matched to corresponding Digital Reconstructed Radiograms (DRR) from the planning CT scan. The match is done using mutual gray scale information. The pair of DRR's for positioning is created in the IGRT system with a threshold in the Look Up Table (LUT). The resulting match provides the necessary shift in couch coordinates to position the stent with an accuracy of 1-2 mm within the planned position. Results. At the present time 39 patients have received the new marker. Of the 39 one has migrated to the bladder. Deviations of more than 5 mm between CTV outlined on CT and MR are seen in several cases and in anterior-posterior (AP), left-right (LR) and cranial-caudal (CC) directions. Intra-fraction translation movements up to +/- 3 mm are seen as well. As the stent is also clearly visible on images taken with high voltage x-rays using electronic portal images devices (EPID), the positioning has been verified independently of the IGRT system. Discussion. The preliminary result of an on going clinical study of a Ni Ti prostate stent, potentially a new fiducial marker for image guided radiotherapy, looks promising. The risk of migration appears to be much lower compared to previous designs

  10. X-ray absorption intensity at high-energy region

    Fujikawa, Takashi; Kaneko, Katsumi

    2012-01-01

    We theoretically discuss X-ray absorption intensity in high-energy region far from the deepest core threshold to explain the morphology-dependent mass attenuation coefficient of some carbon systems, carbon nanotubes (CNTs), highly oriented pyrolytic graphite (HOPG) and fullerenes (C 60 ). The present theoretical approach is based on the many-body X-ray absorption theory including the intrinsic losses (shake-up losses). In the high-energy region the absorption coefficient has correction term dependent on the solid state effects given in terms of the polarization part of the screened Coulomb interaction W p . We also discuss the tail of the valence band X-ray absorption intensity. In the carbon systems C 2s contribution has some influence on the attenuation coefficient even in the high energy region at 20 keV.

  11. Nuclear diagnostics of high intensity laser plasma interactions

    Krushelnick, K.; Santala, M.I.K.; Beg, F.N.; Clark, E.L.; Dangor, A.E.; Tatarakis, M.; Watts, I.; Wei, M.S.; Zepf, M.; Ledingham, K.W.D.; McCanny, T.; Spencer, I.; Clarke, R.J.; Norreys, P.A.

    2002-01-01

    Nuclear activation has been observed in materials exposed to energetic protons and heavy ions generated from high intensity laser-solid interactions (at focused intensities up to 5x10 19 W/cm 2 ). The energy spectrum of the protons is determined through the use of these nuclear activation techniques and is found to be consistent with other ion diagnostics. Heavy ion fusion reactions and large neutron fluxes from the (p, n) reactions were also observed. The reduction of proton emission and increase in heavy ion energy using heated targets was also observed

  12. High intensity proton operation at the Brookhaven AGS accelerator complex

    Ahrens, L.A.; Blaskiewicz, M.; Bleser, E.; Brennan, J.M.; Gardner, C.; Glenn, J.W.; Onillon, E.; Reece, R.K.; Roser, T.; Soukas, A.

    1994-01-01

    With the completion of the AGS rf upgrade, and the implementation of a transition open-quotes jumpclose quotes, all of accelerator systems were in place in 1994 to allow acceleration of the proton intensity available from the AGS Booster injector to AGS extraction energy and delivery to the high energy users. Beam commissioning results with these new systems are presented. Progress in identifying and overcoming other obstacles to higher intensity are given. These include a careful exploration of the stopband strengths present on the AGS injection magnetic porch, and implementation of the AGS single bunch transverse dampers throughout the acceleration cycle

  13. Applications of super - high intensity lasers in nuclear engineering

    Salomaa, R.; Hakola, A.; Santala, M.

    2007-01-01

    Laser-plasma interactions arising when a super intense ultrashort laser pulse impinges a solid target creates intense partly collimated and energy resolved photons, high energy electron and protons and neutrons. In addition the plasma plume can generate huge magnetic and electric fields. Also ultra short X-ray pulses are created. We have participated in some of such experiments at Rutherford and Max-Planck Institute and assessed the applications of such kind as laser-driven accelerators. This paper discusses applications in nuclear engineering (neutron sources, isotope separation, fast ignition and transmutation, etc). In particular the potential for extreme time resolution and to partial energy resolution are assessed

  14. Clinical Outcome of Dose-Escalated Image-Guided Radiotherapy for Spinal Metastases

    Guckenberger, Matthias; Goebel, Joachim; Wilbert, Juergen; Baier, Kurt; Richter, Anne; Sweeney, Reinhart A.; Bratengeier, Klaus; Flentje, Michael

    2009-01-01

    Purpose: To evaluate the outcomes after dose-escalated radiotherapy (RT) for spinal metastases and paraspinal tumors. Methods and Materials: A total of 14 patients, 12 with spinal metastases and a long life expectancy and 2 with paraspinal tumors, were treated for 16 lesions with intensity-modulated, image-guided RT. A median biologic effective dose of 74 Gy 10 (range, 55-86) in a median of 20 fractions (range, 3-34) was prescribed to the target volume. The spinal canal was treated to 40 Gy in 20 fractions using a second intensity-modulated RT dose level in the case of epidural involvement. Results: After median follow-up of 17 months, one local recurrence was observed, for an actuarial local control rate of 88% after 2 years. Local control was associated with rapid and long-term pain relief. Of 11 patients treated for a solitary spinal metastasis, 6 developed systemic disease progression. The actuarial overall survival rate for metastatic patients was 85% and 63% after 1 and 2 years, respectively. Acute Grade 2-3 skin toxicity was seen in 2 patients with no late toxicity greater than Grade 2. No radiation-induced myelopathy was observed. Conclusion: Dose-escalated irradiation of spinal metastases was safe and resulted in excellent local control. Oligometastatic patients with a long life expectancy and epidural involvement are considered to benefit the most from fractionated RT.

  15. Remote Cherenkov imaging-based quality assurance of a magnetic resonance image-guided radiotherapy system.

    Andreozzi, Jacqueline M; Mooney, Karen E; Brůža, Petr; Curcuru, Austen; Gladstone, David J; Pogue, Brian W; Green, Olga

    2018-06-01

    Tools to perform regular quality assurance of magnetic resonance image-guided radiotherapy (MRIgRT) systems should ideally be independent of interference from the magnetic fields. Remotely acquired optical Cherenkov imaging-based dosimetry measurements in water were investigated for this purpose, comparing measures of dose accuracy, temporal dynamics, and overall integrated IMRT delivery. A 40 × 30.5 × 37.5 cm 3 water tank doped with 1 g/L of quinine sulfate was imaged using an intensified charge-coupled device (ICCD) to capture the Cherenkov emission while being irradiated by a commercial MRIgRT system (ViewRay™). The ICCD was placed down-bore at the end of the couch, 4 m from treatment isocenter and behind the 5-Gauss line of the 0.35-T MRI. After establishing optimal camera acquisition settings, square beams of increasing size (4.2 × 4.2 cm 2 , 10.5 × 10.5 cm 2 , and 14.7 × 14.7 cm 2 ) were imaged at 0.93 frames per second, from an individual cobalt-60 treatment head, to develop projection measures related to percent depth dose (PDD) curves and cross beam profiles (CPB). These Cherenkov-derived measurements were compared to ionization chamber (IC) and radiographic film dosimetry data, as well as simulation data from the treatment planning system (TPS). An intensity-modulated radiotherapy (IMRT) commissioning plan from AAPM TG-119 (C4:C-Shape) was also imaged at 2.1 frames per second, and the single linear sum image from 509 s of plan delivery was compared to the dose volume prediction generated by the TPS using gamma index analysis. Analysis of standardized test target images (1024 × 1024 pixels) yielded a pixel resolution of 0.37 mm/pixel. The beam width measured from the Cherenkov image-generated projection CBPs was within 1 mm accuracy when compared to film measurements for all beams. The 502 point measurements (i.e., pixels) of the Cherenkov image-based projection percent depth dose curves (pPDDs) were compared to p

  16. rf coaxial couplers for high-intensity linear accelerators

    Manca, J.J.; Knapp, E.A.

    1980-02-01

    Two rf coaxial couplers that are particularly suitable for intertank connection of the disk-and-washer accelerating structure for use in high-intensity linear accelerators have been developed. These devices have very high coupling to the accelerating structure and very low rf power loss at the operating frequency, and they can be designed for any relative particle velocity β > 0.4. Focusing and monitoring devices can be located inside these couplers

  17. High intensity proton linear accelerator development for nuclear waste transmutation

    Mizumoto, M.; Hasegawa, K.; Oguri, H.; Ito, N.; Kusano, J.; Okumura, Y.; Murata, H.; Sakogawa, K.

    1997-01-01

    A high-intensity proton linear accelerator with an energy of 1.5 GeV and an average current of 10 mA has been proposed for various engineering tests for the transmutation system of nuclear waste by JAERI. The conceptual and optimization studies for this accelerator performed for a proper choice of operating frequency, high b structure, mechanical engineering considerations and RF source aspects are briefly described

  18. CW high intensity non-scaling FFAG proton drivers

    Johnstone, C.; Berz, M.; Makino, K.; Snopok, P.

    2012-01-01

    Accelerators are playing increasingly important roles in basic science, technology, and medicine including nuclear power, industrial irradiation, material science, and neutrino production. Proton and light-ion accelerators in particular have many research, energy and medical applications, providing one of the most effective treatments for many types of cancer. Ultra high-intensity and high-energy (GeV) proton drivers are a critical technology for accelerator-driven sub-critical reactors (ADS)...

  19. High intensity surface plasma waves, theory and PIC simulations

    Raynaud, M.; Héron, A.; Adam, J.-C.

    2018-01-01

    With the development of intense (>1019 W cm-2) short pulses (≤25 fs) laser with very high contrast, surface plasma wave (SPW) can be explored in the relativistic regime. As the SPW propagates with a phase velocity close to the speed of light it may results in a strong acceleration of electron bunches along the surface permitting them to reach relativistic energies. This may be important e.g. for applications in the field of plasma-based accelerators. We investigate in this work the excitation of SPWs on grating preformed over-dense plasmas for laser intensities ranging from 1019 up to 1021 W cm-2. We discuss the nature of the interaction with respect to the solid case in which surface plasmon can be resonantly excited with weak laser intensity. In particular, we show the importance of the pulse duration and focalization of the laser beam on the amplitude of the SPW.

  20. Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study

    Sturdza, Alina; Pötter, Richard; Fokdal, Lars Ulrik

    2016-01-01

    Purpose Image guided brachytherapy (IGBT) for locally advanced cervical cancer allows dose escalation to the high-risk clinical target volume (HRCTV) while sparing organs at risk (OAR). This is the first comprehensive report on clinical outcome in a large multi-institutional cohort. Patients and ...

  1. High energy high intensity coherent photon beam for the SSC

    Tannenbaum, M.J.

    1984-01-01

    What is proposed for the 20 TeV protons hitting a fixed target is to make a tertiary electron beam similar to that which is the basis of the tagged photon beam at Fermilab. Briefly, a zero degree neutral beam is formed by sweeping out the primary proton beam and any secondary charged particles. Then the photons, from the decay of π 0 in the neutral beam, are converted to e + e - pairs in a lead converter and a high quality electron beam is formed. This beam is brought to the target area where it is converted to a photon beam by Bremsstrahlung in a radiator

  2. Radiation control in the intensive care unit for high intensity iridium-192 brain implants

    Sewchand, W.; Drzymala, R.E.; Amin, P.P.; Salcman, M.; Salazar, O.M.

    1987-01-01

    A bedside lead cubicle was designed to minimize the radiation exposure of intensive care unit staff during routine interstitial brain irradiation by removable, high intensity iridium-192. The cubicle shields the patient without restricting intensive care routines. The design specifications were confirmed by exposure measurements around the shield with an implanted anthropomorphic phantom simulating the patient situation. The cubicle reduces the exposure rate around an implant patient by as much as 90%, with the exposure level not exceeding 0.1 mR/hour/mg of radium-equivalent 192 Ir. Evaluation of data accumulated for the past 3 years has shown that the exposure levels of individual attending nurses are 0.12 to 0.36 mR/mg of radium-equivalent 192 Ir per 12-hour shift. The corresponding range for entire nursing teams varies between 0.18 and 0.26. A radiation control index (exposure per mg of radium-equivalent 192 Ir per nurse-hour) is thus defined for individual nurses and nursing teams; this index is a significant guide to the planning of nurse rotations for brain implant patients with various 192 Ir loads. The bedside shield reduces exposure from 192 Ir implants by a factor of about 20, as expected, and the exposure from the lower energy radioisotope iodine-125 is barely detectable

  3. A transparent vacuum window for high-intensity pulsed beams

    Monteil, M; Veness, R

    2011-01-01

    The HiRadMat (High-Radiation to Materials) facility Ill will allow testing of accelerator components, in particular those of the Large Hadron Collider (LHC) at CERN, under the impact of high-intensity pulsed beams. To reach this intensity range, the beam will be focused on a focal point where the target to be tested is located. A 60 mm aperture vacuum window will separate the vacuum of the beam line which is kept under high vacuum 10(-8) mbar, from the test area which is at atmospheric pressure. This window has to resist collapse due to beam passage. The high-intensity of the beam means that typical materials used for standard vacuum windows (such as stainless steel, aluminium and titanium alloy) cannot endure the energy deposition induced by the beam passage. Therefore, a vacuum window has been designed to maintain the differential pressure whilst resisting collapse due to the beam impact on the window. In this paper, we will present calculations of the energy transfer from beam to window, the design of the ...

  4. Generation of Ultra-high Intensity Laser Pulses

    Fisch, N.J.; Malkin, V.M.

    2003-01-01

    Mainly due to the method of chirped pulse amplification, laser intensities have grown remarkably during recent years. However, the attaining of very much higher powers is limited by the material properties of gratings. These limitations might be overcome through the use of plasma, which is an ideal medium for processing very high power and very high total energy. A plasma can be irradiated by a long pump laser pulse, carrying significant energy, which is then quickly depleted in the plasma by a short counterpropagating pulse. This counterpropagating wave effect has already been employed in Raman amplifiers using gases or plasmas at low laser power. Of particular interest here are the new effects which enter in high power regimes. These new effects can be employed so that one high-energy optical system can be used like a flashlamp in what amounts to pumping the plasma, and a second low-power optical system can be used to extract quickly the energy from the plasma and focus it precisely. The combined system can be very compact. Thus, focused intensities more than 10 25 W/cm 2 can be contemplated using existing optical elements. These intensities are several orders of magnitude higher than what is currently available through chirped pump amplifiers

  5. Proton and Ion Sources for High Intensity Accelerators

    Scrivens, R

    2004-01-01

    Future high intensity ion accelerators, including the Spallation Neutron Source (SNS), the European Spallation Source (ESS), the Superconducting Proton Linac (SPL) etc, will require high current and high duty factor sources for protons and negative hydrogen ions. In order to achieve these goals, a comparison of the Electron Cyclotron Resonance, radio-frequency and Penning ion sources, among others, will be made. For each of these source types, the present operational sources will be compared to the state-of-the-art research devices with special attention given to reliability and availability. Finally, the future research and development aims will be discussed.

  6. High intensity proton linac activities at Los Alamos

    Rusnak, B.; Chan, K.C.; Campbell, B.

    1998-01-01

    High-current proton linear accelerators offer an attractive alternative for generating the intense neutron fluxes needed for transmutations technologies, tritium production and neutron science. To achieve the fluxes required for tritium production, a 100-mA, 1700-MeV cw proton accelerator is being designed that uses superconducting cavities for the high-energy portion of the linac, from 211 to 1,700 MeV. The development work supporting the linac design effort is focused on three areas: superconducting cavity performance for medium-beta cavities at 700 MHz, high power rf coupler development, and cryomodule design. An overview of the progress in these three areas is presented

  7. A high intensity positron beam at the Brookhaven reactor

    Weber, M.; Lynn, K.G.; Roellig, L.O.; Mills, A.P. Jr.; Moodenbaugh, A.R.

    1987-01-01

    We describe a high intensity, low energy positron beam utilizing high specific activity /sup 64/Cu sources (870 Ci/g) produced in a reactor with high thermal neutron flux. Fast-to-slow moderation can be performed in a self moderation mode or with a transmission moderator. Slow positron rates up to 1.6 x 10/sup 8/ e/sup +//s with a half life of 12.8 h are calculated. Up to 1.0 x 10/sup 8/ e/sup +//s have been observed. New developments including a Ne moderator and an on-line isotope separation process are discussed. 21 refs., 9 figs

  8. HELIOS: A high intensity chopper spectrometer at LANSCE

    Mason, T.E.; Broholm, C.; Fultz, B.

    1998-01-01

    A proposal to construct a high intensity chopper spectrometer at LANSCE as part of the SPSS upgrade project is discussed. HELIOS will be optimized for science requiring high sensitivity neutron spectroscopy. This includes studies of phonon density of states in small polycrystalline samples, magnetic excitations in quantum magnets and highly correlated electron systems, as well as parametric studies (as a function of pressure, temperature, or magnetic field) of S(Q,ω). By employing a compact design together with the use of supermirror guide in the incident flight path the neutron flux at HELIOS will be significantly higher than any other comparable instrument now operating

  9. HELIOS: A high intensity chopper spectrometer at LANSCE

    Mason, T.E. [Oak Ridge National Lab., TN (United States); Broholm, C. [Johns Hopkins Univ., Baltimore, MD (United States). Dept. of Physics and Astronomy; Fultz, B. [California Inst. of Tech., Pasadena, CA (United States). Dept. of Materials Science] [and others

    1998-12-31

    A proposal to construct a high intensity chopper spectrometer at LANSCE as part of the SPSS upgrade project is discussed. HELIOS will be optimized for science requiring high sensitivity neutron spectroscopy. This includes studies of phonon density of states in small polycrystalline samples, magnetic excitations in quantum magnets and highly correlated electron systems, as well as parametric studies (as a function of pressure, temperature, or magnetic field) of S(Q,{omega}). By employing a compact design together with the use of supermirror guide in the incident flight path the neutron flux at HELIOS will be significantly higher than any other comparable instrument now operating.

  10. Navigation concepts for magnetic resonance imaging-guided musculoskeletal interventions.

    Busse, Harald; Kahn, Thomas; Moche, Michael

    2011-08-01

    Image-guided musculoskeletal (MSK) interventions are a widely used alternative to open surgical procedures for various pathological findings in different body regions. They traditionally involve one of the established x-ray imaging techniques (radiography, fluoroscopy, computed tomography) or ultrasound scanning. Over the last decades, magnetic resonance imaging (MRI) has evolved into one of the most powerful diagnostic tools for nearly the whole body and has therefore been increasingly considered for interventional guidance as well.The strength of MRI for MSK applications is a combination of well-known general advantages, such as multiplanar and functional imaging capabilities, wide choice of tissue contrasts, and absence of ionizing radiation, as well as a number of MSK-specific factors, for example, the excellent depiction of soft-tissue tumors, nonosteolytic bone changes, and bone marrow lesions. On the downside, the magnetic resonance-compatible equipment needed, restricted space in the magnet, longer imaging times, and the more complex workflow have so far limited the number of MSK procedures under MRI guidance.Navigation solutions are generally a natural extension of any interventional imaging system, in particular, because powerful hardware and software for image processing have become routinely available. They help to identify proper access paths, provide accurate feedback on the instrument positions, facilitate the workflow in an MRI environment, and ultimately contribute to procedural safety and success.The purposes of this work were to describe some basic concepts and devices for MRI guidance of MSK procedures and to discuss technical and clinical achievements and challenges for some selected implementations.

  11. High Intensity Beam Issues in the CERN Proton Synchrotron

    Aumon, Sandra; Rivkin, Leonid

    This PhD work is about limitations of high intensity proton beams observed in the CERN Proton Synchrotron (PS) and, in particular, about issues at injection and transition energies. With its 53 years, the CERN PS would have to operate beyond the limit of its performance to match the future requirements. Beam instabilities driven by transverse impedance and aperture restrictions are important issues for the operation and for the High-Luminosity LHC upgrade which foresees an intensity increase delivered by the injectors. The main subject of the thesis concerns the study of a fast transverse instability occurring at transition energy. The proton beams crossing this energy range are particularly sensitive to wake forces because of the slow synchrotron motion. This instability can cause a strong vertical emittance blow-up and severe losses in less than a synchrotron period. Experimental observations show that the particles at the peak density of the beam longitudinal distribution oscillate in the vertical plane du...

  12. Chrome tannage using high-intensity ultrasonic field.

    Mäntysalo, E; Marjoniemi, M; Kilpeläinen, M

    1997-04-01

    The process time in chrome tannage in leather making, using an elastic compression cycle followed by irradiation by high-intensity ultrasound, is quite short lasting only a few minutes, compared with a process time of several hours in modern chrome tannage. After ultrasonic irradiation, samples were basified in 17 h in chrome liquor at a pH of 4.0 and the shrinkage temperature was measured. The determination of the efficiency for the chrome liquor penetrating into the hides can be based on the steepness of the shrinkage temperature-processing time curve. An approximate value of 20 degrees C min(-1) can be evaluated for the initial slope of the curve when elastic compression and high-intensity ultrasonic irradiation is used, and a processing time of 2 min is required in chrome liquor (plus 17 h basification and 24 h storage time) to obtain leather stable to boiling. Usually, hides are kept in chrome liquor for 2 h.

  13. Entrepreneurship in high-tech and knowledge-intensive sectors

    Christensen, Patrizia V.; Madsen, Henning; Neergaard, Helle

    development of new enterprises in high-tech and knowledge-intensive sectors are analysed in relation to the educational and professional background of the entrepreneur/entrepreneurial team, as well as the personal and professional social networks of the entrepreneurs. The analysis is based on a theoretical...... framework combining theories of human and social capital. Secondary aspects addressed in the research project are questions of male vs. female entrepreneurship, internationalisation-globalisation, and business success/failure.......The paper investigates key factors influencing the establishment and early growth of high-tech and knowledge-intensive new firms in Denmark. Particular attention is paid to the human and social variables affecting the creation, survival, and growth of such firms. The establishment and subsequent...

  14. High-intensity, subkilovolt x-ray calibration facility

    Kuckuck, R.W.; Gaines, J.L.; Ernst, R.D.

    1976-01-01

    A high-intensity subkilovolt x-ray calibration source utilizing proton-induced inner-shell atomic fluorescence of low-Z elements is described. The high photon yields and low bremsstrahlung background associated with this phenomenon are ideally suited to provide intense, nearly monoenergetic x-ray beams. The proton accelerator is a 3 mA, 300 kV Cockroft-Walton using a conventional rf hydrogen ion source. Seven remotely-selectable targets capable of heat dissipation of 5 kW/cm 2 are used to provide characteristic x-rays with energies between 100 and 1000 eV. Source strengths are of the order of 10 13 to 10 14 photons/sec. Methods of reducing spectral contamination due to hydrocarbon build-up on the target are discussed. Typical x-ray spectra (Cu-L, C-K and B-K) are shown

  15. Light and Light Sources High-Intensity Discharge Lamps

    Flesch, Peter G

    2006-01-01

    Light and Light Sources gives an introduction to the working principles of high-intensity discharge (HID) lamps and points out challenges and problems associated with the development and operation of HID lamps. The state-of-the-art in electrode and plasma diagnostics as well as numerical methods used for the understanding of HID lamps are described. This volume addresses students as well as scientists and researchers at universities and in industry.

  16. Silicone rubber curing by high intensity infrared radiation

    Huang, T.; Tsai, J.; Cherng, C.; Chen, J.

    1994-01-01

    A high-intensity (12 kW) and compact (80 cm) infrared heating oven for fast curing (12 seconds) of tube-like silicone rubber curing studies is reported. Quality inspection by DSC and DMA and results from pilot-scale curing oven all suggest that infrared heating provides a better way of vulcanization regarding to curing time, quality, cost, and spacing over conventional hot air heating. copyright 1995 American Institute of Physics

  17. NUMERICAL METHODS FOR THE SIMULATION OF HIGH INTENSITY HADRON SYNCHROTRONS.

    LUCCIO, A.; D' IMPERIO, N.; MALITSKY, N.

    2005-09-12

    Numerical algorithms for PIC simulation of beam dynamics in a high intensity synchrotron on a parallel computer are presented. We introduce numerical solvers of the Laplace-Poisson equation in the presence of walls, and algorithms to compute tunes and twiss functions in the presence of space charge forces. The working code for the simulation here presented is SIMBAD, that can be run as stand alone or as part of the UAL (Unified Accelerator Libraries) package.

  18. Pulsed Power Applications in High Intensity Proton Rings

    Zhang, Wu; Ducimetière, Laurent; Fowler, Tony; Kawakubo, Tadamichi; Mertens, Volker; Sandberg, Jon; Shirakabe, Yoshihisa

    2005-01-01

    The pulsed power technology has been applied in particle accelerators and storage rings for over four decades. It is most commonly used in injection, extraction, beam manipulation, source, and focusing systems. These systems belong to the class of repetitive pulsed power. In this presentation, we review and discuss the history, present status, and future challenge of pulsed power applications in high intensity proton accelerators and storage rings.

  19. Proton induction linacs as high-intensity neutron sources

    Keefe, D.; Hoyer, E.

    1981-01-01

    Proton induction linacs are explored as high intensity neutron sources. The induction linac - concept, properties, experience with electrons, and possibilities - and its limitations for accelerating ions are reviewed. A number of proton induction linac designs are examined with the LIACEP program and general conclusions are given. Results suggest that a proton induction accelerator of the lowest voltage, consistent with good neutron flux, is preferred and could well be cost competitive with the usual rf linac/storage ring designs. (orig.)

  20. Gaussian representation of high-intensity focused ultrasound beams.

    Soneson, Joshua E; Myers, Matthew R

    2007-11-01

    A method for fast numerical simulation of high-intensity focused ultrasound beams is derived. The method is based on the frequency-domain representation of the Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation, and assumes for each harmonic a Gaussian transverse pressure distribution at all distances from the transducer face. The beamwidths of the harmonics are constrained to vary inversely with the square root of the harmonic number, and as such this method may be viewed as an extension of a quasilinear approximation. The technique is capable of determining pressure or intensity fields of moderately nonlinear high-intensity focused ultrasound beams in water or biological tissue, usually requiring less than a minute of computer time on a modern workstation. Moreover, this method is particularly well suited to high-gain simulations since, unlike traditional finite-difference methods, it is not subject to resolution limitations in the transverse direction. Results are shown to be in reasonable agreement with numerical solutions of the full KZK equation in both tissue and water for moderately nonlinear beams.

  1. Compton spectra of atoms at high x-ray intensity

    Son, Sang-Kil; Geffert, Otfried; Santra, Robin

    2017-03-01

    Compton scattering is the nonresonant inelastic scattering of an x-ray photon by an electron and has been used to probe the electron momentum distribution in gas-phase and condensed-matter samples. In the low x-ray intensity regime, Compton scattering from atoms dominantly comes from bound electrons in neutral atoms, neglecting contributions from bound electrons in ions and free (ionized) electrons. In contrast, in the high x-ray intensity regime, the sample experiences severe ionization via x-ray multiphoton multiple ionization dynamics. Thus, it becomes necessary to take into account all the contributions to the Compton scattering signal when atoms are exposed to high-intensity x-ray pulses provided by x-ray free-electron lasers (XFELs). In this paper, we investigate the Compton spectra of atoms at high x-ray intensity, using an extension of the integrated x-ray atomic physics toolkit, xatom. As the x-ray fluence increases, there is a significant contribution from ionized electrons to the Compton spectra, which gives rise to strong deviations from the Compton spectra of neutral atoms. The present study provides not only understanding of the fundamental XFEL-matter interaction but also crucial information for single-particle imaging experiments, where Compton scattering is no longer negligible. , which features invited work from the best early-career researchers working within the scope of J. Phys. B. This project is part of the Journal of Physics series’ 50th anniversary celebrations in 2017. Sang-Kil Son was selected by the Editorial Board of J. Phys. B as an Emerging Leader.

  2. Beam halo in high-intensity hadron linacs

    Gerigk, F

    2006-12-21

    This document aims to cover the most relevant mechanisms for the development of beam halo in high-intensity hadron linacs. The introduction outlines the various applications of high-intensity linacs and it will explain why, in the case of the CERN Superconducting Proton Linac (SPL) study a linac was chosen to provide a high-power beam, rather than a different kind of accelerator. The basic equations, needed for the understanding of halo development are derived and employed to study the effects of initial and distributed mismatch on high-current beams. The basic concepts of the particle-core model, envelope modes, parametric resonances, the free-energy approach, and the idea of core-core resonances are introduced and extended to study beams in realistic linac lattices. The approach taken is to study the behavior of beams not only in simplified theoretical focusing structures but to highlight the beam dynamics in realistic accelerators. All effects which are described and derived with simplified analytic models, are tested in realistic lattices and are thus related to observable effects in linear accelerators. This approach involves the use of high-performance particle tracking codes, which are needed to simulate the behavior of the outermost particles in distributions of up to 100 million macro particles. In the end a set of design rules are established and their impact on the design of a typical high-intensity machine, the CERN SPL, is shown. The examples given in this document refer to two different design evolutions of the SPL study: the first conceptual design report (SPL I) and the second conceptual design report (SPL II). (orig.)

  3. Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

    Smriti Hari

    2016-01-01

    Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates.

  4. The joint project for high-intensity proton accelerators

    NONE

    1999-08-01

    Japan Atomic Energy Research Institute (JAERI) and the High Energy Accelerator Research Organization (KEK) agreed to promote the joint project integrating both the Neutron Science Project (NSP) of JAERI and the Japan Hadron Facility Project (JHF) of KEK for comprehensive studies on basic science and technology using high-intensity proton accelerator. This document describes the joint proposal prepared by the Joint Project Team of JAERI and KEK to construct accelerators and research facilities necessary both for the NSP and the JHF at the site of JAERI Tokai Establishment. (author)

  5. High intensity Discharge lighting; Alumbrado de alta intensidad de descarga

    Mendoza E, Ernesto J [Manufacturera de Reactores, S. A., Mexico, D. F. (Mexico)

    1994-12-31

    This paper gets into contact with some fundamentals in the operation of high discharge intensity lamps. There are useful definitions, as well as the study of the operation of high pressure sodium lamps and of metallic additives operating at less than nominal power. [Espanol] Este trabajo pone al lector en contacto con algunos fundamentos de la operacion de las lamparas de alta intensidad de descarga (HID). Se encuentra con definiciones utiles, asi como el estudio de la operacion de las lamparas de sodio en alta presion y de aditivos metalicos operando a una potencia menor que la nominal.

  6. JAERI-KEK joint project on high intensity proton accelerators

    Nagamiya, Shoji

    2000-01-01

    Japan Atomic Energy Research Institute (JAERI) and the High Energy Accelerator Organization (KEK) are promoting the joint project integrating both the Neutron Science Project (NSP) of JAERI and the Japan Hadron Facility Project (JHF) of KEK for comprehensive studies on basic science and technology using high-intensity proton accelerator. This paper describes the joint project prepared by the Joint Project Team of JAERI and KEK to construct accelerators and research facilities necessary both for the NSP and the JHF at the site of JAERI Tokai Establishment. (author)

  7. Performance of GEM detectors in high intensity particle beams

    Bachmann, S; Ketzer, B; Deutel, M; Ropelewski, Leszek; Sauli, Fabio; Bondar, A E; Buzulutskov, A F; Shekhtman, L I; Sokolov, A; Tatarinov, A A; Vasilev, A; Kappler, S; Schulte, E C

    2001-01-01

    We describe extensive tests of Double GEM and Triple GEM detectors, including full size prototypes for the COMPASS experiment, exposed to high intensity muon, proton and pion beams at the Paul~Scherrer Institute and at CERN. The measurements aim at detecting problems possible under these operation conditions, the main concern being the occurrence of discharges induced by beam particles. Results on the dependence of the probability for induced discharges on the experimental environment are presented and discussed. Implications for the application of GEM~detectors in experiments at high luminosity colliders are illustrated.

  8. High intensity line source for x-ray spectrometer calibration

    Thoe, R.S.

    1986-06-01

    A high intensity electron-impact x-ray source using a one-dimensional Pierce lens has been built for the purpose of calibrating a bent crystal x-ray spectrometer. This source focuses up to 100 mA of 20-keV electrons to a line on a liquid-cooled anode. The line (which can serve as a virtual slit for the spectrometer) measures approximately 800 μ x 2 cm. The source is portable and therefore adaptable to numerous types of spectrometer applications. One particular application, the calibration of a high resolution (r = 10 4 ) time-resolved cyrstal spectrometer, will be discussed in detail

  9. High intensity Discharge lighting; Alumbrado de alta intensidad de descarga

    Mendoza E, Ernesto J. [Manufacturera de Reactores, S. A., Mexico, D. F. (Mexico)

    1993-12-31

    This paper gets into contact with some fundamentals in the operation of high discharge intensity lamps. There are useful definitions, as well as the study of the operation of high pressure sodium lamps and of metallic additives operating at less than nominal power. [Espanol] Este trabajo pone al lector en contacto con algunos fundamentos de la operacion de las lamparas de alta intensidad de descarga (HID). Se encuentra con definiciones utiles, asi como el estudio de la operacion de las lamparas de sodio en alta presion y de aditivos metalicos operando a una potencia menor que la nominal.

  10. Removing Known SPS Intensity Limitations for High Luminosity LHC Goals

    Shaposhnikova, Elena; Bohl, Thomas; Cruikshank, Paul; Goddard, Brennan; Kaltenbacher, Thomas; Lasheen, Alexandre; Perez Espinos, Jaime; Repond, Joël; Salvant, Benoit; Vollinger, Christine

    2016-01-01

    In preparation of the SPS as an LHC injector its impedance was significantly reduced in 1999 - 2000. A new SPS impedance reduction campaign is planned now for the High Luminosity (HL)-LHC project, which requires bunch intensities twice as high as the nominal one. One of the known intensity limitations is a longitudinal multi-bunch instability with a threshold 3 times below this operational intensity. The instability is presently cured using the 4th harmonic RF system and controlled emittance blow-up, but reaching the HL-LHC parameters cannot be assured without improving the machine impedance. Recently the impedance sources responsible for this instability were identified and implementation of their shielding and damping is foreseen during the next long shutdown (2019 - 2020) in synergy with two other important upgrades: amorphous carbon coating of (part of) the vacuum chamber against the e-cloud effect and rearrangement of the 200 MHz RF system. In this paper the strategy of impedance reduction is presented t...

  11. Fluorescence and Magnetic Resonance Dual-Modality Imaging-Guided Photothermal and Photodynamic Dual-Therapy with Magnetic Porphyrin-Metal Organic Framework Nanocomposites

    Zhang, Hui; Li, Yu-Hao; Chen, Yang; Wang, Man-Man; Wang, Xue-Sheng; Yin, Xue-Bo

    2017-03-01

    Phototherapy shows some unique advantages in clinical application, such as remote controllability, improved selectivity, and low bio-toxicity, than chemotherapy. In order to improve the safety and therapeutic efficacy, imaging-guided therapy seems particularly important because it integrates visible information to speculate the distribution and metabolism of the probe. Here we prepare biocompatible core-shell nanocomposites for dual-modality imaging-guided photothermal and photodynamic dual-therapy by the in situ growth of porphyrin-metal organic framework (PMOF) on Fe3O4@C core. Fe3O4@C core was used as T2-weighted magnetic resonance (MR) imaging and photothermal therapy (PTT) agent. The optical properties of porphyrin were well remained in PMOF, and PMOF was therefore selected for photodynamic therapy (PDT) and fluorescence imaging. Fluorescence and MR dual-modality imaging-guided PTT and PDT dual-therapy was confirmed with tumour-bearing mice as model. The high tumour accumulation of Fe3O4@C@PMOF and controllable light excitation at the tumour site achieved efficient cancer therapy, but low toxicity was observed to the normal tissues. The results demonstrated that Fe3O4@C@PMOF was a promising dual-imaging guided PTT and PDT dual-therapy platform for tumour diagnosis and treatment with low cytotoxicity and negligible in vivo toxicity.

  12. Image-guided, Laser-based Fabrication of Vascular-derived Microfluidic Networks

    Heintz, Keely A.; Mayerich, David; Slater, John H.

    2017-01-01

    This detailed protocol outlines the implementation of image-guided, laser-based hydrogel degradation for the fabrication of vascular-derived microfluidic networks embedded in PEGDA hydrogels. Here, we describe the creation of virtual masks that allow for image-guided laser control; the photopolymerization of a micromolded PEGDA hydrogel, suitable for microfluidic network fabrication and pressure head-driven flow; the setup and use of a commercially available laser scanning confocal microscope...

  13. Percutaneous Image-guided radiofrequency ablation of tumors in inoperable patients - immediate complications and overall safety

    Anubha Sahay

    2016-01-01

    Conclusions: Percutaneous image-guided RFA is an option in patients where most other tumor management modalities have been exhausted or rejected. RFA may not be free from side effects such as postablation syndrome, pain, and there may be other serious complications such as bleeding, but based on our observations, percutaneous image-guided RFA of tumors is a safe palliative and therapeutic treatment option.

  14. High intensity accelerator for a wide range of applications

    Conard, E.M.

    1994-01-01

    When looking at commercial applications of accelerators from a market point of view, it appears that a common accelerator design could meet different users' needs. This would benefit both the manufacturer and the user by multiplying the number of machines sold, thus lowering their cost and improving their quality. These applications include: radioisotope production for medical imaging (positron emission tomography), industrial imaging and non-destructive testing (e.g. neutron radiography, explosive and drug detection in luggage or freight). This paper investigates the needs of the various applications and defines their common denominator to establish suitable specifications (type of particles, energy, intensity). Different accelerator types (cyclotrons, linear accelerators and electrostatic machines) are reviewed and compared on performance and estimated costs. A high intensity tandem accelerator design is studied in more detail as it seems the most appropriate candidate. ((orig.))

  15. The different effects of high intensity interval training and moderate intensity interval training for weightlessness countermeasures

    Wang, Lin-Jie; Cheng, Tan; Zhi-Li, Li; Hui-juan, Wang; Wen-juan, Chen; Jianfeng, Zhang; Desheng, Wang; Dongbin, Niu; Qi, Zhao; Chengjia, Yang; Yanqing, Wang

    High intensity interval training (HIIT) has been demonstrated to improve performance in a relatively short training period. But the difference between high intensity interval training and moderate intensity interval training (MIIT) in simulated weightlessness still has not been well studied. This study sought to characterize the difference between 6 weeks high intensity interval training and moderate intensity interval training under reduced weight (RW) gait training device and zero-gravity locomotion system (ZLS). Twenty-three subjects (14M/4F, 32.5±4.5 years) volunteered to participate. They were divided into three groups, that were MITT (alternating 2 min at 40% VO _{2} peak and 2 min at 60% VO _{2} peak for 30min, five days per week) RW group (n=8), HITT (alternating 2 min at 40% VO _{2} peak and 2 min at 90% VO _{2} peak for 30min, three days per week) RW group (n=8) and HITT ZLS group (n=7). The Z-axis load used in RW group was 80% body weight (BW) and in ZLS was 100% BW. Cardiopulmonary function was measured before, after 4-week training and after 6-week training. Isokinetic knee extension-flexion test at 60(°) deg/s and 180(°) deg/s were performed before and after the 6-week training, and isometric knee extension-flexion test at 180(°) deg/s was also examined at the same time. It was found that the VO _{2} peaks, metabolic equivalent (MET), Speedmax and respiratory exchange ratio (RER) were significantly increased after 4 and 6-week training in all three groups and no significant group difference were detected. The peak torque at 60(°) deg/s for right knee flexion were significantly increased after 6 week-training in all three groups, and only in HITT RW group the total power at 60(°) deg/s for right knee flexion enhanced. The total power and average power at 60(°) deg/s for right knee extension decreased significantly after 6-week training in all three groups. The peak torque at 60(°) deg/s for right knee extension in MIIT RW group was

  16. MO-DE-202-00: Image-Guided Interventions: Advances in Intraoperative Imaging, Guidance, and An Emerging Role for Medical Physics in Surgery

    NONE

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  17. High intensity region segmentation in MR imaging of multiple sclerosis

    Rodrigo, F; Filipuzzi, M; Graffigna, J P; Isoardi, R; Noceti, M

    2013-01-01

    Numerous pathologies are often manifest in Magnetic Resonance Imaging (MRI) as hyperintense or bright regions as compared to normal tissue. It is of particular interest to develop an algorithm to detect, identify and define those Regions of Interest (ROI) when analyzing MRI studies, particularly for lesions of Multiple Sclerosis (MS). The objective of this study is to analyze those parameters which optimize segmentation of the areas of interest. To establish which areas should be considered as hyperintense regions, we developed a database (DB), with studies of patients diagnosed with MS. This disease causes axonal demyelination and it is expressed as bright regions in PD, T2 and FLAIR MRI sequences. Thus, with more than 4300 hyperintense regions validated by an expert physician, an algorithm was developed to detect such spots, approximating the results the expert obtained. Alongside these hyperintense lesion regions, it also detected bone regions with high intensity levels, similar to the intensity of the lesions, but with other features that allow a good differentiation.The algorithm will then detect ROIs with similar intensity levels and performs classification through data mining techniques

  18. High intensity interval exercise training in overweight young women.

    Sijie, T; Hainai, Y; Fengying, Y; Jianxiong, W

    2012-06-01

    The purpose of this study was intended to evaluate the effects of a high intensity interval training (HIIT) program on the body composition, cardiac function and aerobic capacity in overweight young women. Sixty female university students (aged 19-20, BMI≥25kg/m2 and percentage body fat ≥ 30%) were chosen and then randomly assigned to each of the HIIT group, the moderate intensity continuous training (MICT) group and the non-training control group. The subjects in both the HIIT and MICT groups underwent exercise training five times per week for 12 weeks. In each of the training sessions, the HIIT group performed interval exercises at the individualized heart rate (HR) of 85% of VO2max and separated by brief periods of low intensity activity (HR at 50% of VO2max), while the MICT group did continuous walking and/or jogging at the individualized HR of 50% of VO2max. Both of these exercise training programs produced significant improvements in the subjects' body composition, left ventricular ejection fraction, heart rate at rest, maximal oxygen uptake and ventilatory threshold. However, the HIIT group achieved better results than those in the MICT group, as it was evaluated by the amount of the effect size. The control group did not achieve any change in all of the measured variables. The tangible results achieved by our relatively large groups of homogeneous subjects have demonstrated that the HIIT program is an effective measure for the treatment of young women who are overweight.

  19. Comparison of biometric measurements obtained by the Verion Image-Guided System versus the auto-refracto-keratometer.

    Velasco-Barona, Cecilio; Cervantes-Coste, Guadalupe; Mendoza-Schuster, Erick; Corredor-Ortega, Claudia; Casillas-Chavarín, Nadia L; Silva-Moreno, Alejandro; Garza-León, Manuel; Gonzalez-Salinas, Roberto

    2018-06-01

    To compare the biometric measurements obtained from the Verion Image-Guided System to those obtained by auto-refracto-keratometer in normal eyes. This is a prospective, observational, comparative study conducted at the Asociación para Evitar la Ceguera en México I.A.P., Mexico. Three sets of keratometry measurements were obtained using the image-guided system to assess the coefficient of variation, the within-subject standard deviation and intraclass correlation coefficient (ICC). A paired Student t test was used to assess statistical significance between the Verion and the auto-refracto-keratometer. A Pearson's correlation coefficient (r) was obtained for all measurements, and the level of agreement was verified using Bland-Altman plots. The right eyes of 73 patients were evaluated by each platform. The Verion coefficient of variation was 0.3% for the flat and steep keratometry, with the ICC being greater than 0.9 for all parameters measured. Paired t test showed statistically significant differences between groups (P = 0.0001). A good correlation was evidenced for keratometry values between platforms (r = 0.903, P = 0.0001 for K1, and r = 0.890, P = 0.0001). Bland-Altman plots showed a wide data spread for all variables. The image-guided system provided highly repeatable corneal power and keratometry measurements. However, significant differences were evidenced between the two platforms, and although values were highly correlated, they showed a wide data spread for all analysed variables; therefore, their interchangeable use for biometry assessment is not advisable.

  20. Summary for the WG4: physics with high intensity lasers

    Takahashi, T.

    2006-01-01

    There are many physics opportunities in laser-beam interactions and innovations in the laser- and the beam technologies expand them or even open new window in the field. Therefore, physics with high intense lasers is an attractive application of nanobeam technologies. The topics in the working group 4 covers fundamental physics based on technique related with nanobeam development aiming to encourage communication between physics and accelerator communities. Due to the limited time for the preparation, we did not try comprehensive coverage of the field but invited topics which are planed near future or can be studied at the ILC test facilities. (author)

  1. KEK/JAERI joint project on high intensity proton accelerators

    Nagamiya, Shoji

    2002-01-01

    From JFY01, which started on April 1, 2001, a new accelerator project to provide high-intensity proton beams proceeded into a construction phase. This project is conducted under a cooperation of two institutions, KEK and JAERI. The accelerator complex will provide 1 MW proton beams at 3 GeV and 0.75 MW beams at 50 GeV. The project will be completed within six years. In this article I will describe a) the project itself, b) sciences to be pursued at this new accelerator complex and c) the present status and future plans of the project. (author)

  2. Multi-energy ion implantation from high-intensity laser

    Cutroneo, Mariapompea; Torrisi, L.; Ullschmied, Jiří; Dudžák, Roman

    2016-01-01

    Roč. 61, č. 2 (2016), s. 109-113 ISSN 0029-5922. [PLASMA 2015 : International Conference on Research and Applications of Plasmas. Warsaw, 07.09.2015-11.09.2015] R&D Projects: GA MŠk(CZ) LM2011019; GA ČR(CZ) GBP108/12/G108 Institutional support: RVO:61389021 ; RVO:61389005 Keywords : high-intensity laser * implantation * material modification Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders; BL - Plasma and Gas Discharge Physics (UFP-V) Impact factor: 0.760, year: 2016

  3. Overview of high intensity proton accelerator facility, J-PARC

    Ikeda, Y.

    2010-01-01

    The J-PARC project of high intensity proton accelerator research complex, conducted jointly by JAERI and KEK, has been completed with demonstration of all beam productions in 2009 as the facility construction phase, and the operation started to offer the secondary beams of neutron, muon, kaon, and neutrino, to the advanced scientific experimental research aiming at making breakthroughs in materials and life science, nuclear and elementary physics, etc. This text describes the overview of the J-PARC present status with emphasis of a performance toward to 1MW power as user facilities. (author)

  4. Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty (TKA) by Bade et al

    Mechlenburg, Inger; Skoffer, Birgit; Dalgas, Ulrik

    2017-01-01

    Recently, a paper entitled "Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial" was published in Arthritis Care Res by Bade et al. (1). We have read the paper with great interest and noted that the study shows essentially no diffe......Recently, a paper entitled "Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial" was published in Arthritis Care Res by Bade et al. (1). We have read the paper with great interest and noted that the study shows essentially...

  5. Development of a spherically focused phased array transducer for ultrasonic image-guided hyperthermia.

    Liu, Jingfei; Foiret, Josquin; Stephens, Douglas N; Le Baron, Olivier; Ferrara, Katherine W

    2016-07-21

    A 1.5 MHz prolate spheroidal therapeutic array with 128 circular elements was designed to accommodate standard imaging arrays for ultrasonic image-guided hyperthermia. The implementation of this dual-array system integrates real-time therapeutic and imaging functions with a single ultrasound system (Vantage 256, Verasonics). To facilitate applications involving small animal imaging and therapy the array was designed to have a beam depth of field smaller than 3.5 mm and to electronically steer over distances greater than 1 cm in both the axial and lateral directions. In order to achieve the required f number of 0.69, 1-3 piezocomposite modules were mated within the transducer housing. The performance of the prototype array was experimentally evaluated with excellent agreement with numerical simulation. A focal volume (2.70 mm (axial)  ×  0.65 mm (transverse)  ×  0.35 mm (transverse)) defined by the  -6 dB focal intensity was obtained to address the dimensions needed for small animal therapy. An electronic beam steering range defined by the  -3 dB focal peak intensity (17 mm (axial)  ×  14 mm (transverse)  ×  12 mm (transverse)) and  -8 dB lateral grating lobes (24 mm (axial)  ×  18 mm (transverse)  ×  16 mm (transverse)) was achieved. The combined testing of imaging and therapeutic functions confirmed well-controlled local heating generation and imaging in a tissue mimicking phantom. This dual-array implementation offers a practical means to achieve hyperthermia and ablation in small animal models and can be incorporated within protocols for ultrasound-mediated drug delivery.

  6. Development of a spherically focused phased array transducer for ultrasonic image-guided hyperthermia

    Liu, Jingfei; Foiret, Josquin; Stephens, Douglas N.; Le Baron, Olivier; Ferrara, Katherine W.

    2016-07-01

    A 1.5 MHz prolate spheroidal therapeutic array with 128 circular elements was designed to accommodate standard imaging arrays for ultrasonic image-guided hyperthermia. The implementation of this dual-array system integrates real-time therapeutic and imaging functions with a single ultrasound system (Vantage 256, Verasonics). To facilitate applications involving small animal imaging and therapy the array was designed to have a beam depth of field smaller than 3.5 mm and to electronically steer over distances greater than 1 cm in both the axial and lateral directions. In order to achieve the required f number of 0.69, 1-3 piezocomposite modules were mated within the transducer housing. The performance of the prototype array was experimentally evaluated with excellent agreement with numerical simulation. A focal volume (2.70 mm (axial)  ×  0.65 mm (transverse)  ×  0.35 mm (transverse)) defined by the  -6 dB focal intensity was obtained to address the dimensions needed for small animal therapy. An electronic beam steering range defined by the  -3 dB focal peak intensity (17 mm (axial)  ×  14 mm (transverse)  ×  12 mm (transverse)) and  -8 dB lateral grating lobes (24 mm (axial)  ×  18 mm (transverse)  ×  16 mm (transverse)) was achieved. The combined testing of imaging and therapeutic functions confirmed well-controlled local heating generation and imaging in a tissue mimicking phantom. This dual-array implementation offers a practical means to achieve hyperthermia and ablation in small animal models and can be incorporated within protocols for ultrasound-mediated drug delivery.

  7. High-Intensity Interval Training Elicits Higher Enjoyment than Moderate Intensity Continuous Exercise

    Thum, Jacob S.; Parsons, Gregory; Whittle, Taylor

    2017-01-01

    Exercise adherence is affected by factors including perceptions of enjoyment, time availability, and intrinsic motivation. Approximately 50% of individuals withdraw from an exercise program within the first 6 mo of initiation, citing lack of time as a main influence. Time efficient exercise such as high intensity interval training (HIIT) may provide an alternative to moderate intensity continuous exercise (MICT) to elicit substantial health benefits. This study examined differences in enjoyment, affect, and perceived exertion between MICT and HIIT. Twelve recreationally active men and women (age = 29.5 ± 10.7 yr, VO2max = 41.4 ± 4.1 mL/kg/min, BMI = 23.1 ± 2.1 kg/m2) initially performed a VO2max test on a cycle ergometer to determine appropriate workloads for subsequent exercise bouts. Each subject returned for two additional exercise trials, performing either HIIT (eight 1 min bouts of cycling at 85% maximal workload (Wmax) with 1 min of active recovery between bouts) or MICT (20 min of cycling at 45% Wmax) in randomized order. During exercise, rating of perceived exertion (RPE), affect, and blood lactate concentration (BLa) were measured. Additionally, the Physical Activity Enjoyment Scale (PACES) was completed after exercise. Results showed higher enjoyment (p = 0.013) in response to HIIT (103.8 ± 9.4) versus MICT (84.2 ± 19.1). Eleven of 12 participants (92%) preferred HIIT to MICT. However, affect was lower (pHIIT versus MICT. Although HIIT is more physically demanding than MICT, individuals report greater enjoyment due to its time efficiency and constantly changing stimulus. Trial Registration: NCT:02981667. PMID:28076352

  8. High-Intensity Interval Training Elicits Higher Enjoyment than Moderate Intensity Continuous Exercise.

    Jacob S Thum

    Full Text Available Exercise adherence is affected by factors including perceptions of enjoyment, time availability, and intrinsic motivation. Approximately 50% of individuals withdraw from an exercise program within the first 6 mo of initiation, citing lack of time as a main influence. Time efficient exercise such as high intensity interval training (HIIT may provide an alternative to moderate intensity continuous exercise (MICT to elicit substantial health benefits. This study examined differences in enjoyment, affect, and perceived exertion between MICT and HIIT. Twelve recreationally active men and women (age = 29.5 ± 10.7 yr, VO2max = 41.4 ± 4.1 mL/kg/min, BMI = 23.1 ± 2.1 kg/m2 initially performed a VO2max test on a cycle ergometer to determine appropriate workloads for subsequent exercise bouts. Each subject returned for two additional exercise trials, performing either HIIT (eight 1 min bouts of cycling at 85% maximal workload (Wmax with 1 min of active recovery between bouts or MICT (20 min of cycling at 45% Wmax in randomized order. During exercise, rating of perceived exertion (RPE, affect, and blood lactate concentration (BLa were measured. Additionally, the Physical Activity Enjoyment Scale (PACES was completed after exercise. Results showed higher enjoyment (p = 0.013 in response to HIIT (103.8 ± 9.4 versus MICT (84.2 ± 19.1. Eleven of 12 participants (92% preferred HIIT to MICT. However, affect was lower (p<0.05 and HR, RPE, and BLa were higher (p<0.05 in HIIT versus MICT. Although HIIT is more physically demanding than MICT, individuals report greater enjoyment due to its time efficiency and constantly changing stimulus.NCT:02981667.

  9. Multifunctional pulse generator for high-intensity focused ultrasound system

    Tamano, Satoshi; Yoshizawa, Shin; Umemura, Shin-Ichiro

    2017-07-01

    High-intensity focused ultrasound (HIFU) can achieve high spatial resolution for the treatment of diseases. A major technical challenge in implementing a HIFU therapeutic system is to generate high-voltage high-current signals for effectively exciting a multichannel HIFU transducer at high efficiencies. In this paper, we present the development of a multifunctional multichannel generator/driver. The generator can produce a long burst as well as an extremely high-voltage short pulse of pseudosinusoidal waves (trigger HIFU) and second-harmonic superimposed waves for HIFU transmission. The transmission timing, waveform, and frequency can be controlled using a field-programmable gate array (FPGA) via a universal serial bus (USB) microcontroller. The hardware is implemented in a compact printed circuit board. The test results of trigger HIFU reveal that the power consumption and the temperature rise of metal-oxide semiconductor field-effect transistors were reduced by 19.9% and 38.2 °C, respectively, from the previous design. The highly flexible performance of the novel generator/driver is demonstrated in the generation of second-harmonic superimposed waves, which is useful for cavitation-enhanced HIFU treatment, although the previous design exhibited difficulty in generating it.

  10. Tumor Penetrating Theranostic Nanoparticles for Enhancement of Targeted and Image-guided Drug Delivery into Peritoneal Tumors following Intraperitoneal Delivery.

    Gao, Ning; Bozeman, Erica N; Qian, Weiping; Wang, Liya; Chen, Hongyu; Lipowska, Malgorzata; Staley, Charles A; Wang, Y Andrew; Mao, Hui; Yang, Lily

    2017-01-01

    The major obstacles in intraperitoneal (i.p.) chemotherapy of peritoneal tumors are fast absorption of drugs into the blood circulation, local and systemic toxicities, inadequate drug penetration into large tumors, and drug resistance. Targeted theranostic nanoparticles offer an opportunity to enhance the efficacy of i.p. therapy by increasing intratumoral drug delivery to overcome resistance, mediating image-guided drug delivery, and reducing systemic toxicity. Herein we report that i.p. delivery of urokinase plasminogen activator receptor (uPAR) targeted magnetic iron oxide nanoparticles (IONPs) led to intratumoral accumulation of 17% of total injected nanoparticles in an orthotopic mouse pancreatic cancer model, which was three-fold higher compared with intravenous delivery. Targeted delivery of near infrared dye labeled IONPs into orthotopic tumors could be detected by non-invasive optical and magnetic resonance imaging. Histological analysis revealed that a high level of uPAR targeted, PEGylated IONPs efficiently penetrated into both the peripheral and central tumor areas in the primary tumor as well as peritoneal metastatic tumor. Improved theranostic IONP delivery into the tumor center was not mediated by nonspecific macrophage uptake and was independent from tumor blood vessel locations. Importantly, i.p. delivery of uPAR targeted theranostic IONPs carrying chemotherapeutics, cisplatin or doxorubicin, significantly inhibited the growth of pancreatic tumors without apparent systemic toxicity. The levels of proliferating tumor cells and tumor vessels in tumors treated with the above theranostic IONPs were also markedly decreased. The detection of strong optical signals in residual tumors following i.p. therapy suggested the feasibility of image-guided surgery to remove drug-resistant tumors. Therefore, our results support the translational development of i.p. delivery of uPAR-targeted theranostic IONPs for image-guided treatment of peritoneal tumors.

  11. Longitudinal tracking studies for a high intensity proton synchrotron

    Lessner, E.; Cho, Y.; Harkay, K.; Symon, K.

    1995-01-01

    Results from longitudinal tracking studies for a high intensity proton synchrotron designed for a 1-MW spallation source are presented. The machine delivers a proton beam of 0.5 mA time-averaged current at a repetition rate of 30 Hz. The accelerator is designed to have radiation levels that allow hands-on-maintenance. However, the high beam intensity causes strong space charge fields whose effects may lead to particle loss and longitudinal instabilities. The space charge fields modify the particle distribution, distort the stable bucket area and reduce the rf linear restoring force. Tracking simulations were conducted to analyze the space charge effects on the dynamics of the injection and acceleration processes and means to circumvent them. The tracking studies led to the establishment of the injected beam parameters and rf voltage program that minimized beam loss and longitudinal instabilities. Similar studies for a 10-GeV synchrotron that uses the 2-GeV synchrotron as its injector are also discussed

  12. Formation of a high intensity low energy positron string

    Donets, E. D.; Donets, E. E.; Syresin, E. M.; Itahashi, T.; Dubinov, A. E.

    2004-05-01

    The possibility of a high intensity low energy positron beam production is discussed. The proposed Positron String Trap (PST) is based on the principles and technology of the Electron String Ion Source (ESIS) developed in JINR during the last decade. A linear version of ESIS has been used successfully for the production of intense highly charged ion beams of various elements. Now the Tubular Electron String Ion Source (TESIS) concept is under study and this opens really new promising possibilities in physics and technology. In this report, we discuss the application of the tubular-type trap for the storage of positrons cooled to the cryogenic temperatures of 0.05 meV. It is intended that the positron flux at the energy of 1-5 eV, produced by the external source, is injected into the Tubular Positron Trap which has a similar construction as the TESIS. Then the low energy positrons are captured in the PST Penning trap and are cooled down because of their synchrotron radiation in the strong (5-10 T) applied magnetic field. It is expected that the proposed PST should permit storing and cooling to cryogenic temperature of up to 5×109 positrons. The accumulated cooled positrons can be used further for various physics applications, for example, antihydrogen production.

  13. Formation of a high intensity low energy positron string

    Donets, E.D.; Donets, E.E.; Syresin, E.M.; Itahashi, T.; Dubinov, A.E.

    2004-01-01

    The possibility of a high intensity low energy positron beam production is discussed. The proposed Positron String Trap (PST) is based on the principles and technology of the Electron String Ion Source (ESIS) developed in JINR during the last decade. A linear version of ESIS has been used successfully for the production of intense highly charged ion beams of various elements. Now the Tubular Electron String Ion Source (TESIS) concept is under study and this opens really new promising possibilities in physics and technology. In this report, we discuss the application of the tubular-type trap for the storage of positrons cooled to the cryogenic temperatures of 0.05 meV. It is intended that the positron flux at the energy of 1-5 eV, produced by the external source, is injected into the Tubular Positron Trap which has a similar construction as the TESIS. Then the low energy positrons are captured in the PST Penning trap and are cooled down because of their synchrotron radiation in the strong (5-10 T) applied magnetic field. It is expected that the proposed PST should permit storing and cooling to cryogenic temperature of up to 5x10 9 positrons. The accumulated cooled positrons can be used further for various physics applications, for example, antihydrogen production

  14. ORBIT : BEAM DYNAMICS CALCULATIONS FOR HIGH - INTENSITY RINGS

    HOLMES, J.A.; DANILOV, V.; GALAMBOS, J.; SHISHLO, A.; COUSINEAU, S.; CHOU, W.; MICHELOTTI, L.; OSTIGUY, F.; WEI, J.

    2002-01-01

    We are developing a computer code, ORBIT, specifically for beam dynamics calculations in high-intensity rings. Our approach allows detailed simulation of realistic accelerator problems. ORBIT is a particle-in-cell tracking code that transports bunches of interacting particles through a series of nodes representing elements, effects, or diagnostics that occur in the accelerator lattice. At present, ORBIT contains detailed models for strip-foil injection including painting and foil scattering; rf focusing and acceleration; transport through various magnetic elements; longitudinal and transverse impedances; longitudinal, transverse, and three-dimensional space charge forces; collimation and limiting apertures; and the calculation of many useful diagnostic quantities. ORBIT is an object-oriented code, written in C++ and utilizing a scripting interface for the convenience of the user. Ongoing improvements include the addition of a library of accelerator maps, BEAMLINE/MXYZPTLK the introduction of a treatment magnet errors and fringe fields; the conversion of the scripting interface to the standard scripting language, Python; and the parallelization of the computations using MPI. The ORBIT code is an open source, powerful, and convenient tool for studying beam dynamics in high-intensity rings

  15. Injection and capture simulations for a high intensity proton synchrotron

    Cho, Y.; Lessner, E.; Symon, K.; Univ. of Wisconsin, Madison, WI

    1994-01-01

    The injection and capture processes in a high intensity, rapid cycling, proton synchrotron are simulated by numerical integration. The equations of motion suitable for rapid numerical simulation are derived so as to maintain symplecticity and second-order accuracy. By careful bookkeeping, the authors can, for each particle that is lost, determine its initial phase space coordinates. They use this information as a guide for different injection schemes and rf voltage programming, so that a minimum of particle losses and dilution are attained. A fairly accurate estimate of the space charge fields is required, as they influence considerably the particle distribution and reduce the capture efficiency. Since the beam is represented by a relatively coarse ensemble of macro particles, the authors study several methods of reducing the statistical fluctuations while retaining the fine structure (high intensity modulations) of the beam distribution. A pre-smoothing of the data is accomplished by the cloud-in-cell method. The program is checked by making sure that it gives correct answers in the absence of space charge, and that it reproduces the negative mass instability properly. Results of simulations for stationary distributions are compared to their analytical predictions. The capture efficiency for the rapid-cycling synchrotron is analyzed with respect to variations in the injected beam energy spread, bunch length, and rf programming

  16. Analysis of technology and seminar on economic trends about High-intensity LED

    2003-09-01

    This is divided into two parts. Contents of this report in the first part are technical trends on high-intensity LED which reports introduction of LED as compound semiconductor, white LED? patent issues, review on technology of High-intensity LED and Reliability of High-intensity LED. The second part deals with economic tends about High-intensity LED. This seminar was held to report analysis and economical trends about High-intensity LED by Korea Industrial Education Institute in 2003.

  17. Image-guided pain therapy. Sympathicolysis; Bildgestuetzte Schmerztherapie. Sympathikolyse

    Burbelko, M.; Wagner, H.J. [Vivantes Klinikum im Friedrichshain, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Gutberlet, M.; Grothoff, M. [Universitaet Leipzig - Herzzentrum, Abteilung fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany)

    2015-06-15

    In the autonomic nerve system most sympathetic neurons synapse peripherally in the ganglia of the sympathetic trunk. A reduction in sympathicotonia by partial elimination of these ganglia is a therapeutic approach that has been used for more than 100 years. In the early 1920s the first attempts at percutaneous sympathicolysis (SL) were carried out. Nowadays, minimally invasive image-guided SL has become an integral part of interventional radiology. Established indications for SL are hyperhidrosis, critical limb ischemia and the complex regional pain syndrome. The standard imaging guidance modality in SL is computed tomography (CT) which allows the exact placement of the puncture needle in the target area under visualization of the surrounding structures. Ethanol is normally used for chemical lysis, which predominantly eliminates the unmyelinated autonomic axons. In order to visualize the distribution of the ethanol during application, iodine-containing contrast medium is added. The sympathetic nervous system (SNS) controls sweat secretion via the efferent neurons; therefore, effective therapy of idiopathic palmar, axillary and plantar hyperhidrosis can be achieved when SL is performed at the corresponding level of the sympathetic trunk. Furthermore, due to the vasomotor innervation of most blood vessels, by reduction of the sympathicotonus an atony of the smooth muscles and therefore vasodilatation occurs, which is used as a palliative therapeutic option in patients with critical limb ischemia. By elimination of the afferent sensory fibers this also results in pain relief. This principle is also used in the SL therapy of the complex regional pain syndrome. After the introduction of CT guidance, major complications have become rare events. In addition to the usual risks of percutaneous interventions there are, however, a number of specific complications, such as syncope caused by irritation of cardiac sympathetic nerves in thoracic SL and ureteral injury in lumbar

  18. Overview of High Intensity Linac Programs in Europe

    Garoby, R

    2004-01-01

    Recent years have seen a boost in the support by the European Union (EU) of accelerator research in Europe. Provided they coordinate their efforts and define common goals and strategies, laboratories and institutions from the member states can receive a financial support reaching 50% of the total project cost. In the field of High Intensity Linacs, the EU has already supported the EURISOL initiative for nuclear physics, which this year is applying for funding of a Design Study, and the development of linacs for Waste Transmutation. More recently, an initiative for high-energy physics has been approved, which includes a programme for the development of pulsed linac technologies. The coordination and synergy imposed by the EU rules increase the benefit of the allocated resources. Combined with the ongoing internal projects in the partner laboratories, these European initiatives represent a strong effort focussed towards the development of linac technologies. This paper summarises the requests from the various E...

  19. High-Intensity Focused Ultrasound Treatment for Advanced Pancreatic Cancer

    Yufeng Zhou

    2014-01-01

    Full Text Available Pancreatic cancer is under high mortality but has few effective treatment modalities. High-intensity focused ultrasound (HIFU is becoming an emerging approach of noninvasively ablating solid tumor in clinics. A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. The principle, mechanism, and clinical outcome of HIFU were introduced first. All 3022 clinical cases of HIFU treatment for the advanced pancreatic cancer alone or in combination with chemotherapy or radiotherapy in 241 published papers were reviewed and summarized for its efficacy, pain relief, clinical benefit rate, survival, Karnofsky performance scale (KPS score, changes in tumor size, occurrence of echogenicity, serum level, diagnostic assessment of outcome, and associated complications. Immune response induced by HIFU ablation may become an effective way of cancer treatment. Comments for a better outcome and current challenges of HIFU technology are also covered.

  20. Optical Fiber High Temperature Sensor Instrumentation for Energy Intensive Industries

    Cooper, Kristie L.; Wang, Anbo; Pickrell, Gary R.

    2006-11-14

    This report summarizes technical progress during the program “Optical Fiber High Temperature Sensor Instrumentation for Energy Intensive Industries”, performed by the Center for Photonics Technology of the Bradley Department of Electrical and Computer Engineering at Virginia Tech. The objective of this program was to use technology recently invented at Virginia Tech to develop and demonstrate the application of self-calibrating optical fiber temperature and pressure sensors to several key energy-intensive industries where conventional, commercially available sensors exhibit greatly abbreviated lifetimes due primarily to environmental degradation. A number of significant technologies were developed under this program, including • a laser bonded silica high temperature fiber sensor with a high temperature capability up to 700°C and a frequency response up to 150 kHz, • the world’s smallest fiber Fabry-Perot high temperature pressure sensor (125 x 20 μm) with 700°C capability, • UV-induced intrinsic Fabry-Perot interferometric sensors for distributed measurement, • a single crystal sapphire fiber-based sensor with a temperature capability up to 1600°C. These technologies have been well demonstrated and laboratory tested. Our work plan included conducting major field tests of these technologies at EPRI, Corning, Pratt & Whitney, and Global Energy; field validation of the technology is critical to ensuring its usefulness to U.S. industries. Unfortunately, due to budget cuts, DOE was unable to follow through with its funding commitment to support Energy Efficiency Science Initiative projects and this final phase was eliminated.

  1. Developing Quality Assurance Processes for Image-Guided Adaptive Radiation Therapy

    Yan Di

    2008-01-01

    Quality assurance has long been implemented in radiation treatment as systematic actions necessary to provide adequate confidence that the radiation oncology service will satisfy the given requirements for quality care. The existing reports from the American Association of Physicists in Medicine Task Groups 40 and 53 have provided highly detailed QA guidelines for conventional radiotherapy and treatment planning. However, advanced treatment processes recently developed with emerging high technology have introduced new QA requirements that have not been addressed previously in the conventional QA program. Therefore, it is necessary to expand the existing QA guidelines to also include new considerations. Image-guided adaptive radiation therapy (IGART) is a closed-loop treatment process that is designed to include the individual treatment information, such as patient-specific anatomic variation and delivered dose assessed during the therapy course in treatment evaluation and planning optimization. Clinical implementation of IGART requires high levels of automation in image acquisition, registration, segmentation, treatment dose construction, and adaptive planning optimization, which brings new challenges to the conventional QA program. In this article, clinical QA procedures for IGART are outlined. The discussion focuses on the dynamic or four-dimensional aspects of the IGART process, avoiding overlap with conventional QA guidelines

  2. Relativistic electron mirrors from high intensity laser nanofoil interactions

    Kiefer, Daniel

    2012-01-01

    The reflection of a laser pulse from a mirror moving close to the speed of light could in principle create an X-ray pulse with unprecedented high brightness owing to the increase in photon energy and accompanying temporal compression by a factor of 4γ 2 , where γ is the Lorentz factor of the mirror. While this scheme is theoretically intriguingly simple and was first discussed by A. Einstein more than a century ago, the generation of a relativistic structure which acts as a mirror is demanding in many different aspects. Recently, the interaction of a high intensity laser pulse with a nanometer thin foil has raised great interest as it promises the creation of a dense, attosecond short, relativistic electron bunch capable of forming a mirror structure that scatters counter-propagating light coherently and shifts its frequency to higher photon energies. However, so far, this novel concept has been discussed only in theoretical studies using highly idealized interaction parameters. This thesis investigates the generation of a relativistic electron mirror from a nanometer foil with current state-of-the-art high intensity laser pulses and demonstrates for the first time the reflection from those structures in an experiment. To achieve this result, the electron acceleration from high intensity laser nanometer foil interactions was studied in a series of experiments using three inherently different high power laser systems and free-standing foils as thin as 3nm. A drastic increase in the electron energies was observed when reducing the target thickness from the micrometer to the nanometer scale. Quasi-monoenergetic electron beams were measured for the first time from ultrathin (≤5nm) foils, reaching energies up to ∝35MeV. The acceleration process was studied in simulations well-adapted to the experiments, indicating the transition from plasma to free electron dynamics as the target thickness is reduced to the few nanometer range. The experience gained from those

  3. Relativistic electron mirrors from high intensity laser nanofoil interactions

    Kiefer, Daniel

    2012-12-21

    The reflection of a laser pulse from a mirror moving close to the speed of light could in principle create an X-ray pulse with unprecedented high brightness owing to the increase in photon energy and accompanying temporal compression by a factor of 4γ{sup 2}, where γ is the Lorentz factor of the mirror. While this scheme is theoretically intriguingly simple and was first discussed by A. Einstein more than a century ago, the generation of a relativistic structure which acts as a mirror is demanding in many different aspects. Recently, the interaction of a high intensity laser pulse with a nanometer thin foil has raised great interest as it promises the creation of a dense, attosecond short, relativistic electron bunch capable of forming a mirror structure that scatters counter-propagating light coherently and shifts its frequency to higher photon energies. However, so far, this novel concept has been discussed only in theoretical studies using highly idealized interaction parameters. This thesis investigates the generation of a relativistic electron mirror from a nanometer foil with current state-of-the-art high intensity laser pulses and demonstrates for the first time the reflection from those structures in an experiment. To achieve this result, the electron acceleration from high intensity laser nanometer foil interactions was studied in a series of experiments using three inherently different high power laser systems and free-standing foils as thin as 3nm. A drastic increase in the electron energies was observed when reducing the target thickness from the micrometer to the nanometer scale. Quasi-monoenergetic electron beams were measured for the first time from ultrathin (≤5nm) foils, reaching energies up to ∝35MeV. The acceleration process was studied in simulations well-adapted to the experiments, indicating the transition from plasma to free electron dynamics as the target thickness is reduced to the few nanometer range. The experience gained from those

  4. High intensive short laser pulse interaction with submicron clusters media

    Faenov, A. Ya

    2008-01-01

    The interaction of short intense laser pulses with structured targets, such as clusters, exhibits unique features, stemming from the enhanced absorption of the incident laser light compared to solid targets. Due to the increased absorption, these targets are heated significantly, leading to enhanced emission of x rays in the keV range and generation of electrons and multiple charged ions with kinetic energies from tens of keV to tens of MeV. Possible applications of these targets can be an electron/ion source for a table top accelerator, a neutron source for a material damage study, or an x ray source for microscopy or lithography. The overview of recent results, obtained by the high intensive short laser pulse interaction with different submicron clusters media will be presented. High resolution K and L shell spectra of plasma generated by superintense laser irradiation of micron sized Ar, Kr and Xe clusters have been measured with intensity 10"17"-10"19"W/cm"2"and a pulse duration of 30-1000fs. It is found that hot electrons produced by high contrast laser pulses allow the isochoric heating of clusters and shift the ion balance toward the higher charge states, which enhances both the X ray line yield and the ion kinetic energy. Irradiation of clusters, produced from such gas mixture, by a fs Ti:Sa laser pulses allows to enhance the soft X ray radiation of Heβ(665.7eV)and Lyα(653.7eV)of Oxygen in 2-8 times compare with the case of using as targets pure CO"2"or N"2"O clusters and reach values 2.8x10"10"(∼3μJ)and 2.7x10"10"(∼2.9μJ)ph/(sr·pulse), respectively. Nanostructure conventional soft X ray images of 100nm thick Mo and Zr foils in a wide field of view (cm"2"scale)with high spatial resolution (700nm)are obtained using the LiF crystals as soft X ray imaging detectors. When the target used for the ion acceleration studies consists of solid density clusters embedded into the background gas, its irradiation by high intensity laser light makes the target

  5. High-Intensity Events in International Women's Team Handball Matches.

    Luteberget, Live S; Spencer, Matt

    2017-01-01

    International women's team handball is a physically demanding sport and is intermittent in nature. The aim of the study was to profile high-intensity events (HIEs) in international women's team handball matches with regard to playing positions. Twenty female national-team handball players were equipped with inertial movement units (OptimEye S5, Catapult Sports, Australia) in 9 official international matches. Players were categorized in 4 different playing positions: backs, wings, pivots, and goalkeepers (GKs). PlayerLoad™, accelerations (Acc), changes of direction (CoD), decelerations (Dec), and the sum of the latter 3, HIEs, were extracted from raw-data files using the manufacturer's software. All Acc, Dec, CoD, and HIEs >2.5 m/s were included. Data were log-transformed and differences were standardized for interpretation of magnitudes and reported with effect-size statistics. Mean numbers of events were 0.7 ± 0.4 Acc/min, 2.3 ± 0.9 Dec/min, and 1.0 ± 0.4 CoD/min. Substantial differences between playing positions, ranging from small to very large, were found in the 3 parameters. Backs showed a most likely greater frequency for HIE/min (5.0 ± 1.1 HIE/min) than all other playing positions. Differences between playing positions were also apparent in PlayerLoad/min. HIEs in international women's team handball are position specific, and the overall intensity depends on the positional role within a team. Specific HIE and intensity profiles from match play provide useful information for a better understanding of the overall game demands and for each playing position.

  6. Outcomes of exertional rhabdomyolysis following high-intensity resistance training.

    Huynh, A; Leong, K; Jones, N; Crump, N; Russell, D; Anderson, M; Steinfort, D; Johnson, D F

    2016-05-01

    High-intensity resistance training (HIRT) programmes are increasingly popular amongst personal trainers and those attending gymnasiums. We report the experience of exertional rhabdomyolysis (ER) at two tertiary hospitals in Melbourne, Australia. To compare the clinical outcomes of ER with other causes of rhabdomyolysis. Retrospective cross-sectional study of patients presenting with a serum creatine kinase (CK) of greater than 25 000 units/L from 1 September 2013 to 31 August 2014 at two tertiary referral hospitals in Melbourne, Australia. Records were examined to identify care measures implemented during hospital stay, clinical outcomes during admission and on subsequent follow up. Thirty four cases of rhabdomyolysis with a CK of greater than 25 000 units/L (normal range: 20-180 units/L) were identified during the 12-month study period. Twelve of the 34 cases (35%) had ER with 10 of 12 related to HIRT. No acute kidney injury, intensive care admission or death were seen among those with ER. All cases were managed conservatively, with 11 admitted and 9 receiving intravenous fluids only. In contrast, patients with rhabdomyolysis from other causes experienced significantly higher rates of intensive care admission (64%, P = 0.0002), acute kidney injury (82%, P = 0.0001) and death (27%, P = 0.069). ER resulting from HIRT appears to have a benign course compared with rhabdomyolysis of other aetiologies in patients with a serum CK greater than 25 000 units/L. Conservative management of ER appears to be adequate, although this requires confirmation in future prospective studies. © 2016 Royal Australasian College of Physicians.

  7. Characterization of the onboard imaging unit for the first clinical magnetic resonance image guided radiation therapy system

    Hu, Yanle, E-mail: Hu.Yanle@mayo.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 and Department of Radiation Oncology, Mayo Clinic in Arizona, Phoenix, Arizona 85054 (United States); Rankine, Leith; Green, Olga L.; Kashani, Rojano; Li, H. Harold; Li, Hua; Rodriguez, Vivian; Santanam, Lakshmi; Wooten, H. Omar; Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Nana, Roger; Shvartsman, Shmaryu; Victoria, James; Dempsey, James F. [ViewRay, Inc., Oakwood Village, Ohio 44146 (United States)

    2015-10-15

    Purpose: To characterize the performance of the onboard imaging unit for the first clinical magnetic resonance image guided radiation therapy (MR-IGRT) system. Methods: The imaging performance characterization included four components: ACR (the American College of Radiology) phantom test, spatial integrity, coil signal to noise ratio (SNR) and uniformity, and magnetic field homogeneity. The ACR phantom test was performed in accordance with the ACR phantom test guidance. The spatial integrity test was evaluated using a 40.8 × 40.8 × 40.8 cm{sup 3} spatial integrity phantom. MR and computed tomography (CT) images of the phantom were acquired and coregistered. Objects were identified around the surfaces of 20 and 35 cm diameters of spherical volume (DSVs) on both the MR and CT images. Geometric distortion was quantified using deviation in object location between the MR and CT images. The coil SNR test was performed according to the national electrical manufacturers association (NEMA) standards MS-1 and MS-9. The magnetic field homogeneity test was measured using field camera and spectral peak methods. Results: For the ACR tests, the slice position error was less than 0.10 cm, the slice thickness error was less than 0.05 cm, the resolved high-contrast spatial resolution was 0.09 cm, the resolved low-contrast spokes were more than 25, the image intensity uniformity was above 93%, and the percentage ghosting was less than 0.22%. All were within the ACR recommended specifications. The maximum geometric distortions within the 20 and 35 cm DSVs were 0.10 and 0.18 cm for high spatial resolution three-dimensional images and 0.08 and 0.20 cm for high temporal resolution two dimensional cine images based on the distance-to-phantom-center method. The average SNR was 12.0 for the body coil, 42.9 for the combined torso coil, and 44.0 for the combined head and neck coil. Magnetic field homogeneities at gantry angles of 0°, 30°, 60°, 90°, and 120° were 23.55, 20.43, 18.76, 19

  8. Characterization of the onboard imaging unit for the first clinical magnetic resonance image guided radiation therapy system

    Hu, Yanle; Rankine, Leith; Green, Olga L.; Kashani, Rojano; Li, H. Harold; Li, Hua; Rodriguez, Vivian; Santanam, Lakshmi; Wooten, H. Omar; Mutic, Sasa; Nana, Roger; Shvartsman, Shmaryu; Victoria, James; Dempsey, James F.

    2015-01-01

    Purpose: To characterize the performance of the onboard imaging unit for the first clinical magnetic resonance image guided radiation therapy (MR-IGRT) system. Methods: The imaging performance characterization included four components: ACR (the American College of Radiology) phantom test, spatial integrity, coil signal to noise ratio (SNR) and uniformity, and magnetic field homogeneity. The ACR phantom test was performed in accordance with the ACR phantom test guidance. The spatial integrity test was evaluated using a 40.8 × 40.8 × 40.8 cm 3 spatial integrity phantom. MR and computed tomography (CT) images of the phantom were acquired and coregistered. Objects were identified around the surfaces of 20 and 35 cm diameters of spherical volume (DSVs) on both the MR and CT images. Geometric distortion was quantified using deviation in object location between the MR and CT images. The coil SNR test was performed according to the national electrical manufacturers association (NEMA) standards MS-1 and MS-9. The magnetic field homogeneity test was measured using field camera and spectral peak methods. Results: For the ACR tests, the slice position error was less than 0.10 cm, the slice thickness error was less than 0.05 cm, the resolved high-contrast spatial resolution was 0.09 cm, the resolved low-contrast spokes were more than 25, the image intensity uniformity was above 93%, and the percentage ghosting was less than 0.22%. All were within the ACR recommended specifications. The maximum geometric distortions within the 20 and 35 cm DSVs were 0.10 and 0.18 cm for high spatial resolution three-dimensional images and 0.08 and 0.20 cm for high temporal resolution two dimensional cine images based on the distance-to-phantom-center method. The average SNR was 12.0 for the body coil, 42.9 for the combined torso coil, and 44.0 for the combined head and neck coil. Magnetic field homogeneities at gantry angles of 0°, 30°, 60°, 90°, and 120° were 23.55, 20.43, 18.76, 19

  9. Proceedings of the third ICFA mini-workshop on high intensity, high brightness hadron accelerators

    Roser, T.

    1997-01-01

    The third mini-workshop on high intensity, high brightness hadron accelerators was held at Brookhaven National Laboratory on May 7-9, 1997 and had about 30 participants. The workshop focussed on rf and longitudinal dynamics issues relevant to intense and/or bright hadron synchrotrons. A plenary session was followed by four sessions on particular topics. This document contains copies of the viewgraphs used as well as summaries written by the session chairs

  10. High Intensity Effects in the SNS Accumulator Ring

    Holmes, Jeffrey A.; Cousineau, Sarah M.; Danilov, Viatcheslav; Plum, Michael A.; Shishlo, Andrei P.

    2008-01-01

    Currently operating at 0.5 MW beam power on target, the Spallation Neutron Source (SNS) is already the world's most powerful pulsed neutron source. However, we are only one third of the way to full power. As we ramp toward full power, the control of the beam and beam loss in the ring will be critical. In addition to practical considerations, such as choice of operating point, painting scheme, RF bunching, and beam scattering, it may be necessary to understand and mitigate collective effects due to space charge, impedances, and electron clouds. At each stage of the power ramp-up, we use all available resources to understand and to minimize beam losses. From the standpoint of beam dynamics, the losses observed so far under normal operating conditions have not involved collective phenomena. We are now entering the intensity regime in which this may change. In dedicated high intensity beam studies, we have already observed resistive wall, extraction kicker impedance-driven, and electron cloud activities. The analysis and simulation of this data are important ongoing activities at SNS. This paper discusses the status of this work, as well as other considerations necessary to the successful full power operation of SNS.

  11. Muscular soreness following prolonged intermittent high-intensity shuttle running.

    Thompson, D; Nicholas, C W; Williams, C

    1999-05-01

    The aim of this study was to examine the impact of prolonged intermittent high-intensity shuttle running on soreness and markers of muscle damage. Sixteen males took part in the study, half of whom were assigned to a running group and half to a resting control group. The exercise protocol involved 90 min of intermittent shuttle running and walking (Loughborough Intermittent Shuttle Test: LIST), reflecting the activity pattern found in multiple-sprint sports such as soccer. Immediately after exercise, there was a significant increase (P < 0.05) in serum activities of creatine kinase and aspartate aminotransferase, and values remained above baseline for 48 h (P < 0.05). Median peak activities of creatine kinase and aspartate aminotransferase occurred 24 h post-exercise and were 774 and 43 U x l(-1), respectively. The intensity of general muscle soreness, and in the specific muscles investigated, was greater than baseline for 72 h after the shuttle test (P < 0.05), peaking 24-48 h post-exercise (P < 0.05). Muscle soreness was not correlated with either creatine kinase or aspartate aminotransferase activity. Soreness was most frequently reported in the hamstrings. Neither soreness nor serum enzyme activity changed in the controls over the 4 day observation period. It appears that unaccustomed performance of prolonged intermittent shuttle running produces a significant increase in both soreness and markers of muscle damage.

  12. High-intensity lower limb endurance training in chronic respiratory disease

    Tanaka, Takako; Arizono, Shinichi; Hanada, Masatoshi; Senjyu, Hideaki

    2015-01-01

    High-intensity endurance training is mainly undertaken during pulmonary rehabilitation for patients with chronic respiratory disease. High-intensity endurance training is recommended in many clinical management guidelines. High-intensity endurance training involves training generally at an intensity of at 60-80% of the patient’s peak work capacity or higher. The effects of high-intensity lower limb endurance training have mostly been investigated in chronic obstructive pulmonary disease (COPD...

  13. High intensity laser interactions with sub-micron droplets

    Mountford, L.C.

    1999-01-01

    A high-density source of liquid ethanol droplets has been developed, characterised and used in laser interaction studies for the first time. Mie Scattering and attenuation measurements show that droplets with a radius of (0.5 ± 0.1) μm and atomic densities of 10 19 atoms/cm 3 can be produced, bridging the gap between clusters and macroscopic solids. Lower density (10 16 cm -3 ) sprays can also be produced and these are electrostatically split into smaller droplets with a radius of (0.3 ± 0.1) μm. This work has been accepted for publication in Review of Scientific Instruments. A range of high intensity interaction experiments have been carried out with this unique sub-micron source. The absolute yield of keV x-rays, generated using 527 nm, 2 ps pulses focused to ∼10 17 W/cm 2 , was measured for the first time. ∼7 μJ of x-rays with photon energies above 1 keV were produced, comparable to yields obtained from much higher Z Xenon clusters. At intensities ≤10 16 W/cm 2 the yield from droplets exceeds that from solid targets of similar Z. The droplet medium is debris free and self-renewing, providing a suitable x-ray source for lithographic techniques. Due to the spacing between the droplets, it was expected that the droplet plasma temperature would exceed that of a solid target plasma, which is typically limited by rapid heat conduction to <1 keV. Analysis of the x-ray data shows this to be true with a mean droplet plasma temperature of (2 ± 0.8) keV, and a number of measurements exceeding 5 keV (to appear in Applied Physics Letters). The absorption of high intensity laser pulses in the dense spray has been measured for the first time and this was found to be wavelength and polarisation independent and in excess of 60%. These first interaction measurements clearly indicate that there are significant differences between the laser heating of droplet, solid and cluster targets. (author)

  14. Predicting respiratory motion signals for image-guided radiotherapy using multi-step linear methods (MULIN)

    Ernst, Floris; Schweikard, Achim

    2008-01-01

    Forecasting of respiration motion in image-guided radiotherapy requires algorithms that can accurately and efficiently predict target location. Improved methods for respiratory motion forecasting were developed and tested. MULIN, a new family of prediction algorithms based on linear expansions of the prediction error, was developed and tested. Computer-generated data with a prediction horizon of 150 ms was used for testing in simulation experiments. MULIN was compared to Least Mean Squares-based predictors (LMS; normalized LMS, nLMS; wavelet-based multiscale autoregression, wLMS) and a multi-frequency Extended Kalman Filter (EKF) approach. The in vivo performance of the algorithms was tested on data sets of patients who underwent radiotherapy. The new MULIN methods are highly competitive, outperforming the LMS and the EKF prediction algorithms in real-world settings and performing similarly to optimized nLMS and wLMS prediction algorithms. On simulated, periodic data the MULIN algorithms are outperformed only by the EKF approach due to its inherent advantage in predicting periodic signals. In the presence of noise, the MULIN methods significantly outperform all other algorithms. The MULIN family of algorithms is a feasible tool for the prediction of respiratory motion, performing as well as or better than conventional algorithms while requiring significantly lower computational complexity. The MULIN algorithms are of special importance wherever high-speed prediction is required. (orig.)

  15. Prior image constrained scatter correction in cone-beam computed tomography image-guided radiation therapy.

    Brunner, Stephen; Nett, Brian E; Tolakanahalli, Ranjini; Chen, Guang-Hong

    2011-02-21

    X-ray scatter is a significant problem in cone-beam computed tomography when thicker objects and larger cone angles are used, as scattered radiation can lead to reduced contrast and CT number inaccuracy. Advances have been made in x-ray computed tomography (CT) by incorporating a high quality prior image into the image reconstruction process. In this paper, we extend this idea to correct scatter-induced shading artifacts in cone-beam CT image-guided radiation therapy. Specifically, this paper presents a new scatter correction algorithm which uses a prior image with low scatter artifacts to reduce shading artifacts in cone-beam CT images acquired under conditions of high scatter. The proposed correction algorithm begins with an empirical hypothesis that the target image can be written as a weighted summation of a series of basis images that are generated by raising the raw cone-beam projection data to different powers, and then, reconstructing using the standard filtered backprojection algorithm. The weight for each basis image is calculated by minimizing the difference between the target image and the prior image. The performance of the scatter correction algorithm is qualitatively and quantitatively evaluated through phantom studies using a Varian 2100 EX System with an on-board imager. Results show that the proposed scatter correction algorithm using a prior image with low scatter artifacts can substantially mitigate scatter-induced shading artifacts in both full-fan and half-fan modes.

  16. Frame-less image-guided intracranial and extracranial radiosurgery using the Cyberknife robotic system

    Gibbs, I.C.

    2006-01-01

    The Cyberknife TM is an image-guided robotic radiosurgery system. The image guidance system includes a kilo-voltage X-ray imaging source and amorphous silica detectors. The radiation delivery device is a mobile X-band linear accelerator mounted onto a robotic arm. Through a highly complex interplay between the image guidance system, an automated couch, and the high-speed linear accelerator, near real-time tracking of the target is achieved. The Cyberknife TM gained Federal Drug Administration clearance in the United States in 2001 for treatment of tumors 'anywhere in the body where radiation treatment is indicated'. Because the Cyberknife TM system does not rely on rigid fixation of a stereotactic frame, tumors outside of the intracranial compartment, even those tumors that move with respiration can be treated with a similar degree of ease as intracranial targets. A description of the Cyberknife TM technology and a review of some of the current intracranial and extracranial applications are detailed herein. (author)

  17. Predicting respiratory motion signals for image-guided radiotherapy using multi-step linear methods (MULIN)

    Ernst, Floris; Schweikard, Achim [University of Luebeck, Institute for Robotics and Cognitive Systems, Luebeck (Germany)

    2008-06-15

    Forecasting of respiration motion in image-guided radiotherapy requires algorithms that can accurately and efficiently predict target location. Improved methods for respiratory motion forecasting were developed and tested. MULIN, a new family of prediction algorithms based on linear expansions of the prediction error, was developed and tested. Computer-generated data with a prediction horizon of 150 ms was used for testing in simulation experiments. MULIN was compared to Least Mean Squares-based predictors (LMS; normalized LMS, nLMS; wavelet-based multiscale autoregression, wLMS) and a multi-frequency Extended Kalman Filter (EKF) approach. The in vivo performance of the algorithms was tested on data sets of patients who underwent radiotherapy. The new MULIN methods are highly competitive, outperforming the LMS and the EKF prediction algorithms in real-world settings and performing similarly to optimized nLMS and wLMS prediction algorithms. On simulated, periodic data the MULIN algorithms are outperformed only by the EKF approach due to its inherent advantage in predicting periodic signals. In the presence of noise, the MULIN methods significantly outperform all other algorithms. The MULIN family of algorithms is a feasible tool for the prediction of respiratory motion, performing as well as or better than conventional algorithms while requiring significantly lower computational complexity. The MULIN algorithms are of special importance wherever high-speed prediction is required. (orig.)

  18. High-Intensity Intermittent Exercise and Fat Loss

    Stephen H. Boutcher

    2011-01-01

    Full Text Available The effect of regular aerobic exercise on body fat is negligible; however, other forms of exercise may have a greater impact on body composition. For example, emerging research examining high-intensity intermittent exercise (HIIE indicates that it may be more effective at reducing subcutaneous and abdominal body fat than other types of exercise. The mechanisms underlying the fat reduction induced by HIIE, however, are undetermined. Regular HIIE has been shown to significantly increase both aerobic and anaerobic fitness. HIIE also significantly lowers insulin resistance and results in a number of skeletal muscle adaptations that result in enhanced skeletal muscle fat oxidation and improved glucose tolerance. This review summarizes the results of HIIE studies on fat loss, fitness, insulin resistance, and skeletal muscle. Possible mechanisms underlying HIIE-induced fat loss and implications for the use of HIIE in the treatment and prevention of obesity are also discussed.

  19. High intensity neutrino source superconducting solenoid cyrostat design

    Page, T.M.; Nicol, T.H.; Feher, S.; Terechkine, I.; Tompkins, J.; /Fermilab

    2006-06-01

    Fermi National Accelerator Laboratory (FNAL) is involved in the development of a 100 MeV superconducting linac. This linac is part of the High Intensity Neutrino Source (HINS) R&D Program. The initial beam acceleration in the front end section of the linac is achieved using room temperature spoke cavities, each of which is combined with a superconducting focusing solenoid. These solenoid magnets are cooled with liquid helium at 4.5K, operate at 250 A and have a maximum magnetic field strength of 7.5 T. The solenoid cryostat will house the helium vessel, suspension system, thermal shield, multilayer insulation, power leads, instrumentation, a vacuum vessel and cryogenic distribution lines. This paper discusses the requirements and detailed design of these superconducting solenoid cryostats.

  20. An outline of research facilities of high intensity proton accelerator

    Tanaka, Shun-ichi

    1995-01-01

    A plan called PROTON ENGINEERING CENTER has been proposed in JAERI. The center is a complex composed of research facilities and a beam shape and storage ring based on a proton linac with an energy of 1.5 GeV and an average current of 10 mA. The research facilities planned are OMEGA·Nuclear Energy Development Facility, Neutron Facility for Material Irradiation, Nuclear Data Experiment Facility, Neutron Factory, Meson Factory, spallation Radioisotope Beam Facility, and Medium Energy Experiment Facility, where high intensity proton beam and secondary particle beams such as neutrons, π-mesons, muons, and unstable isotopes originated from the protons are available for promoting the innovative research of nuclear energy and basic science and technology. (author)

  1. High intensity proton accelerator and its application (Proton Engineering Center)

    Tanaka, Shun-ichi

    1995-01-01

    A plan called PROTON ENGINEERING CENTER has been proposed in JAERI. The center is a complex composed of research facilities and a beam shape and storage ring based on a proton linac with an energy of 1.5 GeV and an average current of 10 mA. The research facilities planned are OMEGA·Nuclear Energy Development Facility, Neutron Facility for Material Irradiation, Nuclear Data Experiment Facility, Neutron Factory, Meson Factory, Spallation Radioisotope Beam Facility, and Medium Energy Experiment Facility, where high intensity proton beam and secondary particle beams such as neutrons, π-mesons, muons, and unstable isotopes originated from the protons are available for promoting the innovative research of nuclear energy and basic science and technology. (author)

  2. Simplified shielding calculation system for high-intensity proton accelerators

    Masumura, Tomomi; Nakashima, Hiroshi; Nakane, Yoshihiro; Sasamoto, Nobuo [Center for Neutron Science, Tokai Research Establishment, Japan Atomic Energy Research Institute, Tokai, Ibaraki (Japan)

    2000-06-01

    A simplified shielding calculation system is developed for applying conceptual shielding design of facilities in the joint project for high-intensity proton accelerators. The system is composed of neutron transmission calculation part for bulk shielding using simplified formulas: Moyer model and Tesch's formula, and neutron skyshine calculation part using an empirical formula: Stapleton's formula. The system is made with the Microsoft Excel software for user's convenience. This report provides a manual for the system as well as calculation conditions used in the calculation such as Moyer model's parameters. In this report preliminary results based on data at December 8, 1999, are also shown as an example. (author)

  3. Calculated intensity of high-energy neutron beams

    Mustapha, B.; Nolen, J.A.; Back, B.B.

    2004-01-01

    The flux, energy and angular distributions of high-energy neutrons produced by in-flight spallation and fission of a 400 MeV/A 238 U beam and by the break-up of a 400 MeV/A deuteron beam are calculated. In both cases very intense secondary neutron beams are produced, peaking at zero degrees, with a relatively narrow energy spread. Such secondary neutron beams can be produced with the primary beams from the proposed rare isotope accelerator driver linac. The break-up of a 400 kW deuteron beam on a liquid-lithium target can produce a neutron flux of >10 10 neutrons/cm 2 /s at a distance of 10 m from the target

  4. Pedalling rate affects endurance performance during high-intensity cycling

    Nielsen, Jens Steen; Hansen, Ernst Albin; Sjøgaard, Gisela

    2004-01-01

    The purpose of this study into high-intensity cycling was to: (1) test the hypothesis that endurance time is longest at a freely chosen pedalling rate (FCPR), compared to pedalling rates 25% lower (FCPR-25) and higher (FCPR+25) than FCPR, and (2) investigate how physiological variables......, and endurance time at W90 with FCPR-25, FCPR, and FCPR+25. Power reserve was calculated as the difference between applied power output at a given pedalling rate and peak crank power at this same pedalling rate. W90 was 325 (47) W. FCPR at W90 was 78 (11) rpm, resulting in FCPR-25 being 59 (8) rpm and FCPR+25...... time was negatively related to VO(2max), W90 and % MHC I, while positively related to power reserve. In conclusion, at group level, endurance time was longer at FCPR and at a pedalling rate 25% lower compared to a pedalling rate 25% higher than FCPR. Further, inter-individual physiological variables...

  5. Fast damping in mismatched high intensity beam transportation

    V. Variale

    2001-08-01

    Full Text Available A very fast damping of beam envelope oscillation amplitudes was recently observed in simulations of high intensity beam transport, through periodic FODO cells, in mismatched conditions [V. Variale, Nuovo Cimento Soc. Ital. Fis. 112A, 1571–1582 (1999 and T. Clauser et al., in Proceedings of the Particle Accelerator Conference, New York, 1999 (IEEE, Piscataway, NJ, 1999, p. 1779]. A Landau damping mechanism was proposed at the origin of observed effect. In this paper, to further investigate the source of this fast damping, extensive simulations have been carried out. The results presented here support the interpretation of the mechanism at the origin of the fast damping as a Landau damping effect.

  6. High Intensity, Pulsed, D-D Neutron Generator

    Williams, D.L.; Vainionpaa, J.H.; Jones, G.; Piestrup, M.A.; Gary, C.K.; Harris, J.L.; Fuller, M.J.; Cremer, J.T.; Ludewigt, Bernhard A.; Kwan, J.W.; Reijonen, J.; Leung, K.-N.; Gough, R.A.

    2008-01-01

    Single ion-beam RF-plasma neutron generators are presented as a laboratory source of intense neutrons. The continuous and pulsed operations of such a neutron generator using the deuterium-deuterium fusion reaction are reported. The neutron beam can be pulsed by switching the RF plasma and/or a gate electrode. These generators are actively vacuum pumped so that a continuous supply of deuterium gas is present for the production of ions and neutrons. This contributes to the generator's long life. These single-beam generators are capable of producing up to 1E10 n/s. Previously, Adelphi and LBNL have demonstrated these generators applications in fast neutron radiography, Prompt Gamma Neutron Activation Analysis (PGNAA) and Neutron Activation Analysis (NAA). Together with an inexpensive compact moderator, these high-output neutron generators extend useful applications to home laboratory operations.

  7. Multiscale registration of medical images based on edge preserving scale space with application in image-guided radiation therapy

    Li, Dengwang; Li, Hongsheng; Wan, Honglin; Chen, Jinhu; Gong, Guanzhong; Wang, Hongjun; Wang, Liming; Yin, Yong

    2012-08-01

    Mutual information (MI) is a well-accepted similarity measure for image registration in medical systems. However, MI-based registration faces the challenges of high computational complexity and a high likelihood of being trapped into local optima due to an absence of spatial information. In order to solve these problems, multi-scale frameworks can be used to accelerate registration and improve robustness. Traditional Gaussian pyramid representation is one such technique but it suffers from contour diffusion at coarse levels which may lead to unsatisfactory registration results. In this work, a new multi-scale registration framework called edge preserving multiscale registration (EPMR) was proposed based upon an edge preserving total variation L1 norm (TV-L1) scale space representation. TV-L1 scale space is constructed by selecting edges and contours of images according to their size rather than the intensity values of the image features. This ensures more meaningful spatial information with an EPMR framework for MI-based registration. Furthermore, we design an optimal estimation of the TV-L1 parameter in the EPMR framework by training and minimizing the transformation offset between the registered pairs for automated registration in medical systems. We validated our EPMR method on both simulated mono- and multi-modal medical datasets with ground truth and clinical studies from a combined positron emission tomography/computed tomography (PET/CT) scanner. We compared our registration framework with other traditional registration approaches. Our experimental results demonstrated that our method outperformed other methods in terms of the accuracy and robustness for medical images. EPMR can always achieve a small offset value, which is closer to the ground truth both for mono-modality and multi-modality, and the speed can be increased 5-8% for mono-modality and 10-14% for multi-modality registration under the same condition. Furthermore, clinical application by adaptive

  8. Multiscale registration of medical images based on edge preserving scale space with application in image-guided radiation therapy

    Li Dengwang; Wan Honglin; Li Hongsheng; Chen Jinhu; Gong Guanzhong; Yin Yong; Wang Hongjun; Wang Liming

    2012-01-01

    Mutual information (MI) is a well-accepted similarity measure for image registration in medical systems. However, MI-based registration faces the challenges of high computational complexity and a high likelihood of being trapped into local optima due to an absence of spatial information. In order to solve these problems, multi-scale frameworks can be used to accelerate registration and improve robustness. Traditional Gaussian pyramid representation is one such technique but it suffers from contour diffusion at coarse levels which may lead to unsatisfactory registration results. In this work, a new multi-scale registration framework called edge preserving multiscale registration (EPMR) was proposed based upon an edge preserving total variation L1 norm (TV-L1) scale space representation. TV-L1 scale space is constructed by selecting edges and contours of images according to their size rather than the intensity values of the image features. This ensures more meaningful spatial information with an EPMR framework for MI-based registration. Furthermore, we design an optimal estimation of the TV-L1 parameter in the EPMR framework by training and minimizing the transformation offset between the registered pairs for automated registration in medical systems. We validated our EPMR method on both simulated mono- and multi-modal medical datasets with ground truth and clinical studies from a combined positron emission tomography/computed tomography (PET/CT) scanner. We compared our registration framework with other traditional registration approaches. Our experimental results demonstrated that our method outperformed other methods in terms of the accuracy and robustness for medical images. EPMR can always achieve a small offset value, which is closer to the ground truth both for mono-modality and multi-modality, and the speed can be increased 5–8% for mono-modality and 10–14% for multi-modality registration under the same condition. Furthermore, clinical application by

  9. An optimum method for pulsed high intensity focused ultrasound treatment of large volumes using the InSightec ExAblate (registered) 2000 system

    O' Neill, B E; Karmonik, C; Li, K C P, E-mail: beoneill@tmhs.or [The Methodist Hospital Research Institute, 6565 Fannin, Houston TX 77030 (United States)

    2010-11-07

    Pulsed high intensity focused ultrasound (pHIFU) is a method for delivering ultrasound to tissue while avoiding high temperatures. The technique has been suggested for non-destructively enhancing local uptake of drugs. Side effects include thermal necrosis; therefore, real-time monitoring of tissue temperature is advantageous. This paper outlines a method for improving the treatment efficiency of pHIFU using the MR image-guided InSightec ExAblate (registered) 2000 system, an ultrasound system integrated into a whole body human MRI scanner with the ability to measure temperature at the treatment location in near real time. Thermal measurements obtained during treatment of a tissue phantom were used to determine appropriate heating parameters, and compared to in vivo treatment of rabbit muscle. Optimization of the treatment procedure and ultrasound transducer steering patterns was then conducted with the goal of minimizing treatment time while avoiding overheating. The optimization was performed on the basis of approximate solutions to the standard bioheat equation. The commercial system software of the Exablate (registered) system was modified to assist in this optimization. Depending on the size of the treatment volume, the presented results demonstrate that it is possible to use the technique described to cut treatment times significantly, up to one-third of that required by the current standard treatment cycle.

  10. What IAPT CBT High-Intensity Trainees Do After Training.

    Liness, Sheena; Lea, Susan; Nestler, Steffen; Parker, Hannah; Clark, David M

    2017-01-01

    The UK Department of Health Improving Access to Psychological Therapies (IAPT) initiative set out to train a large number of therapists in cognitive behaviour therapies (CBT) for depression and anxiety disorders. Little is currently known about the retention of IAPT CBT trainees, or the use of CBT skills acquired on the course in the workplace after training has finished. This study set out to conduct a follow-up survey of past CBT trainees on the IAPT High Intensity CBT Course at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), one of the largest IAPT High Intensity courses in the UK. Past trainees (n = 212) across 6 cohorts (2008-2014 intakes) were contacted and invited to participate in a follow-up survey. A response rate of 92.5% (n = 196) was achieved. The vast majority of IAPT trainees continue to work in IAPT services posttraining (79%) and to practise CBT as their main therapy modality (94%); 61% have become CBT supervisors. A minority (23%) have progressed to other senior roles in the services. Shortcomings are reported in the use of out-of-office CBT interventions, the use of disorder-specific outcome measures and therapy recordings to inform therapy and supervision. Past trainees stay working in IAPT services and continue to use CBT methods taught on the course. Some NICE recommended treatment procedures that are likely to facilitate patients' recovery are not being routinely implemented across IAPT services. The results have implications for the continued roll out of the IAPT programme, and other future large scale training initiatives.

  11. Material studies for pulsed high-intensity proton beam targets

    Simos, N.; Kirk, H.; Ludewig, H.; Thieberger, P.; Weng, W-T.; McDonald, K.; Yoshimura, K.

    2004-01-01

    Intense beams for muon colliders and neutrino facilities require high-performance target stations of 1-4 MW proton beams. The physics requirements for such a system push the envelope of our current knowledge as to how materials behave under high-power beams for both short and long exposure. The success of an adopted scheme that generates, captures and guides secondary particles depends on the useful life expectancy of this critical system. This paper presents an overview of what has been achieved during the various phases of the experimental effort including a tentative plan to continue the effort by expanding the material matrix. The first phase of the project was to study the changes after irradiation in mechanical properties and specially in thermal expansion coefficient of various materials. During phase-I the study attention was primarily focused on Super-invar and in a lesser degree on Inconel-718. Invar is a metal alloy which predominantly consists of 62% Fe, 32% Ni and 5% Co. It is showed that this metal, whose non-irradiated properties held such promise, can only be considered a serious target candidate for an intense proton beam only if one can anneal the atomic displacements followed by the appropriate heat treatment to restore its favorable expansion coefficient. New materials that have been developed for various industrial needs by optimizing key properties, might be of value for the accelerator community. These materials like carbon-carbon composites, titanium alloys, the Toyota 'gum metal', the Vascomax material and the AlBeMet alloy will be explored and tested in the second phase of the project. (A.C.)

  12. Frequency conversion of high-intensity, femtosecond laser pulses

    Banks, P S

    1997-06-01

    Almost since the invention of the laser, frequency conversion of optical pulses via non- linear processes has been an area of active interest. However, third harmonic generation using ~(~1 (THG) in solids is an area that has not received much attention because of ma- terial damage limits. Recently, the short, high-intensity pulses possible with chirped-pulse amplification (CPA) laser systems allow the use of intensities on the order of 1 TW/cm2 in thin solids without damage. As a light source to examine single-crystal THG in solids and other high field inter- actions, the design and construction of a Ti:sapphire-based CPA laser system capable of ultimately producing peak powers of 100 TW is presented. Of special interest is a novel, all-reflective pulse stretcher design which can stretch a pulse temporally by a factor of 20,000. The stretcher design can also compensate for the added material dispersion due to propagation through the amplifier chain and produce transform-limited 45 fs pulses upon compression. A series of laser-pumped amplifiers brings the peak power up to the terawatt level at 10 Hz, and the design calls for additional amplifiers to bring the power level to the 100 TW level for single shot operation. The theory for frequency conversion of these short pulses is presented, focusing on conversion to the third harmonic in single crystals of BBO, KD*P, and d-LAP (deuterated I-arginine phosphate). Conversion efficiencies of up to 6% are obtained with 500 fs pulses at 1053 nm in a 3 mm thick BBO crystal at 200 GW/cm 2. Contributions to this process by unphasematched, cascaded second harmonic generation and sum frequency generation are shown to be very significant. The angular relationship between the two orders is used to measure the tensor elements of C = xt3)/4 with Crs = -1.8 x 1O-23 m2/V2 and .15Cri + .54Crs = 4.0 x 1O-23 m2/V2. Conversion efficiency in d-LAP is about 20% that in BBO and conversion efficiency in KD*P is 1% that of BBO. It is calculated

  13. Intrafractional prostate motion during online image guided intensity-modulated radiotherapy for prostate cancer

    Budiharto, Tom; Slagmolen, Pieter; Haustermans, Karin; Maes, Frederik; Junius, Sara; Verstraete, Jan; Oyen, Raymond; Hermans, Jeroen; Van den Heuvel, Frank

    2011-01-01

    Introduction: Intrafractional motion consists of two components: (1) the movement between the on-line repositioning procedure and the treatment start and (2) the movement during the treatment delivery. The goal of this study is to estimate this intrafractional movement of the prostate during prostate cancer radiotherapy. Material and methods: Twenty-seven patients with prostate cancer and implanted fiducials underwent a marker match procedure before a five-field IMRT treatment. For all fields, in-treatment images were obtained and then processed to enable automatic marker detection. Combining the subsequent projection images, five positions of each marker were determined using the shortest path approach. The residual set-up error (RSE) after kV-MV based prostate localization, the prostate position as a function of time during a radiotherapy session and the required margins to account for intrafractional motion were determined. Results: The mean RSE and standard deviation in the antero-posterior, cranio-caudal and left-right direction were 2.3 ± 1.5 mm, 0.2 ± 1.1 mm and -0.1 ± 1.1 mm, respectively. Almost all motions occurred in the posterior direction before the first treatment beam as the percentage of excursions >5 mm was reduced significantly when the RSE was not accounted for. The required margins for intrafractional motion increased with prolongation of the treatment. Application of a repositioning protocol after every beam could decrease the 1 cm margin from CTV to PTV by 2 mm. Conclusions: The RSE is the main contributor to intrafractional motion. This RSE after on-line prostate localization and patient repositioning in the posterior direction emphasizes the need to speed up the marker match procedure. Also, a prostate IMRT treatment should be administered as fast as possible, to ensure that the pre-treatment repositioning efforts are not erased by intrafractional prostate motion. This warrants an optimized workflow with the use of faster treatment techniques.

  14. Enhancing Plasma Surface Modification using high Intensity and high Power Ultrasonic Acoustic Waves

    2010-01-01

    high intensity and high power acoustic waves (102) by at least one ultrasonic high intensity and high power acoustic wave generator (101 ), wherein the ultrasonic acoustic waves are directed to propagate towards said surface (314) of the object (100) so that a laminar boundary layer (313) of a gas...... or a mixture of gases (500) flow in contact with said solid object (100) is thinned or destructed for at least a part of said surface (314). In this way, the plasma can more efficiently access and influence the surface of the solid object to be treated by the plasma, which speeds the process time up...

  15. High intensity proton linear accelerator for Neutron Science Project

    Mizumoto, Motoharu

    1999-01-01

    JAERI has been proposing the Neutron Science Project (NSP) which will be composed of a high intensity proton accelerator and various research facilities. With an energy of 1.5 GeV and a beam power of 8 MW, the accelerator is required for basic research fields and nuclear waste transmutation studies. The R and D work has been carried out for the components of the accelerator. In the low energy accelerator part, a beam test with an ion source and an RFQ has been performed with a current of 80 mA and a duty factor of 10% at an energy of 2 MeV. A 1 m long high power test model of DTL has been fabricated and tested with a duty factor of 20%. In the high energy accelerator part, a superconducting (SC) linac has been selected as a main option from 100 MeV to 1.5 GeV. A test stand for SC linac cavity with equipment of cryogenics, vacuum, RF source and cavity processing and cleaning system has been prepared to test the fabrication process and physics issues. The vertical tests of β = 0.5 (145 MeV) and β = 0.89 (1.1 GeV) single cell SC cavities have been made resulting in a maximum electric field strength of 44 MV/m and 47 MV/m at 2 K, respectively. (author)

  16. Rectal dose variation during the course of image-guided radiation therapy of prostate cancer

    Chen Lili; Paskalev, Kamen; Xu Xiu; Zhu, Jennifer; Wang Lu; Price, Robert A.; Hu Wei; Feigenberg, Steven J.; Horwitz, Eric M.; Pollack, Alan; Charlie Ma, C.M.

    2010-01-01

    Background and purpose: To investigate the change in rectal dose during the treatment course for intensity-modulated radiotherapy (IMRT) of prostate cancer with image-guidance. Materials and methods: Twenty prostate cancer patients were recruited for this retrospective study. All patients have been treated with IMRT. For each patient, MR and CT images were fused for target and critical structure delineation. IMRT treatment planning was performed on the simulation CT images. Inter-fractional motion during the course of treatment was corrected using a CT-on-rails system. The rectum was outlined on both the original treatment plan and the subsequent daily CT images from the CT-on-rails by the same investigator. Dose distributions on these daily CT images were recalculated with the isocenter shifts relative to the simulation CT images using the leaf sequences/MUs based on the original treatment plan. The rectal doses from the subsequent daily CTs were compared with the original doses planned on the simulation CT using our clinical acceptance criteria. Results: Based on 20 patients with 139 daily CT sets, 28% of the subsequent treatment dose distributions did not meet our criterion of V 40 65 < 17%. The inter-fractional rectal volume variation is significant for some patients. Conclusions: Due to the large inter-fractional variation of the rectal volume, it is more favorable to plan prostate IMRT based on an empty rectum and deliver treatment to patients with an empty rectum. Over 70% of actual treatments showed better rectal doses than our clinical acceptance criteria. A significant fraction (27%) of the actual treatments would benefit from adaptive image-guided radiotherapy based on daily CT images.

  17. Patient positioning with X-ray detector self-calibration for image guided therapy

    Selby, B.P.; Sakas, G.; Stilla, U.; Groch, W.-D.

    2011-01-01

    Full text: Automatic alignment estimation from projection images has a range of applications, but misaligned cameras induce inaccuracies. Calibration methods for optical cameras requiring calibration bodies or detectable features have been a matter of research for years. Not so for image guided therapy, although exact patient pose recovery is crucial. To image patient anatomy, X-ray instead of optical equipment is used. Feature detection is often infeasible. Furthermore, a method not requiring a calibration body, usable during treatment, would be desirable to improve accuracy of the patient alignment. We present a novel approach not relying on image features but combining intensity based calibration with 3D pose recovery. A stereoscopic X-ray camera model is proposed, and effects of erroneous parameters on the patient alignment are evaluated. The relevant camera parameters are automatically computed by comparison of X-ray to CT images and are incorporated in the patient alignment computation. The methods were tested with ground truth data of an anatomic phantom with artificially produced misalignments and available real-patient images from a particle therapy machine. We show that our approach can compensate patient alignment errors through mis-calibration of a camera from more than 5 mm to below 0.2 mm. Usage of images with artificial noise shows that the method is robust against image degradation of 2-5%. X-ray camera sel calibration improves accuracy when cameras are misaligned. We could show that rigid body alignment was computed more accurately and that self-calibration is possible, even if detection of corresponding image features is not. (author)

  18. Retractor-induced brain shift compensation in image-guided neurosurgery

    Fan, Xiaoyao; Ji, Songbai; Hartov, Alex; Roberts, David; Paulsen, Keith

    2013-03-01

    In image-guided neurosurgery, intraoperative brain shift significantly degrades the accuracy of neuronavigation that is solely based on preoperative magnetic resonance images (pMR). To compensate for brain deformation and to maintain the accuracy in image guidance achieved at the start of surgery, biomechanical models have been developed to simulate brain deformation and to produce model-updated MR images (uMR) to compensate for brain shift. To-date, most studies have focused on shift compensation at early stages of surgery (i.e., updated images are only produced after craniotomy and durotomy). Simulating surgical events at later stages such as retraction and tissue resection are, perhaps, clinically more relevant because of the typically much larger magnitudes of brain deformation. However, these surgical events are substantially more complex in nature, thereby posing significant challenges in model-based brain shift compensation strategies. In this study, we present results from an initial investigation to simulate retractor-induced brain deformation through a biomechanical finite element (FE) model where whole-brain deformation assimilated from intraoperative data was used produce uMR for improved accuracy in image guidance. Specifically, intensity-encoded 3D surface profiles at the exposed cortical area were reconstructed from intraoperative stereovision (iSV) images before and after tissue retraction. Retractor-induced surface displacements were then derived by coregistering the surfaces and served as sparse displacement data to drive the FE model. With one patient case, we show that our technique is able to produce uMR that agrees well with the reconstructed iSV surface after retraction. The computational cost to simulate retractor-induced brain deformation was approximately 10 min. In addition, our approach introduces minimal interruption to the surgical workflow, suggesting the potential for its clinical application.

  19. Image-guided ultrasound phased arrays are a disruptive technology for non-invasive therapy.

    Hynynen, Kullervo; Jones, Ryan M

    2016-09-07

    Focused ultrasound offers a non-invasive way of depositing acoustic energy deep into the body, which can be harnessed for a broad spectrum of therapeutic purposes, including tissue ablation, the targeting of therapeutic agents, and stem cell delivery. Phased array transducers enable electronic control over the beam geometry and direction, and can be tailored to provide optimal energy deposition patterns for a given therapeutic application. Their use in combination with modern medical imaging for therapy guidance allows precise targeting, online monitoring, and post-treatment evaluation of the ultrasound-mediated bioeffects. In the past there have been some technical obstacles hindering the construction of large aperture, high-power, densely-populated phased arrays and, as a result, they have not been fully exploited for therapy delivery to date. However, recent research has made the construction of such arrays feasible, and it is expected that their continued development will both greatly improve the safety and efficacy of existing ultrasound therapies as well as enable treatments that are not currently possible with existing technology. This review will summarize the basic principles, current statures, and future potential of image-guided ultrasound phased arrays for therapy.

  20. In-room CT techniques for image-guided radiation therapy

    Ma, C.-M. Charlie; Paskalev, Kamen M.S.

    2006-01-01

    Accurate patient setup and target localization are essential to advanced radiation therapy treatment. Significant improvement has been made recently with the development of image-guided radiation therapy, in which image guidance facilitates short treatment course and high dose per fraction radiotherapy, aiming at improving tumor control and quality of life. Many imaging modalities are being investigated, including x-ray computed tomography (CT), ultrasound imaging, positron emission tomography, magnetic resonant imaging, magnetic resonant spectroscopic imaging, and kV/MV imaging with flat panel detectors. These developments provide unique imaging techniques and methods for patient setup and target localization. Some of them are different; some are complementary. This paper reviews the currently available kV x-ray CT systems used in the radiation treatment room, with a focus on the CT-on-rails systems, which are diagnostic CT scanners moving on rails installed in the treatment room. We will describe the system hardware including configurations, specifications, operation principles, and functionality. We will review software development for image fusion, structure recognition, deformation correction, target localization, and alignment. Issues related to the clinical implementation of in-room CT techniques in routine procedures are discussed, including acceptance testing and quality assurance. Clinical applications of the in-room CT systems for patient setup, target localization, and adaptive therapy are also reviewed for advanced radiotherapy treatments

  1. 5-ALA Fluorescence Image Guided Resection of Glioblastoma Multiforme: A Meta-Analysis of the Literature

    Samy Eljamel

    2015-05-01

    Full Text Available Background: Glioblastoma multiforme (GBM is one of the most deadly cancers in humans. Despite recent advances in anti-cancer therapies, most patients with GBM die from local disease progression. Fluorescence image guided surgical resection (FIGR was recently advocated to enhance local control of GBM. This is meta-analyses of 5-aminolevulinic (5-ALA induced FIGR. Materials: Review of the literature produced 503 potential publications; only 20 of these fulfilled the inclusion criteria of this analysis, including a total of 565 patients treated with 5-ALA-FIGR reporting on its outcomes and 800 histological samples reporting 5-ALA-FIGR sensitivity and specificity. Results: The mean gross total resection (GTR rate was 75.4% (95% CI: 67.4–83.5, p < 0.001. The mean time to tumor progression (TTP was 8.1 months (95% CI: 4.7–12, p < 0.001. The mean overall survival gain reported was 6.2 months (95% CI: −1–13, p < 0.001. The specificity was 88.9% (95% CI: 83.9–93.9, p < 0.001 and the sensitivity was 82.6% (95% CI: 73.9–91.9, p < 0.001. Conclusion: 5-ALA-FIGR in GBM is highly sensitive and specific, and imparts significant benefits to patients in terms of improved GTR and TTP.

  2. Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures.

    Dagnino, Giulio; Georgilas, Ioannis; Morad, Samir; Gibbons, Peter; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

    2017-11-01

    Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces involved in the fragment manipulation (due to the presence of soft tissue, e.g., muscles) which might result in fracture malreduction. Integration of robotic assistance and 3D image guidance can potentially overcome these issues. The authors propose an image-guided surgical robotic system for the percutaneous treatment of knee joint fractures, i.e., the robot-assisted fracture surgery (RAFS) system. It allows simultaneous manipulation of two bone fragments, safer robot-bone fixation system, and a traction performing robotic manipulator. This system has led to a novel clinical workflow and has been tested both in laboratory and in clinically relevant cadaveric trials. The RAFS system was tested on 9 cadaver specimens and was able to reduce 7 out of 9 distal femur fractures (T- and Y-shape 33-C1) with acceptable accuracy (≈1 mm, ≈5°), demonstrating its applicability to fix knee joint fractures. This study paved the way to develop novel technologies for percutaneous treatment of complex fractures including hip, ankle, and shoulder, thus representing a step toward minimally-invasive fracture surgeries.

  3. WE-H-209-00: Carson/Zagzebski Distinguished Lectureship: Image Guided Ultrasound Therapy

    NONE

    2016-06-15

    Focused ultrasound has been shown to be the only method that allows noninvasive thermal coagulation of tissues and recently this potential has been explored for image-guided drug delivery. In this presentation, the advances in ultrasound phased array technology for energy delivery, exposure monitoring and control will be discussed. Experimental results from novel multi-frequency transmit/receive arrays will be presented. In addition, the feasibility of fully electronically focused and steered high power arrays with many thousands of transducer elements will be discussed. Finally, some of the recent clinical and preclinical results for the treatment of brain disease will be reviewed. Learning Objectives: Introduce FUS therapy principles and modern techniques Discuss use of FUS for drug delivery Cover the technology required to deliver FUS and monitor therapy Present clinical examples of the uses of these techniques This research was supported by funding from The Canada Research Chair Program, Grants from CIHR and NIH (no. EB003268).; K. Hynynen, Canada Foundation for Innovation; Canadian Institutes of Health Research; Focused Ultrasound Surgery Foundation; Canada Research Chair Program; Natural Sciences and Engineering Research Council of Canada; Ontario Research Fund; National Institutes of Health; Canadian Cancer Society Research Institute; The Weston Brain Institute; Harmonic Medical; Focused Ultrasound Instruments.

  4. Endoscopic trans-nasal approach for biopsy of orbital tumors using image-guided neuro-navigation system

    Sieskiewicz, A.; Mariak, Z.; Rogowski, M.; Lyson, T.

    2008-01-01

    Histopathological diagnosis of intraorbital tumors is of crucial value for planning further therapy. The aim of the study was to explore clinical utility of image-guided endoscopy for biopsy of orbital tumors. Trans-nasal endoscopic biopsy of intraorbital mass lesions was performed in 6 patients using a neuro-navigation system (Medtronic Stealth Station Treon plus). The CT and MRI 1 mm slice images were fused by the system in order to visualise both bony and soft tissue structures. The anatomic fiducial registration protocol was used during the procedure. All lesions were precisely localised and the biopsies could be taken from the representative part of the pathological mass. None of the patients developed aggravation of ocular symptoms after the procedure. The operative corridor as well as the size of orbital wall fenestration could be limited to a minimum. The accuracy of neuro-navigation remained high and stable during the entire procedure. The image-guided neuro-navigation system facilitated endoscopic localisation and biopsy of intraorbital tumors and contributed to the reduction of surgical trauma during the procedure. The technique was particularly useful in small, medially located, retrobulbar tumors and in unclear situations when the structure of the lesion resembled surrounding intraorbital tissue. (author)

  5. Investigations on transport and storage of high ion beam intensities

    Joshi, Ninad Shrikrishna

    2009-01-01

    In the framework of this thesis the intense low energy ion beam transport was investigated. Especially, the beam transport in toroidal magnetic field configurations was discussed, as it may allow the accumulation of high intensive beams in the future. One of the specific tasks is to design an injection system that can be used for the proposed low energy accumulator ring. A simulation code (TBT) was written to describe the particle motion in curved segments. Particle in Cell techniques were utilized to simulate a multi particle dynamics. A possibility of reading an external data file was made available so that a measured distribution can be used to compare simulation results with measured ones. A second order cloud in cell method was used to calculate charge density and in turn to solve Poisson's equation. Further simulations were performed to study the self field effects on beam transport. Experiments were performed to compare the simulation results and gain practical experience. The preparatory experiments consisted of building and characterization of the ion source in a first step. Along with the momentum spectrometer and emittance scanner the beam properties were studied. Low mass ion beams He + and mixed p, H 2+ , H 3+ beams were analyzed. In the second stage, beams were transported through a solenoid and the phase space distribution was measured as a function of the magnetic field for different beam energies. The phase-space as distributions measured in a first stage were simulated backward and then again forward transported through the solenoid. The simulated results were then compared with the measured distribution. The LINTRA transport program was used. The phase-space distribution was further simulated for transport experiments in a toroidal magnetic field. The transport program that was used to simulate the beam in the toroid was also used to design the injection system. The injection system with its special field configurations was designed to perform

  6. Investigations on transport and storage of high ion beam intensities

    Joshi, Ninad Shrikrishna

    2009-08-25

    In the framework of this thesis the intense low energy ion beam transport was investigated. Especially, the beam transport in toroidal magnetic field configurations was discussed, as it may allow the accumulation of high intensive beams in the future. One of the specific tasks is to design an injection system that can be used for the proposed low energy accumulator ring. A simulation code (TBT) was written to describe the particle motion in curved segments. Particle in Cell techniques were utilized to simulate a multi particle dynamics. A possibility of reading an external data file was made available so that a measured distribution can be used to compare simulation results with measured ones. A second order cloud in cell method was used to calculate charge density and in turn to solve Poisson's equation. Further simulations were performed to study the self field effects on beam transport. Experiments were performed to compare the simulation results and gain practical experience. The preparatory experiments consisted of building and characterization of the ion source in a first step. Along with the momentum spectrometer and emittance scanner the beam properties were studied. Low mass ion beams He{sup +} and mixed p, H{sup 2+}, H{sup 3+} beams were analyzed. In the second stage, beams were transported through a solenoid and the phase space distribution was measured as a function of the magnetic field for different beam energies. The phase-space as distributions measured in a first stage were simulated backward and then again forward transported through the solenoid. The simulated results were then compared with the measured distribution. The LINTRA transport program was used. The phase-space distribution was further simulated for transport experiments in a toroidal magnetic field. The transport program that was used to simulate the beam in the toroid was also used to design the injection system. The injection system with its special field configurations was

  7. Inelastic scattering in condensed matter with high intensity Moessbauer radiation

    Yelon, W.B.; Schupp, G.

    1993-02-01

    The QUEGS facility at MURR has produced a number of new results and demonstrated the range of potential applications of high resolution, high intensity Moessbauer scattering. This work has been carried out by both MU and Purdue researchers and includes published results on Na, W, pentadecane, polydimethylsiloxane and other systems, manuscripts submitted on alkali halides (Phys. Rev. B) and accurate Moessbauer lineshape measurements (Phys. Rev. C), and manuscripts in preparation on glycerol, NiAl and Moessbauer spectra obtained by modulating a scattering crystal. Recently, new collaborations have been initiated which will substantially enhance our efforts. These are with W. Steiner (Vienna), G. Coddens (Saclay), and R. D. Taylor (Los Alamos). Steiner is experienced with Fe-57 Moessbauer scattering, while Coddens specializes in quasielastic neutron scattering; both of these areas naturally complement our work. R. D. Taylor has pioneered Moessbauer spectroscopy from the time of its discovery and has already made important contributions to our study of lattice dynamics and superconductivity for lead alloyed with small quantities of tin. At the same time, a significant instrument upgrade is underway, funded in part by the DOE-URIP program

  8. Interaction of High Intensity Electromagnetic Waves with Plasmas: Final Report

    Shvets, G.

    2008-01-01

    The focus of our work during the duration of this grant was on the following areas: (a) the fundamental plasma physics of intense laser-plasma interactions, including the nonlinear excitation of plasma waves for accelerator applications, as well as the recently discovered by us phenomenon of the relativistic bi-stability of relativistic plasma waves driven by a laser beatwave; (b) interaction of high power microwave beams with magnetized plasma, including some of the recently discovered by us phenomena such as the Undulator Induced Transparency (UIT) as well as the new approaches to dynamic manipulation of microwave pulses; (c) investigations of the multi-color laser pulse interactions in the plasma, including the recently discovered by us phenomenon of Electromagnetic Cascading (EC) and the effect of the EC of three-dimensional dynamics of laser pulses (enhanced/suppressed selffocusing etc.); (d) interaction of high-current electron beams with the ambient plasma in the context of Fast Ignitor (FI) physics, with the emphasis on the nonlinear dynamics of the Weibel instability and beam filamentation.

  9. Pulmonary Vein Isolation by High Intensity Focused Ultrasound

    Matthias Antz

    2007-04-01

    Full Text Available Pulmonary vein isolation (PVI using radiofrequency current (RFC ablation is a potentially curative treatment option for patients with atrial fibrillation (AF. The shortcomings of the RFC technology (technically challenging, long procedure times, complications steadily kindle the interest in new energy sources and catheter designs. High intensity focused ultrasound (HIFU has the ability to precisely focus ultrasound waves in a defined area with a high energy density. HIFU balloon catheters (BC positioned at the PV ostia appear to be an ideal tool to transmit the ablation energy in a circumferential manner to the PV ostia and may therefore bear substantial advantage over conventional ablation catheters in PVI procedures. In clinical trials the HIFU BC has shown promising success rates similar to RFC catheter ablation for PVI in patients with AF. However, procedure times are still long and serious complications have been observed. Therefore, it may be a valuable alternative to the conventional techniques in selected patients but further clinical trials have to be initiated.

  10. Production and Studies of Photocathodes for High Intensity Electron Beams

    Chevallay, E; Legros, P; Suberlucq, Guy; Trautner, H

    2000-01-01

    For short, high-intensity electron bunches, alkali-tellurides have proved to be a reliable photo-cathode material. Measurements of lifetimes in an rf gun of the CLIC Test Facility II at field strengths greater than 100 MV/m are presented. Before and after using them in this gun, the spectral response of the CS-Te and Rb-Te cathodes were determined with the help of an optical parametric oscillator. The behaviour of both materials can be described by Spicer's 3-step model. Whereas during the use the threshold for photo-emission in Cs-Te was shifted to higher proton energies, that of Rb-Te did not change. Our latest investigations on the stoichiometric ratio of the components are shown. The preparation of the photo-cathodes was monitored with 320 nm wavelength light , with the aim of improving the measurement sensitivity. The latest results on the protection of Cs-Te cathode surfaces with CsBr against pollution are summarized. New investigations on high mean current production are presented.,

  11. High-intensity focused ultrasound ablation around the tubing.

    Siu, Jun Yang; Liu, Chenhui; Zhou, Yufeng

    2017-01-01

    High-intensity focused ultrasound (HIFU) has been emerging as an effective and noninvasive modality in cancer treatment with very promising clinical results. However, a small vessel in the focal region could be ruptured, which is an important concern for the safety of HIFU ablation. In this study, lesion formation in the polyacrylamide gel phantom embedded with different tubing (inner diameters of 0.76 mm and 3 mm) at varied flow speeds (17-339 cm/s) by HIFU ablation was photographically recorded. Produced lesions have decreased length (~30%) but slightly increased width (~6%) in comparison to that without the embedded tubing. Meanwhile, bubble activities during the exposures were measured by passive cavitation detection (PCD) at the varied pulse repetition frequency (PRF, 10-30 Hz) and duty cycle (DC, 10%-20%) of the HIFU bursts. High DC and low flow speed were found to produce stronger bubble cavitation whereas no significant influence of the PRF. In addition, high-speed photography illustrated that the rupture of tubing was produced consistently after the first HIFU burst within 20 ms and then multiple bubbles would penetrate into the intraluminal space of tubing through the rupture site by the acoustic radiation force. Alignment of HIFU focus to the anterior surface, middle, and posterior surface of tubing led to different characteristics of vessel rupture and bubble introduction. In summary, HIFU-induced vessel rupture is possible as shown in this phantom study; produced lesion sizes and shapes are dependent on the focus alignment to the tubing, flow speed, and tubing properties; and bubble cavitation and the formation liquid jet may be one of the major mechanisms of tubing rupture as shown in the high-speed photography.

  12. Determination of tolerances in the positioning of the treatment table from an image-guided system

    Perez Moreno, J. M.; Zucca Aparicio, D.; Fernandez leton, P.; Garcia Ruiz-Zorrilla, J.; Minanbres Moro, A.

    2011-01-01

    The use of techniques of image-guided radiotherapy (TGRT) aims to reduce the uncertainties associated with patient positioning. One of the techniques more recent development is the cone beam CT (CBCT), consisting of the acquisition of volumetric images of the patient by a detector integrated into the linear accelerator. By analyzing the results of all sessions of treatment to all patients in which the positioning has been carried out with image-guided system MV CBCT have been determined tolerance tables for translational coordinates of the table treatment based on pathology and immobilization system used. (Author)

  13. Cranial nerve threshold for thermal injury induced by MRI-guided high-intensity focused ultrasound (MRgHIFU): preliminary results on an optic nerve model.

    Harnof, Sagi; Zibly, Zion; Cohen, Zvi; Shaw, Andrew; Schlaff, Cody; Kassel, Neal F

    2013-04-01

    Future clinical applications of magnetic resonance imaging-guided high-intensity focused ultrasound (MRgHIFU) are moving toward the management of different intracranial pathologies. We sought to validate the production, safety, and efficacy of thermal injury to cranial nerves generated by MRgHIFU. In this study, five female domestic pigs underwent a standard bifrontal craniectomy under general anesthesia. Treatment was then given using an MRgHIFU system to induce hyperthermic ablative sonication (6 to 10 s; 50 to 2000 J.) Histological analyses were done to confirm nerve damage; temperature measured on the optic nerve was approximately 53.4°C (range: 39°C to 70°C.) Histology demonstrated a clear definition between a necrotic, transitional zone, and normal tissue. MRgHIFU induces targeted thermal injury to nervous tissue within a specific threshold of 50°C to 60°C with the tissue near the sonication center yielding the greatest effect; adjacent tissue showed minimal changes. Additional studies utilizing this technology are required to further establish accurate threshold parameters for optic nerve thermo-ablation.

  14. Rainfall intensity characteristics at coastal and high altitude stations ...

    a given amount of rain occurs is important because heavier rainfall leads to greater runoff, greater soil erosion and less infiltration into the water table. A knowledge of rainfall intensity therefore becomes. Keywords. Rainfall intensity; Kerala; cumulative distribution. J. Earth Syst. Sci. 116, No. 5, October 2007, pp. 451–463.

  15. Energy compensation after sprint- and high-intensity interval training.

    Schubert, Matthew M; Palumbo, Elyse; Seay, Rebekah F; Spain, Katie K; Clarke, Holly E

    2017-01-01

    Many individuals lose less weight than expected in response to exercise interventions when considering the increased energy expenditure of exercise (ExEE). This is due to energy compensation in response to ExEE, which may include increases in energy intake (EI) and decreases in non-exercise physical activity (NEPA). We examined the degree of energy compensation in healthy young men and women in response to interval training. Data were examined from a prior study in which 24 participants (mean age, BMI, & VO2max = 28 yrs, 27.7 kg•m-2, and 32 mL∙kg-1∙min-1) completed either 4 weeks of sprint-interval training or high-intensity interval training. Energy compensation was calculated from changes in body composition (air displacement plethysmography) and exercise energy expenditure was calculated from mean heart rate based on the heart rate-VO2 relationship. Differences between high (≥ 100%) and low (high levels of energy compensation gained fat mass, lost fat-free mass, and had lower change scores for VO2max and NEPA. Linear regression results indicated that lower levels of energy compensation were associated with increases in ΔVO2max (p interval training. In agreement with prior work, increases in ΔVO2max and ΔNEPA were associated with lower energy compensation. Future studies should focus on identifying if a dose-response relationship for energy compensation exists in response to interval training, and what underlying mechanisms and participant traits contribute to the large variation between individuals.

  16. Creatine kinase response to high-intensity aerobic exercise in adult-onset muscular dystrophy

    Andersen, Søren P; Sveen, Marie-Louise; Hansen, Regitze S

    2013-01-01

    We investigated the effect of high-intensity exercise on plasma creatine kinase (CK) in patients with muscular dystrophies.......We investigated the effect of high-intensity exercise on plasma creatine kinase (CK) in patients with muscular dystrophies....

  17. The WARP Code: Modeling High Intensity Ion Beams

    Grote, David P.; Friedman, Alex; Vay, Jean-Luc; Haber, Irving

    2005-01-01

    The Warp code, developed for heavy-ion driven inertial fusion energy studies, is used to model high intensity ion (and electron) beams. Significant capability has been incorporated in Warp, allowing nearly all sections of an accelerator to be modeled, beginning with the source. Warp has as its core an explicit, three-dimensional, particle-in-cell model. Alongside this is a rich set of tools for describing the applied fields of the accelerator lattice, and embedded conducting surfaces (which are captured at sub-grid resolution). Also incorporated are models with reduced dimensionality: an axisymmetric model and a transverse ''slice'' model. The code takes advantage of modern programming techniques, including object orientation, parallelism, and scripting (via Python). It is at the forefront in the use of the computational technique of adaptive mesh refinement, which has been particularly successful in the area of diode and injector modeling, both steady-state and time-dependent. In the presentation, some of the major aspects of Warp will be overviewed, especially those that could be useful in modeling ECR sources. Warp has been benchmarked against both theory and experiment. Recent results will be presented showing good agreement of Warp with experimental results from the STS500 injector test stand

  18. High-intensity interval training improves obstructive sleep apnoea.

    Karlsen, Trine; Nes, Bjarne Martens; Tjønna, Arnt Erik; Engstrøm, Morten; Støylen, Asbjørn; Steinshamn, Sigurd

    2016-01-01

    Three hours per week of vigorous physical activity is found to be associated with reduced odds of sleep-disordered breathing. To investigate whether 12 weeks of high-intensity interval training (HIIT) reduced the apnoea-hypopnea index (AHI) in obese subjects with moderate-to-severe obstructive sleep apnoea. In a prospective randomised controlled exercise study, 30 (body mass index 37±6 kg/m 2 , age 51±9 years) patients with sleep apnoea (AHI 41.5±25.3 events/hour) were randomised 1:1 to control or 12 weeks of supervised HIIT (4×4 min of treadmill running or walking at 90%-95% of maximal heart rate two times per week). In the HIIT group, the AHI was reduced by 7.5±11.6 events/hour (within-group pHIIT improved the AHI and self-reported daytime sleepiness in subjects with obese sleep apnoea without any change in the desaturation index and body weight.

  19. The WARP Code: Modeling High Intensity Ion Beams

    Grote, D P; Friedman, A; Vay, J L; Haber, I

    2004-01-01

    The Warp code, developed for heavy-ion driven inertial fusion energy studies, is used to model high intensity ion (and electron) beams. Significant capability has been incorporated in Warp, allowing nearly all sections of an accelerator to be modeled, beginning with the source. Warp has as its core an explicit, three-dimensional, particle-in-cell model. Alongside this is a rich set of tools for describing the applied fields of the accelerator lattice, and embedded conducting surfaces (which are captured at sub-grid resolution). Also incorporated are models with reduced dimensionality: an axisymmetric model and a transverse ''slice'' model. The code takes advantage of modern programming techniques, including object orientation, parallelism, and scripting (via Python). It is at the forefront in the use of the computational technique of adaptive mesh refinement, which has been particularly successful in the area of diode and injector modeling, both steady-state and time-dependent. In the presentation, some of the major aspects of Warp will be overviewed, especially those that could be useful in modeling ECR sources. Warp has been benchmarked against both theory and experiment. Recent results will be presented showing good agreement of Warp with experimental results from the STS500 injector test stand. Additional information can be found on the web page http://hif.lbl.gov/theory/WARP( ) summary.html

  20. A modified space charge routine for high intensity bunched beams

    Lapostolle, P.; Garnett, R.W.; Wangler, T.P.

    1996-01-01

    In 1991 a space charge calculation for bunched beam with a three-dimensional ellipsoid was proposed, replacing the usual SCHEFF routines. It removes the cylindrical symmetry required in SCHEFF and avoids the point to point interaction computation, whose number of simulation points is limited. This routine has now been improved with the introduction of two or three ellipsoids giving a good representation of the complex non-symmetrical form of the bunch (unlike the 3-d ellipsoidal assumption). The ellipsoidal density distributions are computed with a new method, avoiding the difficulty encountered near the centre (the axis in 2-d problems) by the previous method. It also provides a check of the ellipsoidal symmetry for each part of the distribution. Finally, the Fourier analysis reported in 1991 has been replaced by a very convenient Hermite expansion, which gives a simple but accurate representation of practical distributions. Comparisons with other space charge routines have been made, particularly with the ones applying other techniques such as SCHEFF. Introduced in the versatile beam dynamics code DYNAC, it should provide a good tool for the study of the various parameters responsible for the halo formation in high intensity linacs. (orig.)

  1. A review of adolescent high-intensity interval training.

    Logan, Greig R M; Harris, Nigel; Duncan, Scott; Schofield, Grant

    2014-08-01

    Despite the promising evidence supporting positive effects of high-intensity interval training (HIIT) on the metabolic profile in adults, there is limited research targeting adolescents. Given the rising burden of chronic disease, it is essential to implement strategies to improve the cardiometabolic health in adolescence, as this is a key stage in the development of healthy lifestyle behaviours. This narrative review summarises evidence of the relative efficacy of HIIT regarding the metabolic health of adolescents. Methodological inconsistencies confound our ability to draw conclusions; however, there is meaningful evidence supporting HIIT as a potentially efficacious exercise modality for use in the adolescent cohort. Future research must examine the effects of various HIIT protocols to determine the optimum strategy to deliver cardiometabolic health benefits. Researchers should explicitly show between-group differences for HIIT intervention and steady-state exercise or control groups, as the magnitude of difference between HIIT and other exercise modalities is of key interest to public health. There is scope for research to examine the palatability of HIIT as an exercise modality for adolescents through investigating perceived enjoyment during and after HIIT, and consequent long-term exercise adherence.

  2. Robotic Assisted Laparoscopic Prostatectomy after High Intensity Focused Ultrasound Failure

    Leon Telis

    2017-01-01

    Full Text Available Background. Prostate cancer is the most common cancer diagnosed in men. As new focal therapies become more popular in treatment of prostate cancer, failure cases requiring salvage therapy with either surgical or other techniques are being reported. Objective. To report the options in treatment of prostate cancer after recurrence or failure of the primary treatment modality. Methods. We report a salvage robotic assisted laparoscopic radical prostatectomy (RALP for prostate cancer recurrence following high intensity focused ultrasound treatment (HIFU in the United States. Results. A 67-year-old man who underwent HIFU treatment for prostate adenocarcinoma 2 years prior was presented with a rising prostate specific antigen of 6.1 ng/mL to our clinic. A biopsy proven recurrent disease in the area of previous treatment documented the failure of treatment. The patient elected to undergo a salvage RALP. The operation time was 159 minutes. The patient was discharged from the hospital on postoperative day 1 with no complications. The catheter was removed on post-op day 10. The patient reserved sexual function and urinary continence. The PSA levels on 6 months’ follow-up are undetectable. Conclusions. Salvage RALP is an effective and safe treatment choice for recurrent prostate adenocarcinoma following failed HIFU treatment if operated by an experienced surgeon.

  3. Commissioning and quality assurance of the x-ray volume imaging system of an image-guided radiotherapy capable linear accelerator

    Muralidhar, K.R.; Narayana Murthy, P.; Kumar, Rajneesh

    2008-01-01

    An Image-Guided Radiotherapy-capable linear accelerator (Elekta Synergy) was installed at our hospital, which is equipped with a kV x-ray volume imaging (XVI) system and electronic portal imaging device (iViewGT). The objective of this presentation is to describe the results of commissioning measurements carried out on the XVI facility to verify the manufacturer's specifications and also to evolve a QA schedule which can be used to test its performance routinely. The QA program consists of a series of tests (safety features, geometric accuracy, and image quality). These tests were found to be useful to assess the performance of the XVI system and also proved that XVI system is very suitable for image-guided high-precision radiation therapy. (author)

  4. Commissioning and quality assurance of the X-ray volume Imaging system of an image-guided radiotherapy capable linear accelerator

    Muralidhar K

    2008-01-01

    Full Text Available An Image-Guided Radiotherapy-capable linear accelerator (Elekta Synergy was installed at our hospital, which is equipped with a kV x-ray volume imaging (XVI system and electronic portal imaging device (iViewGT. The objective of this presentation is to describe the results of commissioning measurements carried out on the XVI facility to verify the manufacturer′s specifications and also to evolve a QA schedule which can be used to test its performance routinely. The QA program consists of a series of tests (safety features, geometric accuracy, and image quality. These tests were found to be useful to assess the performance of the XVI system and also proved that XVI system is very suitable for image-guided high-precision radiation therapy.

  5. Fast lesion mapping during HIFU treatment using harmonic motion imaging guided focused ultrasound (HMIgFUS) in vitro and in vivo

    Han, Yang; Wang, Shutao; Payen, Thomas; Konofagou, Elisa

    2017-04-01

    The successful clinical application of high intensity focused ultrasound (HIFU) ablation depends on reliable monitoring of the lesion formation. Harmonic motion imaging guided focused ultrasound (HMIgFUS) is an ultrasound-based elasticity imaging technique, which monitors HIFU ablation based on the stiffness change of the tissue instead of the echo intensity change in conventional B-mode monitoring, rendering it potentially more sensitive to lesion development. Our group has shown that predicting the lesion location based on the radiation force-excited region is feasible during HMIgFUS. In this study, the feasibility of a fast lesion mapping method is explored to directly monitor the lesion map during HIFU. The harmonic motion imaging (HMI) lesion map was generated by subtracting the reference HMI image from the present HMI peak-to-peak displacement map, as streamed on the computer display. The dimensions of the HMIgFUS lesions were compared against gross pathology. Excellent agreement was found between the lesion depth (r 2  =  0.81, slope  =  0.90), width (r 2  =  0.85, slope  =  1.12) and area (r 2  =  0.58, slope  =  0.75). In vivo feasibility was assessed in a mouse with a pancreatic tumor. These findings demonstrate that HMIgFUS can successfully map thermal lesions and monitor lesion development in real time in vitro and in vivo. The HMIgFUS technique may therefore constitute a novel clinical tool for HIFU treatment monitoring.

  6. Evaluation of the precision of portal-image-guided head-and-neck localization: An intra- and interobserver study

    Court, Laurence E.; Allen, Aaron; Tishler, Roy

    2007-01-01

    There is increasing evidence that, for some patients, image-guided intensity-modulated radiation therapy (IMRT) for head-and-neck cancer patients may maintain target dose coverage and critical organ (e.g., parotids) dose closer to the planned doses than setup using lasers alone. We investigated inter- and intraobserver uncertainties in patient setup in head-and-neck cancer patients. Twenty-two sets of orthogonal digital portal images (from five patients) were selected from images used for daily localization of head-and-neck patients treated with IMRT. To evaluate interobserver variations, five radiation therapists compared the portal images with the plan digitally reconstructed radiographs and reported shifts for the isocenter (∼C2) and for a supraclavicular reference point. One therapist repeated the procedure a month later to evaluate intraobserver variations. The procedure was then repeated with teams of two therapists. The frequencies for which agreement between the shift reported by the observer and the daily mean shift (average of all observers for a given image set) were less than 1.5 and 2.5 mm were calculated. Standard errors of measurement for the intra- and interobserver uncertainty (SEM intra and SEM inter ) for the individual and teams were calculated. The data showed that there was very little difference between individual therapists and teams. At isocenter, 80%-90% of all reported shifts agreed with the daily average within 1.5 mm, showing consistency in the ways both individuals and teams interpret the images (SEM inter ∼1 mm). This dropped to 65% for the supraclavicular point (SEM inter ∼1.5 mm). Uncertainties increased for larger setup errors. In conclusion, image-guided patient positioning allows head-and-neck patients to be controlled within 3-4 mm. This is similar to the setup uncertainties found for most head-and-neck patients, but may provide some improvement for the subset of patients with larger setup uncertainties

  7. High-intensity interval training vs. moderate-intensity continuous training in the prevention/management of cardiovascular disease

    Hussain, S; Macaluso, A; Pearson, S

    2016-01-01

    Moderate-intensity continuous training (MICT) has long been considered the most effective exercise treatment modality for the prevention and management of cardiovascular disease, but more recently high-intensity interval training (HIIT) has emerged into the clinical environment has been viewed as a potential alternative to MICT in accruing such benefits. HIIT was initially found to induce significant improvements in numerous physiological and health-related indices, to a similar if not superi...

  8. HIGH ENERGY DENSITY PHYSICS EXPERIMENTS WITH INTENSE HEAVY ION BEAMS

    Bieniosek, F.M.; Henestroza, E.; Leitner, M.; Logan, B.G.; More, R.M.; Roy, P.K.; Ni, P.; Seidl, P.A.; Waldron, W.L.; Barnard, J.J.

    2008-01-01

    The US heavy ion fusion science program has developed techniques for heating ion-beam-driven warm dense matter (WDM) targets. The WDM conditions are to be achieved by combined longitudinal and transverse space-charge neutralized drift compression of the ion beam to provide a hot spot on the target with a beam spot size of about 1 mm, and pulse length about 1-2 ns. As a technique for heating volumetric samples of matter to high energy density, intense beams of heavy ions are capable of delivering precise and uniform beam energy deposition dE/dx, in a relatively large sample size, and the ability to heat any solid-phase target material. Initial experiments use a 0.3 MeV K+ beam (below the Bragg peak) from the NDCX-I accelerator. Future plans include target experiments using the NDCX-II accelerator, which is designed to heat targets at the Bragg peak using a 3-6 MeV lithium ion beam. The range of the beams in solid matter targets is about 1 micron, which can be lengthened by using porous targets at reduced density. We have completed the fabrication of a new experimental target chamber facility for WDM experiments, and implemented initial target diagnostics to be used for the first target experiments in NDCX-1. The target chamber has been installed on the NDCX-I beamline. The target diagnostics include a fast multi-channel optical pyrometer, optical streak camera, VISAR, and high-speed gated cameras. Initial WDM experiments will heat targets by compressed NDCX-I beams and will explore measurement of temperature and other target parameters. Experiments are planned in areas such as dense electronegative targets, porous target homogenization and two-phase equation of state

  9. Inelastic scattering in condensed matter with high intensity Moessbauer radiation

    Yelon, W.B.; Schupp, G.

    1990-10-01

    We give a progress report for the work which has been carried out in the last three years with DOE support. A facility for high-intensity Moessbauer scattering is now fully operational at the University of Missouri Research Reactor (MURR) as well as facility at Purdue, using special isotopes produced at MURR. High precision, fundamental Moessbauer effect studies have been carried out using scattering to filter the unwanted radiation. These have led to a new Fourier transform method for describing Moessbauer effect (ME) lineshape and a direct method of fitting ME data to the convolution integral. These methods allow complete correction for source resonance self absorption (SRSA) and the accurate representation of interference effects that add an asymmetric component to the ME lines. We have begun applying these techniques to attenuated ME sources whose central peak has been attenuated by stationary resonant absorbers, to more precisely determine interference parameters and line-shape behavior in the resonance asymptotic region. This analysis is important to both the fundamental ME studies and to scattering studies for which a deconvolution is essential for extracting the correct recoilless fractions and interference parameters. A number of scattering studies have been successfully carried out including a study of the thermal diffuse scattering in Si, which led to an analysis of the resolution function for gamma-ray scattering. Also studied was the anharmonic motion in Na and the satellite reflection Debye-Waller factor in TaS 2 , which indicate phason rather than phonon behavior. We have begun quasielastic diffusion studies in viscous liquids and current results are summarized. These advances, coupled to our improvements in MIcrofoil Conversion Electron spectroscopy lay the foundation for the proposed research outlined in this request for a three-year renewal of DOE support

  10. Gamma scattering in condensed matter with high intensity Moessbauer radiation

    1990-01-01

    We give a progress report for the work which has been carried out in the last three years with DOE support. A facility for high-intensity Moessbauer scattering is now fully operational at the University of Missouri Research Reactor (MURR) as well as a facility at Purdue, using special isotopes produced at MURR. High precision, fundamental Moessbauer effect studies have been carried out using scattering to filter the unwanted radiation. These have led to a new Fourier transform method for describing Moessbauer effect (ME) lineshape and a direct method of fitting ME data to the convolution integral. These methods allow complete correction for source resonance self absorption (SRSA) and the accurate representation of interference effects that add an asymmetric component to the ME lines. We have begun applying these techniques to attenuated ME sources whose central peak has been attenuated by stationary resonant absorbers, to more precisely determine interference parameters and line-shape behavior in the resonance asymptotic region. This analysis is important to both the fundamental ME studies and to scattering studies for which a deconvolution is essential for extracting the correct recoilless fractions and interference parameters. A number of scattering studies have been successfully carried out including a study of the thermal diffuse scattering in Si, which led to an analysis of the resolution function for gamma-ray scattering. Also studied was the anharmonic motion in Na and the satellite reflection Debye-Waller factor in TaS 2 , which indicate phason rather than phonon behavior. We have begun quasielastic diffusion studies in viscous liquids and current results are summarized. These advances, coupled to our improvements in MIcrofoil Conversion Electron spectroscopy lay the foundation for the proposed research outlined in this request for a three-year renewal of DOE support

  11. Inelastic scattering in condensed matter with high intensity moessbauer radiation

    Yelon, W.B.; Schupp, G.

    1991-05-01

    We give a progress report for the work which has been carried out in the last three years with DOE support. A facility for high-intensity Moessbauer scattering is not fully operational at the University of Missouri Research Reactor (MURR) as well as a facility at Purdue, using special isotopes produced at MURR. High precision, fundamental Moessbauer effect studies have been carried out using Bragg scattering filters to suppress unwanted radiation. These have led to a Fourier transform method for describing Moessbauer effect (ME) lineshape and a direct method of fitting ME data to the convolution integral. These methods allow complete correction for source resonance self absorption and the accurate representation of interference effects that add an asymmetric component to the ME lines. We have begun applying these techniques to attenuated ME sources whose central peak has been attenuated by stationary resonant absorbers, to make a novel independent determination of interference parameters and line-shape behavior in the resonance asymptotic region. This analysis is important to both fundamental ME studies and to scattering studies for which a deconvolution is essential for extracting the correct recoilless fractions and interference parameters. A number of scattering studies have been successfully carried out including a study of the thermal diffuse scattering in Si, which led to an analysis of the resolution function for gamma-ray scattering. Also studied was the anharmonic motion in Na metal and the charge density wave satellite reflection Debye-Waller factor in TaS 2 , which indicate phason rather than phonon behavior. Using a specially constructed sample cell which enables us to vary temperatures from -10 C to 110 C, we have begun quasielastic diffusion studies in viscous liquids and current results are summarized. Included are the temperature and Q dependence of the scattering in pentadecane and diffusion in glycerol

  12. Markerless laser registration in image-guided oral and maxillofacial surgery.

    Marmulla, Rüdiger; Lüth, Tim; Mühling, Joachim; Hassfeld, Stefan

    2004-07-01

    The use of registration markers in computer-assisted surgery is combined with high logistic costs and efforts. Markerless patient registration using laser scan surface registration techniques is a new challenging method. The present study was performed to evaluate the clinical accuracy in finding defined target points within the surgical site after markerless patient registration in image-guided oral and maxillofacial surgery. Twenty consecutive patients with different cranial diseases were scheduled for computer-assisted surgery. Data set alignment between the surgical site and the computed tomography (CT) data set was performed by markerless laser scan surface registration of the patient's face. Intraoral rigidly attached registration markers were used as target points, which had to be detected by an infrared pointer. The Surgical Segment Navigator SSN++ has been used for all procedures. SSN++ is an investigative product based on the SSN system that had previously been developed by the presenting authors with the support of Carl Zeiss (Oberkochen, Germany). SSN++ is connected to a Polaris infrared camera (Northern Digital, Waterloo, Ontario, Canada) and to a Minolta VI 900 3D digitizer (Tokyo, Japan) for high-resolution laser scanning. Minimal differences in shape between the laser scan surface and the surface generated from the CT data set could be detected. Nevertheless, high-resolution laser scan of the skin surface allows for a precise patient registration (mean deviation 1.1 mm, maximum deviation 1.8 mm). Radiation load, logistic costs, and efforts arising from the planning of computer-assisted surgery of the head can be reduced because native (markerless) CT data sets can be used for laser scan-based surface registration.

  13. Image-guided surgery and therapy: current status and future directions

    Peters, Terence M.

    2001-05-01

    Image-guided surgery and therapy is assuming an increasingly important role, particularly considering the current emphasis on minimally-invasive surgical procedures. Volumetric CT and MR images have been used now for some time in conjunction with stereotactic frames, to guide many neurosurgical procedures. With the development of systems that permit surgical instruments to be tracked in space, image-guided surgery now includes the use of frame-less procedures, and the application of the technology has spread beyond neurosurgery to include orthopedic applications and therapy of various soft-tissue organs such as the breast, prostate and heart. Since tracking systems allow image- guided surgery to be undertaken without frames, a great deal of effort has been spent on image-to-image and image-to- patient registration techniques, and upon the means of combining real-time intra-operative images with images acquired pre-operatively. As image-guided surgery systems have become increasingly sophisticated, the greatest challenges to their successful adoption in the operating room of the future relate to the interface between the user and the system. To date, little effort has been expended to ensure that the human factors issues relating to the use of such equipment in the operating room have been adequately addressed. Such systems will only be employed routinely in the OR when they are designed to be intuitive, unobtrusive, and provide simple access to the source of the images.

  14. Automated tru-cut imaging-guided core needle biopsy of canine ...

    The purpose of this study was to evaluate the diagnostic value of imaging-guided core needle biopsy for canine orbital mass diagnosis. A second excisional biopsy obtained during surgery or necropsy was used as the reference standard. A prospective feasibility study was conducted in 23 canine orbital masses at a single ...

  15. Image-guided focused ultrasound ablation of breast cancer: current status, challenges, and future directions

    Schmitz, A.C.; Gianfelice, D.; Daniel, B.L.; Mali, W.P.T.M.; Bosch, M.A.A.J. van den

    2008-01-01

    Image-guided focussed ultrasound (FUS) ablation is a noninvasive procedure that has been used for treatment of benign or malignant breast tumours. Image-guidance during ablation is achieved either by using real-time ultrasound (US) or magnetic resonance imaging (MRI). The past decade phase I

  16. Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

    Webers, V.S.C.; Bauer, N.J.C.; Visser, N.; Berendschot, T.T.J.M.; van den Biggelaar, F.J.H.M.; Nuijts, R.M.M.A.

    2017-01-01

    Purpose To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. Setting University Eye Clinic Maastricht, Maastricht, the Netherlands. Design Prospective randomized clinical trial. Methods Eyes with

  17. Imaging-guided hyperstimulation analgesia in low back pain

    Gorenberg M

    2013-06-01

    Full Text Available Miguel Gorenberg,1,2 Kobi Schwartz31Department of Nuclear Medicine, B'nai Zion Medical Center, Haifa, Israel; 2The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; 3Department of Physical Therapy, B'nai Zion Medical Center, Haifa, IsraelAbstract: Low back pain in patients with myofascial pain syndrome is characterized by painful active myofascial trigger points (ATPs in muscles. This article reviews a novel, noninvasive modality that combines simultaneous imaging and treatment, thus taking advantage of the electrodermal information available from imaged ATPs to deliver localized neurostimulation, to stimulate peripheral nerve endings (Aδ fibers and in turn, to release endogenous endorphins. "Hyperstimulation analgesia" with localized, intense, low-rate electrical pulses applied to painful ATPs was found to be effective in 95% patients with chronic nonspecific low back pain, in a clinical validation study.Keywords: myofascial, noninvasive, electrical, impedance

  18. Energy compensation after sprint- and high-intensity interval training.

    Matthew M Schubert

    Full Text Available Many individuals lose less weight than expected in response to exercise interventions when considering the increased energy expenditure of exercise (ExEE. This is due to energy compensation in response to ExEE, which may include increases in energy intake (EI and decreases in non-exercise physical activity (NEPA. We examined the degree of energy compensation in healthy young men and women in response to interval training.Data were examined from a prior study in which 24 participants (mean age, BMI, & VO2max = 28 yrs, 27.7 kg•m-2, and 32 mL∙kg-1∙min-1 completed either 4 weeks of sprint-interval training or high-intensity interval training. Energy compensation was calculated from changes in body composition (air displacement plethysmography and exercise energy expenditure was calculated from mean heart rate based on the heart rate-VO2 relationship. Differences between high (≥ 100% and low (< 100% levels of energy compensation were assessed. Linear regressions were utilized to determine associations between energy compensation and ΔVO2max, ΔEI, ΔNEPA, and Δresting metabolic rate.Very large individual differences in energy compensation were noted. In comparison to individuals with low levels of compensation, individuals with high levels of energy compensation gained fat mass, lost fat-free mass, and had lower change scores for VO2max and NEPA. Linear regression results indicated that lower levels of energy compensation were associated with increases in ΔVO2max (p < 0.001 and ΔNEPA (p < 0.001.Considerable variation exists in response to short-term, low dose interval training. In agreement with prior work, increases in ΔVO2max and ΔNEPA were associated with lower energy compensation. Future studies should focus on identifying if a dose-response relationship for energy compensation exists in response to interval training, and what underlying mechanisms and participant traits contribute to the large variation between individuals.

  19. Functional image guided radiation therapy planning in volumetric modulated arc therapy for patients with malignant pleural mesothelioma

    Yoshiko Doi, MD

    2017-04-01

    Conclusions: Significant reductions in fV5, fV10, fMLD, V5, and MLD were achieved with the functional image guided VMAT plan without negative effects on other factors. LAA-based functional image guided radiation therapy planning in VMAT is a feasible method to spare the functional lung in patients with MPM.

  20. Development of a High Intensity Focused Ultrasound (HIFU) Hydrophone System

    Schafer, Mark E.; Gessert, James

    2009-01-01

    The growing clinical use of High Intensity Focused Ultrasound (HIFU) has driven a need for reliable, reproducible measurements of HIFU acoustic fields. We have previously presented data on a reflective scatterer approach, incorporating several novel features for improved bandwidth, reliability, and reproducibility [Proc. 2005 IEEE Ultrasonics Symposium, 1739-1742]. We now report on several design improvements which have increase the signal to noise ratio of the system, and potentially reduced the cost of implementation. For the scattering element, we now use an artificial sapphire material to provide a more uniform radiating surface. The receiver is a segmented, truncated spherical structure with a 10 cm radius; the scattering element is positioned at the center of the sphere. The receiver is made from 25 micron thick, biaxially stretched PVDF, with a Pt-Au electrode on the front surface. In the new design, a specialized backing material provides the stiffness required to maintain structural stability, while at the same time providing both electrical shielding and ultrasonic absorption. Compared with the previous version, the new receiver design has improved the noise performance by 8-12 dB; the new scattering sphere has reduced the scattering loss by another 14 dB, producing an effective sensitivity of -298 dB re 1 microVolt/Pa. The design trade-off still involves receiver sensitivity with effective spot size, and signal distortion from the scatter structure. However, the reduced cost and improved repeatability of the new scatter approach makes the overall design more robust for routine waveform measurements of HIFU systems.

  1. Topics in high-intensity laser plasma interaction

    Leemans, W.P.

    1991-01-01

    The interaction of high intensity laser pulses with pre-formed and laser-produced plasmas is studied. Through experiments and simulations we have investigated stimulated Compton scattering in preformed plasmas and the plasma physics aspects of tunnel-ionized gases. A theoretical study is presented on the nonlinear dynamics of relativistic plasma waves driven by colinear optical mixing. The electron density-fluctuation spectra induced by stimulated Compton scattering have been directly observed for the first time. A CO2 laser was focused into pre-formed plasmas with densities n(e) varied from 0.4-6 x 10(exp 16) cu cm. The fluctuations corresponding to backscatter were probed using Thomson scattering. At low n(e), the scattered spectra peak at a frequency shift Delta omega is approximately kv e and appears to be in a linear regime. At the highest n(e), a nonlinear saturation of the SCS instability is observed due to a self-induced perturbation of the electron distribution function. Tunnel-ionized plasmas have been studied through experiments and particle simulations. Experimentally, qualitative evidence for plasma temperature control by varying the laser polarization was obtained by the measurement of stimulated Compton scattering fluctuation spectra and x-ray emission from such plasmas. A higher parallel temperature than expected from the single-particle tunneling model was observed. Simulations indicate that stochastic heating and the Weibel instability play an important role in plasma heating in all directions and isotropization. The non-linear dynamics associated with beatwave (Delta omega, Delta k) excited long wavelength plasma waves in the presence of strong, short wavelength density ripple have been examined, using the relativistic Lagrangian oscillator model. This model shows period doubling that roughly follows Feigenbaum scaling, and a transition to chaos

  2. Five-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    Mendenhall, Nancy P.; Hoppe, Bradford S.; Nichols, Romaine C.; Mendenhall, William M.; Morris, Christopher G.; Li, Zuofeng; Su, Zhong; Williams, Christopher R.; Costa, Joseph; Henderson, Randal H.

    2014-01-01

    Purpose: To report 5-year clinical outcomes of 3 prospective trials of image-guided proton therapy for prostate cancer. Methods and Materials: A total of 211 prostate cancer patients (89 low-risk, 82 intermediate-risk, and 40 high-risk) were treated in institutional review board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel therapy followed by androgen deprivation therapy for high-risk disease. Toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Median follow-up was 5.2 years. Results: Five-year rates of biochemical and clinical freedom from disease progression were 99%, 99%, and 76% in low-, intermediate-, and high-risk patients, respectively. Actuarial 5-year rates of late CTCAE, version 3.0 (or version 4.0) grade 3 gastrointestinal and urologic toxicity were 1.0% (0.5%) and 5.4% (1.0%), respectively. Median pretreatment scores and International Prostate Symptom Scores at >4 years posttreatment were 8 and 7, 6 and 6, and 9 and 8, respectively, among the low-, intermediate-, and high-risk patients. There were no significant changes between median pretreatment summary scores and Expanded Prostate Cancer Index Composite scores at >4 years for bowel, urinary irritative and/or obstructive, and urinary continence. Conclusions: Five-year clinical outcomes with image-guided proton therapy included extremely high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes. Further follow-up and a larger patient experience are necessary to confirm these favorable outcomes

  3. Five-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    Mendenhall, Nancy P., E-mail: menden@shands.ufl.edu [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Hoppe, Bradford S.; Nichols, Romaine C.; Mendenhall, William M.; Morris, Christopher G.; Li, Zuofeng; Su, Zhong [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Williams, Christopher R.; Costa, Joseph [Division of Urology, College of Medicine, University of Florida, Jacksonville, Florida (United States); Henderson, Randal H. [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States)

    2014-03-01

    Purpose: To report 5-year clinical outcomes of 3 prospective trials of image-guided proton therapy for prostate cancer. Methods and Materials: A total of 211 prostate cancer patients (89 low-risk, 82 intermediate-risk, and 40 high-risk) were treated in institutional review board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel therapy followed by androgen deprivation therapy for high-risk disease. Toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Median follow-up was 5.2 years. Results: Five-year rates of biochemical and clinical freedom from disease progression were 99%, 99%, and 76% in low-, intermediate-, and high-risk patients, respectively. Actuarial 5-year rates of late CTCAE, version 3.0 (or version 4.0) grade 3 gastrointestinal and urologic toxicity were 1.0% (0.5%) and 5.4% (1.0%), respectively. Median pretreatment scores and International Prostate Symptom Scores at >4 years posttreatment were 8 and 7, 6 and 6, and 9 and 8, respectively, among the low-, intermediate-, and high-risk patients. There were no significant changes between median pretreatment summary scores and Expanded Prostate Cancer Index Composite scores at >4 years for bowel, urinary irritative and/or obstructive, and urinary continence. Conclusions: Five-year clinical outcomes with image-guided proton therapy included extremely high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes. Further follow-up and a larger patient experience are necessary to confirm these favorable outcomes.

  4. SU-E-I-39: Molecular Image Guided Cancer Stem Cells Therapy

    Abdollahi, H

    2014-06-01

    Purpose: Cancer stem cells resistance to radiation is a problematic issue that has caused a big fail in cancer treatment. Methods: As a primary work, molecular imaging can indicate the main mechanisms of radiation resistance of cancer stem cells. By developing and commissioning new probes and nanomolecules and biomarkers, radiation scientist will able to identify the essential pathways of radiation resistance of cancer stem cells. As the second solution, molecular imaging is a best way to find biological target volume and delineate cancer stem cell tissues. In the other hand, by molecular imaging techniques one can image the treatment response in tumor and also in normal tissue. In this issue, the response of cancer stem cells to radiation during therapy course can be imaged, also the main mechanisms of radiation resistance and finding the best radiation modifiers (sensitizers) can be achieved by molecular imaging modalities. In adaptive radiotherapy the molecular imaging plays a vital role to have higher tumor control probability by delivering high radiation doses to cancer stem cells in any time of treatment. The outcome of a feasible treatment is dependent to high cancer stem cells response to radiation and removing all of which, so a good imaging modality can show this issue and preventing of tumor recurrence and metastasis. Results: Our results are dependent to use of molecular imaging as a new modality in the clinic. We propose molecular imaging as a new radiobiological technique to solve radiation therapy problems due to cancer stem cells. Conclusion: Molecular imaging guided cancer stem cell diagnosis and therapy is a new approach in the field of cancer treatment. This new radiobiological imaging technique should be developed in all clinics as a feasible tool that is more biological than physical imaging.

  5. TU-A-304-01: Introduction and Workflow of Image-Guided SBRT

    Salter, B.

    2015-01-01

    Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems

  6. TU-A-304-01: Introduction and Workflow of Image-Guided SBRT

    Salter, B. [University of Utah Huntsman Cancer Institute (United States)

    2015-06-15

    Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

  7. Dual source and dual detector arrays tetrahedron beam computed tomography for image guided radiotherapy

    Kim, Joshua; Zhang, Tiezhi; Lu, Weiguo

    2014-01-01

    Cone-beam computed tomography (CBCT) is an important online imaging modality for image guided radiotherapy. But suboptimal image quality and the lack of a real-time stereoscopic imaging function limit its implementation in advanced treatment techniques, such as online adaptive and 4D radiotherapy. Tetrahedron beam computed tomography (TBCT) is a novel online imaging modality designed to improve on the image quality provided by CBCT. TBCT geometry is flexible, and multiple detector and source arrays can be used for different applications. In this paper, we describe a novel dual source–dual detector TBCT system that is specially designed for LINAC radiation treatment machines. The imaging system is positioned in-line with the MV beam and is composed of two linear array x-ray sources mounted aside the electrical portal imaging device and two linear arrays of x-ray detectors mounted below the machine head. The detector and x-ray source arrays are orthogonal to each other, and each pair of source and detector arrays forms a tetrahedral volume. Four planer images can be obtained from different view angles at each gantry position at a frame rate as high as 20 frames per second. The overlapped regions provide a stereoscopic field of view of approximately 10–15 cm. With a half gantry rotation, a volumetric CT image can be reconstructed having a 45 cm field of view. Due to the scatter rejecting design of the TBCT geometry, the system can potentially produce high quality 2D and 3D images with less radiation exposure. The design of the dual source–dual detector system is described, and preliminary results of studies performed on numerical phantoms and simulated patient data are presented. (paper)

  8. Dual source and dual detector arrays tetrahedron beam computed tomography for image guided radiotherapy

    Kim, Joshua; Lu, Weiguo; Zhang, Tiezhi

    2014-02-01

    Cone-beam computed tomography (CBCT) is an important online imaging modality for image guided radiotherapy. But suboptimal image quality and the lack of a real-time stereoscopic imaging function limit its implementation in advanced treatment techniques, such as online adaptive and 4D radiotherapy. Tetrahedron beam computed tomography (TBCT) is a novel online imaging modality designed to improve on the image quality provided by CBCT. TBCT geometry is flexible, and multiple detector and source arrays can be used for different applications. In this paper, we describe a novel dual source-dual detector TBCT system that is specially designed for LINAC radiation treatment machines. The imaging system is positioned in-line with the MV beam and is composed of two linear array x-ray sources mounted aside the electrical portal imaging device and two linear arrays of x-ray detectors mounted below the machine head. The detector and x-ray source arrays are orthogonal to each other, and each pair of source and detector arrays forms a tetrahedral volume. Four planer images can be obtained from different view angles at each gantry position at a frame rate as high as 20 frames per second. The overlapped regions provide a stereoscopic field of view of approximately 10-15 cm. With a half gantry rotation, a volumetric CT image can be reconstructed having a 45 cm field of view. Due to the scatter rejecting design of the TBCT geometry, the system can potentially produce high quality 2D and 3D images with less radiation exposure. The design of the dual source-dual detector system is described, and preliminary results of studies performed on numerical phantoms and simulated patient data are presented.

  9. SU-E-I-39: Molecular Image Guided Cancer Stem Cells Therapy

    Abdollahi, H

    2014-01-01

    Purpose: Cancer stem cells resistance to radiation is a problematic issue that has caused a big fail in cancer treatment. Methods: As a primary work, molecular imaging can indicate the main mechanisms of radiation resistance of cancer stem cells. By developing and commissioning new probes and nanomolecules and biomarkers, radiation scientist will able to identify the essential pathways of radiation resistance of cancer stem cells. As the second solution, molecular imaging is a best way to find biological target volume and delineate cancer stem cell tissues. In the other hand, by molecular imaging techniques one can image the treatment response in tumor and also in normal tissue. In this issue, the response of cancer stem cells to radiation during therapy course can be imaged, also the main mechanisms of radiation resistance and finding the best radiation modifiers (sensitizers) can be achieved by molecular imaging modalities. In adaptive radiotherapy the molecular imaging plays a vital role to have higher tumor control probability by delivering high radiation doses to cancer stem cells in any time of treatment. The outcome of a feasible treatment is dependent to high cancer stem cells response to radiation and removing all of which, so a good imaging modality can show this issue and preventing of tumor recurrence and metastasis. Results: Our results are dependent to use of molecular imaging as a new modality in the clinic. We propose molecular imaging as a new radiobiological technique to solve radiation therapy problems due to cancer stem cells. Conclusion: Molecular imaging guided cancer stem cell diagnosis and therapy is a new approach in the field of cancer treatment. This new radiobiological imaging technique should be developed in all clinics as a feasible tool that is more biological than physical imaging

  10. Advanced approaches to high intensity laser-driven ion acceleration

    Henig, Andreas

    2010-01-01

    Since the pioneering work that was carried out 10 years ago, the generation of highly energetic ion beams from laser-plasma interactions has been investigated in much detail in the regime of target normal sheath acceleration (TNSA). Creation of ion beams with small longitudinal and transverse emittance and energies extending up to tens of MeV fueled visions of compact, laser-driven ion sources for applications such as ion beam therapy of tumors or fast ignition inertial con finement fusion. However, new pathways are of crucial importance to push the current limits of laser-generated ion beams further towards parameters necessary for those applications. The presented PhD work was intended to develop and explore advanced approaches to high intensity laser-driven ion acceleration that reach beyond TNSA. In this spirit, ion acceleration from two novel target systems was investigated, namely mass-limited microspheres and nm-thin, free-standing diamond-like carbon (DLC) foils. Using such ultrathin foils, a new regime of ion acceleration was found where the laser transfers energy to all electrons located within the focal volume. While for TNSA the accelerating electric field is stationary and ion acceleration is spatially separated from laser absorption into electrons, now a localized longitudinal field enhancement is present that co-propagates with the ions as the accompanying laser pulse pushes the electrons forward. Unprecedented maximum ion energies were obtained, reaching beyond 0.5 GeV for carbon C 6+ and thus exceeding previous TNSA results by about one order of magnitude. When changing the laser polarization to circular, electron heating and expansion were shown to be efficiently suppressed, resulting for the first time in a phase-stable acceleration that is dominated by the laser radiation pressure which led to the observation of a peaked C 6+ spectrum. Compared to quasi-monoenergetic ion beam generation within the TNSA regime, a more than 40 times increase in

  11. Advanced approaches to high intensity laser-driven ion acceleration

    Henig, Andreas

    2010-04-26

    Since the pioneering work that was carried out 10 years ago, the generation of highly energetic ion beams from laser-plasma interactions has been investigated in much detail in the regime of target normal sheath acceleration (TNSA). Creation of ion beams with small longitudinal and transverse emittance and energies extending up to tens of MeV fueled visions of compact, laser-driven ion sources for applications such as ion beam therapy of tumors or fast ignition inertial con finement fusion. However, new pathways are of crucial importance to push the current limits of laser-generated ion beams further towards parameters necessary for those applications. The presented PhD work was intended to develop and explore advanced approaches to high intensity laser-driven ion acceleration that reach beyond TNSA. In this spirit, ion acceleration from two novel target systems was investigated, namely mass-limited microspheres and nm-thin, free-standing diamond-like carbon (DLC) foils. Using such ultrathin foils, a new regime of ion acceleration was found where the laser transfers energy to all electrons located within the focal volume. While for TNSA the accelerating electric field is stationary and ion acceleration is spatially separated from laser absorption into electrons, now a localized longitudinal field enhancement is present that co-propagates with the ions as the accompanying laser pulse pushes the electrons forward. Unprecedented maximum ion energies were obtained, reaching beyond 0.5 GeV for carbon C{sup 6+} and thus exceeding previous TNSA results by about one order of magnitude. When changing the laser polarization to circular, electron heating and expansion were shown to be efficiently suppressed, resulting for the first time in a phase-stable acceleration that is dominated by the laser radiation pressure which led to the observation of a peaked C{sup 6+} spectrum. Compared to quasi-monoenergetic ion beam generation within the TNSA regime, a more than 40 times

  12. The High Luminosity Challenge: potential and limitations of High Intensity High Brightness in the LHC and its injectors

    De Maria, R; Banfi, D; Barranco, J; Bartosik, H; Benedetto, E; Bruce, R; Brüning, O; Calaga, R; Cerutti, F; Damerau, H; Esposito, L; Fartoukh, S; Fitterer, M; Garoby, R; Gilardoni, S; Giovannozzi, M; Goddard, B; Gorini, B; Hanke, K; Iadarola, G; Lamont, M; Meddahi, M; Métral, E; Mikulec, B; Mounet, N; Papaphilippou, Y; Pieloni, T; Redaelli, S; Rossi, L; Rumolo, G; Shaposhnikova, E; Sterbini, G; Todesco, E; Tomás, R; Zimmermann, F; Valishev, A

    2014-01-01

    High-intensity and high-brightness beams are key ingredients to maximize the LHC integrated luminosity and to exploit its full potential. This contribution describes the optimization of beam and machine parameters to maximize the integrated luminosity as seen by the LHC experiments, by taking into account the expected intensity and brightness reach of LHC itself and its injector chain as well as the capabilities of the detectors for next run and foreseen upgrade scenarios.

  13. High-Intensity Femtosecond Laser Interaction with Rare Gas Clusters

    林亚风; 钟钦; 曾淳; 陈哲

    2001-01-01

    With a 45 fs multiterawatt 790 nm laser system and jets of argon and krypton atomic clusters, a study of the interaction of fs intense laser pulses with large size rare gas dusters was conducted. The maximum laser intensity of about 7 × 1016 W/cm2 and dusters composed of thousands of atoms which were determined through Rayleigh scattering measurements were involved inthe experiments. On the one hand, the results indicate that the interaction is strongly cluster size dependent. The stronger the interaction, the larger the clusters are. On the other hand, a saturation followed by a drop of the energy of ions ejected from the interaction will occur when the laser intensity exceeds a definite value for clusters of a certain size.

  14. High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension

    Mohr, Magni; Nordsborg, Nikolai Baastrup; Lindenskov, Annika

    2014-01-01

    To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n = 21; HIT), moderate-intensity (n = 21; MOD), and control groups (n = 20; CON). HIT perfor...

  15. Use of percutaneous image-guided coaxial core-needle biopsy for diagnosis of intraabdominal lymphoma

    Shimizu, Ikuo; Okazaki, Yoichi; Takeda, Wataru; Kirihara, Takehiko; Sato, Keijiro; Fujikawa, Yuko; Ueki, Toshimitsu; Hiroshima, Yuki; Sumi, Masahiko; Ueno, Mayumi; Ichikawa, Naoaki; Kobayashi, Hikaru

    2014-01-01

    Although pathological diagnosis is essential for managing malignant lymphoma, intraabdominal lesions are generally difficult to approach due to the invasiveness of abdominal surgery. Here, we report the use of percutaneous image-guided coaxial core-needle biopsy (CNB) to obtain intraabdominal specimens for diagnosing intraabdominal lymphomas, which typically requires histopathological and immunohistochemical evaluation. We retrospectively reviewed consecutive cases involving computed tomography (CT)- or ultrasonography (US)-guided CNB to obtain pathological specimens for intraabdominal lesions from 1999 to 2011. Liver, spleen, kidney, and inguinal node biopsies were excluded. We compared CNBs with laparotomic biopsies. A total of 66 CNBs were performed for 59 patients (32 males, 27 females; median age, 63.5), including second or third repeat procedures. Overall diagnostic rate was 88.5%. None of the patients required additional surgical biopsies. Notably, the median interval between recognition of an intraabdominal mass and biopsy was only 1 day. Forty-five procedures were performed for hematological malignancies. Adequate specimens were obtained for histopathological diagnosis in 86% of cases. Flow cytometry detected lymphoma cells in 79.5% of cases. Twelve patients (nine males, three females; median age, 60) were eligible for surgical biopsy. While every postoperative course was satisfactory, median duration from lesion recognition to therapy initiation for lymphoma cases was significantly shorter for CNB than for surgical biopsy (14 vs. 35 days). While one-fourth of the patients were not eligible for the procedures, CNB is safe and highly effective for diagnosis of intraabdominal lymphomas. This method significantly improves sampling and potentially helps attain immunohistological distinction, allowing for more timely therapy initiation

  16. Automatic block-matching registration to improve lung tumor localization during image-guided radiotherapy

    Robertson, Scott Patrick

    To improve relatively poor outcomes for locally-advanced lun