International Journal of Cancer Therapy and Oncology
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Upright CBCT: A novel imaging technique
Get PDFPurpose: We present a method for acquiring and correcting upright images using the on board CBCT imager. An upright imaging technique would allow for the introduction of upright radiation therapy treatments, which would benefit a variety of patients including those with thoracic cancers whose lung volumes are increased in an upright position and those who experience substantial discomfort during supine treatment positions.Methods: To acquire upright CBCT images, the linac head was positioned at 0 degrees, the KV imager and detector arms extended to their lateral positions, and the couch placed at 270 degrees. The KV imager was programmed to begin taking continuous fluoroscopic projections as the couch rotated from 270 to 90 degrees. The FOV was extended by performing this procedure twice, once with the detector shifted 14.5 cm towards the gantry and once with it shifted 14.5 cm away from the gantry. The two resulting sets of images were stitched together prior to reconstruction. The imaging parameters were chosen to deliver the some dose as that delivered during a simulation CT. A simulation CT was deformably registered to an upright CBCT reconstruction in order to evaluate the possibility of correcting the HU values via mapping.Results: Both spatial linearity and high contrast resolution were maintained in upright CBCT when compared to a simulation CT. Low contrast resolution and HU linearity decreased. Streaking artifacts were caused by the limited 180 degree arc angle and a sharp point artifact in the center of the axial slices resulted at the site of the stitching. A method for correcting the HUs was shown to be robust against these artifacts.Conclusion: Upright CBCT could be of great benefit to many patients. This study demonstrates its feasibility and presents solutions to some of its first hurdles before clinical implementation.--------------------------Cite this article as:Fave X, Yang J, Balter P, Court L. Upright CBCT: A novel imaging technique. Int J Cancer Ther Oncol 2014; 2(2):020221. DOI: 10.14319/ijcto.0202.2
Treatment planning for the lung cancer
Get PDFThis article is a letter to editor, and it doesn't include an abstract. Full text of this article is available in HTML and PDF.Cite this article as: Gill S. Treatment planning for lung cancer. Int J Cancer Ther Oncol 2014; 2(1):020117.DOI: http://dx.doi.org/10.14319/ijcto.0201.17
Coexistent squamous cell carcinoma and tuberculosis in the cervix: a rare case report
Get PDFTuberculosis may coexist with malignancy. But coexistence of tuberculosis and cancer in cervix is extremely rare. We present a rare case of coexistent squamous cell carcinona and tuberculosis of uterine cervix in a 35 years old lady who presented with chief complaints of white discharge and bleeding per vagina since 1 year. Histopathological findings of carcinomatous nests along with epithelioid granuloma, langhans type of giant cells and positive acid fast bacilli in the tissue section give authenticity to our diagnosis. Tuberculosis complicating malignancy may occur in regions with high prevalence of this disease. Hence, proper diagnosis of tuberculosis in a patient with cancer assumes importance as it may add to the surveillance of the patient........................................................Cite this article as:Sharma M, Ahmed S, Sharma J, Kataki AC, Sarma A. Coexistent squamous cell carcinoma and tuberculosis in the cervix: a rare case report. Int J Cancer Ther Oncol 2014; 2(3):020314. DOI: 10.14319/ijcto.0203.1
Epworth Sleepiness Scale- a novel tool to assess somnolence syndrome in patients receiving radiotherapy to the brain
Get PDFPurpose: Radiation to brain causes early, early-delayed, and delayed side effects. There is paucity of literature regarding early-delayed effects like somnolence syndrome. Existing studies use general symptom assessment and visual analog scales. Epworth Sleepiness Scale (ESS) is a time tested tool to assess daytime sleepiness in various conditions. In this study, the ESS has been used to determine the occurrence of somnolence in patients receiving cranial radiotherapy for primary and metastatic brain tumors. Thus the ESS has been used in a novel setting in our study. The ESS is a simple to administer questionnaire and may be useful in grading the severity of somnolence. To our knowledge, this is the second study to determine post radiation somnolence using ESS. Methods: This prospective study was conducted in 23 patients with primary and metastatic brain tumor. Patient demographics and tumor type and grade was noted. Those with Karnofsky Performance Scale (KPS) less than 70 and with pre-existing sleep disorders were excluded. Radiotherapy regimen included palliative whole brain radiation for brain metastases and conformal adjuvant radiotherapy for primary brain tumors as per standard guidelines. All subjects included were administered ESS at baseline and weekly thereafter during and for 6 weeks after radiation. Results: All 23 patients (median age 50 years) completed the planned questionnaires until 6 weeks post radiation. Twenty (87%) patients had primary brain tumors whereas three (13%) patients had metastatic lesions in brain. Of the 23 patients, 14 patients (60.86%) had abnormal or increased daytime sleepiness; of which 3 had ESS scores greater than 16. Conclusion: Somnolence was noted in 60.86% of the patients, which is in accordance with existing literature. Epworth sleepiness scale is an effective tool to detect and quantify somnolence, However, it does not consider other symptoms of somnolence syndrome and hence should be combined with visual analog scale to get complete information
Monte Carlo study of secondary electron production from gold nanoparticle in proton beam irradiation
Get PDFPurpose: In this study, we examined some characteristics of secondary electrons produced by gold nanoparticle (NP) during proton beam irradiation.Method: By using the Geant4 Monte Carlo simulation toolkit, we simulated the NP at the range from radius (r) of 17.5 nm, 25 nm, 35 nm to r = 50 nm. The proton beam energies used were 20MeV, 50MeV, and 100MeV. Findings on secondary electron production and their average kinetic energy are presented in this paper. Results: Firstly, for NP with a finite size, the secondary electron production increase with decreasing incident proton beam energy and secondary buildup existed outside NP. Secondly, the average kinetic energy of secondary electrons produced by a gold NP increased with incident proton beam energy. Thirdly, the larger the NP size, the more the secondary electron production.Conclusion: Collectively, our results suggest that apart from biological uptake efficiency, we should take the secondary electron production effect into account when considering the potential use of NPs in proton beam irradiation.-----------------------------------------------Cite this article as: Gao J, Zheng Y. Monte Carlo study of secondary electron production from gold nanoparticle in proton beam irradiation. Int J Cancer Ther Oncol 2014; 2(2):02025.DOI: http://dx.doi.org/10.14319/ijcto.0202.
An evaluation of the stability of image quality parameters of Varian on-board imaging (OBI) and EPID imaging systems
Get PDFPurpose: Quality assurance of the image quality for image guided localization systems is crucial to ensure accurate visualization and localization of target volumes. In this study, the stability of selected image parameters was assessed and evaluated for CBCT mode, planar radiographic kV mode and the radiographic MV EPID mode.Methods and Materials: The CATPHAN, QckV-1 and QC-3 phantoms were used to evaluate the image quality parameters. The planar radiographic images were analyzed in PIPSpro™ with spatial resolution (f30, f40, f50) being recorded. For OBI CBCT, High quality head Full-Fan acquisition and Pelvis Half-Fan acquisition modes were evaluated for Uniformity, Noise, Spatial Resolution, HU constancy and geometric distortion. Dose and kVp for the OBI were recorded using the Unfors RaySafe Xi system with the R/F High Detector for planar kV and the CT detector for CBCT. Dose for the MV EPID was recorded using a PTW975 Semiflex Ion Chamber, webline electrometer and 1cm SolidWater™.Results: For each metric, values were normalized to the mean and the standard deviations were recorded. Table 1 shows the standard deviation for all results. Using this, tolerances can be reported as a warning threshold of 1σ and an action threshold of 2σ. Table 2 shows the warning and action tolerances for the planar radiographic modalities while Table 3 and 4 show tolerance levels for the Full-Fan and Half-Fan, respectively.Conclusion: A study was performed to assess the stability of the basic image quality parameters recommended by TG-142 for the Varian OBI and EPID Imaging systems. The two systems show consistent imaging and dosimetric properties over the evaluated time frame.----------------------------Cite this article as: Stanley DN, Papanikolaou N, Gutierrez AN. An evaluation of the stability of image quality parameters of Varian on-board imaging (OBI) and EPID imaging systems. Int J Cancer Ther Oncol 2014; 2(2):020236. DOI: 10.14319/ijcto.0202.3
Consistency analysis for the performance of planar detector systems used in advanced radiotherapy
Get PDFPurpose: To evaluate the performance linked to the consistency of a-Si EPID and ion-chamber array detectors for dose verification in advanced radiotherapy.Methods: Planar measurements were made for 250 patients using an array of ion chamber and a-Si EPID. For pre-treatment verification, the plans were generated on the phantom for re-calculation of doses. The γ-evaluation method with the criteria: dose-difference (DD) ≤ 3% and distance-to-agreement (DTA) ≤ 3 mm was used for the comparison of measurements. Also, the central axis (CAX) doses were measured using 0.125cc ion chamber and were compared with the central chamber of array and central pixel correlated dose value from EPID image. Two types of statistical approaches were applied for the analysis. Conventional statistics used analysis of variance (ANOVA) and unpaired t-test to evaluate the performance of the detectors. And statistical process control (SPC) was utilized to study the statistical variation for the measured data. Control charts (CC) based on an average , standard deviation ( ) and exponentially weighted moving averages (EWMA) were prepared. The capability index (Cpm) was determined as an indicator for the performance consistency of the two systems.Results: Array and EPID measurements had the average gamma pass rates as 99.9% ± 0.15% and 98.9% ± 1.06% respectively. For the point doses, the 0.125cc chamber results were within 2.1% ± 0.5% of the central chamber of the array. Similarly, CAX doses from EPID and chamber matched within 1.5% ± 0.3%. The control charts showed that both the detectors were performing optimally and all the data points were within ± 5%. EWMA charts revealed that both the detectors had a slow drift along the mean of the processes but was found well within ± 3%. Further, higher Cpm values for EPID demonstrate its higher efficiency for radiotherapy techniques.Conclusion: The performances of both the detectors were seen to be of high quality irrespective of the radiotherapy technique. Higher Cpm values for EPID indicate its higher efficiency than array
Nasal glioma with psammomatous calcification- An unusual presentation
Get PDFCongenital midline swellings of nose are encountered rarely, and nasal gliomas constitute about 5% of such lesions. Various theories have been suggested to explain the pathogenesis. Imaging preferably by MRI is mandated to study the extent and to rule out intracranial extension. Clinically, these masses are firm and incompressible. Histologically, they are made up of astrocytes and neuroglial cells, embedded in fibrous and vascular connective tissue. The mainstay of treatment is conservative surgical excision because nasal gliomas are slow-growing, rarely recurrent, and have no malignant potential. We present a case of congenital extranasal glioma with psammomatous calcification and without any intracranial extension in an eighteen month old boy.--------------------------------------------Cite this article as: Sherwani RK, Akhtar K, Ray PS, Ahmad SS. Nasal glioma with psammomatous calcification- An unusual presentation. Int J Cancer Ther Oncol 2014; 2(2):02027. DOI: 10.14319/ijcto.0202.
Radiobiological investigations at tumor cell lines by exploiting aspects of chronological dose administration
Get PDFPurpose: Using 31P-NMR spectroscopy the chronological behavior of the ATP-metabolism of the tumor spheroids C3H-MA, 9L-Gliome and the mono-layer L1210 has been analyzed via increase and decrease of the β-peak. The goal of this study is to elaborate an optimal fractionation scheme with regard to the irradiation of tumor spheroids and possibly to human tumors. Methods: The NMR-spectroscopy has been carried out by the FID technique (free induction decay), and the intensity of the β-peak provides a measure of the survival fraction S after radiation exposure with 30 kV X-rays. The linear-quadratic model has to be generalized in order to be valid for irradiation beyond the shoulder. Results and Conclusion: All three cell lines show characteristic periods, and a homeostatic control cannot be recognized. Essential components of these periods are circadian (i.e. one day), circa-semiseptan (i.e. 3.5 days) and circa-septan (i.e. one week). The determination of the survival fractions provides an optimum exploitation of radiation damages, when the ATP-concentration assumes a maximum value. This optimum is reached, when all three cycles exhibit an ATP maximum, which is only possible by accounting for the circa-septan rhythm.--------------------------------------Cite this article as: Ulmer W. Radiobiological investigations at tumor cell lines by exploiting aspects of chronological dose administration. Int J Cancer Ther Oncol 2014; 2(3):020312. DOI:10.14319/ijcto.0203.12
Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis: Case report
Get PDFWe describe the case of a 65 year-old male presenting with a tender right testicular mass, confirmed to be a tumour on ultrasound. The patient underwent a radical inguinal orchidectomy and histology revealed multiple adenomatoid tumours in epididymis and tunica vaginalis. This is an infrequent benign tumour of mesothelial origin that has rarely been reported as multiple lesions in the literature. Immunohistochemistry demonstrates that adenomatoid tumour and mesotheliomas share the expression of podoplanin (D2-40) which is helpful to differentiate them from carcinomas. On the other hand adenomatoid tumour is differentiated from mesothelioma on morphological grounds since the former does not exhibit cellular atypia, mitotic activity or bland focal tumour necrosis. Although testis preserving surgery can be an option for benign adenomatoid tumours, most patients (as in our case) proceed to orchidectomy as diagnosing them confidently can be difficult.---------------------------Cite this article as: Abroaf A, Veeratterapillay R, Vasdev N, Majo J, Sherif AE, Paez E. Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis : Case Report. Int J Cancer Ther Oncol 2014; 2(1):02021.DOI: http://dx.doi.org/10.14319/ijcto.0202.