106 research outputs found
Image guided and adaptive radiotherapy for muscle invasive bladder cancer
No full text© 2014 Dr. Farshad ForoudiPublications included in thesis:Foroudi, F., Haworth, A., Pangehel, A., Wong, J., Roxby, P., Duchesne, G., et al. (2009). Inter-observer variability of clinical target volume delineation for bladder cancer using CT and cone beam CT. Journal of Medical Imaging & Radiation Oncology, 53, 100-106. DOI: 10.1111/j.1754-9485.2009.02044.xForoudi, F., Wong, J., Haworth, A., Baille, A., McAlpine, J., Rolfo, A., et al. (2009). Offline adaptive radiotherapy for bladder cancer using cone beam computed tomography. Journal of Medical Imaging & Radiation Oncology, 53, 226-233. 10.1111/j.1754-9485.2009.02066.xForoudi, F., Wong, J., Kron, T., Roxby, P., Haworth, A., Bailey, A., et al. (2010). Development and evaluation of a training program for therapeutic radiographers as a basis for online adaptive radiation therapy for bladder carcinoma. Radiography, 16(1), 14-20. DOI: 10.1016/j.radi.2009.09.002Foroudi, F., Wong, J., Kron, T., Rolfo, A., Haworth, A., Roxby, P., et al. (2011). Online adaptive radiotherapy for muscle invasive bladder cancer: results of a pilot study. International Journal of Radiation Oncology Biology Physics, 81(3), 765-771. DOI: 10.1016/j.ijrobp.2010.06.061Foroudi, F., Wilson, L., Bressel, M., Haworth, A., Hornby, C., Pham, D., et al. (2012). A dosimetric comparison of 3D conformal vs intensity modulated vs volumetric arc radiation therapy for muscle invasive bladder cancer. Radiation Oncology, 7:111. DOI: 10.1186/1748-717X-7-111Foroudi, F., Pham, D., Bressel, M., Wong, J., Rolfo, A., Roxby, P., et al. (2012). Bladder cancer radiotherapy margins: a comparison of daily alignment using skin or bone or soft tissue. Clinical Oncology, 24(10), 673-681. DOI: 10.1016/j.clon.2012.06.012Foroudi, F., Pham, D., Bressel, M., Tongs, D., Rolfo, A., Styles, C., et al. (2013). The utility of e-Learning to support training for a multi-centre bladder online adaptive radiotherapy trial (TROG 10.01 BOLART). Radiotherapy Oncology, 109(1), 165-169. DOI: 10.1016/j.radonc.2012.10.019Foroudi, F., Pham, D., Bressel, M., Gill, S., & Kron, T. (2012). Intra-fraction bladder motion in radiotherapy estimated from pretreatment and posttreatment volumetric imaging. International Journal of Radiation Oncology Biology Physics, 86(1), 77-82. DOI: 10.1016/j.ijrobp.2012.11.035Foroudi, F., Pham, D., Bressel, M., Hardcastle, N., Gill, S., & Kron, T. (2014). Comparison of margins, integral dose and interfraction target coverage with image guided radiotherapy (IGRT) compared to non-image guided radiotherapy for bladder cancer. Clinical Oncology, 26(8), 497-505. DOI: 10.1016/j.clon.2014.03.007Foroudi, F., Pham, D., Rolfo, A., Bresse,l M., Tang, C. I., Tan, A., et al. (2014).The outcome of a multicentre feasibility study of online adaptive radiotherapy for muscle invasive bladder cancer TROG 10.01 BOLART. Radiotherapy and Oncology, 111(2), 316-320. DOI: 10.1016/j.radonc.2014.02.015Introduction: Bladder cancer is one of the ten most frequent cancers in Australia. It is also the only common cancer for which survival has decreased over the last twenty years. The two curative treatment options for muscle invasive bladder cancer are radical surgery requiring removal of the bladder, or radical radiotherapy (alone or in combination with chemotherapy). Radical radiotherapy allows many patients to keep their natural bladder. As a dynamic soft tissue organ, the bladder size, shape and position vary with bladder and rectal filling, requiring traditional radiotherapy fields to have large margins around the target. With conventional radiation treatment such large margins increase the risk of normal tissue side effects and yet there still remains the risk of missing the bladder cancer on some treatment fractions.
Methods: I have developed an innovative technique with a new device, cone beam computed tomography to match radiation fields and volume on a daily basis to the bladder position and size. This technique reduced the margin of the radiation fields required around the bladder. I have led a number of training programs and their evaluation to teach radiation therapists to conduct such treatments. In addition to the development work, I have conducted a prospective pilot study in 27 participants, of this adaptive radiotherapy technique. Following further refinement I led the multi-centre clinical trial that established the technique as standard of care in a number of institutions.
Results: I found that cone beam computer tomography was of sufficient quality to be used to match radiation fields to the bladder on a daily basis. I determined that such daily matching prior to treatment was better than an ‘offline” process where an average radiation treatment plan was created after several radiation treatments. I found in our pilot study that adaptive radiation treatment decreased surrounding normal tissue irradiation. Separate studies showed that both workshop and e-Learning based radiation therapist training increased confidence and decreased variation from the gold standard (radiation oncologist results). I conducted a number of studies examining appropriate margins for bladder cancer radiation treatment with different imaging techniques. Through a multi-centre feasibility study of 54 participants, I introduced the image guided adaptive radiotherapy technique into a number of Australia centres, and demonstrated that, while technically possible, the margin around the bladder in this protocol was too small.
Conclusions: Image guided and adaptive radiotherapy is possible in many radiation therapy departments with likely benefits for patients in terms of cancer control and reduced normal tissue side effects. Through my work the technique has been established as standard of care in a number of Australian and New Zealand centres. However such radiotherapy techniques can continue to be optimised. Future phase III studies are required to conclusively prove their benefit
Enhancing Customer Engagement Through Artificial Intelligence Authenticity
No full textData Availability Statement:
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.Supporting Information is available online at: https://onlinelibrary.wiley.com/doi/10.1111/jpim.70008#support-information-section .Summary:
• Our study shows that designing authentic AI systems can significantly enhance customer engagement by building trust, raising performance expectations, and encouraging users to invest effort, especially in high-stakes sectors like healthcare.
For managers, this means going beyond efficiency to focus on relationship-building.
• Authentic AI should blend functional traits (accuracy, credibility) with emotional traits (realism, connectedness, social presence, and individuality) to align with evolving customer expectations.
Managers can achieve this by personalizing interactions based on customer history, enabling AI to recall previous conversations, and adapting tone to emotional cues to create a sense of continuity and care.
• Tailoring which authenticity components to emphasize (e.g., credibility in healthcare, social presence in retail) and ensuring regular audits, updates, and human oversight can improve engagement, build loyalty, and deliver stronger returns on AI investments.Given the limited research on the factors and mechanisms underlying artificial intelligence (AI) authenticity, we examine its use in fostering breakthrough knowledge and enhancing customer engagement. We devised a robust model grounded in mind perception and social exchange theories, with a focus on the outcomes of AI authenticity. Tested across 452 virtual health home stations, the findings reveal that both performance expectation and effort expectation serve as mediators between AI authenticity and customer engagement. This research provides managers with comprehensive insights into the defining attributes and operational mechanics of AI authenticity, thereby highlighting its critical importance in boosting customer engagement.The authors received no specific funding for this work
Sparing healthy tissue and increasing tumor dose using Bayesian modeling of geometric uncertainties for planning target volume personalization
No full text
Large institutional variations in use of androgen deprivation therapy with definitive radiotherapy in a population-based cohort of men with intermediate- and high-risk prostate cancer
No full textObjective: To evaluate the pattern of use of androgen deprivation therapy (ADT) with definitive radiotherapy (RT) in men with prostate cancer (PCa) in a population-based study in Australia. Patients and Methods: This is a prospective cohort of men with intermediate- and high-risk PCa, captured in the population-based Prostate Cancer Outcome Registry Victoria, who were treated with definitive prostate RT between January 2010 and December 2015. The primary outcome of interest was ADT utilization. Chi-squared test for trend was used to evaluate the temporal trend in the use of ADT over the study period. Multivariate logistic regressions were used to evaluate the effects of patient-, tumour- and treatment-related factors, and treatment institutions (public/ private and metropolitan/ regional) on the likelihood of ADT utilization. Results: A total of 1806 men were included in the study, 199 of whom (11%) had favourable National Comprehensive Cancer Network (NCCN) intermediate-risk disease (i.e. only one intermediate-risk feature, primary Gleason grade 3, and <50% biopsy core involved), 687 (38%) had unfavourable NCCN intermediate-risk disease, and 920 (51%) had high-risk disease. Of the 1806 men, 1155 (64%) received ADT with RT. Men with NCCN high-risk PCa (84%) were more likely to have ADT than men with favourable NCCN intermediate-risk (32%) and unfavourable NCCN intermediate-risk (46%) PCa (P < 0.001). Men treated in public institutions (66%, vs 47% in private institutions; P < 0.001) and regional centres (78%, vs 59% in metropolitan institutions; P < 0.001) were more likely to receive ADT. There was a trend towards an increase in ADT utilization from 50% in 2010 to 64% in 2015 (P < 0.001). In multivariate analyses (adjusting for age, tumour-related factors, year of treatment and use of brachytherapy boost), treatment institution (public and regional) remained independently associated with increased likelihood of ADT utilization. Men with intermediate-risk PCa treated in regional and public institutions were 2.7 times (95% confidence interval [CI] 1.9-3.9; P < 0.001) and 2.8 times (95% CI 1.4-5.3; P = 0.002), more likely to receive ADT with RT, respectively, while men with high-risk PCa treated in regional and public institutions were 3.1 times (95% CI 1.7-5.7; P < 0.001) and 3.0 times (95% CI 1.7-5.4; P < 0.001), more likely to receive ADT with RT, respectively. Conclusion: This is the largest Australasian contemporary series reporting on the pattern of use of ADT with definitive prostate RT. While there was an increasing trend towards use of ADT over time, ADT still appeared to be underutilized in certain groups of patients who may benefit from ADT, with approximately one in five men with high-risk and one in two with unfavourable intermediate-risk PCa not receiving ADT with RT. There was notable variation in the use of ADT between public vs private and metropolitan vs regional institutions.</p
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