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Schlaak RA, SenthilKumar G, Boerma M, Bergom C. Advances in Preclinical Research Models of Radiation-Induced Cardiac Toxicity. Cancers (Basel) 2020; 12:E415. [PMID: 32053873 PMCID: PMC7072196 DOI: 10.3390/cancers12020415] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/08/2020] [Accepted: 02/08/2020] [Indexed: 12/12/2022] Open
Abstract
Radiation therapy (RT) is an important component of cancer therapy, with >50% of cancer patients receiving RT. As the number of cancer survivors increases, the short- and long-term side effects of cancer therapy are of growing concern. Side effects of RT for thoracic tumors, notably cardiac and pulmonary toxicities, can cause morbidity and mortality in long-term cancer survivors. An understanding of the biological pathways and mechanisms involved in normal tissue toxicity from RT will improve future cancer treatments by reducing the risk of long-term side effects. Many of these mechanistic studies are performed in animal models of radiation exposure. In this area of research, the use of small animal image-guided RT with treatment planning systems that allow more accurate dose determination has the potential to revolutionize knowledge of clinically relevant tumor and normal tissue radiobiology. However, there are still a number of challenges to overcome to optimize such radiation delivery, including dose verification and calibration, determination of doses received by adjacent normal tissues that can affect outcomes, and motion management and identifying variation in doses due to animal heterogeneity. In addition, recent studies have begun to determine how animal strain and sex affect normal tissue radiation injuries. This review article discusses the known and potential benefits and caveats of newer technologies and methods used for small animal radiation delivery, as well as how the choice of animal models, including variables such as species, strain, and age, can alter the severity of cardiac radiation toxicities and impact their clinical relevance.
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Affiliation(s)
- Rachel A. Schlaak
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Gopika SenthilKumar
- Medical Scientist Training Program, Medical College of Wisconsin; Milwaukee, WI 53226, USA;
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Marjan Boerma
- Division of Radiation Health, Department of Pharmaceutical Sciences, The University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Carmen Bergom
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Esplen N, Therriault-Proulx F, Beaulieu L, Bazalova-Carter M. Preclinical dose verification using a 3D printed mouse phantom for radiobiology experiments. Med Phys 2019; 46:5294-5303. [PMID: 31461781 DOI: 10.1002/mp.13790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/16/2019] [Accepted: 08/16/2019] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Dose verification in preclinical radiotherapy is often challenged by a lack of standardization in the techniques and technologies commonly employed along with the inherent difficulty of dosimetry associated with small-field kilovoltage sources. As a consequence, the accuracy of dosimetry in radiobiological research has been called into question. Fortunately, the development and characterization of realistic small-animal phantoms has emerged as an effective and accessible means of improving dosimetric accuracy and precision in this context. The application of three-dimensional (3D) printing, in particular, has enabled substantial improvements in the conformity of representative phantoms with respect to the small animals they are modeled after. In this study, our goal was to evaluate a fully 3D printed mouse phantom for use in preclinical treatment verification of sophisticated therapies for various anatomical targets of therapeutic interest. METHODS An anatomically realistic mouse phantom was 3D printed based on segmented microCT data of a tumor-bearing mouse. The phantom was modified to accommodate both laser-cut EBT3 radiochromic film within the mouse thorax and a plastic scintillator dosimeter (PSD), which may be placed within the brain, abdomen, or 1-cm flank subcutaneous tumor. Various treatments were delivered on an image-guided small-animal irradiator in order to determine the doses to isocenter using a PSD and validate lateral- and depth-dose distributions using film dosimeters. On-board cone-beam CT imaging was used to localize isocenter to the film plane or PSD active element prior to irradiation. The PSD irradiations comprised a 3 × 3 mm2 brain arc, 5 × 5 mm2 parallel-opposed pair (POP), and 5-beam 10 × 10 mm2 abdominal coplanar arrangement while two-dimensional (2D) film dose distributions were acquired using a 3 × 3 mm2 arc and both 5 × 5 and 10 × 10 mm2 3-beam coplanar plans. A validated Monte Carlo (MC) model of the source was used as to verify the accuracy of the film and PSD dose measurements. computer-aided design (CAD) geometries for the mouse phantom and dosimeters were imported directly into the MC code to allow for highly accurate reproduction of the physical experiment conditions. Experimental and MC-derived film data were co-registered and film dose profiles were compared for points above 90% of the dose maximum. Point dose measurements obtained with the PSD were similarly compared for each of the candidate (brain, abdomen, and tumor) treatment sites. RESULTS For each treatment configuration and anatomical target, the MC-calculated and measured doses met the proposed 5% agreement goal for dose accuracy in radiobiology experiments. The 2D film and MC dose distributions were successfully registered and mean doses for lateral profiles were found to agree to within 2.3% in all cases. Isocentric point-dose measurements taken with the PSD were similarly consistent, with a maximum percentage deviation of 3.2%. CONCLUSIONS Our study confirms the utility of 3D printed phantom design in providing accurate dose estimates for a variety of preclinical treatment paradigms. As a tool for pretreatment dose verification, the phantom may be of particular interest to researchers for its ability to facilitate precise dosimetry while fostering a reduction in cost for radiobiology experiments.
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Affiliation(s)
- Nolan Esplen
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, V8P 5C2, Canada
| | - François Therriault-Proulx
- Departement de Radio-Oncologie and Centre de recherche du CHU de Quebec, CHU de Quebec, Quebec, QC, G1R 3S1, Canada
| | - Luc Beaulieu
- Departement de Radio-Oncologie and Centre de recherche du CHU de Quebec, CHU de Quebec, Quebec, QC, G1R 3S1, Canada.,Departement de physique and Centre de recherche sur le Cancer, Université Laval, Quebec, QC, G1V 0A6, Canada
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Esplen N, Alyaqoub E, Bazalova-Carter M. Technical Note: Manufacturing of a realistic mouse phantom for dosimetry of radiobiology experiments. Med Phys 2018; 46:1030-1036. [PMID: 30488962 DOI: 10.1002/mp.13310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The goal of this work was to design a realistic mouse phantom as a useful tool for accurate dosimetry in radiobiology experiments. METHODS A subcutaneous tumor-bearing mouse was scanned in a microCT scanner, its organs manually segmented and contoured. The resulting geometries were converted into a stereolithographic file format (STL) and sent to a multimaterial 3D printer. The phantom was split into two parts to allow for lung excavation and 3D-printed with an acrylic-like material and consisted of the main body (mass density ρ=1.18 g/cm3 ) and bone (ρ=1.20 g/cm3 ). The excavated lungs were filled with polystyrene (ρ=0.32 g/cm3 ). Three cavities were excavated to allow the placement of a 1-mm diameter plastic scintillator dosimeter (PSD) in the brain, the center of the body and a subcutaneous tumor. Additionally, a laser-cut Gafchromic film can be placed in between the two phantom parts for 2D dosimetric evaluation. The expected differences in dose deposition between mouse tissues and the mouse phantom for a 220-kVp beam delivered by the small animal radiation research platform (SARRP) were calculated by Monte Carlo (MC). RESULTS MicroCT scans of the phantom showed excellent material uniformity and confirmed the material densities given by the manufacturer. MC dose calculations revealed that the dose measured by tissue-equivalent dosimeters inserted into the phantom in the brain, abdomen, and subcutaneous tumor would be underestimated by 3-5%, which is deemed to be an acceptable error assuming the proposed 5% accuracy of radiobiological experiments. CONCLUSIONS The low-cost mouse phantom can be easily manufactured and, after a careful dosimetric characterization, may serve as a useful tool for dose verification in a range of radiobiology experiments.
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Affiliation(s)
- Nolan Esplen
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
| | - Eisa Alyaqoub
- Department of Electrical Engineering, University of Victoria, Victoria, BC, Canada
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Anvari A, Poirier Y, Sawant A. Kilovoltage transit and exit dosimetry for a small animal image-guided radiotherapy system using built-in EPID. Med Phys 2018; 45:4642-4651. [DOI: 10.1002/mp.13134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/08/2018] [Accepted: 08/08/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Akbar Anvari
- Department of Radiation Oncology; University of Maryland School of Medicine; Baltimore MD 21201 USA
| | - Yannick Poirier
- Department of Radiation Oncology; University of Maryland School of Medicine; Baltimore MD 21201 USA
| | - Amit Sawant
- Department of Radiation Oncology; University of Maryland School of Medicine; Baltimore MD 21201 USA
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Cho N, Tsiamas P, Velarde E, Tryggestad E, Jacques R, Berbeco R, McNutt T, Kazanzides P, Wong J. Validation of GPU-accelerated superposition-convolution dose computations for the Small Animal Radiation Research Platform. Med Phys 2018. [DOI: 10.1002/mp.12862] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Nathan Cho
- Department of Computer Science; Johns Hopkins University; Baltimore MD 21218 USA
| | - Panagiotis Tsiamas
- Department of Radiation Oncology; Brigham and Women's Hospital; Dana-Farber Cancer Institute and Harvard Medical School; Boston MA 02215 USA
| | - Esteban Velarde
- Department of Radiation Oncology and Molecular Radiation Sciences; Johns Hopkins University; Baltimore MD 21287 USA
| | - Erik Tryggestad
- Department of Radiation Oncology and Molecular Radiation Sciences; Johns Hopkins University; Baltimore MD 21287 USA
| | - Robert Jacques
- Department of Computer Science; Johns Hopkins University; Baltimore MD 21218 USA
| | - Ross Berbeco
- Department of Radiation Oncology; Brigham and Women's Hospital; Dana-Farber Cancer Institute and Harvard Medical School; Boston MA 02215 USA
| | - Todd McNutt
- Department of Radiation Oncology and Molecular Radiation Sciences; Johns Hopkins University; Baltimore MD 21287 USA
| | - Peter Kazanzides
- Department of Computer Science; Johns Hopkins University; Baltimore MD 21218 USA
| | - John Wong
- Department of Radiation Oncology and Molecular Radiation Sciences; Johns Hopkins University; Baltimore MD 21287 USA
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Ghita M, McMahon SJ, Thompson HF, McGarry CK, King R, Osman SOS, Kane JL, Tulk A, Schettino G, Butterworth KT, Hounsell AR, Prise KM. Small field dosimetry for the small animal radiotherapy research platform (SARRP). Radiat Oncol 2017; 12:204. [PMID: 29282134 PMCID: PMC5745702 DOI: 10.1186/s13014-017-0936-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 12/02/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Preclinical radiation biology has become increasingly sophisticated due to the implementation of advanced small animal image guided radiation platforms into laboratory investigation. These small animal radiotherapy devices enable state-of-the-art image guided therapy (IGRT) research to be performed by combining high-resolution cone beam computed tomography (CBCT) imaging with an isocentric irradiation system. Such platforms are capable of replicating modern clinical systems similar to those that integrate a linear accelerator with on-board CBCT image guidance. METHODS In this study, we present a dosimetric evaluation of the small animal radiotherapy research platform (SARRP, Xstrahl Inc.) focusing on small field dosimetry. Physical dosimetry was assessed using ion chamber for calibration and radiochromic film, investigating the impact of beam focus size on the dose rate output as well as beam characteristics (beam shape and penumbra). Two film analysis tools) have been used to assess the dose output using the 0.5 mm diameter aperture. RESULTS Good agreement (between 1.7-3%) was found between the measured physical doses and the data provided by Xstrahl for all apertures used. Furthermore, all small field dosimetry data are in good agreement for both film reading methods and with our Monte Carlo simulations for both focal spot sizes. Furthermore, the small focal spot has been shown to produce a more homogenous beam with more stable penumbra over time. CONCLUSIONS FilmQA Pro is a suitable tool for small field dosimetry, with a sufficiently small sampling area (0.1 mm) to ensure an accurate measurement. The electron beam focus should be chosen with care as this can potentially impact on beam stability and reproducibility.
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Affiliation(s)
- Mihaela Ghita
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
| | - Stephen J McMahon
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
| | - Hannah F Thompson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
| | - Conor K McGarry
- Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, BT9 7AB, UK
| | - Raymond King
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.,Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, BT9 7AB, UK
| | - Sarah O S Osman
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.,Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, BT9 7AB, UK
| | - Jonathan L Kane
- Xstrahl Inc, 480 Brogdon Road, Suite 300, Suwanee, GA, 30024, USA
| | - Amanda Tulk
- Xstrahl Ltd, The Coliseum, Watchmoor Park, Riverside Way, Camberley, Surrey, GU15 3YL, UK
| | - Giuseppe Schettino
- National Physical Laboratory, Hampton Road, Teddington, Middlesex, TW11 0LW, UK
| | - Karl T Butterworth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
| | - Alan R Hounsell
- Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, BT9 7AB, UK
| | - Kevin M Prise
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
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Ford E, Deye J. Current Instrumentation and Technologies in Modern Radiobiology Research—Opportunities and Challenges. Semin Radiat Oncol 2016; 26:349-55. [DOI: 10.1016/j.semradonc.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Jermoumi M, Korideck H, Bhagwat M, Zygmanski P, Makrigiogos GM, Berbeco RI, Cormack RC, Ngwa W. Comprehensive quality assurance phantom for the small animal radiation research platform (SARRP). Phys Med 2015; 31:529-35. [PMID: 25964129 DOI: 10.1016/j.ejmp.2015.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/11/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the Small Animal Radiation Research Platform (SARRP). METHODS AND MATERIALS A QA phantom was developed for carrying out daily, monthly and annual QA tasks including: imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of 15 (60 × 60 × 5 mm(3)) kV-energy tissue equivalent solid water slabs. The phantom can incorporate optically stimulated luminescence dosimeters (OSLD), Mosfet or film. One slab, with inserts and another slab with hole patterns are particularly designed for image QA. RESULTS Output constancy measurement results showed daily variations within 3%. Using the Mosfet in phantom as target, results showed that the difference between TPS calculations and measurements was within 5%. Annual QA results for the Percentage depth dose (PDD) curves, lateral beam profiles, beam flatness and beam profile symmetry were found consistent with results obtained at commissioning. PDD curves obtained using film and OSLDs showed good agreement. Image QA was performed monthly, with image-quality parameters assessed in terms of CBCT image geometric accuracy, CT number accuracy, image spatial resolution, noise and image uniformity. CONCLUSIONS The results show that the developed QA phantom can be employed as a tool for comprehensive performance evaluation of the SARRP. The study provides a useful reference for development of a comprehensive quality assurance program for the SARRP and other similar small animal irradiators, with proposed tolerances and frequency of required tests.
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Affiliation(s)
- M Jermoumi
- Department of Applied Physics, Medical Physics Program, University of Massachusetts at Lowell, MA, USA; Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
| | - H Korideck
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - M Bhagwat
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - P Zygmanski
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - G M Makrigiogos
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - R I Berbeco
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - R C Cormack
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - W Ngwa
- Department of Applied Physics, Medical Physics Program, University of Massachusetts at Lowell, MA, USA; Department of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
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Bazalova M, Nelson G, Noll JM, Graves EE. Modality comparison for small animal radiotherapy: a simulation study. Med Phys 2014; 41:011710. [PMID: 24387502 DOI: 10.1118/1.4842415] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Small animal radiation therapy has advanced significantly in recent years. Whereas in the past dose was delivered using a single beam and a lead shield for sparing of healthy tissue, conformal doses can be now delivered using more complex dedicated small animal radiotherapy systems with image guidance. The goal of this paper is to investigate dose distributions for three small animal radiation treatment modalities. METHODS This paper presents a comparison of dose distributions generated by the three approaches-a single-field irradiator with a 200 kV beam and no image guidance, a small animal image-guided conformal system based on a modified microCT scanner with a 120 kV beam developed at Stanford University, and a dedicated conformal system, SARRP, using a 220 kV beam developed at Johns Hopkins University. The authors present a comparison of treatment plans for the three modalities using two cases: a mouse with a subcutaneous tumor and a mouse with a spontaneous lung tumor. A 5 Gy target dose was calculated using the EGSnrc Monte Carlo codes. RESULTS All treatment modalities generated similar dose distributions for the subcutaneous tumor case, with the highest mean dose to the ipsilateral lung and bones in the single-field plan (0.4 and 0.4 Gy) compared to the microCT (0.1 and 0.2 Gy) and SARRP (0.1 and 0.3 Gy) plans. The lung case demonstrated that due to the nine-beam arrangements in the conformal plans, the mean doses to the ipsilateral lung, spinal cord, and bones were significantly lower in the microCT plan (2.0, 0.4, and 1.9 Gy) and the SARRP plan (1.5, 0.5, and 1.8 Gy) than in single-field irradiator plan (4.5, 3.8, and 3.3 Gy). Similarly, the mean doses to the contralateral lung and the heart were lowest in the microCT plan (1.5 and 2.0 Gy), followed by the SARRP plan (1.7 and 2.2 Gy), and they were highest in the single-field plan (2.5 and 2.4 Gy). For both cases, dose uniformity was greatest in the single-field irradiator plan followed by the SARRP plan due to the sensitivity of the lower energy microCT beam to target heterogeneities and image noise. CONCLUSIONS The two treatment planning examples demonstrate that modern small animal radiotherapy techniques employing image guidance, variable collimation, and multiple beam angles deliver superior dose distributions to small animal tumors as compared to conventional treatments using a single-field irradiator. For deep-seated mouse tumors, however, higher-energy conformal radiotherapy could result in higher doses to critical organs compared to lower-energy conformal radiotherapy. Treatment planning optimization for small animal radiotherapy should therefore be developed to take full advantage of the novel conformal systems.
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Affiliation(s)
- Magdalena Bazalova
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
| | - Geoff Nelson
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
| | - John M Noll
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
| | - Edward E Graves
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California 94305
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