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Poitier B, Dahdah P, Bernardini M, Coroyer L, Nouar M, Akar RA, Bel A, Smadja DM, Du Puy-Montbrun L, Achouh P. Incidence and impact of hypoattenuated leaflet thickening following aortic valve replacement using a glycerol-preserved bioprosthesis. JTCVS Open 2024; 18:9-11. [PMID: 38690433 PMCID: PMC11056483 DOI: 10.1016/j.xjon.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 05/02/2024]
Affiliation(s)
- Bastien Poitier
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Pierre Dahdah
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Margaux Bernardini
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Lucas Coroyer
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Mohamed Nouar
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Ramzi Abi Akar
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Alain Bel
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - David M. Smadja
- Hematology Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | | | - Paul Achouh
- Cardiac Surgery Department, AP-HP, Georges Pompidou European Hospital, Paris, France
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Fortin W, Gautier CH, Escande R, Bel A, Sutter W, El Batti S, Julia P, Achouh P, Alsac JM. Thoracic Endovascular Repair after Total Aortic Arch Replacement with Frozen Elephant Trunk for Type a Aortic Dissection. Ann Vasc Surg 2024; 99:290-297. [PMID: 37858671 DOI: 10.1016/j.avsg.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/12/2023] [Accepted: 08/17/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The management of residual aortic dissection after initial type A repair with the Frozen elephant trunk technique remains mostly unexplored. This work aimed to evaluate endovascular second-stage surgery for patients with residual aortic dissection. METHODS A retrospective analysis of consecutive patients that underwent Type A aortic repair with Frozen elephant trunk, followed by a second-stage endovascular procedure was done from March 2016 to December 2021. The primary outcome was aortic-related adverse events or mortality, and secondary outcomes were aortic remodeling and perioperative complications. Remodeling was assessed by comparing the difference in ratios for true lumen/total aortic diameters on pre-operative and follow-up scans. RESULTS Thirty-four patients underwent second-stage surgery after Type A repair during the study period (7 thoracic endovascular aortic repair extensions, 1 STABLE/PETTICOAT, and 26 STABILISE). Median follow-up was 23 months (range 2-66 months). There were no perioperative deaths or major complications and 1 reoperation for left subclavian re-embolization. At the last follow-up, there was no aortic-related mortality. There were 5 aortic-related adverse events, including another subclavian re-embolization and a preplanned open conversion. Risk factors were connective tissue disorders (P = 0.01) and aortic aneurysms >55 mm (P = 0.03). Distal remodeling reached statistical significance in all segments (P < 0.01) and was greater for patients treated with the STABILISE technique when compared to extended thoracic endovascular aortic repair (P = 0.01). CONCLUSIONS Second-stage endovascular management of residual aortic dissection after initial Frozen elephant trunk repair showed excellent perioperative and good midterm outcomes and induced significant remodeling of the entire aorta in most cases, particularly with the STABILISE procedure.
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Affiliation(s)
- William Fortin
- Department of Vascular Surgery, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada; Department of Medicine, University of Montreal, Montreal, Canada.
| | - Charles-Henri Gautier
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
| | - Remi Escande
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
| | - Alain Bel
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
| | - Willy Sutter
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
| | - Salma El Batti
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
| | - Pierre Julia
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
| | - Paul Achouh
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
| | - Jean-Marc Alsac
- Department of Cardiac and Vascular Surgery, Assistance Publique - Hôpitaux de Paris, Centre-Université Paris Cité, Hôpital Européen Georges-Pompidou, Paris, France; Department of Medicine, Université de Paris, Paris, France
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Barten DLJ, van Kesteren Z, Laan JJ, Dassen MG, Westerveld GH, Pieters BR, de Jonge CS, Stoker J, Bel A. Precision assessment of bowel motion quantification using 3D cine-MRI for radiotherapy. Phys Med Biol 2024; 69:04NT01. [PMID: 38232395 DOI: 10.1088/1361-6560/ad1f89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/17/2024] [Indexed: 01/19/2024]
Abstract
Objective. The bowel is an important organ at risk for toxicity during pelvic and abdominal radiotherapy. Identifying regions of high and low bowel motion with MRI during radiotherapy may help to understand the development of bowel toxicity, but the acquisition time of MRI is rather long. The aim of this study is to retrospectively evaluate the precision of bowel motion quantification and to estimate the minimum MRI acquisition time.Approach. We included 22 gynaecologic cancer patients receiving definitive radiotherapy with curative intent. The 10 min pre-treatment 3D cine-MRI scan consisted of 160 dynamics with an acquisition time of 3.7 s per volume. Deformable registration of consecutive images generated 159 deformation vector fields (DVFs). We defined two motion metrics, the 50th percentile vector lengths (VL50) of the complete set of DVFs was used to measure median bowel motion. The 95th percentile vector lengths (VL95) was used to quantify high motion of the bowel. The precision of these metrics was assessed by calculating their variation (interquartile range) in three different time frames, defined as subsets of 40, 80, and 120 consecutive images, corresponding to acquisition times of 2.5, 5.0, and 7.5 min, respectively.Main results. For the full 10 min scan, the minimum motion per frame of 50% of the bowel volume (M50%) ranged from 0.6-3.5 mm for the VL50 motion metric and 2.3-9.0 mm for the VL95 motion metric, across all patients. At 7.5 min scan time, the variation in M50% was less than 0.5 mm in 100% (VL50) and 95% (VL95) of the subsets. A scan time of 5.0 and 2.5 min achieved a variation within 0.5 mm in 95.2%/81% and 85.7%/57.1% of the subsets, respectively.Significance. Our 3D cine-MRI technique quantifies bowel loop motion with 95%-100% confidence with a precision of 0.5 mm variation or less, using a 7.5 min scan time.
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Affiliation(s)
- D L J Barten
- Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZAmsterdam, The Netherlands
| | - Z van Kesteren
- Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZAmsterdam, The Netherlands
| | - J J Laan
- Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZAmsterdam, The Netherlands
| | - M G Dassen
- Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZAmsterdam, The Netherlands
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - G H Westerveld
- Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZAmsterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus University Medical Center, Department of Radiation Oncology, Rotterdam, The Netherlands
| | - B R Pieters
- Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZAmsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - C S de Jonge
- Amsterdam UMC location University of Amsterdam, Department of Radiology and Nuclear Medicine, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - J Stoker
- Amsterdam UMC location University of Amsterdam, Department of Radiology and Nuclear Medicine, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - A Bel
- Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZAmsterdam, The Netherlands
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Veldman JK, van Duren KML, Parkes M, Stevens MF, van Schuppen J, van Kesteren Z, van den Aardweg JG, van Tienhoven G, Bel A, van Dijk IW. Rapid Mechanical Ventilation Superior to Rapid Jet Ventilation for Diaphragm Motion Reduction in Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e731. [PMID: 37786127 DOI: 10.1016/j.ijrobp.2023.06.2251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To account for respiratory motion in radiotherapy either large target volumes are defined, or patients are instructed to breath-hold repeatedly. Alternatively, non-invasive ventilation induced regularized breathing at high frequencies may reduce motion, minimizing irradiated volumes. We quantified the motion of the right hemidiaphragm during rapid non-invasive mechanical ventilation (NI-MV) and rapid non-invasive jet ventilation (JET) to compare the effectiveness on respiratory motion. MATERIALS/METHODS After ethics committee approval and written informed consent, 15 healthy volunteers enrolled in this study. During a first session, they were trained being ventilated with NI-MV and JET to regularize their breathing. The ventilation frequencies under investigation included 60 breaths per minute (brpm) NI-MV (60NI-MV), and 60, 150, 250 and 400 brpm JET (60JET, 150JET, 250JET and 400JET, respectively). In a second session, ultrasound movies of 40 sec (temporal resolution 23 Hz) were acquired in the sagittal plane twice for each ventilation frequency. We quantified the magnitude of ventilation-induced rhythmic motion as the mean distance between each subsequent end-inspiration and end-expiration position of the diaphragm. Also, we determined the overall maximum motion of the diaphragm over the 40 sec measurement. We tested for statistically significant differences between median rhythmic motion and overall maximum motion during all frequencies (paired Wilcoxon's tests (n = 10); corrected p-value for multiple testing (p = 0.05/N)). RESULTS All volunteers were successfully trained. There were no significant differences between repeated measurements of each ventilation frequency; hence we pooled the data. We found that 60NI-MV resulted in significantly smaller rhythmic motion compared to 60JET (median 5.0 mm and 8.9 mm respectively; p<0.001). Higher ventilation frequencies with JET decreased the median rhythmic motion magnitude (2.3 mm, 1.0 mm and 0.5 mm at 150JET, 250JET and 400JET respectively; p<0.001). However, during these higher frequencies the smaller rhythmic motion magnitudes did not result in smaller overall maximum motion compared to 60NI-MV. The median overall motion was 17.2 mm, 15.8 mm and 13.4 mm for 150JET, 250JET and 400JET respectively (p<0.005 only between 60JET and 400JET). The overall maximum motion during 60NI-MV was significantly smaller compared to 60JET (12.3 mm and 24.1 mm respectively; p<0.001). The US movies clearly showed that volunteers superimposed spontaneous breathing on top of JET. Finally, volunteers indicated NI-MV to be more comfortable than JET. CONCLUSION Mechanical ventilation at 60 brpm maximally reduced the overall motion of the right hemidiaphragm and was more comfortable than jet ventilation. Therefore, mechanical ventilation appears to be superior to control respiratory motion for radiotherapy.
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Affiliation(s)
- J K Veldman
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - K M L van Duren
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - M Parkes
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - M F Stevens
- Department of Anaesthesiology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - J van Schuppen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - Z van Kesteren
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - J G van den Aardweg
- Department of Pulmonology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - G van Tienhoven
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - I W van Dijk
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
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5
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Bel A, Azzarouali S, Goudschaal K, den Boer D, Daniels L, Visser J, Hulshof M. Clinical Feasibility of Daily Online Adaptive Bladder Cancer Radiotherapy with Cone Beam CT, Using Fiducial Makers. Int J Radiat Oncol Biol Phys 2023; 117:e643. [PMID: 37785915 DOI: 10.1016/j.ijrobp.2023.06.2055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiotherapy (RT) for muscle invasive bladder cancer is challenging due to varying bladder filling. We assessed the efficacy and feasibility of online adaptive RT (oART), applying a focal boost to the tumor, in terms of dose and workflow. MATERIALS/METHODS Bladder cancer patients (N = 15) were treated with oART on a ring-shaped Linac. This system integrates imaging (CBCT) with AI-based organ and tumor segmentation, adaptive treatment planning and delivery. Before treatment the GTV was demarcated with liquid markers. On the planning CT organs-at-risk and the GTV were contoured. The reference treatment plan was optimized with total dose for PTV (elective bladder, lymph nodes) 40Gy/20 fractions and an integrated focal boost to the GTV (15Gy). Margins were 3mm (GTV-CTV) and 5mm (CTV-PTV). Before each daily treatment, a CBCT was acquired. Bladder, rectum and GTV were determined by the AI. Planning CT and CBCT were registered to generate other organs at risk. Subsequently, the dose of the reference plan was calculated for this anatomy (scheduled plan). An adaptive plan was generated by reoptimization. Subsequently, a second pretreatment CBCT (CBCT2) was made to verify and correct the position, when necessary. Target coverage for PTV and GTV (V95%) and dose outside the target were evaluated on CBCT2. Radiation therapists (RTTs) executed the oART workflow with medical physicists (MPs) and radiation oncologists (ROs) on call. The time (median [range]) and personnel involvement were monitored. RESULTS For all adaptive plans V95%>98% for CTV and GTV (boost) volumes. For scheduled plans this was 53.5% (CTV boost) and 98.5% (bladder+lymph nodes). For adaptive vs scheduled plans, the volume of dose (40Gy) to tissue outside the PTV reduced with 150cm3(p<0. 01). Median session time (patient entering-leaving) was 32 [25-45] min for the first 5 patients and reduced to 27 [20-61] min for subsequent patients. About 30% of this time was reoptimization. AI-generated GTVs were corrected in 75% for the first 5 patients and 40% for subsequent patients (taking 5min). Fiducial markers were clearly visible on CBCTs supporting GTV localization. ROs and MPs were consulted during each first fraction (5% of total) and 12% of the remaining fractions. CONCLUSION The adaptive procedure is well feasible in clinical practice with an RTT-only workflow. The procedure takes longer than conventional RT, with reoptimization as a main factor. Dosimetric result are clearly favorable compared to delivery of non-adaptive plans.
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Affiliation(s)
- A Bel
- Department of Radiation Oncology, Amsterdam UMC - location University of Amsterdam, Amsterdam, The Netherlands
| | - S Azzarouali
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - K Goudschaal
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - D den Boer
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - L Daniels
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - J Visser
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - M Hulshof
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Corniquet M, Khalifé M, Lellouch AG, Bel A, Bellenfant F, Julia P, Alsac JM, El Batti S, Ben Abdallah I. Ruptured infective native thoracic aortic aneurysm treated by endovascular repair as a bridge therapy to open repair. J Med Vasc 2023; 48:36-40. [PMID: 37120270 DOI: 10.1016/j.jdmv.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/14/2023] [Indexed: 05/01/2023]
Abstract
We report the case of a 70-year-old woman who presented with a ruptured infective native thoracic aortic aneurysm (INTAA), associated with spondylodiscitis and posterior mediastinitis. She underwent a staged hybrid repair: urgent thoracic endovascular aortic repair was first performed as a bridge therapy in the context of septic shock. Allograft repair using cardiopulmonary bypass was performed five days later. Given the complexity of INTAA, multidisciplinary teamwork was paramount to determine the most appropriate treatment strategy, including procedure planning with multiple operators as well as perioperative care. Therapeutic alternatives are discussed.
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Affiliation(s)
- M Corniquet
- Department of cardiovascular surgery, Hôpital Européen Georges-Pompidou (HEGP), Université Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75015 Paris, France; Inserm, UMR S 1140, Fondation Alain Carpentier, Laboratoire de Recherches Biochirugicales, 75015 Paris, France.
| | - M Khalifé
- Department of orthopedic surgery, HEGP, Université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France.
| | - A G Lellouch
- Department of plastic surgery, HEGP, Université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France.
| | - A Bel
- Department of cardiovascular surgery, Hôpital Européen Georges-Pompidou (HEGP), Université Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75015 Paris, France; Inserm, UMR S 1140, Fondation Alain Carpentier, Laboratoire de Recherches Biochirugicales, 75015 Paris, France.
| | - F Bellenfant
- Department of anesthesiology and critical care, HEGP, Université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France.
| | - P Julia
- Department of cardiovascular surgery, Hôpital Européen Georges-Pompidou (HEGP), Université Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75015 Paris, France.
| | - J-M Alsac
- Department of cardiovascular surgery, Hôpital Européen Georges-Pompidou (HEGP), Université Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75015 Paris, France; Inserm, UMR S 1140, Fondation Alain Carpentier, Laboratoire de Recherches Biochirugicales, 75015 Paris, France.
| | - S El Batti
- Department of cardiovascular surgery, Hôpital Européen Georges-Pompidou (HEGP), Université Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75015 Paris, France; Inserm, UMR S 1140, Fondation Alain Carpentier, Laboratoire de Recherches Biochirugicales, 75015 Paris, France.
| | - I Ben Abdallah
- Department of cardiovascular surgery, Hôpital Européen Georges-Pompidou (HEGP), Université Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75015 Paris, France; Inserm, UMR S 1140, Fondation Alain Carpentier, Laboratoire de Recherches Biochirugicales, 75015 Paris, France.
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Morfouace M, Hol M, Schoot R, Arruti N, Wiersma J, Mandeville H, Dávila-Fajardo R, Pieters B, Saeed P, Bel A, Indelicato D. Exploration of dose-toxicity for ophthalmological adverse events in pediatric head and neck rhabdomyosarcoma survivors. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Meijer K, Van Dijk I, Frank M, Hoek AVD, Balgobind B, Janssens G, Wendling M, Maduro J, Bryce-Atkinson A, Loginova A, Bel A. Interfractional diaphragm and abdominal organ motion in 189 children during radiotherapy: a multicenter study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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van Kesteren Z, Veldman JK, Parkes MJ, Stevens MF, Balasupramaniam P, van den Aardweg JG, van Tienhoven G, Bel A, van Dijk IWEM. Correction: Quantifying the reduction of respiratory motion by mechanical ventilation with MRI for radiotherapy. Radiat Oncol 2022; 17:113. [PMID: 35765010 PMCID: PMC9238002 DOI: 10.1186/s13014-022-02071-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Z van Kesteren
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - J K Veldman
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M J Parkes
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M F Stevens
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Anesthesiology, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - P Balasupramaniam
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J G van den Aardweg
- Department of Pulmonology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - G van Tienhoven
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - I W E M van Dijk
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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10
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van Kesteren Z, Veldman JK, Parkes MJ, Stevens MF, Balasupramaniam P, van den Aardweg JG, van Tienhoven G, Bel A, van Dijk IWEM. Quantifying the reduction of respiratory motion by mechanical ventilation with MRI for radiotherapy. Radiat Oncol 2022; 17:99. [PMID: 35597956 PMCID: PMC9123684 DOI: 10.1186/s13014-022-02068-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/12/2022] [Indexed: 12/13/2022] Open
Abstract
Background Due to respiratory motion, accurate radiotherapy delivery to thoracic and abdominal tumors is challenging. We aimed to quantify the ability of mechanical ventilation to reduce respiratory motion, by measuring diaphragm motion magnitudes in the same volunteers during free breathing (FB), mechanically regularized breathing (RB) at 22 breaths per minute (brpm), variation in mean diaphragm position across multiple deep inspiration breath-holds (DIBH) and diaphragm drift during single prolonged breath-holds (PBH) in two MRI sessions. Methods In two sessions, MRIs were acquired from fifteen healthy volunteers who were trained to be mechanically ventilated non-invasively We measured diaphragm motion amplitudes during FB and RB, the inter-quartile range (IQR) of the variation in average diaphragm position from one measurement over five consecutive DIBHs, and diaphragm cranial drift velocities during single PBHs from inhalation (PIBH) and exhalation (PEBH) breath-holds. Results RB significantly reduced the respiratory motion amplitude by 39%, from median (range) 20.9 (10.6–41.9) mm during FB to 12.8 (6.2–23.8) mm. The median IQR for variation in average diaphragm position over multiple DIBHs was 4.2 (1.0–23.6) mm. During single PIBHs with a median duration of 7.1 (2.0–11.1) minutes, the median diaphragm cranial drift velocity was 3.0 (0.4–6.5) mm/minute. For PEBH, the median duration was 5.8 (1.8–10.2) minutes with 4.4 (1.8–15.1) mm/minute diaphragm drift velocity. Conclusions Regularized breathing at a frequency of 22 brpm resulted in significantly smaller diaphragm motion amplitudes compared to free breathing. This would enable smaller treatment volumes in radiotherapy. Furthermore, prolonged breath-holding from inhalation and exhalation with median durations of six to seven minutes are feasible. Trial registration Medical Ethics Committee protocol NL.64693.018.18.
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Affiliation(s)
- Z van Kesteren
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - J K Veldman
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M J Parkes
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M F Stevens
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Anesthesiology, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - P Balasupramaniam
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J G van den Aardweg
- Department of Pulmonology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - G van Tienhoven
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - I W E M van Dijk
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Azzarouali S, Goudschaal K, den Boer D, Visser J, Hulshof M, Bel A. PD-0235 AI-based online adaptive CBCT-guided radiotherapy for bladder cancer using SIB and fiducial markers. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02790-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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van Kesteren Z, Veldman J, Parkes M, Tienhoven G, van den Aardweg J, Stevens M, Bel A, van Dijk I. PD-0233 Breathing amplitude is reduced by rapid shallow breathing at 60 breaths/minute. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02788-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Parkes M, Van Dijk I, Veldman J, Van Kesteren Z, Stevens M, Van Tienhoven G, Van Den Aardweg J, Green S, Clutton-Brock T, Bel A. PO-1072 Mechanical re-inflation to maintain chest inflation during prolonged breath-holds for radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Veldman J, van Kesteren Z, Gunwhy E, Parkes M, Stevens M, van den Aardweg J, van Tienhoven G, Bel A, van Dijk I. PD-0229 3D abdominal organ motion correlates strongly with the diaphragm during prolonged breath-holds. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02784-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Van Ngoc Ty C, Bel A, Fitton I, Clement O. Radiation dose optimization for endomyocardial biopsies. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00495-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Goudot G, Amrane M, El Ayoubi R, Bel A, Gendron N, Khider L, Durivage A, Smadja DM, Messas E, Achouh P, Mirault T. Thrombus of the Aorta and SARS-CoV-2 Infection: Cause or Trigger? Front Cardiovasc Med 2021; 8:700292. [PMID: 34552963 PMCID: PMC8450357 DOI: 10.3389/fcvm.2021.700292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/13/2021] [Indexed: 12/29/2022] Open
Abstract
Objective: Coronavirus disease 19 is a well-established cause of rare arterial thrombosis. Nevertheless, the exact mechanism of arterial thrombosis remains to be elucidated. We herein report the case of a large floating thrombus of the aortic arch, its surgical management and histological analysis. Case: A 65-year-old patient presented to the emergency department with a suspected stroke. He was non-smoker, but presented cardiovascular risk factors, namely hypertension, type 2 diabetes and hyperlipidaemia. A computed tomography of the aorta revealed a large floating thrombus of the aortic arch, at the base of the brachiocephalic trunk, suspected to be the etiology of stroke. Therapeutic anticoagulation was immediately started. The decision was made to perform an open aortic replacement surgery because of the symptomatic thromboembolic event with recent cerebral infarction and the potential harmfulness of the thrombus due to its size. A mobile thrombus was observed at the base of the brachiocephalic trunk by echocardiography. It was attached to a small area of the upper aortic wall and had an irregular surface. Histology revealed a platelet-rich thrombus lying on an aortic atherosclerotic plaque without pronounced inflammation. No plaque ulceration was present but endothelial cell desquamation was observed consistent with plaque erosion. Conclusion: In our case, there was a thrombus lying on an atherosclerotic plaque with intact thick fibrous cap, but associated with a plaque erosion mechanism. The thrombus formation appeared more likely to relate to a very localized endothelial injury.
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Affiliation(s)
- Guillaume Goudot
- Vascular Medicine Department, Georges Pompidou European Hospital, Institut National de la Sante et de la Recherche Medicale (INSERM) U970 Paris Research Cardiovascular Center (PARCC), Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - Mourad Amrane
- Cardiac Surgery Department, Georges Pompidou European Hospital, Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - Rida El Ayoubi
- Pathology Department, Georges Pompidou European Hospital, Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - Alain Bel
- Cardiac Surgery Department, Georges Pompidou European Hospital, Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - Nicolas Gendron
- Université de Paris, Innovative Therapies in Hemostasis, Institut National de la Sante et de la Recherche Medicale (INSERM), Paris, France.,Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre-Université de Paris (APHP-CUP), Paris, France
| | - Lina Khider
- Vascular Medicine Department, Georges Pompidou European Hospital, Institut National de la Sante et de la Recherche Medicale (INSERM) U970 Paris Research Cardiovascular Center (PARCC), Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - Andréanne Durivage
- Vascular Medicine Department, Georges Pompidou European Hospital, Institut National de la Sante et de la Recherche Medicale (INSERM) U970 Paris Research Cardiovascular Center (PARCC), Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - David M Smadja
- Université de Paris, Innovative Therapies in Hemostasis, Institut National de la Sante et de la Recherche Medicale (INSERM), Paris, France.,Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre-Université de Paris (APHP-CUP), Paris, France
| | - Emmanuel Messas
- Vascular Medicine Department, Georges Pompidou European Hospital, Institut National de la Sante et de la Recherche Medicale (INSERM) U970 Paris Research Cardiovascular Center (PARCC), Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - Paul Achouh
- Cardiac Surgery Department, Georges Pompidou European Hospital, Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
| | - Tristan Mirault
- Vascular Medicine Department, Georges Pompidou European Hospital, Institut National de la Sante et de la Recherche Medicale (INSERM) U970 Paris Research Cardiovascular Center (PARCC), Assistance Publique Hopitaux de Paris (APHP), Université de Paris, Paris, France
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Dassen M, Barten D, Laan J, Westerveld H, Bel A, Van Kesteren Z. PH-0267 Exploration of feasible motion metrics for bowel motion quantification in pelvic radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07282-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Bleeker M, Hulshof M, Bel A, Sonke J, van der Horst A. OC-0617 Gastric deformation models for adaptive radiotherapy: Personalized vs Population-based strategy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Frank M, de Jong R, Visser J, van Wieringen N, Wiersma J, Geijsen D, Bel A. OC-0618 Feasibility CBCT-based online adaptive 5x5Gy radiotherapy for neoadjuvant rectal cancer treatment. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Joshi Y, Bories MC, Aissaoui N, Grinda JM, Bel A, Latremouille C, Jouan J. Percutaneous venopulmonary artery extracorporeal membrane oxygenation for right heart failure after left ventricular assist device insertion. Interact Cardiovasc Thorac Surg 2021; 33:978-985. [PMID: 34313320 DOI: 10.1093/icvts/ivab197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/24/2021] [Accepted: 06/13/2021] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Right ventricular failure after left ventricular assist device (LVAD) insertion is associated with significant mortality and morbidity. Mechanical support options include right ventricular assist devices, venoarterial extracorporeal membrane oxygenation (ECMO) and venopulmonary artery ECMO, the latter often involving central cannulation. We sought to evaluate the feasibility and early outcomes of a truly percutaneous venopulmonary artery (pVPA) ECMO strategy, with the potential advantage of bedside removal once weaned. METHODS Data from a single tertiary centre were reviewed retrospectively from January 2014 to January 2019. During this time, 54 patients underwent LVAD insertion, with 19 requiring mechanical support for right ventricular failure. Among them, 10 patients received pVPA ECMO. Implantation of the pVPA ECMO was performed under transoesophageal echocardiography and fluoroscopy guidance, with an inflow cannula placed in the right atrium via the right femoral vein and an outflow cannula placed in the left pulmonary artery (PA) via the right internal jugular vein. RESULTS Cannula insertion was 100% successful with no need for repositioning. Eight patients (80%) were able to be successfully weaned (at the bedside); 6 were discharged from the hospital and there were no cases of early sepsis, mediastinitis or thromboembolism. At follow-up, 5 patients had received transplants (50%), with 1 on LVAD support as destination therapy (10%). Survival was 60 ± 15% and 50 ± 16% at 6 and 12 months, respectively. CONCLUSIONS pVPA ECMO is 100% technically feasible and is an efficient method for temporary right ventricular support after LVAD insertion with the advantage of simple bedside removal and avoidance of a PA graft remnant in the chest cavity.
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Affiliation(s)
- Yashutosh Joshi
- St Vincent's Hospital, Sydney, NSW, Australia.,Western Sydney University, Blacktown Clinical School, Sydney, NSW, Australia.,St Vincent's Clinical School UNSW, Sydney, NSW, Australia
| | - Marie-Cecile Bories
- Hôpital Européen Georges Pompidou, Département de Chirurgie Cardio-vasculaire, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Nadia Aissaoui
- Hôpital Européen Georges Pompidou, Service de Réanimation médicale, Assistance Publique Hôpitaux de Paris, Paris, France.,Université Paris-Descartes, Paris, France
| | - Jean-Michel Grinda
- Hôpital Européen Georges Pompidou, Département de Chirurgie Cardio-vasculaire, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Alain Bel
- Hôpital Européen Georges Pompidou, Département de Chirurgie Cardio-vasculaire, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Christian Latremouille
- Hôpital Européen Georges Pompidou, Département de Chirurgie Cardio-vasculaire, Assistance Publique Hôpitaux de Paris, Paris, France.,Université Paris-Descartes, Paris, France
| | - Jérôme Jouan
- Hôpital Européen Georges Pompidou, Département de Chirurgie Cardio-vasculaire, Assistance Publique Hôpitaux de Paris, Paris, France.,Université Paris-Descartes, Paris, France
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van der Meer M, Pieters B, Niehoff P, Milickovic N, Niatsetski Y, Alderliesten T, Bosman P, Bel A. PO-0200 Comparison of catheter position planning algorithms for HDR prostate brachytherapy under uncertainty. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06359-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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van der Meer M, van Dorth D, Bosman P, Pieters B, Niatsetski Y, Alderliesten T, Bel A. PO-0216 Healthy tissue constraints for catheter position optimization in HDR prostate brachytherapy planning. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06375-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Virgolin M, Wang Z, Balgobind BV, van Dijk IWEM, Wiersma J, Kroon PS, Janssens GO, van Herk M, Hodgson DC, Zadravec Zaletel L, Rasch CRN, Bel A, Bosman PAN, Alderliesten T. Surrogate-free machine learning-based organ dose reconstruction for pediatric abdominal radiotherapy. Phys Med Biol 2020; 65:245021. [PMID: 32580177 DOI: 10.1088/1361-6560/ab9fcc] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To study radiotherapy-related adverse effects, detailed dose information (3D distribution) is needed for accurate dose-effect modeling. For childhood cancer survivors who underwent radiotherapy in the pre-CT era, only 2D radiographs were acquired, thus 3D dose distributions must be reconstructed from limited information. State-of-the-art methods achieve this by using 3D surrogate anatomies. These can however lack personalization and lead to coarse reconstructions. We present and validate a surrogate-free dose reconstruction method based on Machine Learning (ML). Abdominal planning CTs (n = 142) of recently-treated childhood cancer patients were gathered, their organs at risk were segmented, and 300 artificial Wilms' tumor plans were sampled automatically. Each artificial plan was automatically emulated on the 142 CTs, resulting in 42,600 3D dose distributions from which dose-volume metrics were derived. Anatomical features were extracted from digitally reconstructed radiographs simulated from the CTs to resemble historical radiographs. Further, patient and radiotherapy plan features typically available from historical treatment records were collected. An evolutionary ML algorithm was then used to link features to dose-volume metrics. Besides 5-fold cross validation, a further evaluation was done on an independent dataset of five CTs each associated with two clinical plans. Cross-validation resulted in mean absolute errors ≤ 0.6 Gy for organs completely inside or outside the field. For organs positioned at the edge of the field, mean absolute errors ≤ 1.7 Gy for [Formula: see text], ≤ 2.9 Gy for [Formula: see text], and ≤ 13% for [Formula: see text] and [Formula: see text], were obtained, without systematic bias. Similar results were found for the independent dataset. To conclude, we proposed a novel organ dose reconstruction method that uses ML models to predict dose-volume metric values given patient and plan features. Our approach is not only accurate, but also efficient, as the setup of a surrogate is no longer needed.
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Affiliation(s)
- M Virgolin
- Life Sciences and Health Group, Centrum Wiskunde & Informatica, The Netherlands. shared first authorship, the two authors contributed equally to this work
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Bryce-Atkinson A, de Jong R, Bel A, Aznar MC, Whitfield G, van Herk M. Evaluation of Ultra-low-dose Paediatric Cone-beam Computed Tomography for Image-guided Radiotherapy. Clin Oncol (R Coll Radiol) 2020; 32:835-844. [PMID: 33067079 DOI: 10.1016/j.clon.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/11/2020] [Accepted: 09/29/2020] [Indexed: 01/01/2023]
Abstract
AIMS In image-guided radiotherapy, daily cone-beam computed tomography (CBCT) is rarely applied to children due to concerns over imaging dose. Simulating low-dose CBCT can aid clinical protocol design by allowing visualisation of new scan protocols in patients without delivering additional dose. This work simulated ultra-low-dose CBCT and evaluated its use for paediatric image-guided radiotherapy by assessment of image registration accuracy and visual image quality. MATERIALS AND METHODS Ultra-low-dose CBCT was simulated by adding the appropriate amount of noise to projection images prior to reconstruction. This simulation was validated in phantoms before application to paediatric patient data. Scans from 20 patients acquired at our current clinical protocol (0.8 mGy) were simulated for a range of ultra-low doses (0.5, 0.4, 0.2 and 0.125 mGy) creating 100 scans in total. Automatic registration accuracy was assessed in all 100 scans. Inter-observer registration variation was next assessed for a subset of 40 scans (five scans at each simulated dose and 20 scans at the current clinical protocol). This subset was assessed for visual image quality by Likert scale grading of registration performance and visibility of target coverage, organs at risk, soft-tissue structures and bony anatomy. RESULTS Simulated and acquired phantom scans were in excellent agreement. For patient scans, bony atomy registration discrepancies for ultra-low-dose scans fell within 2 mm (translation) and 1° (rotation) compared with the current clinical protocol, with excellent inter-observer agreement. Soft-tissue registration showed large discrepancies. Bone visualisation and registration performance reached over 75% acceptability (rated 'well' or 'very well') down to the lowest doses. Soft-tissue visualisation did not reach this threshold for any dose. CONCLUSION Ultra-low-dose CBCT was accurately simulated and evaluated in patient data. Patient scans simulated down to 0.125 mGy were appropriate for bony anatomy set-up. The large dose reduction could allow for more frequent (e.g. daily) image guidance and, hence, more accurate set-up for paediatric radiotherapy.
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Affiliation(s)
- A Bryce-Atkinson
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| | - R de Jong
- Department of Radiation Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - M C Aznar
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - G Whitfield
- Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK; The Children's Brain Tumour Research Network, The University of Manchester, Royal Manchester Children's Hospital, Manchester, UK
| | - M van Herk
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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De Jong R, Visser J, Crama K, Van Wieringen N, Wiersma J, Geijsen D, Bel A. OC-0439: Quantifying the benefit of online adaptive radiotherapy for rectal cancer compared to plan selection. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Laan J, Barten D, Van Kesteren Z, Pieters B, Bel A, Westerveld H. OC-0568: The effect of external beam radiotherapy on bowel motility in gynaecological cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Van Herten Y, Van Wieringen N, Wiersma J, De Jong R, Bel A. PO-1894: AD-HOC adaptive radiotherapy: how often do anatomical changes lead to treatment adaptation? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01912-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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28
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Bryce-Atkinson A, De Jong R, Bel A, Aznar M, Whitfield G, Van Herk M. PO-1740: Quantitative evaluation of ultra-low dose paediatric cone beam CT for image-guided radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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29
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Van Dijk I, Parkes M, Stevens M, Balasupramaniam P, Van den Aardweg J, Van Tienhoven G, Van Kesteren Z, Bel A. OC-0339: First MRI based quantification of diaphragm motion during prolonged breath-holds up to 8 minutes. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00363-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Crama K, Brondijk E, Visser J, Bel A. PO-1864: Can underdosage due to breast swelling be mitigated with robust optimization for breast radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01882-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Barten D, Van Kesteren Z, Visser J, Laan J, Westerveld H, Bel A. PO-1730: Development of a framework to quantify bowel motility in 3D using MRI. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01748-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Den Boer D, Veldman J, Bel A, Van Kesteren Z. PO-1723: Evaluation of outlier rejection in 4D-MRI for motion estimation of subsequent sessions. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01741-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bertholet J, Distefano G, Noble D, Bel A, VanLeeuwen R, Roggen T, Duchateau M, Thørnqvist S, Garibaldi C, Tilly N, Mollá RG, Bonaque J, Oelfke U, Aznar M, Heijmen B. PD-0311: Patterns of practice for adaptive and real-time radiation therapy part II: interfractional changes. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00335-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Virgolin M, Wang Z, Balgobind B, Van Dijk I, Wiersma J, Hodgson D, Bryce-Atkinson A, Van Herk M, Rasch C, Zadravec Zaletel L, Kroon P, Janssens G, Bel A, Bosman P, Alderliesten T. OC-0225: Highly-individualized dose reconstruction for pediatric abdominal radiotherapy with machine learning. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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35
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Veldman J, Den Boer D, Bel A, Van Kesteren Z. PO-1644: Inter-session variability of 4DMRI image quality after outlier rejection. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01662-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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36
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Nelissen K, Barten D, Laan J, Westerveld H, Bel A, Van Kesteren Z. PO-1729: Quality assurance of deformable image registration for bowel motility quantification. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Messas E, Rémond MC, Goudot G, Zarka S, Penot R, Mateo P, Kwiecinski W, Escudero DS, Bel A, Ialy-Radio N, Bertrand B, Bruneval P, Marijon E, Spaargaren R, Tanter M, Pernot M. Feasibility and safety of non-invasive ultrasound therapy (NIUT) on an porcine aortic valve. Phys Med Biol 2020; 65:215004. [PMID: 33104523 DOI: 10.1088/1361-6560/aba6d3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Calcific aortic stenosis (CAS) is associated with advanced age and comorbidities, therefore a non-invasive therapy for it would be beneficial. We previously demonstrated that ultrasound therapy improved calcified bioprosthetic valve function in an open chest model. For translational applications, we tested non-invasive ultrasound therapy (NIUT) transthoracically on swine aortic valves and investigated the need for antithrombotic treatment as a follow-up. Primary objective: feasibility and safety of NIUT. Secondary objectives: occurrence, severity and evolution of side effects during therapy and at 1 month follow-up. The device (Valvosoft, Cardiawave) consisted of an electronically steered multi-element transducer and a 2D echocardiographic probe. Three groups of swine received treatment on aortic valves: NIUT (group 1; n = 10); NIUT and 1 month antithrombotic treatment (group 2; n = 5); sham group (group 3; n = 4). Feasibility was successfully reached in all treated swine (n = 15) and no life-threatening arrhythmia were detected. Non-sustained ventricular tachycardia occurred during the procedure in seven swine. Decrease or interruption of NIUT ended arrhythmia. Histopathology revealed no valve or surrounding tissue damage and echocardiography revealed no valvular dysfunction. Only one animal had side effects [right ventricle (RV) dilatation], but the RV normalized after therapy cessation with no sequelae at follow-up. No disturbance in biological markers nor valve thrombosis were observed at follow-up. Antithrombotic treatment did not demonstrate any advantage. Survival at 30 d was 100%. We demonstrated, in vivo, the feasibility and safety of transthoracic NIUT on aortic valves in a swine model without serious adverse events. We expect this first-time transthoracic delivery of NIUT to pave the way towards a new non-invasive approach to valve softening in human CAS to restore valve function.
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Affiliation(s)
- Emmanuel Messas
- Cardio-Vascular Departement, Hôpital Européen Georges Pompidou, Université of Paris, UMR 970, Paris, France. French Research Consortium STOP-AS, supported by the French Government, managed by the National Research Agency (ANR) under the program 'Investissements d'Avenir' with the reference ANR-16-RHUS-003, Rouen, France. These authors contributed equally to this work. Author to whom any correspondence should be addressed
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de Jong R, Crama KF, Visser J, van Wieringen N, Wiersma J, Geijsen ED, Bel A. Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit. Radiat Oncol 2020; 15:162. [PMID: 32641080 PMCID: PMC7371470 DOI: 10.1186/s13014-020-01597-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/11/2020] [Indexed: 12/21/2022] Open
Abstract
Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 cm3 in LCRT, while the average difference per patient ranged from − 206 cm3 to − 40 cm3. For SCRT the median difference was − 62 cm3, while the range of the average difference per patient was − 105 cm3 to − 51 cm3. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands).
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Affiliation(s)
- R de Jong
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
| | - K F Crama
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - J Visser
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - N van Wieringen
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - J Wiersma
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - E D Geijsen
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
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Ranchordás S, du Puy-Montbrun L, Bel A, Achouh P. Tetraplegia after branched frozen elephant trunk implantation for acute type A aortic dissection. J Card Surg 2020; 35:1694-1696. [PMID: 32419257 DOI: 10.1111/jocs.14623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 58-year-old male patient presented with acute type A aortic dissection. Complete arch and ascending aorta replacement were performed using a Thoraflex Hybrid prosthesis. The left subclavian artery was ligated and the remaining supra-aortic trunks were reimplanted using the branches of the prosthesis. After an uneventful early postoperative period, sudden onset of hypotension and bradycardia occurred, with severe vasoplegia, requiring vasopressors. Ischemia of the upper left limb and compartment syndrome ensued, leading to left carotid subclavian bypass. After discontinuation of sedation, tetraplegia was noted due to spinal cord ischemia from C3 to C7.
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Affiliation(s)
- Sara Ranchordás
- Cardiac Surgery Department, Hospital of Santa Cruz, Carnaxide, Portugal
| | - Léonora du Puy-Montbrun
- Cardiovascular Surgery Department, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - Alain Bel
- Cardiovascular Surgery Department, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - Paul Achouh
- Cardiovascular Surgery Department, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
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Maree SC, Bosman PAN, van Wieringen N, Niatsetski Y, Pieters BR, Bel A, Alderliesten T. Automatic bi-objective parameter tuning for inverse planning of high-dose-rate prostate brachytherapy. ACTA ACUST UNITED AC 2020; 65:075009. [DOI: 10.1088/1361-6560/ab7362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Faure EM, El Batti S, Sutter W, Bel A, Julia P, Achouh P, Alsac JM. Stent-assisted balloon dilatation of chronic aortic dissection. J Thorac Cardiovasc Surg 2020; 162:1467-1473. [DOI: 10.1016/j.jtcvs.2020.01.081] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/06/2020] [Accepted: 01/27/2020] [Indexed: 11/30/2022]
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de Jong R, Visser J, Crama KF, van Wieringen N, Wiersma J, Geijsen ED, Bel A. Dosimetric benefit of an adaptive treatment by means of plan selection for rectal cancer patients in both short and long course radiation therapy. Radiat Oncol 2020; 15:13. [PMID: 31931829 PMCID: PMC6958623 DOI: 10.1186/s13014-020-1461-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/06/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To compare target coverage and dose to the organs at risk in two approaches to rectal cancer: a clinically implemented adaptive radiotherapy (ART) strategy using plan selection, and a non-adaptive (non-ART) strategy. METHODS The inclusion of the first 20 patients receiving adaptive radiotherapy produced 10 patients with a long treatment schedule (25x2Gy) and 10 patients with a short schedule (5X5Gy). We prepared a library of three plans with different anterior PTV margins to the upper mesorectum, and selected the most appropriate plan on daily Conebeam CT scans (CBCT). We also created a non-adaptive treatment plan with a 20 mm margin. Bowel bag, bladder and target volume were delineated on CBCT. Daily DHVs were calculated based on the dose distribution of the selected and non-adaptive plans. Coverage of the target volume was compared per fraction between the ART and non-ART plans, as was the dose to the bladder and small bowel, assessing the following dose levels: V15Gy, V30Gy, V40Gy, V15Gy and V95% for long treatment schedules, and V15Gy and V95% for short ones. RESULTS Target volume coverage was maintained from 98.3% (non-ART) to 99.0% (ART)(p = 0.878). In the small bowel, ART appeared to have produced significant reductions in the long treatment schedule at V15Gy, V40Gy, V45Gy and V95% (p < 0.05), but with small absolute differences. The DVH parameters tested for the short treatment schedule did not differ significantly. In the bladder, all DVH parameters in both schedules showed significant reductions (p < 0.05), also with small absolute differences. CONCLUSIONS The adaptive treatment maintained target coverage and reduced dose to the organs at risk. TRIAL REGISTRATION Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center, W19_194 # 19.233.
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Affiliation(s)
- R de Jong
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
| | - J Visser
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - K F Crama
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - N van Wieringen
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - J Wiersma
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - E D Geijsen
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
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Van Dijk I, Windmeijer C, De Jong R, Balgobind B, Bel A. An European survey to evaluate clinical practice of image-guided radiation therapy in children - On behalf of the participating members of the Pediatric Radiation Oncology Society and our projectbased consortium. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brosseau C, Danger R, Durand M, Durand E, Foureau A, Lacoste P, Tissot A, Roux A, Reynaud-Gaubert M, Kessler R, Mussot S, Dromer C, Brugière O, Mornex JF, Guillemain R, Claustre J, Magnan A, Brouard S, Velly J, Rozé H, Blanchard E, Antoine M, Cappello M, Ruiz M, Sokolow Y, Vanden Eynden F, Van Nooten G, Barvais L, Berré J, Brimioulle S, De Backer D, Créteur J, Engelman E, Huybrechts I, Ickx B, Preiser T, Tuna T, Van Obberghe L, Vancutsem N, Vincent J, De Vuyst P, Etienne I, Féry F, Jacobs F, Knoop C, Vachiéry J, Van den Borne P, Wellemans I, Amand G, Collignon L, Giroux M, Angelescu D, Chavanon O, Hacini R, Martin C, Pirvu A, Porcu P, Albaladejo P, Allègre C, Bataillard A, Bedague D, Briot E, Casez‐Brasseur M, Colas D, Dessertaine G, Francony G, Hebrard A, Marino M, Protar D, Rehm D, Robin S, Rossi‐Blancher M, Augier C, Bedouch P, Boignard A, Bouvaist H, Briault A, Camara B, Chanoine S, Dubuc M, Quétant S, Maurizi J, Pavèse P, Pison C, Saint‐Raymond C, Wion N, Chérion C, Grima R, Jegaden O, Maury J, Tronc F, Flamens C, Paulus S, Philit F, Senechal A, Glérant J, Turquier S, Gamondes D, Chalabresse L, Thivolet‐Bejui F, Barnel C, Dubois C, Tiberghien A, Pimpec‐Barthes F, Bel A, Mordant P, Achouh P, Boussaud V, Méléard D, Bricourt M, Cholley B, Pezella V, Brioude G, D'Journo X, Doddoli C, Thomas P, Trousse D, Dizier S, Leone M, Papazian L, Bregeon F, Coltey B, Dufeu N, Dutau H, Garcia S, Gaubert J, Gomez C, Laroumagne S, Mouton G, Nieves A, Picard C, Rolain J, Sampol E, Secq V, Perigaud C, Roussel J, Senage T, Mugniot A, Danner I, Haloun A, Abbes S, Bry C, Blanc F, Lepoivre T, Botturi‐Cavaillès K, Loy J, Bernard M, Godard E, Royer P, Henrio K, Dartevelle P, Fabre D, Fadel E, Mercier O, Stephan F, Viard P, Cerrina J, Dorfmuller P, Feuillet S, Ghigna M, Hervén P, Le Roy Ladurie F, Le Pavec J, Thomas de Montpreville V, Lamrani L, Castier Y, Mordant P, Cerceau P, Augustin P, Jean‐Baptiste S, Boudinet S, Montravers P, Dauriat G, Jébrak G, Mal H, Marceau A, Métivier A, Thabut G, Lhuillier E, Dupin C, Bunel V, Falcoz P, Massard G, Santelmo N, Ajob G, Collange O, Helms O, Hentz J, Roche A, Bakouboula B, Degot T, Dory A, Hirschi S, Ohlmann‐Caillard S, Kessler L, Schuller A, Bennedif K, Vargas S, Bonnette P, Chapelier A, Puyo P, Sage E, Bresson J, Caille V, Cerf C, Devaquet J, Dumans‐Nizard V, Felten M, Fischler M, Si Larbi A, Leguen M, Ley L, Liu N, Trebbia G, De Miranda S, Douvry B, Gonin F, Grenet D, Hamid A, Neveu H, Parquin F, Picard C, Stern M, Bouillioud F, Cahen P, Colombat M, Dautricourt C, Delahousse M, D'Urso B, Gravisse J, Guth A, Hillaire S, Honderlick P, Lequintrec M, Longchampt E, Mellot F, Scherrer A, Temagoult L, Tricot L, Vasse M, Veyrie C, Zemoura L, Dahan M, Murris M, Benahoua H, Berjaud J, Le Borgne Krams A, Crognier L, Brouchet L, Mathe O, Didier A, Krueger T, Ris H, Gonzalez M, Aubert J, Nicod L, Marsland B, Berutto T, Rochat T, Soccal P, Jolliet P, Koutsokera A, Marcucci C, Manuel O, Bernasconi E, Chollet M, Gronchi F, Courbon C, Hillinger S, Inci I, Kestenholz P, Weder W, Schuepbach R, Zalunardo M, Benden C, Buergi U, Huber L, Isenring B, Schuurmans M, Gaspert A, Holzmann D, Müller N, Schmid C, Vrugt B, Rechsteiner T, Fritz A, Maier D, Deplanche K, Koubi D, Ernst F, Paprotka T, Schmitt M, Wahl B, Boissel J, Olivera‐Botello G, Trocmé C, Toussaint B, Bourgoin‐Voillard S, Séve M, Benmerad M, Siroux V, Slama R, Auffray C, Charron D, Lefaudeux D, Pellet J. Blood CD9 + B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2019; 19:3162-3175. [PMID: 31305014 DOI: 10.1111/ajt.15532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 01/25/2023]
Abstract
Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.
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Affiliation(s)
- Carole Brosseau
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Richard Danger
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Maxim Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Eugénie Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurore Foureau
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Philippe Lacoste
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Adrien Tissot
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Antoine Roux
- Hôpital Foch, Suresnes, France.,Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Versailles, France
| | | | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie et Transplantation Pulmonaire, Paris, France
| | | | | | - Johanna Claustre
- Clinique Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U1055, Grenoble, France
| | - Antoine Magnan
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Centre d'Investigation Clinique (CIC) Biothérapie, CHU Nantes, Nantes, France
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Visser J, de Boer P, Crama KF, van Kesteren Z, Rasch CRN, Stalpers LJA, Bel A. Dosimetric comparison of library of plans and online MRI-guided radiotherapy of cervical cancer in the presence of intrafraction anatomical changes. Radiat Oncol 2019; 14:126. [PMID: 31300000 PMCID: PMC6624982 DOI: 10.1186/s13014-019-1322-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/18/2019] [Indexed: 12/05/2022] Open
Abstract
Background Online magnetic resonance imaging (MRI)-guided radiotherapy of cervical cancer has the potential to further reduce dose to organs at risk (OAR) as compared to a library of plans (LOP) approach. This study presents a dosimetric comparison of an MRI-guided strategy with a LOP strategy taking intrafraction anatomical changes into account. Methods The 14 patients included in this study were treated with chemo radiation at our institute and received weekly MRIs after informed consent. The MRI-guided strategy consisted of treatment plans created on the weekly sagittal MRI with 3 mm and 5 mm planning target volume (PTV) margin for clinical target volume (CTV) cervix-uterus (MRI_3mm and MRI_5mm). The plans for the LOP strategy were based on interpolations of CTV cervix-uterus on pretreatment full and empty bladder scans. Dose volume histogram (DVH) parameters were compared for targets and OARs as delineated on the weekly transversal MRI, which was acquired on average 10 min after the sagittal MRI. Results For the MRI_5mm strategy D98% of the high-risk CTV was at least 95% for all weekly MRIs of all patients, while for the LOP and MRI_3mm strategy this requirement was not satisfied for at least one weekly MRI for 1 and 3 patients, respectively. The average reduction of the volume of the reference dose (95% of the prescribed dose) as compared to the LOP strategy was 464 cm3 for the MRI_3mm strategy, and 422 cm3 for the MRI_5mm strategy. The bowel bag constraint V40Gy < 350 cm3 was violated for 13 patients for the LOP strategy and for 5 patients for both MRI_3mm and MRI_5mm strategy. Conclusions With online MRI-guided radiotherapy of cervical cancer considerable sparing of OARs can be achieved. If a new treatment plan can be generated and delivered within 10 min, an online MRI-guided strategy with a 5 mm PTV margin for CTV cervix-uterus is sufficient to account for intrafraction anatomical changes. Trial registration NL44492.018.13. Electronic supplementary material The online version of this article (10.1186/s13014-019-1322-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J Visser
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
| | - P de Boer
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Present Address: Radiotherapeutisch Instituut Friesland, Borniastraat 36, Leeuwarden, the Netherlands
| | - K F Crama
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Z van Kesteren
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - C R N Rasch
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Present Address: Department of Radiation Oncology, Leiden University Medical Center, University of Leiden, Albinusdreef 2, Leiden, The Netherlands
| | - L J A Stalpers
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
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Menasché P, Vanneaux V, Hagège A, Bel A, Cholley B, Parouchev A, Cacciapuoti I, Al-Daccak R, Benhamouda N, Blons H, Agbulut O, Tosca L, Trouvin JH, Fabreguettes JR, Bellamy V, Charron D, Tartour E, Tachdjian G, Desnos M, Larghero J. Transplantation of Human Embryonic Stem Cell-Derived Cardiovascular Progenitors for Severe Ischemic Left Ventricular Dysfunction. J Am Coll Cardiol 2019; 71:429-438. [PMID: 29389360 DOI: 10.1016/j.jacc.2017.11.047] [Citation(s) in RCA: 257] [Impact Index Per Article: 51.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND In addition to scalability, human embryonic stem cells (hESCs) have the unique advantage of allowing their directed differentiation toward lineage-specific cells. OBJECTIVES This study tested the feasibility of leveraging the properties of hESCs to generate clinical-grade cardiovascular progenitor cells and assessed their safety in patients with severe ischemic left ventricular dysfunction. METHODS Six patients (median age 66.5 years [interquartile range (IQR): 60.5 to 74.7 years]; median left ventricular ejection fraction 26% [IQR: 22% to 32%]) received a median dose of 8.2 million (IQR: 5 to 10 million) hESC-derived cardiovascular progenitors embedded in a fibrin patch that was epicardially delivered during a coronary artery bypass procedure. The primary endpoint was safety at 1 year and focused on: 1) cardiac or off-target tumor, assessed by imaging (computed tomography and fluorine-18 fluorodeoxyglucose positron emission tomography scans); 2) arrhythmias, detected by serial interrogations of the cardioverter-defibrillators implanted in all patients; and 3) alloimmunization, assessed by the presence of donor-specific antibodies. Patients were followed up for a median of 18 months. RESULTS The protocol generated a highly purified (median 97.5% [IQR: 95.5% to 98.7%]) population of cardiovascular progenitors. One patient died early post-operatively from treatment-unrelated comorbidities. All others had uneventful recoveries. No tumor was detected during follow-up, and none of the patients presented with arrhythmias. Three patients developed clinically silent alloimmunization. All patients were symptomatically improved with an increased systolic motion of the cell-treated segments. One patient died of heart failure after 22 months. CONCLUSIONS This trial demonstrates the technical feasibility of producing clinical-grade hESC-derived cardiovascular progenitors and supports their short- and medium-term safety, thereby setting the grounds for adequately powered efficacy studies. (Transplantation of Human Embryonic Stem Cell-derived Progenitors in Severe Heart Failure [ESCORT]; NCT02057900).
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Affiliation(s)
- Philippe Menasché
- Department of Cardiovascular Surgery, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Paris, France; National Institute of Health and Medical Research (INSERM) U970, Hôpital Européen Georges Pompidou, Paris, France.
| | - Valérie Vanneaux
- Cell Therapy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France; INSERM, Clinical Investigation Center in Biotherapies (CBT-501) and U1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France
| | - Albert Hagège
- University Paris Descartes, Sorbonne Paris Cité, Paris, France; National Institute of Health and Medical Research (INSERM) U970, Hôpital Européen Georges Pompidou, Paris, France; Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Alain Bel
- Department of Cardiovascular Surgery, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Bernard Cholley
- University Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Anesthesiology and Intensive Care, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Alexandre Parouchev
- Cell Therapy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France; INSERM, Clinical Investigation Center in Biotherapies (CBT-501) and U1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France
| | - Isabelle Cacciapuoti
- Cell Therapy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France; INSERM, Clinical Investigation Center in Biotherapies (CBT-501) and U1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France
| | - Reem Al-Daccak
- INSERM U976, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Nadine Benhamouda
- Department of Biological Immunology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Hélène Blons
- INSERM Mixed Research Units (UMR)-S1147, National Scientific Research Center (CNRS) Non CNRS Structure 5014, Sorbonne Paris Cité, Department of Biochemistry, Pharmacogenetic and Molecular Oncology Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Onnik Agbulut
- Sorbonne Universités, Université Pierre et Marie Curie, University Paris-6, Institut de Biologie Paris-Seine, UMR CNRS 8256, Biological Adaptation and Ageing, Paris, France
| | - Lucie Tosca
- Assistance Publique-Hôpitaux de Paris, University Paris Sud, Histology-Embryology-Cytogenetics, Hôpitaux Universitaires Paris Sud, Clamart, France
| | - Jean-Hugues Trouvin
- School of Pharmacy, University Paris Descartes, Paris, France; Central Pharmacy, Pharmaceutical Innovation Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Roch Fabreguettes
- Central Pharmacy, Clinical Trials Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Valérie Bellamy
- National Institute of Health and Medical Research (INSERM) U970, Hôpital Européen Georges Pompidou, Paris, France
| | - Dominique Charron
- Human Leukocyte Antigen and Médecine, Hôpital Saint-Louis, INSERM U976, Paris, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Eric Tartour
- University Paris Descartes, Sorbonne Paris Cité, Paris, France; National Institute of Health and Medical Research (INSERM) U970, Hôpital Européen Georges Pompidou, Paris, France; Department of Biological Immunology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Gérard Tachdjian
- Assistance Publique-Hôpitaux de Paris, University Paris Sud, Histology-Embryology-Cytogenetics, Hôpitaux Universitaires Paris Sud, Clamart, France
| | - Michel Desnos
- University Paris Descartes, Sorbonne Paris Cité, Paris, France; National Institute of Health and Medical Research (INSERM) U970, Hôpital Européen Georges Pompidou, Paris, France; Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Jérôme Larghero
- Cell Therapy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France; INSERM, Clinical Investigation Center in Biotherapies (CBT-501) and U1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France
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Faure EM, El Batti S, Sutter W, Bel A, Julia P, Achouh P, Alsac JM. Stent-assisted balloon-induced intimal disruption and relamination of distal remaining aortic dissection after acute DeBakey type I repair. J Thorac Cardiovasc Surg 2019; 157:2159-2165. [DOI: 10.1016/j.jtcvs.2018.10.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 11/16/2022]
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van Kesteren Z, van der Horst A, Gurney-Champion OJ, Bones I, Tekelenburg D, Alderliesten T, van Tienhoven G, Klaassen R, van Laarhoven HWM, Bel A. A novel amplitude binning strategy to handle irregular breathing during 4DMRI acquisition: improved imaging for radiotherapy purposes. Radiat Oncol 2019; 14:80. [PMID: 31088490 PMCID: PMC6518684 DOI: 10.1186/s13014-019-1279-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 04/22/2019] [Indexed: 11/25/2022] Open
Abstract
Background For radiotherapy of abdominal cancer, four-dimensional magnetic resonance imaging (4DMRI) is desirable for tumor definition and the assessment of tumor and organ motion. However, irregular breathing gives rise to image artifacts. We developed a outlier rejection strategy resulting in a 4DMRI with reduced image artifacts in the presence of irregular breathing. Methods We obtained 2D T2-weighted single-shot turbo spin echo images, with an interleaved 1D navigator acquisition to obtain the respiratory signal during free breathing imaging in 2 patients and 12 healthy volunteers. Prior to binning, upper and lower inclusion thresholds were chosen such that 95% of the acquired images were included, while minimizing the distance between the thresholds (inclusion range (IR)). We compared our strategy (Min95) with three commonly applied strategies: phase binning with all images included (Phase), amplitude binning with all images included (MaxIE), and amplitude binning with the thresholds set as the mean end-inhale and mean end-exhale diaphragm positions (MeanIE). We compared 4DMRI quality based on:Data included (DI); percentage of images remaining after outlier rejection. Reconstruction completeness (RC); percentage of bin-slice combinations containing at least one image after binning. Intra-bin variation (IBV); interquartile range of the diaphragm position within the bin-slice combination, averaged over three central slices and ten respiratory bins. IR. Image smoothness (S); quantified by fitting a parabola to the diaphragm profile in a sagittal plane of the reconstructed 4DMRI.
A two-sided Wilcoxon’s signed-rank test was used to test for significance in differences between the Min95 strategy and the Phase, MaxIE, and MeanIE strategies. Results Based on the fourteen subjects, the Min95 binning strategy outperformed the other strategies with a mean RC of 95.5%, mean IBV of 1.6 mm, mean IR of 15.1 mm and a mean S of 0.90. The Phase strategy showed a poor mean IBV of 6.2 mm and the MaxIE strategy showed a poor mean RC of 85.6%, resulting in image artifacts (mean S of 0.76). The MeanIE strategy demonstrated a mean DI of 85.6%. Conclusions Our Min95 reconstruction strategy resulted in a 4DMRI with less artifacts and more precise diaphragm position reconstruction compared to the other strategies. Trial registration Volunteers: protocol W15_373#16.007; patients: protocol NL47713.018.14 Electronic supplementary material The online version of this article (10.1186/s13014-019-1279-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Z van Kesteren
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
| | - A van der Horst
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - O J Gurney-Champion
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.,Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK, SM2 5NG, UK
| | - I Bones
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - D Tekelenburg
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - T Alderliesten
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - G van Tienhoven
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - R Klaassen
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - H W M van Laarhoven
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - A Bel
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
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Van der Meer M, Bosman P, Pieters B, Niatsetski Y, Alderliesten T, Bel A. OC-0396 Robust HDR prostate brachytherapy planning accounting for organ reconstruction settings. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Slooten E, Van Wieringen N, De Jong R, Balgobind B, Huijskens S, Windmeijer C, Van Dijk I, Bel A. EP-1991 PTV margin evaluation for pediatric craniospinal irradiation with 3D and 2D position verification. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32411-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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