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Piedimonte S, Tsang K, Jembere N, Murphy J, Karapetian T, Gao J, McCurdy B, Sacco J, Kupets R. Defining the Longitudinal Risk of CIN 3+ for <CIN 2 Colposcopy for Patients Referred With High-Grade Cytology. J Low Genit Tract Dis 2024; 28:7-11. [PMID: 37906611 DOI: 10.1097/lgt.0000000000000765] [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] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To determine the baseline and cumulative risk of cervical intraepithelial neoplasia (CIN)3 and invasive cervical cancer in participants referred to colposcopy with high-grade cytology and METHODS The authors linked administrative databases including cytology, pathology, cancer registries, and physician billing history to identify participants referred to colposcopy between January 2012 and December 2013 with high-grade cytology (atypical squamous cells [ASC]-H, high-grade squamous intraepithelial lesion [HSIL], invasive squamous cell carcinoma, adenocarcinoma, atypical glandular cells [AGC], adenocarcinoma in situ) and had RESULTS Among 4,168 women referred to colposcopy for ASC-H, HSIL, squamous cell carcinoma, or adenocarcinoma, the 3- and 5-year CIN3 incidence rates were 17.7%/20.0% no biopsy, 13.0%/15.1% negative biopsy, and 18.9%/20.0% low-grade squamous intraepithelial lesion (LSIL) biopsies. The 3- and 5-year incidences of invasive cancer were: 1.25%/1.68% no biopsy, 0.78%/1.04% negative biopsy, and 0%/0% LSIL biopsy. When the initial cytology was AGC/adenocarcinoma in situ (n = 944), the 3- and 5-year rates of CIN3 were 7.42%/8.39% no biopsy, 7.41%/9.26% negative biopsy, and 7.69%/7.69% LSIL biopsy. The invasive cancer rates were 1.12%/1.54% no biopsy, 0.46%/0.46% negative biopsy, and 0.0%/0.0% LSIL biopsy. By screening cytology, participants referred for HSIL had the highest 3- and 5-year rates of CIN3 (18.9% and 21%) compared with AGC (7.22%/8.28%) and ASC-H (15.5%/18%). The 3- and 5-year invasive cancer rates were 1.38%/1.75% HSIL, 0.85%/1.17% AGC, and 0.91%/1.36% ASC-H. CONCLUSIONS In participants referred for high-grade cytology where colposcopy shows
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Affiliation(s)
- Sabrina Piedimonte
- Division of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Kyle Tsang
- Cancer Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | | | - Joan Murphy
- Division of Gynecologic Oncology, University of Toronto, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Tina Karapetian
- Cancer Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Julia Gao
- Cancer Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Bronwen McCurdy
- Cancer Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Jocelyn Sacco
- Cancer Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Rachel Kupets
- Division of Gynecologic Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
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Cheng J, Buduhan G, Venkataraman S, Bashir B, Ahmed N, Tan L, Kidane B, Sasaki D, Rathod S, Sivananthan G, Koul R, Leylek A, Butler J, McCurdy B, Kim J. Endobronchial Implanted Real-Time Radiofrequency (RF) Transponder Beacon Guided, Respiratory-Gated, Stereotactic Body Radiotherapy for Moving Lung Tumors: Interim Analysis of a Prospective Phase I/II Cohort Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1500] [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: 10/31/2022]
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Mitera G, Tsang D, Wright P, Sussman J, Craig T, Thompson R, Tyldesley S, Foxcroft S, Goddard K, Greenland J, Koul R, McCurdy B, Milosevic M, Morneau M, Morrison A, Pan L, Pantarotto J, Rutledge R, Warde P, Patel S. First Pan-Canadian Consensus Recommendations for Proton Beam Therapy Access in Canada. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1439] [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: 10/31/2022]
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Tinmouth J, Paramalingam A, Bellini A, Cotterchio M, Dekker E, Doctorow R, Hassan C, Haddad E, Lofters A, MacIntosh D, Martin J, McCurdy B, Murray I, Naglie H, Paroschy-Harris C, Rabeneck L, Stogios C, Telford JJ, Venkatesh R, Wong C, Zenlea T, Dube C. A63 REFINING THE CANADIAN ASSOCIATION OF GASTROENTEROLOGY GUIDELINE ON SCREENING IN PERSONS WITH A FAMILY HISTORY OF NONHEREDITARY COLORECTAL CANCER OR ADENOMA: A MODIFIED DELPHI PROCESS. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.061] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In 2018, the Canadian Association of Gastroenterology (CAG) published an extensive systematic review and guideline on screening in persons with a family history (FHx) of nonhereditary colorectal cancer (CRC) and adenoma. While CAG’s recommendations were evidence-based, some recommendations lacked precision (e.g. ranges for some start ages & intervals) and screening cessation age was not addressed, leading to implementation challenges for practitioners and CRC screening programs.
Aims
To review and update the evidence since the 2018 guideline and to formulate implementable recommendations in the Ontario context that are aligned with the CAG guideline.
Methods
ColonCancerCheck (Ontario’s organized CRC screening program) conducted a modified version of the literature search used by CAG (Jan 2017 - Sept 2019). A 19-member expert panel with Canadian and international representatives from endoscopy, primary care, epidemiology, organized CRC screening programs, Ontario’s cancer system and the general public refined the recommendations of the CAG guideline for the purposes of implementation in an organized CRC screening program using a modified Delphi process. This iterative process involved a series of webinars and anonymous survey rounds where the panel reviewed evidence materials and provided online feedback to develop, refine & achieve consensus on screening recommendations in persons with a FHx of CRC/adenoma. Consensus was achieved if ≥75% of members agreed or strongly agreed with the statement.
Results
Six new systematic reviews and 2 new guidelines were identified. New evidence included data on the absolute risk (10 year & lifetime risk) of CRC by type of FHx, as well as the performance of fecal immunochemical testing (FIT) and barriers to CRC screening in persons with a FHx of CRC. The expert panel participated in 3 webinars and 4 online surveys to arrive at consensus. Panel recommendations and level of consensus will be reported for the 6 statements (Table).
Conclusions
Building from the CAG guideline, we derived evidence-based and implementable recommendations for screening persons with a FHx of CRC or adenoma.
Funding Agencies
Ontario Health (Cancer Care Ontario)
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Affiliation(s)
- J Tinmouth
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - A Bellini
- William Osler Health Centre-Brampton Civic Hospital, Toronto, ON, Canada
| | | | - E Dekker
- Universiteit van Amsterdam Faculteit Geneeskunde, Amsterdam, Noord-Holland, Netherlands
| | | | - C Hassan
- Poliambulatorio Nuovo Regina Margherita, Roma, Lazio, Italy
| | - E Haddad
- Chatham-Kent Health Alliance, Chatham, ON, Canada
| | - A Lofters
- Women’s College Hospital, Toronto, ON, Canada
| | - D MacIntosh
- Queen Elizabeth II Health Science Centre, Halifax, NS, Canada
| | - J Martin
- Grand River Hospital, Kitchener, ON, Canada
| | | | - I Murray
- Intestinal Health Institute, Unionville, ON, Canada
| | - H Naglie
- General Public, Toronto, ON, Canada
| | - C Paroschy-Harris
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada
| | | | | | - J J Telford
- University of British Columbia, Vancouver, BC, Canada
| | | | - C Wong
- University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - T Zenlea
- Women’s College Hospital, Toronto, ON, Canada
| | - C Dube
- Ottawa Hospital Civic Campus, Ottawa, ON, Canada
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Loblaw D, Quon H, Ong A, Alayed Y, Cheung P, Chu W, Chung H, Vesprini D, Chowdhury A, Panjwani D, Pang G, Korol R, Davidson M, Ravi A, McCurdy B, Zhang L, Mamedov A, Deabreu A. Accelerating Prostate Stereotactic Ablative Body Radiotherapy (SABR): Efficacy and Toxicity of a Randomized Phase II Study of 11 Versus 29 Days Overall Treatment Time (PATRIOT Study; ClinicalTrials.gov NCT01423474). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Roy S, Loblaw A, Cheung P, Chu W, Chung HT, Vesprini D, Ong A, Chowdhury A, Panjwani D, Pang G, Korol R, Davidson M, Ravi A, McCurdy B, Helou J, Zhang L, Mamedov A, Deabreu A, Quon HC. Prostate-specific Antigen Bounce After Stereotactic Body Radiotherapy for Prostate Cancer: A Pooled Analysis of Four Prospective Trials. Clin Oncol (R Coll Radiol) 2019; 31:621-629. [PMID: 31126725 DOI: 10.1016/j.clon.2019.05.001] [Citation(s) in RCA: 5] [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: 11/06/2018] [Revised: 03/05/2019] [Accepted: 04/01/2019] [Indexed: 12/21/2022]
Abstract
AIMS We conducted a pooled analysis of four prospective stereotactic body radiotherapy (SBRT) trials of low- and intermediate-risk prostate cancer to evaluate the incidence of prostate-specific antigen (PSA) bounce and its correlation with the time-dose-fraction schedule. The correlation between bounce with PSA response at 4 years (nadir PSA < 0.4 ng/ml) and biochemical failure-free survival (BFFS) was also explored. MATERIALS AND METHODS The study included four treatment groups: 35 Gy/five fractions once per week (QW) (TG-1; n = 84); 40 Gy/five fractions QW (TG-2; n = 100); 40 Gy/five fractions every other day (TG-3; n = 73); and 26 Gy/two fractions QW (TG-4; n = 30). PSA bounce was defined as a rise in PSA by 0.2 ng/ml (nadir + 0.2) or 2 ng/ml (nadir + 2.0) above nadir followed by a decrease back to nadir. Patients with fewer than three follow-up PSA tests were excluded from the pooled analysis. RESULTS In total, 287 patients were included, with a median follow-up of 5.0 years. The pooled 5-year cumulative incidence of bounce by nadir + 2.0 was 8%. The 2-year cumulative incidences of PSA bounce by nadir + 0.2 were 28.9, 21, 19.6 and 16.7% (P = 0.12) and by nadir + 2.0 were 7.2, 8, 2.7 and 6.7% (P = 0.32) for TG-1 to TG-4, respectively. Multivariable analysis revealed that for nadir + 2.0, pre-treatment PSA (odds ratio 0.49; 95% confidence interval 0.26-0.97) correlated with PSA bounce. Although PSA bounce by nadir + 0.2 (odds ratio 0.10; 95% confidence interval 0.04-0.24) and nadir + 2.0 (odds ratio 0.29; 95% confidence interval 0.09-0.93) was associated with a lower probability of PSA response at 4 years, there was no association between bounce by nadir + 0.2 (hazard ratio 0.36; 95% confidence interval 0.08-1.74) or nadir + 2 (hazard ratio 1.77; 95% confidence interval 0.28-11.07) with BFFS. CONCLUSION The incidence of PSA bounce was independent of time-dose-fraction schedule for prostate SBRT. One in 13 patients experienced a bounce high enough to be misinterpreted as biochemical failure, and clinicians should avoid early salvage interventions in these patients. There was no association between PSA bounce and BFFS.
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Affiliation(s)
- S Roy
- Tom Baker Cancer Center, Department of Oncology, University of Calgary, Calgary, Canada
| | - A Loblaw
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - P Cheung
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - W Chu
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - H T Chung
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - D Vesprini
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - A Ong
- CancerCare Manitoba, University of Manitoba, Winnipeg, Canada
| | - A Chowdhury
- CancerCare Manitoba, University of Manitoba, Winnipeg, Canada
| | | | - G Pang
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - R Korol
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - M Davidson
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - A Ravi
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - B McCurdy
- CancerCare Manitoba, University of Manitoba, Winnipeg, Canada
| | - J Helou
- Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - L Zhang
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - A Mamedov
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - A Deabreu
- Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - H C Quon
- Tom Baker Cancer Center, Department of Oncology, University of Calgary, Calgary, Canada.
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Roy S, Loblaw D, Cheung P, Chu W, Chung H, Vesprini D, Ong A, Chowdhury A, Panjwani D, Pang G, Korol R, Davidson M, Ravi A, McCurdy B, Helou J, Zhang L, Mamedov A, Deabreu A, Quon H. PSA Bounce after Stereotactic Body Radiation Therapy for Prostate Cancer: Pooled Analysis from 4 SBRT Trials Evaluating Different Time-Dose-Fraction Schedules. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.263] [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: 10/28/2022]
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Cenin D, Tinmouth J, Dube C, McCurdy B, Paszat L, Rabeneck L, Lansdorp-Vogelaar I. A198 PERSONALIZING THE AGE TO STOP COLORECTAL CANCER SCREENING IN CANADA BASED ON COMORBIDITY AND PRIOR SCREENING HISTORY: MODEL ESTIMATES OF HARMS AND BENEFITS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.198] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Cenin
- Erasmus MC, Rotterdam, Netherlands
| | - J Tinmouth
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - C Dube
- The Ottawa Hospital, Ottawa, ON, Canada
| | - B McCurdy
- Cancer Care Ontario, Toronto, ON, Canada
| | - L Paszat
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - L Rabeneck
- Cancer Care Ontario, Toronto, ON, Canada
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Dubey A, Sharma A, Leylek A, Harris C, Sasaki D, Butler J, Rickey D, McCurdy B. Using Optical Scanner and 3-Dimensional Printer Technology to Create Lead Shielding for Radiation Therapy of Facial Skin Cancer With Low-Energy Photons: An Exciting Innovation. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Aviles JA, Sasaki D, Jensen M, Rickey D, Dubey A, Harris C, McCowan P, McCurdy B. On the Physical and Dosimetric Properties of 3-Dimensional Printed Electron Bolus Fabricated Using Polylactic Acid. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Quon H, Ong A, Cheung P, Chu W, Chung H, Vesprini D, Chowdhury A, Panjwani D, Pang G, Korol R, Davidson M, Ravi A, McCurdy B, Zhang L, Bucher O, Mamedov A, Deabreu A, Lylyk E, Loblaw D. PATRIOT Trial: Randomized Phase 2 Study of Prostate Stereotactic Body Radiation Therapy Comparing 11 Versus 29 Days Overall Treatment Time. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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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Ratansi N, Langan A, Blais I, Svara E, Houser K, McCurdy B, Moffatt J, Elliott L. Moving toward patient-based funding through quality-based procedures (QBPs) for GI endoscopy and colposcopy. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.30_suppl.43] [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: 11/20/2022] Open
Abstract
43 Background: As part of the Ministry’s Health System Funding Reform initiative, Cancer Care Ontario is tasked to develop and implement Quality-Based Procedures (QBPs) for programs such as GI Endoscopy and Colposcopy. QBPs are clusters of patients with clinically related diagnoses or treatments that have been identified by an evidence-based framework as providing opportunity for improving quality outcomes and reducing costs. As stated by the Ministry, the goal is to reimburse providers for the types and numbers of patients treated, using evidence-informed rates associated with the quality of care delivered. Methods: QBPs are multiyear and have four key deliverables: Clinical: developing clinical best practices. Funding: tying best practices to pricing. Capacity Planning: understanding procedure types/volumes for capacity management. Monitoring/Evaluation: measuring the QBP’s impact. Developing the QBPs has involved: Creating Clinical Expert Advisory Groups (CEAG) of clinicians who are recognized for their knowledge and expertise. Tasking the CEAG to define quality and develop best practices informed by literature reviews, jurisdictional scans, and guidelines. Documenting these standards and clinical pathways in a clinical handbook, providing information on the practices that should be implemented to ensure consistent care delivery. The development of best practices is imperative to the foundation of the QBP and spans multiple years. Once best practice development is complete, it will be tied to pricing, where the procedure will be micro-costed based on workload, equipment, supplies, and other administrative costs. Results: The QBPs continue to evolve and aim to: Reduce practice variation. Improve patient outcomes. Improve system accountability. Improve cost-effectiveness of services. Effectiveness will be measured through a performance management framework, including an integrated QBP scorecard measuring appropriateness, access, and efficiency. Conclusions: The underpinning for moving towards an evidence-based, patient-based funding model involves defining quality standards and clincal best practices, and applying these guidelines to determine the cost of quality care.
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Affiliation(s)
| | | | | | - Erin Svara
- Cancer Care Ontario, Toronto, ON, Canada
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Asuni G, vanBeek T, McCowan P, VanUytven E, McCurdy B. Clinical Implementation Of EPID-based Daily In Vivo Dose Verification System For SBRT Patients. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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McCowan P, vanUytven E, vanBeek T, McCurdy B. Sci-Thur AM: YIS - 06: An EPID-based 3D patient dose verification method for SBRT-VMAT delivery. Med Phys 2014. [DOI: 10.1118/1.4894939] [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: 11/07/2022] Open
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Rivest R, Venkataraman S, McCurdy B. Sci-Fri PM: Dosimetry-06: Commissioning of a 3D patient specific QA system for hypofractionated prostate treatments. Med Phys 2014. [DOI: 10.1118/1.4894961] [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: 11/07/2022] Open
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Greer P, Fuangrod T, Woodruff H, Rowshanfarzad P, van Uytven E, McCurdy B. Real-Time EPID-Based Dose Verification System for Detection of Gross Radiation Treatment Delivery Errors. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.310] [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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Peterson D, Bashir B, Chowdhury A, McCurdy B, Rivest R, Nugent Z, Demetor S, Ahmed S, Leylek A, Ahmed N. A Prospective Study Measuring Interobserver Variability of GTV With FDG-PET-CT in Stage III Non-small Cell Lung Cancer Using 3D Analysis. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1547] [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: 11/15/2022]
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Champion H, Fiege J, McCurdy B, Potrebko P, Cull A. Sci-Thur AM: Planning - 04: Evaluation of the fluence complexity, solution quality, and run efficiency produced by five fluence parameterizations implemented in PARETO multiobjective radiotherapy treatment planning software. Med Phys 2012; 39:4619-4620. [DOI: 10.1118/1.4740089] [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: 11/07/2022] Open
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Asuni G, Popescu T, McCurdy B. Sci-Fri PM: Delivery - 01: Approach to evaluate the accuracy of individual control-points of a VMAT delivery measured by an EPID. Med Phys 2012; 39:4642. [DOI: 10.1118/1.4740196] [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: 11/07/2022] Open
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Fuangrod T, Woodruff H, VanUytven E, McCurdy B, O'Connor D, Greer P. MO-G-213AB-03: Simulations of Real-Time Geometric and Dosimetic Verification System Using EPID. Med Phys 2012. [DOI: 10.1118/1.4735840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hebb M, Winter J, Champagne K, McCurdy B, Zhu H, Petropoulos L. SU-E-J-55: Development of a Novel Cableless Radiolucent RF Coil for MR-Guided Radiation Therapy (MRgRT™). Med Phys 2012; 39:3665. [DOI: 10.1118/1.4734890] [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: 11/07/2022] Open
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Venugopal N, McCurdy B, Hovdebo J, Al Mehairi S, Alamri A, Sandhu GS, Sivalingam S, Drachenberg D, Ryner L. Automatic conformal prescription of very selective saturation bands for in vivo 1H-MRSI of the prostate. NMR Biomed 2012; 25:643-653. [PMID: 22162346 DOI: 10.1002/nbm.1780] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 07/11/2011] [Accepted: 07/13/2011] [Indexed: 05/31/2023]
Abstract
An important step in the implementation of three-dimensional in vivo proton magnetic resonance spectroscopic imaging ((1)H-MRSI) of the prostate is the placement of spatial saturation pulses around the region of interest (ROI) for the removal of unwanted contaminating signals from peripheral tissue. The present study demonstrates the use of a technique called conformal voxel magnetic resonance spectroscopy (CV-MRS). This method automates the placement, orientation, timing and flip angle of very selective saturation (VSS) pulses around an irregularly-shaped, user-defined ROI. The method employs a user adjustable number of automatically positioned VSS pulses (20 used in the present study) which null the signal from periprostatic lipids while closely conforming the shape of the excitation voxel to the shape of the prostate. A standard endorectal coil in combination with a torso-phased array coil was used for all in vivo prostate studies. Three-dimensional in vivo prostate (1)H-MRSI data were obtained using the proposed semi-automated CV-MRS technique, and compared with a standard point resolved spectroscopy (PRESS) technique at TE = 130 ms using manual placement of saturation pulses. The in vivo prostate (1)H-MRSI data collected from 12 healthy subjects using the CV-MRS method showed significantly reduced lipid contamination throughout the prostate, and reduced baseline distortions. On average there was a 50 ± 17% (range 12% - 68%) reduction in lipids throughout the prostate. A voxel-by-voxel benchmark test of over 850 voxels showed that there were 63% more peaks fitted using the LCModel when using a Cramer-Rao Lower Bound (CRLB) cut-off of 40% when using the optimized conformal voxel technique in comparison to the manual placement approach. The evaluation of this CV-MRS technique has demonstrated the potential for easy automation of the graphical prescription of saturation bands for use in (1)H-MRSI.
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Affiliation(s)
- N Venugopal
- Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba, Canada.
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Potrebko P, Fiege J, Champion H, Cull A, McCurdy B, West M, Lyn E, Butler J, Fewer D. PARETO: A New Multiobjective IMRT Treatment Planning System. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.356] [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: 11/24/2022]
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Eyles J, Heddle N, Webert K, Arnold E, McCurdy B. Do expert assessments converge? An exploratory case study of evaluating and managing a blood supply risk. BMC Public Health 2011; 11:666. [PMID: 21864330 PMCID: PMC3223866 DOI: 10.1186/1471-2458-11-666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Accepted: 08/24/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Examining professional assessments of a blood product recall/withdrawal and its implications for risk and public health, the paper introduces ideas about perceptions of minimal risk and its management. It also describes the context of publicly funded blood transfusion in Canada and the withdrawal event that is the basis of this study. METHODS Interviews with 45 experts from administration, medicine, blood supply, laboratory services and risk assessment took place using a multi-level sampling framework in the aftermath of the recall. These experts either directly dealt with the withdrawal or were involved in the management of the blood supply at the national level. Data from these interviews were coded in NVivo for analysis and interpretation. Analytically, data were interpreted to derive typifications to relate interview responses to risk management heuristics. RESULTS While all those interviewed agreed on the importance of patient safety, differences in the ways in which the risk was contextualized and explicated were discerned. Risk was seen in terms of patient safety, liability or precaution. These different risk logics are illustrated by selected quotations. CONCLUSIONS Expert assessments did not fully converge and it is possible that these different risk logics and discourses may affect the risk management process more generally, although not necessarily in a negative way. Patient safety is not to be compromised but management of blood risk in publicly funded systems may vary. We suggest ways of managing blood risk using formal and safety case approaches.
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Affiliation(s)
- John Eyles
- School of Geography and Earth Sciences, McMaster University, 1280 Main St West, Hamilton, Ontario, Canada
| | - Nancy Heddle
- Transfusion Medicine Program, McMaster University, 1200 Main St West, Hamilton, Ontario, Canada
| | - Kathryn Webert
- Transfusion Medicine Program, McMaster University, 1200 Main St West, Hamilton, Ontario, Canada
| | - Emmy Arnold
- Transfusion Medicine Program, McMaster University, 1200 Main St West, Hamilton, Ontario, Canada
| | - Bronwen McCurdy
- Transfusion Medicine Program, McMaster University, 1200 Main St West, Hamilton, Ontario, Canada
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McCowan P, Rickey D, Rowshanfarzad P, Ansbacher W, Greer P, McCurdy B. SU-E-T-210: Precise Gantry Angle Determination for EPID Images during Rotational IMRT. Med Phys 2011. [DOI: 10.1118/1.3612160] [Citation(s) in RCA: 3] [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: 11/07/2022] Open
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Chytyk K, Van Uytven E, Van Beek T, Greer P, McCurdy B. SU-E-T-205: Physical Model for in Vivo Dose Image Prediction. Med Phys 2011. [DOI: 10.1118/1.3612155] [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: 11/07/2022] Open
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Van Uytven E, McCurdy B, Chytyk K, Van Beek T. SU-C-224-10: Accurate Patient Dose Reconstruction from On-Treatment EPID Images. Med Phys 2011. [DOI: 10.1118/1.3611458] [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: 11/07/2022] Open
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Rowshanfarzad P, Sabet M, McCowan P, McCurdy B, OˈˈConnor D, Greer PB. MO-F-214-08: A New Method for Linear Accelerator Characterization for VMAT Using Cine-EPID. Med Phys 2011. [DOI: 10.1118/1.3613021] [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: 11/07/2022] Open
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Fiege J, Potrebko P, Champion H, Cull A, McCurdy B. TU-A-BRB-06: Evolving and Optimizing IMRT Treatment Plans with PARETO - a Novel Treatment Planning System Based on a Multi-Objective Genetic Algorithm. Med Phys 2011. [DOI: 10.1118/1.3613071] [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: 11/07/2022] Open
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Champion H, Fiege J, Potrebko P, Cull A, McCurdy B. SU-E-T-856: Investigation of Fluence Parameterization Methods for PARETO Multi-Objective Radiation Therapy Treatment Planning Software. Med Phys 2011. [DOI: 10.1118/1.3612820] [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: 11/07/2022] Open
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Asuni G, Rickey D, McCurdy B. Poster - Thur Eve - 04: The Line Spread Function Measurement of a Novel Transmission Detector. Med Phys 2010. [DOI: 10.1118/1.3476109] [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: 11/07/2022] Open
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Lee R, Tran M, McCurdy B, Pistorius S. Poster - Thur Eve - 47: Automatic Comparison of Portal Images for the Detection of Radiotherapy Treatment Delivery Errors. Med Phys 2010. [DOI: 10.1118/1.3476152] [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: 11/07/2022] Open
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Champion H, Fiege J, Potrebko P, Cull A, McCurdy B. Sci-Sat AM(1): Planning - 02: Validation of IMRT Solutions for PARETO Multi-Objective Beam Angle Optimization Software. Med Phys 2010. [DOI: 10.1118/1.3476202] [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: 11/07/2022] Open
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Potrebko P, McCurdy B, Fiege J, Champion H, Cull A. Poster - Thur Eve - 58: Beam Orientation Optimization for IMRT Treatment Planning Using PARETO. Med Phys 2010. [DOI: 10.1118/1.3476163] [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: 11/07/2022] Open
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Fiege J, McCurdy B, Cull A, Champion H, Potrebko P. Sci-Sat AM(1): Planning - 04: PARETO: A Novel Evolutionary Optimization Approach to Multi-Objective Radiotherapy Planning. Med Phys 2010. [DOI: 10.1118/1.3476204] [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: 11/07/2022] Open
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Asuni G, McCurdy B. Poster - Thur Eve - 03: A Monte Carlo Investigation of the Effects of a Novel In Vivo
Transmission Detector on a 6 MV Photon Beam. Med Phys 2010. [DOI: 10.1118/1.3476108] [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: 11/07/2022] Open
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McCurdy B, Malkoske K. SU-GG-T-200: Comparison of a Novel Transmission Detector to a Standard Measurement Technique for Patient IMRT Quality Assurance. Med Phys 2010. [DOI: 10.1118/1.3468589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Asuni G, McCurdy B, Jensen M. Poster - Wed Eve-28: Monte Carlo Study of the Influence of a Novel Transmission Detector on 6 MV Photon Beam. Med Phys 2009. [DOI: 10.1118/1.3244132] [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: 11/07/2022] Open
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Potrebko P, McCurdy B, Fiege J, Cull A. Sci-Thurs PM: Planning-08: Improving IMRT Treatment Planning Using Multi-Objective Beam Orientation Optimization. Med Phys 2009. [DOI: 10.1118/1.3244179] [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: 11/07/2022] Open
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Venkataraman S, Malkoske K, Jensen M, Nakonechny K, Asuni G, McCurdy B. SU-FF-T-353: Influence of a Novel Transmission Detector On 6 MV X-Ray Beam Characteristics. Med Phys 2009. [DOI: 10.1118/1.3181834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Venugopal N, McCurdy B, Drachenberg D, Al Mehairi S, Alamri A, Sandhu GS, Sivalingam S, Ryner L. SU-GG-BRC-10: Shape Matters: Utilization of a Conformal Voxel Technique to Acquire Robust in Vivo Prostate MRSI at Short Echo Times. Med Phys 2009. [DOI: 10.1118/1.3182186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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McCurdy B, Mueller L, Backman E, Venkataraman S, Fleming E, Asuni G, Jensen M, Ur-Rehman F, Pistorius S. SU-GG-T-150: Commissioning and Validation of a Novel Measurement-Based IMRT QA Method, Incorporating Dose Recalculation On Patient CT Data. Med Phys 2008. [DOI: 10.1118/1.2961901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Potrebko P, McCurdy B. Sci-Fri AM: YIS-07: A new paradigm for improving IMRT: Selection of beam orientations by optimizing beam intersection volume. Med Phys 2008; 35:3411. [DOI: 10.1118/1.2965969] [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: 11/07/2022] Open
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Chytyk K, McCurdy B. Sci-Thurs PM: Delivery-04: Comprehensive fluence model for absolute portal dose image prediction in IMRT pre-treatment verification. Med Phys 2008; 35:3399. [DOI: 10.1118/1.2965911] [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: 11/07/2022] Open
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Wong E, McCurdy B, Oliver M, Potrebko P, Bzdusek K, Chen J. TH-C-350-01: Planning and Delivery of IMAT: Comparisons of Single and Multiple Arc Approaches. Med Phys 2008. [DOI: 10.1118/1.2962826] [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: 11/07/2022] Open
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Tran M, McCurdy B, Pistorius S. SU-FF-J-23: Artificial Neural Networks Approach For Clinical Portal Dose Image Comparison. Med Phys 2007. [DOI: 10.1118/1.2760528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Venugopal N, McCurdy B, Ryner L. TH-C-L100J-05: In Vivo Prostate MRSI Using An Improved Outer Volume Suppression Technique. Med Phys 2007. [DOI: 10.1118/1.2761643] [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: 11/07/2022] Open
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Potrebko P, McCurdy B. SU-FF-T-42: A Simple Geometric Algorithm to Predict Optimal Starting Gantry Angles Using Equiangular-Spaced Beams for IMRT of Prostate Cancer. Med Phys 2007. [DOI: 10.1118/1.2760690] [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: 11/07/2022] Open
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Potrebko P, McCurdy B. Sci-Thur PM Therapy-10: Is there an optimal starting gantry angle for equiangular-spaced beam arrangements in IMRT? Med Phys 2006. [DOI: 10.1118/1.2244624] [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: 11/07/2022] Open
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