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Li BT, Daly B, Gospodarowicz M, Bertagnolli MM, Brawley OW, Chabner BA, Fashoyin-Aje L, de Claro RA, Franklin E, Mills J, Legos J, Kaucic K, Li M, The L, Hou T, Wu TH, Albrecht B, Shao Y, Finnegan J, Qian J, Shahidi J, Gasal E, Tendler C, Kim G, Yan J, Morrow PK, Fuchs CS, Zhang L, LaCaze R, Oelrich S, Murphy MJ, Pazdur R, Rudd K, Wu YL. Reimagining patient-centric cancer clinical trials: a multi-stakeholder international coalition. Nat Med 2022; 28:620-626. [PMID: 35440725 DOI: 10.1038/s41591-022-01775-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Bob T Li
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, New York, NY, USA.
| | - Bobby Daly
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Mary Gospodarowicz
- Princess Margaret Cancer Center, , University of Toronto, Toronto, Ontario, Canada
| | | | - Otis W Brawley
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bruce A Chabner
- Massachusetts General Hospital Cancer Center, Boston, MA, USA.,Society for Translational Oncology, Durham, NC, USA
| | - Lola Fashoyin-Aje
- Oncology Center of Excellence, Food and Drug Administration, Silver Spring, MD, USA
| | - R Angelo de Claro
- Oncology Center of Excellence, Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | | | - Mark Li
- Resolution Bioscience, Agilent Technologies, Kirkland, WA, USA
| | - Lydia The
- McKinsey Cancer Center, McKinsey & Company
| | - Tina Hou
- McKinsey Cancer Center, McKinsey & Company
| | | | | | - Yi Shao
- McKinsey Cancer Center, McKinsey & Company
| | | | - Jing Qian
- Asia Society Policy Institute, Asia Society, New York, NY, USA
| | | | | | - Craig Tendler
- Janssen, Johnson and Johnson, New Brunswick, NJ, USA
| | | | | | | | - Charles S Fuchs
- Genentech, South San Francisco, CA, USA.,Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | | | | | | | - Martin J Murphy
- Society for Translational Oncology, Durham, NC, USA.,Shanghai TuoXin Health Promotion Center, Shanghai, China.,CEO Roundtable on Cancer, Morrisville, NC, USA
| | - Richard Pazdur
- Oncology Center of Excellence, Food and Drug Administration, Silver Spring, MD, USA
| | - Kevin Rudd
- Asia Society Policy Institute, Asia Society, New York, NY, USA
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Chinese Thoracic Oncology Group, Guangzhou, China
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Hoffman MA, Murphy MJ, Koester MC, Norcross EC, Johnson ST. Lifesaving Medications Use By Athletic Trainers. J Athl Train 2021; 57:613-620. [PMID: 36170846 PMCID: PMC9528709 DOI: 10.4085/1062-6050-353-21] [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: 11/09/2022]
Abstract
The athletic trainer's (AT) emergency management skill set requires competency in the delivery of basic lifesaving medications. Some lifesaving medications have been a part of athletic training practice for decades, but that list has grown as ATs' practice setting has expanded - increasing the types of em ergent conditions that the AT may have to treat. The 2020 CAATE curricular standards require athletic training students be trained to administer the following: supplemental oxygen, nitroglycerine, low dose aspirin, bronchodilators, epinephrine using automated injection device, glucagon, and naloxone. Clinically, the conditions treated by these medications can be categorized as follows: cardiac, respiratory, hypoglycemia, or anaphylaxis. All ATs should know the indications, contraindications, administration methods, and the details of patient monitoring for each medication. Generally, these medications are safe, have clear indications for use, and few contraindications. While ATs are trained to administer these medications, they must consider state laws and local policies.
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Affiliation(s)
- M A Hoffman
- Mark Hoffman, PhD, ATC, EMT, FNATA, Associate Professor, College of Public Health and Human Sciences, Oregon State University.,Mark Hoffman, PhD, ATC, FNATA, , 541-737-6787
| | - M J Murphy
- Molly Murphy, BS, Athletic Training Student, College of Public Health and Human Sciences, Oregon State University,
| | - M C Koester
- Mick Koester, MD, ATCR, Physician, Slocum Center Orthopedics and Sports Medicine,
| | - E C Norcross
- Emily Norcross MS, ATC, Instructor, College of Public Health and Human Sciences, Oregon State University,
| | - S T Johnson
- Sam Johnson PhD, ATC, Clinical Associate Professor, College of Public Health and Human Sciences, Oregon State University, , Corresponding Author
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Chabner BA, DeVita V, Murphy MJ. An Homage to Two Explorers of Uncharted Cancer Waters. Oncologist 2021; 26:350-351. [PMID: 33660908 DOI: 10.1002/onco.13731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 11/08/2022] Open
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Panagiotou OA, Högg LH, Hricak H, Khleif SN, Levy MA, Magnus D, Murphy MJ, Patel B, Winn RA, Nass SJ, Gatsonis C, Cogle CR. Clinical Application of Computational Methods in Precision Oncology: A Review. JAMA Oncol 2021; 6:1282-1286. [PMID: 32407443 DOI: 10.1001/jamaoncol.2020.1247] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Importance There is an enormous and growing amount of data available from individual cancer cases, which makes the work of clinical oncologists more demanding. This data challenge has attracted engineers to create software that aims to improve cancer diagnosis or treatment. However, the move to use computers in the oncology clinic for diagnosis or treatment has led to instances of premature or inappropriate use of computational predictive systems. Objective To evaluate best practices for developing and assessing the clinical utility of predictive computational methods in oncology. Evidence Review The National Cancer Policy Forum and the Board on Mathematical Sciences and Analytics at the National Academies of Sciences, Engineering, and Medicine hosted a workshop to examine the use of multidimensional data derived from patients with cancer and the computational methods used to analyze these data. The workshop convened diverse stakeholders and experts, including computer scientists, oncology clinicians, statisticians, patient advocates, industry leaders, ethicists, leaders of health systems (academic and community based), private and public health insurance carriers, federal agencies, and regulatory authorities. Key characteristics for successful computational oncology were considered in 3 thematic areas: (1) data quality, completeness, sharing, and privacy; (2) computational methods for analysis, interpretation, and use of oncology data; and (3) clinical infrastructure and expertise for best use of computational precision oncology. Findings Quality control was found to be essential across all stages, from data collection to data processing, management, and use. Collecting a standardized parsimonious data set at every cancer diagnosis and restaging could enhance reliability and completeness of clinical data for precision oncology. Data completeness refers to key data elements such as information about cancer diagnosis, treatment, and outcomes, while data quality depends on whether appropriate variables have been measured in valid and reliable ways. Collecting data from diverse populations can reduce the risk of creating invalid and biased algorithms. Computational systems that aid clinicians should be classified as software as a medical device and thus regulated according to the potential risk posed. To facilitate appropriate use of computational methods that interpret high-dimensional data in oncology, treating physicians need access to multidisciplinary teams with broad expertise and deep training among a subset of clinical oncology fellows in clinical informatics. Conclusions and Relevance Workshop discussions suggested best practices in demonstrating the clinical utility of predictive computational methods for diagnosing or treating cancer.
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Affiliation(s)
- Orestis A Panagiotou
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island
| | - Lori Hoffman Högg
- National Center for Health Promotion and Disease Prevention, Veterans Health Administration, Durham, North Carolina.,Office of Nursing Services, Veterans Health Administration, Washington, DC
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Samir N Khleif
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Mia A Levy
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee.,Division of Hematology and Oncology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - David Magnus
- Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California
| | | | - Bakul Patel
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Robert A Winn
- University of Illinois at Chicago Cancer Center, University of Illinois Hospital and Health Sciences System, Chicago
| | - Sharyl J Nass
- Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine, Washington, DC
| | - Constantine Gatsonis
- Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island
| | - Christopher R Cogle
- Division of Hematology & Oncology, Department of Medicine, University of Florida College of Medicine, Gainesville
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Chabner BA, Bates SE, Fojo AT, Murphy A, Sartor AO, Murphy MJ. A Medical Pearl Harbor: Pandemic Uncovers Societal Fissures and Leadership Breaches. Oncologist 2021; 26:89. [PMID: 33438780 PMCID: PMC7873321 DOI: 10.1002/onco.13677] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 11/08/2022] Open
Abstract
The Editors of The Oncologist remark on recent national events and call for new strategies for the New Year.
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Daugherty CE, Lento HG, Adams ML, Beckert EW, Bender ML, Berman S, Chow L, Davis C, Gedang D, Howe K, Murphy MJ, Porcuna M, Sabolish G, Shen CSJ, Smith NM, Tessaro A. Chloroform-Methanol Extraction Method for Determination of Fat in Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/66.4.927] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Achloroform-methanol extraction method (complete extraction of fat in 3 min) for determining fat in processed and prepared foods has been studied collaboratively. Fourteen collaborators reported single replicate fat results on 7 samples representative of various food types and 2 spiked samples by the proposed method. Each sample was accompanied by a blind duplicate. For statistical purposes, the blind duplicates were treated as paired observations, and there were 2 laboratory outliers. There was a 97.9% agreement among the results from the remaining 12 collaborators and the Associate Referee for the unfortified samples. Recoveries of 93.8 and 98.3% were obtained on fortified samples, based on results obtained from 11 collaborators. The statistical analysis of the results indicate (ranges for standard deviations were Sr = 0.083-0.528, Sb = 0.101-0.379, Sd = 8.130-0.631, for fat values ranging from 1.58 to 26.91%) that this method is adequate for quantitating the fat content in a wide variety of processed foods for nutritional labeling. The method has been adopted official first action.
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Affiliation(s)
- Chester E Daugherty
- Campbell Institute for Research and Technology, Campbell Soup Co., Camden, Nf 08101
| | - Harry G Lento
- Campbell Institute for Research and Technology, Campbell Soup Co., Camden, Nf 08101
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7
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Murphy MJ, Newby JM, Butow P, Loughnan SA, Joubert AE, Kirsten L, Allison K, Shaw J, Shepherd HL, Smith J, Andrews G. Randomised controlled trial of internet-delivered cognitive behaviour therapy for clinical depression and/or anxiety in cancer survivors (iCanADAPT Early). Psychooncology 2019; 29:76-85. [PMID: 31659822 DOI: 10.1002/pon.5267] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 04/27/2019] [Revised: 09/26/2019] [Accepted: 10/13/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate internet-delivered cognitive behavioural therapy (iCBT) on clinical depression and/or anxiety, distress, fear of cancer recurrence, and quality of life in cancer survivors. METHODS Random assignation of 114 participants to iCBT or treatment-as-usual (TAU). The clinician-supervised iCBT program (iCanADAPT Early) consisted of eight lessons over 16 weeks. Self-report questionnaires occurred at baseline, midpoint, and posttreatment for both groups with 3-month follow-up for iCBT participants. A mixed modelling approach to compare groups occurred. RESULTS iCBT was superior to TAU on all outcome measures at posttreatment. Compared with TAU, the iCBT group showed a significant decrease over time in anxiety and depression symptoms (primary outcome, Hospital Anxiety and Depression Scale, Hedges g = 1.51). Additionally the iCBT group had significantly lower general distress (Kessler-10, g = 1.56), fear of cancer recurrence (Fear of Cancer Recurrence Inventory, g = 0.39), and significantly higher quality of life (Functional Assessment of Cancer Therapy-General, g = 0.74) at posttreatment compared with the TAU group. High adherence and satisfaction were found for iCBT with low clinician time. CONCLUSION Clinician-supervised iCBT has significant benefits for cancer survivors with clinical depression and anxiety disorders.
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Affiliation(s)
- M J Murphy
- Clinical Research Unit for Anxiety and Depression, UNSW, NSW, Australia
| | - J M Newby
- Clinical Research Unit for Anxiety and Depression, UNSW, NSW, Australia.,School of Psychology, Faculty of Science, UNSW, NSW, Australia
| | - P Butow
- Psycho-oncology Co-operative Research Group, University of Sydney, NSW, Australia
| | - S A Loughnan
- Clinical Research Unit for Anxiety and Depression, UNSW, NSW, Australia
| | - A E Joubert
- Clinical Research Unit for Anxiety and Depression, UNSW, NSW, Australia
| | - L Kirsten
- Psycho-oncology Co-operative Research Group, University of Sydney, NSW, Australia.,Nepean Cancer Care Centre, NSW, Australia
| | - K Allison
- Psycho-oncology Co-operative Research Group, University of Sydney, NSW, Australia
| | - J Shaw
- Psycho-oncology Co-operative Research Group, University of Sydney, NSW, Australia
| | - H L Shepherd
- Psycho-oncology Co-operative Research Group, University of Sydney, NSW, Australia
| | - J Smith
- Clinical Research Unit for Anxiety and Depression, UNSW, NSW, Australia
| | - G Andrews
- Clinical Research Unit for Anxiety and Depression, UNSW, NSW, Australia
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8
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Moloney F, Twomey M, James K, Kavanagh RG, Fama D, O'Neill S, Grey TM, Moore N, Murphy MJ, O'Connor OJ, Maher MM. A phantom study of the performance of model-based iterative reconstruction in low-dose chest and abdominal CT: When are benefits maximized? Radiography (Lond) 2019; 24:345-351. [PMID: 30292504 DOI: 10.1016/j.radi.2018.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/08/2018] [Revised: 03/26/2018] [Accepted: 04/23/2018] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The aim of this study was to assess and compare the effects of CT image reconstruction techniques on low-dose CT image quality using phantoms. METHODS Anthropomorphic torso and spatial/contrast-resolution phantoms were scanned at decreasing tube currents between 400 and 10 mA. CT thorax and abdomen/pelvis series were reconstructed with filtered back projection (FBP) alone, combined 40% adaptive statistical iterative reconstruction & FBP (ASIR40), and model-based iterative reconstruction (MBIR) [(resolution-preference 05 (RP05) and RP20 in the thorax and RP05 and noise-reduction 05 (NR05) in the abdomen)]. Two readers rated image quality quantitatively and qualitatively. RESULTS In thoracic CT, objective image noise on MBIR RP05 data sets outperformed FBP at 200, 100, 50 and 10 mA and outperformed ASIR40 at 50 and 10 mA (p < 0.001). MBIR RP20 outperformed FBP at 50 and 10 mA and outperformed ASIR40 at 10 mA (p < 0.001). Compared with both FBP and ASIR40, MBIR RP05 demonstrated significantly better signal-to-noise ratio (SNR) at 10 mA. In abdomino-pelvic CT, MBIR RP05 and NR05 outperformed FBP and ASIR at all tube current levels for objective image noise. NR05 demonstrated greater SNR at 200, 100, 50 and 10 mA and RP05 demonstrated greater SNR at 50 and 10 mA compared with both FBP and ASIR. MBIR images demonstrated better subjective image quality scores. Spatial resolution, low-contrast detectability and contrast-to-noise ratio (CNR) were comparable between image reconstruction techniques. CONCLUSION CTs reconstructed with MBIR have lower image noise and improved image quality compared with FBP and ASIR. These effects increase with reduced radiation exposure confirming optimal use for low-dose CT imaging.
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Affiliation(s)
- F Moloney
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland
| | - M Twomey
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland
| | - K James
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland
| | - R G Kavanagh
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland.
| | - D Fama
- Department of Radiology, Cork University Hospital, Cork, Ireland
| | - S O'Neill
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland
| | - T M Grey
- Department of Radiology, Cork University Hospital, Cork, Ireland
| | - N Moore
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland
| | - M J Murphy
- Department of Radiology, Cork University Hospital, Cork, Ireland
| | - O J O'Connor
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland; APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - M M Maher
- Department of Radiology, Cork University Hospital, Cork, Ireland; College of Medicine & Health, University College Cork, Cork, Ireland; APC Microbiome Ireland, University College Cork, Cork, Ireland
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Neilan TG, Rothenberg ML, Amiri-Kordestani L, Sullivan RJ, Steingart RM, Gregory W, Hariharan S, Hammad TA, Lindenfeld J, Murphy MJ, Moslehi JJ. Myocarditis Associated with Immune Checkpoint Inhibitors: An Expert Consensus on Data Gaps and a Call to Action. Oncologist 2018; 23:874-878. [PMID: 29802220 PMCID: PMC6156187 DOI: 10.1634/theoncologist.2018-0157] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 04/19/2018] [Indexed: 12/26/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for cancer. Due to the mechanism of action of ICIs, inflammatory reactions against normal tissue were an anticipated side effect of these agents; these immune-related adverse events have been documented and are typically low grade and manageable. Myocarditis has emerged as an uncommon but potentially life-threatening adverse reaction in patients treated with ICIs. Assessment and characterization of ICI-associated myocarditis is challenging because of its low incidence and protean manifestations. Nevertheless, the seriousness of ICI-associated myocarditis justifies a coordinated effort to increase awareness of this syndrome, identify patients who may be at risk, and enable early diagnosis and appropriate treatment. The "Checkpoint Inhibitor Safety Working Group," a multidisciplinary committee of academic, industry, and regulatory partners, convened at a workshop hosted by Project Data Sphere, LLC, on December 15, 2017. This meeting aimed to evaluate the current information on ICI-associated myocarditis, determine methods to collect and share data on this adverse reaction, and establish task forces to close the identified knowledge gaps. In this report, we summarize the workshop findings and proposed steps to address the impact of ICI-associated myocarditis in patients with cancer.
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Affiliation(s)
- Tomas G Neilan
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Laleh Amiri-Kordestani
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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Abstract
SummaryThe three dimensional structure of human blood platelets has been investigated using two different methods of tissue preparation. It has been demonstrated that freeze-drying preserves platelet structure to a greater degree than other methods which employ air drying.When platelets are prepared by conventional techniques their dendritic projections are uniformly found to be flattened and in contact with the substrate when viewed by scanning electron microscopy. When lyophilisation is used some of these fine cytoplasmic protuberances are found to be freely directed away from the substrate and may in fact elevate the entire platelet body or chromomere. The possible implications of this new observation are discussed in terms of platelet ultrastructure and their role in hemostasis.
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11
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Su Z, Bertagnolli MM, Sartor AO, Symonds CE, Zhang H, Murphy MJ. A novel, open-access data commons for improved disease management in patients (pts) with Merkel cell carcinoma (MCC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21544] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Zhen Su
- EMD Serono Research & Development Institute, Inc., Rockland, MA
| | - Monica M. Bertagnolli
- Dana-Farber-Cancer Institute, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA
| | | | | | - Hao Zhang
- EMD Serono Research & Development Institute, Inc., Rockland, MA
| | - Martin J. Murphy
- CEO Roundtable on Cancer and Project Data Sphere, LLC., Cary, NC
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12
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Wilkerson J, Blagoev KB, Stein WD, Hecht E, Chabot JA, Espinal Dominguez E, Blanco-Codesido M, Murphy MJ, Fojo AT, Bates SE. The rate of tumor growth during treatment accurately predicts the FDA gold standard of overall survival [OS] in a broad range of malignancies. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2545] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - John A. Chabot
- Columbia University College of Physicians and Surgeons/ New York-Presbyterian Hospital, New York, NY
| | | | | | - Martin J. Murphy
- CEO Roundtable on Cancer and Project Data Sphere, LLC., Cary, NC
| | - Antonio Tito Fojo
- National Cancer Institute at the National Institutes of Health, Bethesda, MD
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13
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Handelsman D, Murphy MJ. A legal methodology to enable broad-access sharing and investigation of clinical trial cancer data. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18604] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Martin J. Murphy
- CEO Roundtable on Cancer and Project Data Sphere, LLC., Cary, NC
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14
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Murphy MJ. Q-switched 532-nm laser energy causes significant vascular damage in the capillary plexus: how does this affect laser tattoo removal? Br J Dermatol 2017; 178:1425-1426. [PMID: 29150858 DOI: 10.1111/bjd.16130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M J Murphy
- DermaLase Training Services, 120 Queens Drive, Glasgow, G42 8QN, Strathclyde, U.K
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15
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Murphy MJ, Newby JM, Butow P, Kirsten L, Allison K, Loughnan S, Price MA, Shaw J, Shepherd H, Smith J, Andrews G. Correction to: iCanADAPT early protocol: randomised controlled trial (RCT) of clinician supervised transdiagnostic internet-delivered cognitive behaviour therapy (iCBT) for depression and/or anxiety in early stage cancer survivors -vs- treatment as usual. BMC Cancer 2017; 17:667. [PMID: 28969615 PMCID: PMC5625786 DOI: 10.1186/s12885-017-3655-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- M J Murphy
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent's Hospital, Level 4, O'Brien Centre, St Vincent's Hospital, 394 Victoria Street, Sydney, NSW, 2010, Australia.
| | - J M Newby
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent's Hospital, Level 4, O'Brien Centre, St Vincent's Hospital, 394 Victoria Street, Sydney, NSW, 2010, Australia.,School of Psychology, Faculty of Science, UNSW Australia, Mathews Building, Kensington, NSW, 2052, Australia
| | - P Butow
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O'Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW, 2006, Australia
| | - L Kirsten
- Nepean Cancer Care Centre, Sydney West Cancer Network, Kingswood, NSW, 2747, Australia.,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O'Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW, 2006, Australia
| | - K Allison
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O'Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW, 2006, Australia
| | - S Loughnan
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent's Hospital, Level 4, O'Brien Centre, St Vincent's Hospital, 394 Victoria Street, Sydney, NSW, 2010, Australia
| | - M A Price
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O'Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW, 2006, Australia
| | - J Shaw
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O'Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW, 2006, Australia
| | - H Shepherd
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O'Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW, 2006, Australia
| | - J Smith
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent's Hospital, Level 4, O'Brien Centre, St Vincent's Hospital, 394 Victoria Street, Sydney, NSW, 2010, Australia
| | - G Andrews
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent's Hospital, Level 4, O'Brien Centre, St Vincent's Hospital, 394 Victoria Street, Sydney, NSW, 2010, Australia
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16
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Affiliation(s)
| | - Sean Khozin
- Food and Drug Administration, Silver Spring, MD
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17
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Affiliation(s)
- Monica M Bertagnolli
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
| | - Oliver Sartor
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
| | - Bruce A Chabner
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
| | - Mace L Rothenberg
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
| | - Sean Khozin
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
| | - Charles Hugh-Jones
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
| | - David M Reese
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
| | - Martin J Murphy
- From the Dana-Farber Cancer Institute, Brigham and Women's Hospital (M.M.B.), and Massachusetts General Hospital Cancer Center (B.A.C.), Boston; Tulane Medical School, New Orleans (O.S.); Pfizer (M.L.R.) and Carmine Research (C.H.-J.), New York; Food and Drug Administration, Silver Spring, MD (S.K.); Amgen, Thousand Oaks, CA (D.M.R.); and Project Data Sphere, Cary, NC (M.J.M.)
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Affiliation(s)
- Bruce A Chabner
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
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Eichler H, Bloechl‐Daum B, Bauer P, Bretz F, Brown J, Hampson LV, Honig P, Krams M, Leufkens H, Lim R, Lumpkin MM, Murphy MJ, Pignatti F, Posch M, Schneeweiss S, Trusheim M, Koenig F. "Threshold-crossing": A Useful Way to Establish the Counterfactual in Clinical Trials? Clin Pharmacol Ther 2016; 100:699-712. [PMID: 27650716 PMCID: PMC5114686 DOI: 10.1002/cpt.515] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 12/15/2022]
Abstract
A central question in the assessment of benefit/harm of new treatments is: how does the average outcome on the new treatment (the factual) compare to the average outcome had patients received no treatment or a different treatment known to be effective (the counterfactual)? Randomized controlled trials (RCTs) are the standard for comparing the factual with the counterfactual. Recent developments necessitate and enable a new way of determining the counterfactual for some new medicines. For select situations, we propose a new framework for evidence generation, which we call "threshold-crossing." This framework leverages the wealth of information that is becoming available from completed RCTs and from real world data sources. Relying on formalized procedures, information gleaned from these data is used to estimate the counterfactual, enabling efficacy assessment of new drugs. We propose future (research) activities to enable "threshold-crossing" for carefully selected products and indications in which RCTs are not feasible.
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Affiliation(s)
- H‐G Eichler
- European Medicines AgencyLondonUnited Kingdom
| | - B Bloechl‐Daum
- Department of Clinical PharmacologyMedical University of ViennaViennaAustria
| | - P Bauer
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent SystemsMedical University of ViennaViennaAustria
| | | | - J Brown
- Harvard Medical School/Harvard Pilgrim Health Care InstituteHartfordConnecticutUSA
| | - LV Hampson
- Lancaster UniversityLancasterUnited Kingdom
| | | | - M Krams
- Janssen Pharmaceutical CompaniesRaritanNew JerseyUSA
| | - H Leufkens
- Medicines Evaluation Board, UtrechtUniversity of UtrechtUtrechtThe Netherlands
| | - R Lim
- Health CanadaOttawaOntarioCanada
| | - MM Lumpkin
- Bill and Melinda Gates FoundationSeattleWashingtonUSA
| | - MJ Murphy
- Project Data SphereDurhamNorth CarolinaUSA
| | - F Pignatti
- European Medicines AgencyLondonUnited Kingdom
| | - M Posch
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent SystemsMedical University of ViennaViennaAustria
| | - S Schneeweiss
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - M Trusheim
- MIT Sloan School of ManagementCambridgeMassachusettsUSA
| | - F Koenig
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent SystemsMedical University of ViennaViennaAustria
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Jeffery J, Devendra D, Farrugia J, Gardner D, Murphy MJ, Williams R, Ayling RM, Wilkin TJ. Increased urinary dopamine excretion in association with bilateral carotid body tumours - clinical, biochemical and genetic findings. Ann Clin Biochem 2016; 43:156-60. [PMID: 16536919 DOI: 10.1258/000456306776021517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/18/2022]
Abstract
This report describes a rare case of a patient with increased urinary dopamine excretion in association with bilateral carotid body tumours. Excretion of adrenaline, noradrenaline, metadrenaline, normetadrenaline and 4-hydroxy-3-methoxymandelic acid (HMMA) were within the reference ranges, and an 123I-meta-iodobenzylguanidine (MIBG) scan showed uptake in the neck masses, with no other abnormal uptake anywhere else in the body. The patient is being managed conservatively as the tumours are not amenable to resection on account of their size and vascularity. There are only four previous case reports of dopamine-secreting tumours of the carotid body described in the literature, all of whom were women. The tumours were unilateral in three cases and bilateral in the fourth case. Familial cases of carotid body tumours have a higher prevalence of bilateral tumours than non-familial cases. Recent reports in the literature have suggested that a significant number of patients with extra-adrenal catecholamine-secreting paragangliomas have a genetic mutation in one of the identified susceptibility genes for catecholamine-secreting tumours, despite having no other affected family members, and a mutation has been found in the succinate dehydrogenase gene for this patient.
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Affiliation(s)
- J Jeffery
- Derriford Combined Laboratory, Derriford Hospital, Plymouth PL6 8DH, UK.
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Murphy A, Murphy MJ, Begley CG, Stanley ER, Migliaccio AR, Kaushansky K, Ng AP, Alexander WS, Hilton DJ, Nicola NA. Tribute to Donald Metcalf. Stem Cells 2016; 33:3397-421. [PMID: 26976235 DOI: 10.1002/stem.2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Indexed: 11/06/2022]
Abstract
A collection of tributes and remembrances from esteemed colleagues, mentees, and friends on the life and work of "the father of hematopoietic cytokines".
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Abdallah K, Jenkins R, Hugh-Jones C, Beetsch J, Curt GA, Rothenberg ML, Zhou FL, Simantov R, Dornan J, Murphy MJ. Project Data Sphere initiative: Results from first 6 months of broad access to oncology trials data. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e17691] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Fang Liz Zhou
- Sanofi US, North America Medical Affairs, Bridgewater, NJ
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Hugh-Jones C, Jenkins R, Beetsch J, Abdallah K, Curnyn M, Zhou FL, Rothenberg ML, Curt GA, Dornan J, Murphy MJ. Overcoming barriers to develop a broad access data sharing platform. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e17690] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Fang Liz Zhou
- Sanofi US, North America Medical Affairs, Bridgewater, NJ
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Peluffo MC, Stanley J, Braeuer N, Rotgeri A, Fritzemeier KH, Fuhrmann U, Buchmann B, Adevai T, Murphy MJ, Zelinski MB, Lindenthal B, Hennebold JD, Stouffer RL. A prostaglandin E2 receptor antagonist prevents pregnancies during a preclinical contraceptive trial with female macaques. Hum Reprod 2014; 29:1400-12. [PMID: 24781425 DOI: 10.1093/humrep/deu083] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION Can administration of a prostaglandin (PG) E2 receptor 2 (PTGER2) antagonist prevent pregnancy in adult female monkeys by blocking periovulatory events in the follicle without altering menstrual cyclicity or general health? SUMMARY ANSWER This is the first study to demonstrate that a PTGER2 antagonist can serve as an effective non-hormonal contraceptive in primates. WHAT IS KNOWN ALREADY The requirement for PGE2 in ovulation and the release of an oocyte surrounded by expanded cumulus cells (cumulus-oocyte expansion; C-OE) was established through the generation of PTGS2 and PTGER2 null-mutant mice. A critical role for PGE2 in primate ovulation is supported by evidence that intrafollicular injection of indomethacin in rhesus monkeys suppressed follicle rupture, whereas co-injection of PGE2 with indomethacin resulted in ovulation. STUDY DESIGN, SIZE, DURATION First, controlled ovulation protocols were performed in adult, female rhesus monkeys to analyze the mRNA levels for genes encoding PGE2 synthesis and signaling components in the naturally selected pre-ovulatory follicle at different times after the ovulatory hCG stimulus (0, 12, 24, 36 h pre-ovulation; 36 h post-ovulation, n = 3-4/time point). Second, controlled ovarian stimulation cycles were utilized to obtain multiple cumulus-oocyte complexes (COCs) from rhesus monkeys to evaluate the role of PGE2 in C-OE in vitro (n = 3-4 animals/treatment; ≥3 COCs/animal/treatment). Third, adult cycling female cynomolgus macaques were randomly assigned (n = 10/group) to vehicle (control) or PTGER2 antagonist (BAY06) groups to perform a contraceptive trial. After the first treatment cycle, a male of proven fertility was introduced into each group and they remained housed together for the duration of the 5-month contraceptive trial that was followed by a post-treatment reversibility trial. PARTICIPANTS/MATERIALS, SETTING, METHODS Quantitative real-time PCR, COC culture and expansion, immunofluorescence/confocal microscopy, enzyme immunoassay, contraceptive trial, ultrasonography, complete blood counts, serum biochemistry tests and blood lipid profiles. MAIN RESULTS AND THE ROLE OF CHANCE Several mRNAs encoding proteins involved in PGE2 synthesis, metabolism and signaling increase (P < 0.05) in the periovulatory follicle after administration of an ovulatory hCG bolus. PGE2 signaling through PTGER2 induces cumulus cell expansion and production of hyaluronic acid, which are critical events for fertilization. Moreover, chronic administration of a selective PTGER2 antagonist resulted in a significant (P < 0.05 versus vehicle-treated controls) contraceptive effect without altering steroid hormone patterns or menstrual cyclicity during a 5-months contraceptive trial. Fertility recovered as early as 1 month after ending treatment. LIMITATIONS, REASONS FOR CAUTION This is a proof-of-concept study in a non-human primate model. Further investigations are warranted to elucidate the mechanism(s) of PTGER2 antagonist action in the primate ovary. Although PTGER2 antagonist treatment did not produce any obvious undesirable effects, improvements in the mode of administration, as well as the efficacy of these compounds, are necessary to consider such a contraceptive for women. WIDER IMPLICATIONS OF THE FINDINGS Monitoring as well as improving the efficacy and safety of female contraceptives is an important public health activity. Even though hormonal contraceptives are effective for women, concerns remain regarding their side-effects and long-term use because of the widespread actions of such steroidal products in many tissues. Moreover, some women cannot take hormones for medical reasons. Thus, development of non-hormonal contraceptives for women is warranted. STUDY FUNDING/COMPETING INTEREST(S) Supported by Bayer HealthCare Pharmaceuticals, The Eunice Kennedy Shriver NICHD Contraceptive Development and Research Center (U54 HD055744), NIH Office of the Director (Oregon National Primate Research Center P51 OD011092), and a Lalor Foundation Postdoctoral Basic Research Fellowship (MCP). The use of the Leica confocal was supported by grant number S10RR024585. Some of the authors (N.B., A.R., K.-H.F., U.F., B.B. and B.L.) are employees of Bayer Healthcare Pharma.
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Lawler M, Le Chevalier T, Banks I, Conte P, De Lorenzo F, Meunier F, Pinedo HM, Selby P, Murphy MJ, Johnston PG. A Bill of Rights for patients with cancer in Europe. Lancet Oncol 2014; 15:258-60. [PMID: 24503530 DOI: 10.1016/s1470-2045(13)70552-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology and Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast BT9 7BL, UK.
| | | | - Ian Banks
- European Men's Health Forum, Brussels, Belgium
| | - Pierfranco Conte
- University of Padua and Istituto Oncologico Veneto, Padua, Italy; Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
| | - Francesco De Lorenzo
- Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy; European Cancer Patient Coalition, Brussels, Belgium
| | - Françoise Meunier
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - H M Pinedo
- VuMC Cancer Center, Amsterdam, Netherlands
| | - Peter Selby
- Leeds' Institute of Cancer and Pathology, University of Leeds, UK
| | | | - Patrick G Johnston
- Centre for Cancer Research and Cell Biology and Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast BT9 7BL, UK
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Lawler M, Le Chevalier T, Murphy MJ, Banks I, Conte P, De Lorenzo F, Meunier F, Pinedo H, Selby P, Armand JP, Barbacid M, Barzach M, Bergh J, Bode G, Cameron DA, de Braud F, de Gramont A, Diehl V, Diler S, Erdem S, Fitzpatrick JM, Geissler J, Hollywood D, Højgaard L, Horgan D, Jassem J, Johnson PW, Kapitein P, Kelly J, Kloezen S, La Vecchia C, Löwenberg B, Oliver K, Sullivan R, Tabernero J, Van de Velde CJ, Wilking N, Wilson R, Zielinski C, zur Hausen H, Johnston PG. A catalyst for change: the European cancer Patient's Bill of Rights. Oncologist 2014; 19:217-24. [PMID: 24493667 PMCID: PMC3958470 DOI: 10.1634/theoncologist.2013-0452] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 01/06/2014] [Indexed: 11/17/2022] Open
Abstract
The European Cancer Concord is a unique patient-centered partnership that will act as a catalyst to achieve improved access to an optimal standard of cancer care and research for European citizens. In order to provide tangible benefits for European cancer patients, the partnership proposes the creation of a “European Cancer Patient’s Bill of Rights,” a patient charter that will underpin equitable access to an optimal standard of care for Europe’s citizens.
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Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | | | - Martin J. Murphy
- European Cancer Concord, Society for Translational Oncology, Durham, North Carolina, USA
| | - Ian Banks
- European Men’s Health Forum, Brussels, Belgium
| | | | - Francesco De Lorenzo
- Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
- European Cancer Patient Coalition, Brussels, Belgium
| | - Françoise Meunier
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - H.M. Pinedo
- VuMC Cancer Center, Amsterdam, The Netherlands
| | - Peter Selby
- Department of Medical Oncology, University of Leeds, Leeds, United Kingdom
| | | | | | | | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institut, Stockholm, Sweden
| | - Gerlind Bode
- International Confederation of Childhood Cancer Parent Organizations, Nieuwegein, The Netherlands
| | - David A. Cameron
- Edinburgh Cancer Centre, NHS Lothian & Edinburgh Cancer Research Centre, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Filippo de Braud
- Medical Oncology Division, National Cancer Institute, Milan, Italy
| | | | - Volker Diehl
- Internal Medicine, University of Cologne, Köln, Germany
| | | | - Sema Erdem
- Europa Donna, Piazza Amendola, Milan, Italy
| | - John M. Fitzpatrick
- Irish Cancer Society, Dublin, Ireland
- Department of Surgery, University College Dublin, Dublin, Ireland
| | - Jan Geissler
- Leukemia Patient Advocates Foundation, Berne, Switzerland
- European Patients Academy on Therapeutic Innovation, Riemerling, Germany
| | - Donal Hollywood
- >† Deceased
- Academic Unit of Clinical and Molecular Oncology, St James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - Liselotte Højgaard
- Danish National Research Foundation, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Denis Horgan
- European Alliance for Personalised Medicine, Brussels, Belgium
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - Peter W. Johnson
- Department of Medical Oncology, University of Southampton, Southampton, United Kingdom
- Cancer Research UK, London, United Kingdom
| | | | - Joan Kelly
- Irish Cancer Society, Dublin, Ireland
- European Cancer Leagues, Brussels, Belgium
| | | | - Carlo La Vecchia
- Dipartimento di Epidemiologia, Istituto di Ricerche Farmacologiche “Mario Negri” Milan, Italy
| | - Bob Löwenberg
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kathy Oliver
- International Brain Tumor Alliance, Tadworth, Surrey, United Kingdom
| | - Richard Sullivan
- Institute of Cancer Policy, Kings Health Partners Integrated Cancer Centre, London, United Kingdom
| | | | | | - Nils Wilking
- Department of Oncology, Karolinska Institut, Stockholm, Sweden, and Skåne University Hospital, Lund, Sweden
| | | | - Christoph Zielinski
- Comprehensive Cancer Center and Department of Medicine I, Medical University Vienna - General Hospital, Vienna, Austria
| | - Harald zur Hausen
- German Cancer Research Centre, University of Heidelberg, Heidelberg, Germany
| | - Patrick G. Johnston
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
- School of Medicine, Dentistry and Biomedical Sciences, and Institute of Health Sciences, Queens University Belfast, Belfast, United Kingdom
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Abstract
PURPOSE To develop an algorithm for computing realistic digitally reconstructed radiographs (DRRs) that match real cone-beam CT (CBCT) projections with no artificial adjustments. METHODS The authors used measured attenuation data from cone-beam CT projection radiographs of different materials to obtain a function to convert CT number to linear attenuation coefficient (LAC). The effects of scatter, beam hardening, and veiling glare were first removed from the attenuation data. Using this conversion function the authors calculated the line integral of LAC through a CT along rays connecting the radiation source and detector pixels with a ray-tracing algorithm, producing raw DRRs. The effects of scatter, beam hardening, and veiling glare were then included in the DRRs through postprocessing. RESULTS The authors compared actual CBCT projections to DRRs produced with all corrections (scatter, beam hardening, and veiling glare) and to uncorrected DRRs. Algorithm accuracy was assessed through visual comparison of projections and DRRs, pixel intensity comparisons, intensity histogram comparisons, and correlation plots of DRR-to-projection pixel intensities. In general, the fully corrected algorithm provided a small but nontrivial improvement in accuracy over the uncorrected algorithm. The authors also investigated both measurement- and computation-based methods for determining the beam hardening correction, and found the computation-based method to be superior, as it accounted for nonuniform bowtie filter thickness. The authors benchmarked the algorithm for speed and found that it produced DRRs in about 0.35 s for full detector and CT resolution at a ray step-size of 0.5 mm. CONCLUSIONS The authors have demonstrated a DRR algorithm calculated from first principles that accounts for scatter, beam hardening, and veiling glare in order to produce accurate DRRs. The algorithm is computationally efficient, making it a good candidate for iterative CT reconstruction techniques that require a data fidelity term based on the matching of DRRs and projections.
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Affiliation(s)
- David Staub
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Norkus M, Kilmartin L, Fay D, Murphy MJ, Olaighin G, Barry F. The effect of temperature elevation on cryopreserved mesenchymal stem cells. Cryo Letters 2013; 34:349-359. [PMID: 23995402] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Cryopreservation is of particular importance in stem cell research and regenerative medicine as it permits long term stabilisation of biological cells. Cells retain their regenerative capacity after years of storage at cryogenic temperatures. However, elevation of temperature may occur due to variety of reasons, for example in the event of equipment malfunction or during delays in transportation. To date, a limited amount research has been carried out to examine the effects of temperature elevation on stem cell survival during cryopreservation. METHODS Mesenchymal Stem Cells (MSCs) obtained from 8-12 week Sprague Dawley male rats were cryopreserved according to the standard procedures. Under experimental conditions, cryopreserved specimens were exposed to elevated temperatures ranging from -20 C to 37 C and cellular membrane integrity assessed via trypan-blue exclusion at various time points. RESULTS An approximating model of multiple regression was fitted to the experimental data and optimisation of model parameters was carried out. This model provides an approximation of cell viability in response to elevated temperature conditions. DISCUSSION The results demonstrate that elevation of temperature has a dramatic effect, even over short periods of time, on the viability of cryopreserved specimens. The model presented here could be used to predict the damage suffered by a specimen due to exposure to elevated temperature over a defined period of time.
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Affiliation(s)
- M Norkus
- National Centre for Biomedical Engineering Science, National University of Ireland Galway, Galway, Ireland.
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Abstract
BACKGROUND Previous studies show that statins reduce total cholesterol (TC) concentration by both 21% in primary prevention (PP) and secondary prevention (SP) in clinical trials and by ∼24% in the general population. There are few data about the efficacy of statins on TC concentration and cardiovascular (CV) outcome in patients with chronic kidney disease (CKD). We evaluated the reduction of TC concentration and subsequent risk of CV morbidity and mortality with statins in CKD patients. METHODS A population-based cohort study using a record-linkage database in Tayside, Scotland. A total of 2369 patients who had a primary diagnosis of CKD from Scottish Morbidity Record data or biochemistry database (serum creatinine of 220 μmol/l or higher) and who had at least two separate TC measurements between 1993 and 2007 were studied. Patients were categorized into statin-exposed and statin-unexposed groups according to statin use status during the follow-up. They were also classified into PP (n = 1325) and SP (n = 1044) cohorts at the entry date. The main outcomes were TC concentration change from baseline, CV events [Antiplatelet Trialist's Collaboration (APTC)] and all-cause mortality during the follow-up. Cox regression models, in which statin use was a time-dependent variable, were employed to assess the risk of outcome and adjusted for other known confounders. RESULTS Statin-associated TC concentrations decreased by 0.59 mmol/l (12%) in PP cohort and 0.56 mmol/l (13%) in SP cohort from 4.77 and 4.48 mmol/l at baselines, respectively. Statin use was associated with a reduced risk of APTC events, CV mortality or all-cause mortality in PP {adjusted hazard ratio (HR), 0.65 [95% confidence interval (CI) 0.48-0.88]; 0.73 (95% CI 0.52-0.98); 0.59 (95% CI 0.48-0.73)} and SP [adjusted HR, 0.66 (95% CI 0.52-0.84); 0.60 (95% CI 0.47-0.77); 0.56 (95% CI 0.47-0.68)], respectively. CONCLUSION Statin use reduced TC concentrations by ∼13% in patients with CKD. Statins were protective of APTC events, CV mortality and all-cause mortality in patients with or without established CV disease.
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Affiliation(s)
- X Sheng
- Medicines Monitoring Unit, Division of Medical Sciences, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK
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Zhang C, Christensen GE, Kurtek S, Srivastava A, Weiss E, Murphy MJ, Williamson JF. WE-E-213CD-05: A Non-Rigid Image Registration Algorithm That Accommodates Organ Segmentation Error. Med Phys 2012; 39:3960. [PMID: 28519973 DOI: 10.1118/1.4736161] [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: 11/07/2022] Open
Abstract
PURPOSE To introduce a new deformable image registration algorithm based on surface matching that accommodates organ delineation error in daily Cone-beam CT images based on a priori knowledge of inter-observer segmentation uncertainty. METHODS The dataset includes four prostate cancer patients who underwent primary external beam radiotherapy and had tumors that were confined to the prostate. All imaging was performed without intravenous contrast. Organ surface segmentation errors in a multiple observer-contouring study on the pelvic organs in Fan-beam CT (FBCT) and Cone-beam CT (CBCT) were estimated from the training dataset. A novel deformable image registration algorithm is presented where the organ surface matching is penalized by this error. Portions of the organ surface that are delineated reliably are used to guide the registration whereas the portions that are highly uncertain are ignored. This approach reduces the impact of delineation errors in CBCT. An evaluation experiment compares three algorithms, namely intensity-only registration (INT), equally-weighted surface and image registration (EWSIR) and the proposed uncertainty- weighted surface and image registration. RESULTS The surface dissimilarity was reduced from 0.172 to 0.134, 0.043 and 0.044 respectively after registration. The Jacobian of the transformation found by the proposed method was closer to one than that of EWSIR in the prostate. CONCLUSIONS In prostate external-beam radiotherapy, slice-by-slice 2D manual contouring has variable spatial accuracy. For deformable image registration methods that match segmented surfaces, regions of high inaccuracy can misguide the registration. In contrast to the image registration methods where the FBCT and CBCT surfaces (or other features) are assumed to be exact, our method takes this uncertainty into account. Preliminary results show an improved registration performance suggesting a potential use in IGRT. This work was supported by National Cancer Institute Grant No. P01 CA 116602.
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Affiliation(s)
- C Zhang
- University of Iowa, Iowa City, IA.,Florida State University, Tallahassee, FL.,Virginia Commonwealth University, Richmond, VA
| | - G E Christensen
- University of Iowa, Iowa City, IA.,Florida State University, Tallahassee, FL.,Virginia Commonwealth University, Richmond, VA
| | - S Kurtek
- University of Iowa, Iowa City, IA.,Florida State University, Tallahassee, FL.,Virginia Commonwealth University, Richmond, VA
| | - A Srivastava
- University of Iowa, Iowa City, IA.,Florida State University, Tallahassee, FL.,Virginia Commonwealth University, Richmond, VA
| | - E Weiss
- University of Iowa, Iowa City, IA.,Florida State University, Tallahassee, FL.,Virginia Commonwealth University, Richmond, VA
| | - M J Murphy
- University of Iowa, Iowa City, IA.,Florida State University, Tallahassee, FL.,Virginia Commonwealth University, Richmond, VA
| | - J F Williamson
- University of Iowa, Iowa City, IA.,Florida State University, Tallahassee, FL.,Virginia Commonwealth University, Richmond, VA
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Murphy MJ, Salguero FJ, Siebers JV, Staub D, Vaman C. A method to estimate the effect of deformable image registration uncertainties on daily dose mapping. Med Phys 2012; 39:573-80. [PMID: 22320766 DOI: 10.1118/1.3673772] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To develop a statistical sampling procedure for spatially-correlated uncertainties in deformable image registration and then use it to demonstrate their effect on daily dose mapping. METHODS Sequential daily CT studies are acquired to map anatomical variations prior to fractionated external beam radiotherapy. The CTs are deformably registered to the planning CT to obtain displacement vector fields (DVFs). The DVFs are used to accumulate the dose delivered each day onto the planning CT. Each DVF has spatially-correlated uncertainties associated with it. Principal components analysis (PCA) is applied to measured DVF error maps to produce decorrelated principal component modes of the errors. The modes are sampled independently and reconstructed to produce synthetic registration error maps. The synthetic error maps are convolved with dose mapped via deformable registration to model the resulting uncertainty in the dose mapping. The results are compared to the dose mapping uncertainty that would result from uncorrelated DVF errors that vary randomly from voxel to voxel. RESULTS The error sampling method is shown to produce synthetic DVF error maps that are statistically indistinguishable from the observed error maps. Spatially-correlated DVF uncertainties modeled by our procedure produce patterns of dose mapping error that are different from that due to randomly distributed uncertainties. CONCLUSIONS Deformable image registration uncertainties have complex spatial distributions. The authors have developed and tested a method to decorrelate the spatial uncertainties and make statistical samples of highly correlated error maps. The sample error maps can be used to investigate the effect of DVF uncertainties on daily dose mapping via deformable image registration. An initial demonstration of this methodology shows that dose mapping uncertainties can be sensitive to spatial patterns in the DVF uncertainties.
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Affiliation(s)
- Martin J Murphy
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA 23298, USA
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Armstrong L, Lako M, Buckley N, Lappin TRJ, Murphy MJ, Nolta JA, Pittenger M, Stojkovic M. Editorial: Our top 10 developments in stem cell biology over the last 30 years. Stem Cells 2012; 30:2-9. [PMID: 22162299 DOI: 10.1002/stem.1007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
To celebrate 30 years of peer-reviewed publication of cutting edge stem cell research in Stem Cells, the first journal devoted to this promising field, we pause to review how far we have come in the three-decade lifetime of the Journal. To do this, we will present our views of the 10 most significant developments that have advanced stem cell biology where it is today. With the increasing rate of new data, it is natural that the bulk of these developments would have occurred in recent years, but we must not think that stem cell biology is a young science. The idea of a stem cell has actually been around for quite a long time having appeared in the scientific literature as early as 1868 with Haeckels' concept of a stamzelle as an uncommitted or undifferentiated cell responsible for producing many types of new cells to repair the body [Naturliche Schopfungsgeschichte, 1868; Berlin: Georg Reimer] but it took many years to obtain hard evidence in support of this theory. Not until the work of James Till and Ernest McCulloch in the 1960s did we have proof of the existence of stem cells and until the derivation of embryonal carcinoma cells in the 1960s-1970s and the first embryonic stem cell in 1981, such adult or tissue-specific stem cells were the only known class. The first issue of Stem Cells was published in 1981; no small wonder that most of its papers were devoted to hematopoietic progenitors. More recently, induced pluripotent stem cells (iPSCs) have been developed, and this is proving to be a fertile area of investigation as shown by the volume of publications appearing not only in Stem Cells but also in other journals over the last 5 years. The reader will note that many of the articles in this special issue are concerned with iPSC; however, this reflects the current surge of interest in the topic rather than any deliberate attempt to ignore other areas of stem cell investigation.
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Staub D, Docef A, Brock RS, Vaman C, Murphy MJ. 4D Cone-beam CT reconstruction using a motion model based on principal component analysis. Med Phys 2012; 38:6697-709. [PMID: 22149852 DOI: 10.1118/1.3662895] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To provide a proof of concept validation of a novel 4D cone-beam CT (4DCBCT) reconstruction algorithm and to determine the best methods to train and optimize the algorithm. METHODS The algorithm animates a patient fan-beam CT (FBCT) with a patient specific parametric motion model in order to generate a time series of deformed CTs (the reconstructed 4DCBCT) that track the motion of the patient anatomy on a voxel by voxel scale. The motion model is constrained by requiring that projections cast through the deformed CT time series match the projections of the raw patient 4DCBCT. The motion model uses a basis of eigenvectors that are generated via principal component analysis (PCA) of a training set of displacement vector fields (DVFs) that approximate patient motion. The eigenvectors are weighted by a parameterized function of the patient breathing trace recorded during 4DCBCT. The algorithm is demonstrated and tested via numerical simulation. RESULTS The algorithm is shown to produce accurate reconstruction results for the most complicated simulated motion, in which voxels move with a pseudo-periodic pattern and relative phase shifts exist between voxels. The tests show that principal component eigenvectors trained on DVFs from a novel 2D/3D registration method give substantially better results than eigenvectors trained on DVFs obtained by conventionally registering 4DCBCT phases reconstructed via filtered backprojection. CONCLUSIONS Proof of concept testing has validated the 4DCBCT reconstruction approach for the types of simulated data considered. In addition, the authors found the 2D/3D registration approach to be our best choice for generating the DVF training set, and the Nelder-Mead simplex algorithm the most robust optimization routine.
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Affiliation(s)
- David Staub
- Department of Radiation Oncology, Virignia Commonwealth University, Richmond, Virginia 23298, USA.
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Abstract
PURPOSE To develop an automatic knot placement algorithm to enable the use of NonUniform Rational B-Splines (NURBS) in deformable image registration. METHODS The authors developed a two-step approach to fit a known displacement vector field (DVF). An initial fit was made with uniform knot spacing. The error generated by this fit was then assigned as an attractive force pulling on the knots, acting against a resistive spring force in an iterative equilibration scheme. To demonstrate the accuracy gain of knot optimization over uniform knot placement, we compared the sum of the squared errors and the frequency of large errors. RESULTS Fits were made to a one-dimensional DVF using 1-20 free knots. Given the same number of free knots, the optimized, nonuniform B-spline fit produced a smaller error than the uniform B-spline fit. The accuracy was improved by a mean factor of 4.02. The optimized B-spline was found to greatly reduce the number of errors more than 1 standard deviation from the mean error of the uniform fit. The uniform B-spline had 15 such errors, while the optimized B-spline had only two. The algorithm was extended to fit a two-dimensional DVF using control point grid sizes ranging from 8 x 8 to 15 x 15. Compared with uniform fits, the optimized B-spline fits were again found to reduce the sum of squared errors (mean ratio = 2.61) and number of large errors (mean ratio = 4.50). CONCLUSIONS Nonuniform B-splines offer an attractive alternative to uniform B-splines in modeling the DVF. They carry forward the mathematical compactness of B-splines while simultaneously introducing new degrees of freedom. The increased adaptability of knot placement gained from the generalization to NURBS offers increased local control as well as the ability to explicitly represent topological discontinuities.
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Affiliation(s)
- Travis J Jacobson
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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Pokhrel D, Murphy MJ, Todor DA, Weiss E, Williamson JF. Localizing intracavitary brachytherapy applicators from cone-beam CT x-ray projections via a novel iterative forward projection matching algorithm. Med Phys 2011; 38:1070-80. [PMID: 21452744 DOI: 10.1118/1.3544661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To present a novel method for reconstructing the 3D pose (position and orientation) of radio-opaque applicators of known but arbitrary shape from a small set of 2D x-ray projections in support of intraoperative brachytherapy planning. METHODS The generalized iterative forward projection matching (gIFPM) algorithm finds the six degree-of-freedom pose of an arbitrary rigid object by minimizing the sum-of-squared-intensity differences (SSQD) between the computed and experimentally acquired autosegmented projection of the objects. Starting with an initial estimate of the object's pose, gIFPM iteratively refines the pose parameters (3D position and three Euler angles) until the SSQD converges. The object, here specialized to a Fletcher-Weeks intracavitary brachytherapy (ICB) applicator, is represented by a fine mesh of discrete points derived from complex combinatorial geometric models of the actual applicators. Three pairs of computed and measured projection images with known imaging geometry are used. Projection images of an intrauterine tandem and colpostats were acquired from an ACUITY cone-beam CT digital simulator. An image postprocessing step was performed to create blurred binary applicators only images. To quantify gIFPM accuracy, the reconstructed 3D pose of the applicator model was forward projected and overlaid with the measured images and empirically calculated the nearest-neighbor applicator positional difference for each image pair. RESULTS In the numerical simulations, the tandem and colpostats positions (x,y,z) and orientations (alpha, beta, gamma) were estimated with accuracies of 0.6 mm and 2 degrees, respectively. For experimentally acquired images of actual applicators, the residual 2D registration error was less than 1.8 mm for each image pair, corresponding to about 1 mm positioning accuracy at isocenter, with a total computation time of less than 1.5 min on a 1 GHz processor. CONCLUSIONS This work describes a novel, accurate, fast, and completely automatic method to localize radio-opaque applicators of arbitrary shape from measured 2D x-ray projections. The results demonstrate approximately 1 mm accuracy while compared against the measured applicator projections. No lateral film is needed. By localizing the applicator internal structure as well as radioactive sources, the effect of intra-applicator and interapplicator attenuation can be included in the resultant dose calculations. Further validation tests using clinically acquired tandem and colpostats images will be performed for the accurate and robust applicator/sources localization in ICB patients.
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Affiliation(s)
- Damodar Pokhrel
- Department of Radiation Oncology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia 23298, USA
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Abstract
PURPOSE To demonstrate the feasibility of reconstructing a cone-beam CT (CBCT) image by deformably altering a prior fan-beam CT (FBCT) image such that it matches the anatomy portrayed in the CBCT projection data set. METHODS A prior FBCT image of the patient is assumed to be available as a source image. A CBCT projection data set is obtained and used as a target image set. A parametrized deformation model is applied to the source FBCT image, digitally reconstructed radiographs (DRRs) that emulate the CBCT projection image geometry are calculated and compared to the target CBCT projection data, and the deformation model parameters are adjusted iteratively until the DRRs optimally match the CBCT projection data set. The resulting deformed FBCT image is hypothesized to be an accurate representation of the patient's anatomy imaged by the CBCT system. The process is demonstrated via numerical simulation. A known deformation is applied to a prior FBCT image and used to create a synthetic set of CBCT target projections. The iterative projection matching process is then applied to reconstruct the deformation represented in the synthetic target projections; the reconstructed deformation is then compared to the known deformation. The sensitivity of the process to the number of projections and the DRR/CBCT projection mismatch is explored by systematically adding noise to and perturbing the contrast of the target projections relative to the iterated source DRRs and by reducing the number of projections. RESULTS When there is no noise or contrast mismatch in the CBCT projection images, a set of 64 projections allows the known deformed CT image to be reconstructed to within a nRMS error of 1% and the known deformation to within a nRMS error of 7%. A CT image nRMS error of less than 4% is maintained at noise levels up to 3% of the mean projection intensity, at which the deformation error is 13%. At 1% noise level, the number of projections can be reduced to 8 while maintaining CT image and deformation errors of less than 4% and 13%, respectively. The method is sensitive to contrast mismatch between the simulated projections and the target projections when the soft-tissue contrast in the projections is low. CONCLUSIONS By using prior knowledge available in a FBCT image, the authors show that a CBCT image can be iteratively reconstructed from a comparatively small number of projection images, thus saving acquisition time and reducing imaging dose. This will enable more frequent daily imaging during radiation therapy. Because the process preserves the CT numbers of the FBCT image, the resulting 3D image intensities will be more accurate than a CBCT image reconstructed via conventional backprojection methods. Reconstruction errors are insensitive to noise at levels beyond what would typically be found in CBCT projection data, but are sensitive to contrast mismatch errors between the CBCT projection data and the DRRs.
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Affiliation(s)
- R Scott Brock
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298, USA
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Pokhrel D, Murphy MJ, Todor DA, Weiss E, Williamson JF. Reconstruction of brachytherapy seed positions and orientations from cone-beam CT x-ray projections via a novel iterative forward projection matching method. Med Phys 2011; 38:474-86. [PMID: 21361216 DOI: 10.1118/1.3528220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To generalize and experimentally validate a novel algorithm for reconstructing the 3D pose (position and orientation) of implanted brachytherapy seeds from a set of a few measured 2D cone-beam CT (CBCT) x-ray projections. METHODS The iterative forward projection matching (IFPM) algorithm was generalized to reconstruct the 3D pose, as well as the centroid, of brachytherapy seeds from three to ten measured 2D projections. The gIFPM algorithm finds the set of seed poses that minimizes the sum-of-squared-difference of the pixel-by-pixel intensities between computed and measured autosegmented radiographic projections of the implant. Numerical simulations of clinically realistic brachytherapy seed configurations were performed to demonstrate the proof of principle. An in-house machined brachytherapy phantom, which supports precise specification of seed position and orientation at known values for simulated implant geometries, was used to experimentally validate this algorithm. The phantom was scanned on an ACUITY CBCT digital simulator over a full 660 sinogram projections. Three to ten x-ray images were selected from the full set of CBCT sinogram projections and postprocessed to create binary seed-only images. RESULTS In the numerical simulations, seed reconstruction position and orientation errors were approximately 0.6 mm and 5 degrees, respectively. The physical phantom measurements demonstrated an absolute positional accuracy of (0.78 +/- 0.57) mm or less. The theta and phi angle errors were found to be (5.7 +/- 4.9) degrees and (6.0 +/- 4.1) degrees, respectively, or less when using three projections; with six projections, results were slightly better. The mean registration error was better than 1 mm/6 degrees compared to the measured seed projections. Each test trial converged in 10-20 iterations with computation time of 12-18 min/iteration on a 1 GHz processor. CONCLUSIONS This work describes a novel, accurate, and completely automatic method for reconstructing seed orientations, as well as centroids, from a small number of radiographic projections, in support of intraoperative planning and adaptive replanning. Unlike standard back-projection methods, gIFPM avoids the need to match corresponding seed images on the projections. This algorithm also successfully reconstructs overlapping clustered and highly migrated seeds in the implant. The accuracy of better than 1 mm and 6 degrees demonstrates that gIFPM has the potential to support 2D Task Group 43 calculations in clinical practice.
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Affiliation(s)
- Damodar Pokhrel
- Department of Radiation Oncology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia 23298, USA
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Wu J, Murphy MJ. A neural network based 3D/3D image registration quality evaluator for the head-and-neck patient setup in the absence of a ground truth. Med Phys 2011; 37:5756-64. [PMID: 21158287 DOI: 10.1118/1.3502756] [Citation(s) in RCA: 7] [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: 11/07/2022] Open
Abstract
PURPOSE To develop a neural network based registration quality evaluator (RQE) that can identify unsuccessful 3D/3D image registrations for the head-and-neck patient setup in radiotherapy. METHODS A two-layer feed-forward neural network was used as a RQE to classify 3D/3D rigid registration solutions as successful or unsuccessful based on the features of the similarity surface near the point-of-solution. The supervised training and test data sets were generated by rigidly registering daily cone-beam CTs to the treatment planning fan-beam CTs of six patients with head-and-neck tumors. Two different similarity metrics (mutual information and mean-squared intensity difference) and two different types of image content (entire image versus bony landmarks) were used. The best solution for each registration pair was selected from 50 optimizing attempts that differed only by the initial transformation parameters. The distance from each individual solution to the best solution in the normalized parametrical space was compared to a user-defined error threshold to determine whether that solution was successful or not. The supervised training was then used to train the RQE. The performance of the RQE was evaluated using the test data set that consisted of registration results that were not used in training. RESULTS The RQE constructed using the mutual information had very good performance when tested using the test data sets, yielding the sensitivity, the specificity, the positive predictive value, and the negative predictive value in the ranges of 0.960-1.000, 0.993-1.000, 0.983-1.000, and 0.909-1.000, respectively. Adding a RQE into a conventional 3D/3D image registration system incurs only about 10%-20% increase of the overall processing time. CONCLUSIONS The authors' patient study has demonstrated very good performance of the proposed RQE when used with the mutual information in identifying unsuccessful 3D/3D registrations for daily patient setup. The classifier had very good generality and required only to be trained once for each implementation. When the RQE is incorporated with an automated 3D/3D image registration system, it can improve the robustness of the system.
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Affiliation(s)
- Jian Wu
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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Vaman C, Staub D, Williamson J, Murphy MJ. A method to map errors in the deformable registration of 4DCT images. Med Phys 2010; 37:5765-76. [PMID: 21158288 PMCID: PMC2973991 DOI: 10.1118/1.3488983] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [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: 01/25/2010] [Revised: 07/16/2010] [Accepted: 08/05/2010] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To present a new approach to the problem of estimating errors in deformable image registration (DIR) applied to sequential phases of a 4DCT data set. METHODS A set of displacement vector fields (DVFs) are made by registering a sequence of 4DCT phases. The DVFs are assumed to display anatomical movement, with the addition of errors due to the imaging and registration processes. The positions of physical landmarks in each CT phase are measured as ground truth for the physical movement in the DVF. Principal component analysis of the DVFs and the landmarks is used to identify and separate the eigenmodes of physical movement from the error eigenmodes. By subtracting the physical modes from the principal components of the DVFs, the registration errors are exposed and reconstructed as DIR error maps. The method is demonstrated via a simple numerical model of 4DCT DVFs that combines breathing movement with simulated maps of spatially correlated DIR errors. RESULTS The principal components of the simulated DVFs were observed to share the basic properties of principal components for actual 4DCT data. The simulated error maps were accurately recovered by the estimation method. CONCLUSIONS Deformable image registration errors can have complex spatial distributions. Consequently, point-by-point landmark validation can give unrepresentative results that do not accurately reflect the registration uncertainties away from the landmarks. The authors are developing a method for mapping the complete spatial distribution of DIR errors using only a small number of ground truth validation landmarks.
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Affiliation(s)
- Constantin Vaman
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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Pokhrel D, Murphy MJ, Todor DA, Weiss E, Williamson JF. Clinical application and validation of an iterative forward projection matching algorithm for permanent brachytherapy seed localization from conebeam-CT x-ray projections. Med Phys 2010; 37:5092-101. [PMID: 20964229 DOI: 10.1118/1.3480962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To experimentally validate a new algorithm for reconstructing the 3D positions of implanted brachytherapy seeds from postoperatively acquired 2D conebeam-CT (CBCT) projection images. METHODS The iterative forward projection matching (IFPM) algorithm finds the 3D seed geometry that minimizes the sum of the squared intensity differences between computed projections of an initial estimate of the seed configuration and radiographic projections of the implant. In-house machined phantoms, containing arrays of 12 and 72 seeds, respectively, are used to validate this method. Also, four 103Pd postimplant patients are scanned using an ACUITY digital simulator. Three to ten x-ray images are selected from the CBCT projection set and processed to create binary seed-only images. To quantify IFPM accuracy, the reconstructed seed positions are forward projected and overlaid on the measured seed images to find the nearest-neighbor distance between measured and computed seed positions for each image pair. Also, the estimated 3D seed coordinates are compared to known seed positions in the phantom and clinically obtained VariSeed planning coordinates for the patient data. RESULTS For the phantom study, seed localization error is (0.58 +/- 0.33) mm. For all four patient cases, the mean registration error is better than 1 mm while compared against the measured seed projections. IFPM converges in 20-28 iterations, with a computation time of about 1.9-2.8 min/ iteration on a 1 GHz processor. CONCLUSIONS The IFPM algorithm avoids the need to match corresponding seeds in each projection as required by standard back-projection methods. The authors' results demonstrate approximately 1 mm accuracy in reconstructing the 3D positions of brachytherapy seeds from the measured 2D projections. This algorithm also successfully localizes overlapping clustered and highly migrated seeds in the implant.
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Affiliation(s)
- Damodar Pokhrel
- Department of Radiation Oncology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia 23298, USA
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Dogan N, Song S, Saleh H, Wu J, Murphy MJ. Comparisons of multiple automated anatomy-based image-guidance methods for patient setup before head/neck external beam radiotherapy. J Appl Clin Med Phys 2010; 12:3337. [PMID: 21330980 PMCID: PMC5718585 DOI: 10.1120/jacmp.v12i1.3337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 09/08/2010] [Accepted: 09/13/2010] [Indexed: 11/23/2022] Open
Abstract
The purpose was to assess the variability in automated translational head/neck setup corrections computed from several different imaging modalities and rigid registration methods using patient anatomy. Shifts were calculated using three commercial and one in‐house automated rigid registration methods for nine head/neck patients who were imaged with three different image‐guidance systems. The mean difference between the daily isocenter shifts determined by the four methods ranged from 2.8 to 12.5 mm for all of the test cases. These differences are much greater than the variability observed for a rigid imaging phantom. Image‐guided setup procedures have an uncertainty that depends on the imaging modality, the registration algorithm, the image resolution and the image content. In the absence of an absolute ground truth, the variation in the shifts calculated by several different methods provides a useful estimate of that uncertainty. PACS number: 87,55,km, 87.57.nj, 87.59.‐e, 87.59.bd
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Affiliation(s)
- Nesrin Dogan
- Radiation Oncology Department, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
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Little CB, Smith MM, Cake MA, Read RA, Murphy MJ, Barry FP. The OARSI histopathology initiative - recommendations for histological assessments of osteoarthritis in sheep and goats. Osteoarthritis Cartilage 2010; 18 Suppl 3:S80-92. [PMID: 20864026 DOI: 10.1016/j.joca.2010.04.016] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [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] [Received: 04/19/2010] [Accepted: 04/19/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Sheep and goats are commonly used large animal species for studying pathogenesis and treatment of osteoarthritis (OA). This review focuses on the macroscopic and microscopic criteria for assessing OA in sheep and goats and recommends particular assessment criteria to assist standardization in the conduct and reporting of preclinical trials of OA. METHODS A review was conducted of all published OA studies using sheep and goats and the most common macroscopic, microscopic, or ultrastructural scoring systems were summarised. General recommendations regarding methods of OA assessment in the sheep and goat have been made and a preliminary study of their reliability and utility was undertaken. RESULTS The modified Mankin scoring system is recommended for semiquantitative histological assessment of OA due to its already widespread adoption, ease of use, similarity to scoring systems used for OA in humans, and its achievable inter-rater reliability. Specific recommendations are also provided for histological scoring of synovitis and scoring of macroscopic lesions of OA. CONCLUSIONS The proposed system for assessment of sheep and goat articular tissues appears to provide a useful versatile method to quantify OA change. It is hoped that by adopting more standardised quantitative outcome measures, better comparison between different studies and arthritis models will be possible. The suggested scoring systems can be modified in the future as our knowledge of disease pathophysiology advances.
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Affiliation(s)
- C B Little
- Raymond Purves Bone and Joint Research Laboratories, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney at Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
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Stojkovic M, Pittenger MF, Nolta JA, Lako M, Lappin TRJ, Murphy MJ. Stem Cells' position statement on hESC research. Stem Cells 2010; 28:1A. [PMID: 20809560 DOI: 10.1002/stem.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Wu J, Murphy MJ. Assessing the intrinsic precision of 3D/3D rigid image registration results for patient setup in the absence of a ground truth. Med Phys 2010; 37:2501-8. [PMID: 20632561 DOI: 10.1118/1.3414041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To assess the precision and robustness of patient setup corrections computed from 3D/3D rigid registration methods using image intensity, when no ground truth validation is possible. METHODS Fifteen pairs of male pelvic CTs were rigidly registered using four different in-house registration methods. Registration results were compared for different resolutions and image content by varying the image down-sampling ratio and by thresholding out soft tissue to isolate bony landmarks. Intrinsic registration precision was investigated by comparing the different methods and by reversing the source and the target roles of the two images being registered. RESULTS The translational reversibility errors for successful registrations ranged from 0.0 to 1.69 mm. Rotations were less than 1 degrees. Mutual information failed in most registrations that used only bony landmarks. The magnitude of the reversibility error was strongly correlated with the success/ failure of each algorithm to find the global minimum. CONCLUSIONS Rigid image registrations have an intrinsic uncertainty and robustness that depends on the imaging modality, the registration algorithm, the image resolution, and the image content. In the absence of an absolute ground truth, the variation in the shifts calculated by several different methods provides a useful estimate of that uncertainty. The difference observed by reversing the source and target images can be used as an indication of robust convergence.
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Affiliation(s)
- Jian Wu
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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Letra A, Menezes R, Fonseca RF, Govil M, McHenry T, Murphy MJ, Hennebold JD, Granjeiro JM, Castilla EE, Orioli IM, Martin R, Marazita ML, Bjork BC, Vieira AR. Novel cleft susceptibility genes in chromosome 6q. J Dent Res 2010; 89:927-32. [PMID: 20511563 DOI: 10.1177/0022034510370004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Cleft lip/palate is a defect of craniofacial development. In previous reports, chromosome 6q has been suggested as a candidate region for cleft lip/palate. A multipoint posterior probability of linkage analysis of multiplex families from the Philippines attributed an 88% probability of harboring a cleft-susceptibility gene to a narrower region on bands 6q14.2-14.3. We genotyped 2732 individuals from families and unrelated individuals with and without clefts to investigate the existence of possible cleft-susceptibility genes in this region. We found association of PRSS35 and SNAP91 genes with cleft lip/palate in the case-control cohort and in Caucasian families. Haplotype analyses support the individual associations with PRSS35. We found Prss35 expression in the head and palate of mouse embryos at critical stages for palatogenesis, whereas Snap91 was expressed in the adult brain. We provide further evidence of the involvement of chromosome 6q in cleft lip/palate and suggest PRSS35 as a novel candidate gene.
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Affiliation(s)
- A Letra
- Department of Oral Biology and Center for Craniofacial and Dental Genetics, University of Pittsburgh, 614 Salk Hall, 3501 Terrace Street, Pittsburgh, PA 15261, USA
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Wu J, Murphy MJ, Weiss E, Sleeman WC, Williamson J. Development of a population-based model of surface segmentation uncertainties for uncertainty-weighted deformable image registrations. Med Phys 2010; 37:607-14. [PMID: 20229869 DOI: 10.1118/1.3284209] [Citation(s) in RCA: 7] [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: 11/07/2022] Open
Abstract
PURPOSE To develop a population-based model of surface segmentation uncertainties for uncertainty-weighted surface-based deformable registrations. METHODS The contours of the prostate, the bladder, and the rectum were manually delineated by five observers on fan beam CT images of four prostate cancer patients. First, patient-specific representations of structure segmentation uncertainties were derived by determining the interobserver variability (i.e., standard deviation) of the structure boundary delineation. This was achieved by (1) generating an average structure surface mesh from the structure contours drawn by different observers, and (2) calculating three-dimensional standard deviation surface meshes (SDSMs) based on the perpendicular distances from the individual boundary surface meshes to the average surface mesh computed above. Then an average structure surface mesh was constructed to be the reference mesh for the population-based model. The average structure meshes of the other patients were deformably registered to the reference mesh. The calculated deformable vector fields were used to map the patient-specific SDSMs to the reference mesh to obtain the registered SDSMs. Finally, the population-based SDSM was derived by taking the average of the registered SDSMs in quadrature. RESULTS Population-based structure surface statistical models of the prostate, the bladder, and the rectum were created by mapping the patient-specific SDSMs to the population surface model. Graphical visualization indicates that the boundary uncertainties are dependent on anatomical location. CONCLUSIONS The authors have developed and demonstrated a general method for objectively constructing surface maps of uncertainties derived from topologically complex structure boundary segmentations from multiple observers. The computed boundary uncertainties have significant spatial variations. They can be used as weighting factors for surface-based probabilistic deformable registration.
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Affiliation(s)
- Jian Wu
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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Reisman DB, Javedani JB, Griffith LV, Ellsworth GF, Kuklo RM, Goerz DA, White AD, Tallerico LJ, Gidding DA, Murphy MJ, Chase JB. Note: The full function test explosive generator. Rev Sci Instrum 2010; 81:036109. [PMID: 20370232 DOI: 10.1063/1.3359998] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We have conducted three tests of a new pulsed power device called the full function test. These tests represented the culmination of an effort to establish a high energy pulsed power capability based on high explosive pulsed power (HEPP) technology. This involved an extensive computational modeling, engineering, fabrication, and fielding effort. The experiments were highly successful and a new U.S. record for magnetic energy was obtained.
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Affiliation(s)
- D B Reisman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA.
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Reisman DB, Javedani JB, Ellsworth GF, Kuklo RM, Goerz DA, White AD, Tallerico LJ, Gidding DA, Murphy MJ, Chase JB. The advanced helical generator. Rev Sci Instrum 2010; 81:034701. [PMID: 20370202 DOI: 10.1063/1.3309788] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A high explosive pulsed power generator called the advanced helical generator (AHG) has been designed, built, and successfully tested. The AHG incorporates design principles of voltage and current management to obtain a high current and energy gain. Its design was facilitated by the use of modern modeling tools as well as high precision manufacture. The result was a first-shot success. The AHG delivered 16 MA of current and 11 MJ of energy to a quasistatic 80 nH inductive load. A current gain of 160 times was obtained with a peak exponential rise time of 20 micros. We will describe in detail the design and testing of the AHG.
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Affiliation(s)
- D B Reisman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA.
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Murphy MJ, Adler JR, Bodduluri M, Dooley J, Forster K, Hai J, Le Q, Luxton G, Martin D, Poen J. Image-Guided Radiosurgery for the Spine and Pancreas. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/10929080009148895] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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