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Siva S, Bressel M, Sidhom M, Sridharan S, Vanneste B, Davey R, Ruben J, Foroudi F, Higgs BG, Lin C, Raman A, Hardcastle N, Shaw M, Mancuso P, Lawrentschuk N, Wood S, Brook N, Kron T, Martin JM, Pryor DI. TROG 15.03/ANZUP International Multicenter Phase II Trial of Focal Ablative STereotactic RAdiotherapy for Cancers of the Kidney (FASTRACK II). Int J Radiat Oncol Biol Phys 2023; 117:S3. [PMID: 37784470 DOI: 10.1016/j.ijrobp.2023.06.208] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic body radiotherapy (SBRT) is an emerging non-invasive alternative for primary renal cell cancer (RCC) in patients unsuitable for surgery. The objective of the FASTRACK II clinical trial was to investigate the efficacy of SBRT for primary RCC. MATERIALS/METHODS This non-randomized, intergroup multi-institutional phase II study was activated in 7 Australian centers and 1 Dutch center, through the Trans Tasman Radiation Oncology Group (TROG) and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP). Eligible patients had biopsy confirmed diagnosis of primary RCC with a single lesion within a kidney, ECOG performance ≤2 and were medically inoperable, high risk or declined surgery. For tumors ≤4 cm a single fraction of 26 Gy was prescribed, for tumors > 4 cm, 42 Gy in three fractions was prescribed. The primary outcome of the study was to estimate the efficacy of SBRT for primary RCC, defined as local control based on RECIST criteria. The study was powered assuming that 1-year local control would be 90%, with the null hypothesis of ≤80% considered undesirable and not worthy of proceeding to a future randomized controlled trial. RESULTS Between July 2016 and February 2020, 70 patients were enrolled with a median follow-up of 42 months. Median age was 77 years. Forty-nine patients were male (70%), median BMI was 32 and median Charlson comorbidity score was 7. The median [IQR] RENAL complexity score was 8 [7-10]. Biopsy confirmation was 100%. Twenty-three patients (33%) had T1a disease. The median (interquartile range [IQR]) tumor size was 4.6cm [3.7-5.5]; it was 3.3cm [3.0-3.6] in those receiving single fraction (n = 23), and 5.3cm [4.6-6.0] in those receiving 3-fraction SBRT (n = 47). During real-time pre-treatment quality assurance review, 10 cases (14.3%) required resubmission for protocol deviation, 2119 variables were assessed at final review, and final protocol compliance was 99.3%. Seven (10%) patients experienced grade 3 treatment-related adverse events, with no grade 4 or 5 events observed. Eleven (16%) patients reported no adverse events. Local control was 100% throughout the lifetime of the trial (p<0.001). Cancer-specific survival was also 100% throughout the lifetime of the trial. Freedom from distant failure (95% CIs) at 1 and 3 years was 99% (90-100%). Overall survival (95% CIs) at 1 and 3 years was 99% (90-100%) and 82% (70-89%), respectively. Baseline mean eGFR (95% CI) was 61.1 mLs/min (56.6; 65.6) and reduced by -10.8 mLs/min (-13.0; -8.6) by 1-year, by -14.6 mLs/min (-17.0; -12.2) by 2-years and plateaued thereafter. CONCLUSION In the first multicenter prospective trial of a non-surgical primary RCC cohort, enrolling mostly T1b+ disease, SBRT was an effective treatment strategy with no observed local failures. We observed an acceptable side effect profile and renal function after SBRT. These outcomes support the design of a future randomized clinical trial of SBRT versus surgery for primary RCC. The trial was registered with ID: NCT02613819.
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Affiliation(s)
- S Siva
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - M Bressel
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Sidhom
- Liverpool Hospital Cancer Therapy Centre, University of New South Wales, School of Medicine, Sydney, NSW, Australia
| | - S Sridharan
- Calvary Mater Newcastle, Waratah & School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - B Vanneste
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - R Davey
- TROG Cancer Research, Waratah, NSW, Australia
| | - J Ruben
- The William Buckland Radiotherapy Centre, Alfred Health, Melbourne, VIC, Australia
| | - F Foroudi
- Austin Health, Radiation Oncology, Melbourne, Australia
| | - B G Higgs
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - C Lin
- Dept of Radiation Oncology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - A Raman
- Royal Newcastle Centre, John Hunter Hospital & School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - N Hardcastle
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Shaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - P Mancuso
- Urology Department, Liverpool Hospital, Sydney, NSW, Australia
| | - N Lawrentschuk
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - S Wood
- Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - N Brook
- Department of Surgery, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - T Kron
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - J M Martin
- Department of Radiation Oncology, Calvary Mater Newcastle & School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - D I Pryor
- Princess Alexandra Hospital, Brisbane, QLD, Australia
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Rembielak A, Budrukkar A, Kron T. Function Preservation with Brachytherapy: Reviving the Art. Clin Oncol (R Coll Radiol) 2023; 35:485-488. [PMID: 37394265 DOI: 10.1016/j.clon.2023.06.010] [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] [Received: 03/08/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Affiliation(s)
- A Rembielak
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK.
| | | | - T Kron
- Peter MacCallum Cancer Centre, Melbourne, Australia
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Swain M, Budrukkar A, Rembielak A, Kron T, Agarwal JP. Challenges in the Sustainability of Brachytherapy Service in Contemporary Radiotherapy. Clin Oncol (R Coll Radiol) 2023:S0936-6555(23)00205-4. [PMID: 37302881 DOI: 10.1016/j.clon.2023.05.013] [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] [Received: 03/14/2023] [Revised: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 06/13/2023]
Abstract
Brachytherapy has a long history of delivering a highly conformal radiation dose to the target volume with sparing of adjacent normal tissue and has an irreplaceable role in certain cancers, such as cervical and prostate cancers. There have been futile attempts to replace brachytherapy with other radiation techniques. Despite that there are multifaceted challenges in preserving this dying art, from establishment, to a trained workforce, to maintenance of the equipment and source replacement costs. Here we focus on the challenges to access brachytherapy, the availability and distribution of care across the globe and appropriate training leading to proper implementation of the procedure. Brachytherapy holds a significant place in the treatment armamentarium of most common cancers, such as cervical, prostate, head and neck and skin cancers. However, there is an uneven distribution of brachytherapy facilities, not only across the globe, but also at a national level, with a larger proportion of facilities concentrated in certain regions, more so in low and low-middle income countries. The regions with the highest incidence of cervical cancer have the least access to brachytherapy facilities. Attempts to bridge the gap are essential and should be focused on uniform distribution and access to care, improving training of the workforce through specialised training programmes, reducing the cost of care, planning to reduce the recurring cost, generating evidence and research guidelines, renewing interest in brachytherapy through rebranding, use of social media and building an attainable long-term roadmap.
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Affiliation(s)
- M Swain
- Department of Radiation Oncology, Tata Memorial Hospital, HomiBhabha National Institute (HBNI), Parel, Mumbai, India
| | - A Budrukkar
- Department of Radiation Oncology, Tata Memorial Hospital, HomiBhabha National Institute (HBNI), Parel, Mumbai, India
| | - A Rembielak
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - T Kron
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - J P Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, HomiBhabha National Institute (HBNI), Parel, Mumbai, India.
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Berger D, Van Dyk S, Beaulieu L, Major T, Kron T. Modern Tools for Modern Brachytherapy. Clin Oncol (R Coll Radiol) 2023:S0936-6555(23)00182-6. [PMID: 37217434 DOI: 10.1016/j.clon.2023.05.003] [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] [Received: 10/14/2022] [Revised: 03/28/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023]
Abstract
This review aims to showcase the brachytherapy tools and technologies that have emerged during the last 10 years. Soft-tissue contrast using magnetic resonance and ultrasound imaging has seen enormous growth in use to plan all forms of brachytherapy. The era of image-guided brachytherapy has encouraged the development of advanced applicators and given rise to the growth of individualised 3D printing to achieve reproducible and predictable implants. These advances increase the quality of implants to better direct radiation to target volumes while sparing normal tissue. Applicator reconstruction has moved beyond manual digitising, to drag and drop of three-dimensional applicator models with embedded pre-defined source pathways, ready for auto-recognition and automation. The simplified TG-43 dose calculation formalism directly linked to reference air kerma rate of high-energy sources in the medium water remains clinically robust. Model-based dose calculation algorithms accounting for tissue heterogeneity and applicator material will advance the field of brachytherapy dosimetry to become more clinically accurate. Improved dose-optimising toolkits contribute to the real-time and adaptive planning portfolio that harmonises and expedites the entire image-guided brachytherapy process. Traditional planning strategies remain relevant to validate emerging technologies and should continue to be incorporated in practice, particularly for cervical cancer. Overall, technological developments need commissioning and validation to make the best use of the advanced features by understanding their strengths and limitations. Brachytherapy has become high-tech and modern by respecting tradition and remaining accessible to all.
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Affiliation(s)
- D Berger
- International Atomic Energy Agency, Vienna International Centre, Vienna, Austria.
| | - S Van Dyk
- Radiation Therapy Services, Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - L Beaulieu
- Service de Physique Médicale et Radioprotection, et Axe Oncologie du Centre de Recherche du CHU de Québec, CHU de Québec, Québec, Canada; Département de Physique, de Génie Physique et d'Optique et Centre de Recherche sur le Cancer, Université Laval, Québec, Canada
| | - T Major
- Radiotherapy Centre, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
| | - T Kron
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
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Gaudreault M, Chang D, Hardcastle N, Jackson P, Kron T, Hofman M, Siva S. Combined Biology-Guided Radiotherapy and Lutetium PSMA Treatment in Metastatic Prostate Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bucknell N, Hardcastle N, Woon B, Bressel M, Byrne K, Selbie L, Callahan J, Hanna G, Hofman M, Ball D, Kron T, Siva S. EP05.01-023 Feasibility of Functional Lung Avoidance using Ga-68 4D Ventilation Perfusion PET/CT: The HI-FIVE Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Siva S, Bressel M, Sogono P, Shaw M, Chander S, Chu J, Plumridge N, Byrne K, Kothari G, Bucknell N, Hardcastle N, Kron T, Wheeler G, MacManus M, Hanna G, Ball D, David S. MO-0711 Impact of operability and total metastatic ablation on outcomes after SABR for oligometastases. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02409-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gaudreault M, Chang D, Hardcastle N, Jackson P, Kron T, Hofman M, Hanna G, Shirvani S, Siva S. Evaluation of PSMA-PET Biology-Guided Radiotherapy Sequential Boost to the PSMA-avid Subvolume in the Prostate Region in Low-Volume Advanced Prostate Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lukovic J, Moore A, Lee M, Willis D, Ahmed S, Akra M, Hortobagyi E, Joon D, Kron T, Liu Z, Ryan J, Thomas M, Wall K, Ward I, Wiltshire K, O'Callaghan C, Wong R, Ringash J, Haustermans K, Leong T. The Feasibility of Quality Assurance in the TOPGEAR International Phase III Clinical Trial of Neoadjuvant Chemoradiotherapy for Gastric Cancer (An Intergroup Trial of the AGITG/TROG/EORTC/CCTG). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kry S, Lye J, Clark C, Andratschke N, Dimitriadis A, Followill D, Howell R, Hussein M, Ishikawa M, Kito S, Kron T, Lee J, Michalski J, Monti A, Reynaert N, Taylor P, Venables K, Xiao Y, Lehmann J. PD-0899 Report dose-to-medium in clinical trials; a consensus from the Global Harmonisation Group. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07178-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hardcastle N, Cook O, Ray X, Moore A, Moore K, Pryor D, Rossi A, Foroudi F, Kron T, Siva S. OC-0426 Prospective knowledge-based planning for personalised plan QA in a multi-centre kidney SABR trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06913-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Siva S, Bressel M, Mai T, Le H, Vinod S, de Silva H, Macdonald S, Skala M, Hardcastle N, Rezo A, Pryor D, Gill S, Higgs B, Wagenfuehr K, Montgomery R, Awad R, Chesson B, Eade T, Wong W, Sasso G, De Abreu Lourenco R, Kron T, Ball D, Neeson P. OC-0335 Final results of TROG 13.01 SAFRON II: Single vs multi-fraction SABR for pulmonary oligometastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kron T, Bressel M, Lonski P, Hill C, Mercieca-Bebber R, Ahern V, Lehman M, Johnson C, Latty D, Ward R, Miller D, Banjade D, Moriss D, De Abreu Lourenco R, Woodcock J, Montgomery R, Lehmann J, Chua B. PH-0225 TROG 14.04: Multicentre study of feasibility and impact on anxiety of DIBH in breast cancer patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07277-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yeh J, Foroudi F, Tai K, Bressel M, Kron T. PD-0851 Clinical outcomes of online adaptive RT and conventional RT for muscle invasive bladder cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gaudreault M, Siva S, Kron T, Hardcastle N. PH-0544 Clinical impacts of managing motion in kidney stereotactic ablative body radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07354-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kumar K, Gulal O, Franich RD, Kron T, Yeo AU. A validation framework to assess performance of commercial deformable image registration in lung radiotherapy. Phys Med 2021; 87:106-114. [PMID: 34139382 DOI: 10.1016/j.ejmp.2021.06.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Deformable image registration (DIR) can play an important role in the context of adaptive radiotherapy. The AAPM Task Group 132 (TG-132) has described several quantitative measures for DIR error assessment but they can only be accurately defined when there is a ground-truth present in high-contrast regions. This work aims to set out a framework to obtain optimal results for CT-CT lung DIR in clinical setting for a commercially available system by quantifying the DIR performance in both low- and high-contrast regions. METHODS Five publicly available thorax datasets were used to assess the DIR quality. A "Ghost fiducial" method was implemented by windowing the contrast in a new feature provided by Varian Velocity v4.1. Target registration error (TRE) of the landmarks and Dice-similarity coefficient of the tumour were calculated at three different contrast settings to assess the algorithm in high- and low-contrast scenarios. RESULTS For the original unedited dataset, higher resolution DIR methods showed best performance acceptable within the recommended limit according to TG-132, when actual displacements were less than 10 mm. The relation of the actual displacement of the landmarks and TRE shows the limited capacity of the algorithm to deal with movements larger than 10 mm. CONCLUSION This work found the performance of DIR methods and settings available in Varian Velocity v4.1 to be a function of contrast level as well as extent of motion. This highlights the need for multiple metrics to assess different aspects of DIR performance for various applications related to low-contrast and/or high-contrast regions.
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Affiliation(s)
- K Kumar
- Peter MacCallum Cancer Centre, Physical Sciences Department, University of Melbourne, VIC, Australia; School of Science, RMIT University, Melbourne, VIC, Australia
| | - O Gulal
- Peter MacCallum Cancer Centre, Physical Sciences Department, University of Melbourne, VIC, Australia
| | - R D Franich
- Peter MacCallum Cancer Centre, Physical Sciences Department, University of Melbourne, VIC, Australia; School of Science, RMIT University, Melbourne, VIC, Australia
| | - T Kron
- Peter MacCallum Cancer Centre, Physical Sciences Department, University of Melbourne, VIC, Australia; School of Science, RMIT University, Melbourne, VIC, Australia
| | - A U Yeo
- Peter MacCallum Cancer Centre, Physical Sciences Department, University of Melbourne, VIC, Australia; School of Science, RMIT University, Melbourne, VIC, Australia.
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Siva S, Bressel M, Kron T, Mai T, Le H, Montgomery R, Hardcastle N, Rezo A, Gill S, Higgs B, Pryor D, De Abreu Lourenco R, Awad R, Chesson B, Eade T, Skala M, Sasso G, Wong W, Vinod S, Ball D. Stereotactic Ablative Fractionated Radiotherapy versus Radiosurgery for Oligometastatic Neoplasia to the Lung: A Randomized Phase II Trial. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Korte J, Cardenas C, Kron T, Hardcastle N, Wang J, Bahig H, Elgohari B, Court L, Fuller C, Ng S. Reproducibility of Head and Neck MRI Radiomic Features Between Two Common Analysis Packages. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fog L, Wirth A, MacManus M, Downes S, Grace M, Moggre A, Mugabe K, Neveri G, Nourbehesht L, Panetieri V, Pope D, Sim L, Stanton C, Steer B, Stewart A, Ungureanu E, Kron T. PO-1464: Total body irradiation practice in Australia and New Zealand: Results of a Survey. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gaudreault M, Hardcastle N, Jackson P, Callahan J, Kron T, Huntzinger C, Shirvani S, Da Silva A, Hofman M, Hanna G, Siva S. Suitability of PSMA-PET Biology-Guided Radiotherapy for Low Volume Metastases in Newly Diagnosed Prostate Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wilson C, Moseshvili E, Tacey M, Quin I, Lawrentschuk N, Bolton D, Joon DL, Chao M, Dunshea T, Kron T, Foroudi F. Assessment of Intrafraction Motion of the Urinary Bladder Using Magnetic Resonance Imaging (cineMRI). Clin Oncol (R Coll Radiol) 2019; 32:101-109. [PMID: 31607612 DOI: 10.1016/j.clon.2019.09.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 06/03/2019] [Revised: 08/06/2019] [Accepted: 08/29/2019] [Indexed: 11/18/2022]
Abstract
AIM To assess the intrafraction motion of the urinary bladder and delineate the appropriate margin size for radiotherapy planning, for both the full and empty bladder. MATERIALS AND METHODS This was a single-site, single-arm study of 20 patients planned to undergo radical cystectomy for histologically confirmed muscle-invasive bladder cancer. Patients underwent magnetic resonance imaging (cineMRI) of the entire pelvis using a 3-Tesla system, prior to cystectomy. Patients first underwent a cineMRI with a full bladder, then voided and underwent a second MRI with an empty bladder. All MRI sequences were acquired over 18 min. We assessed the differences in bladder filling and subsequent bladder wall displacement, between the empty and full bladder, during a time period consistent with radiotherapy treatment delivery. RESULTS Twenty patients underwent cineMRI of the entire pelvis. The maximum mean directional displacements of the bladder walls over the 18 min duration of the scan for the empty bladders were 9.8 mm superiorly, 1.1 mm inferiorly, 2.39 mm anteriorly, 3.73 mm posteriorly, 2.74 mm to the left and 2.48 mm to the right. The maximal mean displacements for the full bladders were 9.2 mm superiorly, 1.1 mm inferiorly, 2.28 mm anteriorly, 1.08 mm posteriorly, 1.85 mm to the left and 1.73 mm to the right. Statistically significant differences were seen in the posterior, left and right displacements but were quantitatively small. CONCLUSIONS Intrafractional motion secondary to bladder filling showed minimal variation between the full and empty bladder. Similar clinical target volume to planning target volume margins can be applied for the delivery of radiotherapy for a full and empty bladder.
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Affiliation(s)
- C Wilson
- Austin Health, Heidelberg, Victoria, Australia.
| | | | - M Tacey
- Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - I Quin
- GenesisCare, Wembley, Western Australia, Australia
| | | | - D Bolton
- Austin Health, Heidelberg, Victoria, Australia
| | - D L Joon
- Austin Health, Heidelberg, Victoria, Australia
| | - M Chao
- Austin Health, Heidelberg, Victoria, Australia
| | - T Dunshea
- Austin Health, Heidelberg, Victoria, Australia; MIA Radiology, Heidelberg, Victoria, Australia
| | - T Kron
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - F Foroudi
- Austin Health, Heidelberg, Victoria, Australia
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Bucknell N, Kron T, Herschtal A, Irving L, Siva S, Ball D. P2.17-21 A Post-Hoc Analysis of TROG 09.02 (CHISEL) Phase III Trial Investigating Pulmonary Function Changes After SABR and Conformal Radiation Therapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stansook N, Biasi G, Utitsarn K, Petasecca M, Metcalfe P, Carolan M, Lerch MLF, Perevertaylo VL, Kron T, Rosenfeld AB. 2D monolithic silicon-diode array detectors in megavoltage photon beams: does the fabrication technology matter? A medical physicist's perspective. Australas Phys Eng Sci Med 2019. [PMID: 30790139 DOI: 10.1007/s13246-019-00736-7/figures/10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
A family of prototype 2D monolithic silicon-diode array detectors (MP512, Duo, Octa) has been proposed by the Centre for Medical Radiation Physics, University of Wollongong (Australia) for relative dosimetry in small megavoltage photon beams. These detectors, which differ in the topology of their 512 sensitive volumes, were originally fabricated on bulk p-type substrates. More recently, they have also been fabricated on epitaxial p-type substrates. In the literature, their performance has been individually characterized for quality assurance (QA) applications. The present study directly assessed and compared that of a MP512-bulk and that of a MP512-epitaxial in terms of radiation hardness, long-term stability, response linearity with dose, dose per pulse and angular dependence. Their measurements of output factors, off-axis ratios and percentage depth doses in square radiation fields collimated by the jaws and produced by 6 MV and 10 MV flattened photon beams were then benchmarked against those by commercially available detectors. The present investigation was aimed at establishing, from a medical physicist's perspective, how the bulk and epitaxial fabrication technologies would affect the implementation of the MP512s into a QA protocol. Based on results, the MP512-epitaxial would offer superior radiation hardness, long-term stability and achievable uniformity and reproducibility of the response across the 2D active area.
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Affiliation(s)
- N Stansook
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
- Department of Radiology, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - G Biasi
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
| | - K Utitsarn
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
- Department of Medical Services, Lopburi Cancer Hospital, Lopburi, Thailand
| | - M Petasecca
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia
| | - P Metcalfe
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
| | - M Carolan
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia
- Illawarra Cancer Care Centre (ICCC), Wollongong, Australia
| | - M L F Lerch
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia
| | | | - T Kron
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
- Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Cancer Institute, University of Melbourne, Melbourne, Australia
| | - A B Rosenfeld
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia.
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia.
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25
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Kron T. SP-0679 Challenges in SBRT physics. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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26
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Korte J, Hardcastle N, Everitt S, Kron T. EP-2088 Upright open-source cone beam CT imaging for radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32508-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Biasi G, Utitsarn K, Petasecca M, Carolan M, Perevertaylo V, Tomé W, Lerch M, Kron T, Rosenfeld A. PO-0901 2D solid-state array detectors: a technique for in-vivo dose verification at varying effective area. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31321-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Vinod S, Choong C, Vial P, Kron T, Ball D. PO-0769 Lung Organ-at-Risk volumes – The need for a better definition in the era of 4DCT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31189-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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29
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Biasi G, Hardcastle N, Petasecca M, Guatelli S, Perevertaylo V, Rosenfeld A, Kron T. EP-1754 High-resolution assessment of dose calculations in small MV photon beams on and off central axis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32174-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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30
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Biasi G, Al Shukaili K, Petasecca M, Corde S, Guatelli S, Perevertaylo VL, Kron T, Rosenfeld AB. Today’s monolithic silicon array detector for small field dosimetry: the Octa. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1742-6596/1154/1/012002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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32
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Stansook N, Biasi G, Utitsarn K, Petasecca M, Metcalfe P, Carolan M, Lerch MLF, Perevertaylo VL, Kron T, Rosenfeld AB. 2D monolithic silicon-diode array detectors in megavoltage photon beams: does the fabrication technology matter? A medical physicist's perspective. Australas Phys Eng Sci Med 2019; 42:443-451. [PMID: 30790139 DOI: 10.1007/s13246-019-00736-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 02/19/2019] [Indexed: 01/24/2023]
Abstract
A family of prototype 2D monolithic silicon-diode array detectors (MP512, Duo, Octa) has been proposed by the Centre for Medical Radiation Physics, University of Wollongong (Australia) for relative dosimetry in small megavoltage photon beams. These detectors, which differ in the topology of their 512 sensitive volumes, were originally fabricated on bulk p-type substrates. More recently, they have also been fabricated on epitaxial p-type substrates. In the literature, their performance has been individually characterized for quality assurance (QA) applications. The present study directly assessed and compared that of a MP512-bulk and that of a MP512-epitaxial in terms of radiation hardness, long-term stability, response linearity with dose, dose per pulse and angular dependence. Their measurements of output factors, off-axis ratios and percentage depth doses in square radiation fields collimated by the jaws and produced by 6 MV and 10 MV flattened photon beams were then benchmarked against those by commercially available detectors. The present investigation was aimed at establishing, from a medical physicist's perspective, how the bulk and epitaxial fabrication technologies would affect the implementation of the MP512s into a QA protocol. Based on results, the MP512-epitaxial would offer superior radiation hardness, long-term stability and achievable uniformity and reproducibility of the response across the 2D active area.
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Affiliation(s)
- N Stansook
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia.,Department of Radiology, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - G Biasi
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
| | - K Utitsarn
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia.,Department of Medical Services, Lopburi Cancer Hospital, Lopburi, Thailand
| | - M Petasecca
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia
| | - P Metcalfe
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia
| | - M Carolan
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia.,Illawarra Cancer Care Centre (ICCC), Wollongong, Australia
| | - M L F Lerch
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia
| | | | - T Kron
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia.,Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Cancer Institute, University of Melbourne, Melbourne, Australia
| | - A B Rosenfeld
- Centre for Medical Radiation Physics (CMRP), University of Wollongong, Wollongong, Australia. .,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia.
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Ball D, Mai G, Vinod S, Babington S, Ruben J, Kron T, Chesson B, Herschtal A, Vanevski M, Rezo A, Elder C, Skala M, Wirth A, Wheeler G, Lim A, Shaw M, Schofield P, Irving L, Solomon B. Quality of life in the CHISEL randomized trial of stereotactic ablative radiotherapy (SABR) versus standard radiotherapy for stage I non-small cell lung cancer (Trans-Tasman Radiation Oncology Group 09.02). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Kent A, Hardcastle N, Kron T, Wheeler G, Hegi-Johnson F. P3.08-17 Paediatric Motion Management Solutions for Particle Therapy Based Thoracic Stereotactic Ablative Body Radiotherapy (SABR). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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35
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Biasi G, Petasecca M, Guatelli S, Kron T, Rosenfeld A. EP-1720: A silicon diode array detector for small field dosimetry with flattening filter free beams. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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36
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Biasi G, Petasecca M, Guatelli S, Hardcastle N, Carolan M, Perevertaylo V, Kron T, Rosenfeld AB. A novel high-resolution 2D silicon array detector for small field dosimetry with FFF photon beams. Phys Med 2017; 45:117-126. [PMID: 29472075 DOI: 10.1016/j.ejmp.2017.12.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/13/2017] [Accepted: 12/15/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Flattening filter free (FFF) beams are increasingly being considered for stereotactic radiotherapy (SRT). For the first time, the performance of a monolithic silicon array detector under 6 and 10 MV FFF beams was evaluated. The dosimeter, named "Octa" and designed by the Centre for Medical Radiation Physics (CMRP), was tested also under flattened beams for comparison. METHODS Output factors (OFs), percentage depth-dose (PDD), dose profiles (DPs) and dose per pulse (DPP) dependence were investigated. Results were benchmarked against commercially available detectors for small field dosimetry. RESULTS The dosimeter was shown to be a 'correction-free' silicon array detector for OFs and PDD measurements for all the beam qualities investigated. Measured OFs were accurate within 3% and PDD values within 2% compared against the benchmarks. Cross-plane, in-plane and diagonal DPs were measured simultaneously with high spatial resolution (0.3 mm) and real time read-out. A DPP dependence (24% at 0.021 mGy/pulse relative to 0.278 mGy/pulse) was found and could be easily corrected for in the case of machine specific quality assurance applications. CONCLUSIONS Results were consistent with those for monolithic silicon array detectors designed by the CMRP and previously characterized under flattened beams only, supporting the robustness of this technology for relative dosimetry for a wide range of beam qualities and dose per pulses. In contrast to its predecessors, the design of the Octa offers an exhaustive high-resolution 2D dose map characterization, making it a unique real-time radiation detector for small field dosimetry for field sizes up to 3 cm side.
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Affiliation(s)
- G Biasi
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - M Petasecca
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - S Guatelli
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - N Hardcastle
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M Carolan
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia; Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, NSW, Australia
| | | | - T Kron
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Cancer Institute, University of Melbourne, Australia
| | - A B Rosenfeld
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia.
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37
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Gill S, Gandhidasan S, Kron T, Ball D, Shaw M, Chander S, Bressel M, Chesson B, David S, Siva S. Ablation of oligometastasis cancer with stereotactic ablative body radiotherapy exploiting the stepwise theory of metastasis: A retrospective review of a single institution series. Respir Med 2017. [DOI: 10.1016/j.rmed.2017.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Ball D, Mai T, Vinod S, Babington S, Ruben J, Kron T, Chesson B, Herschtal A, Rezo A, Elder C, Skala M, Wirth A, Wheeler G, Lim A, Vanevski M, Shaw M. MA 13.07 A Randomized Trial of SABR vs Conventional Radiotherapy for Inoperable Stage I Non-Small Cell Lung Cancer: TROG09.02 (CHISEL). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.565] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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Thomas R, Turgeon G, Hofman M, Callahan J, Anderson N, Hardcastle N, Kron T, Bressel M, Steinfort D, Shaw M, Plumridge N, Macmanus M, Hicks R, Ball D, Siva S. P2.14-001 Mid-Treatment Perfusion PET/CT Is More Effective Than Ventilation PET/CT in Functionally-Adapted Radiotherapy for NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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40
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Lonski P, Walton L, Anderson N, Lydon J, Kron T, Chesson B, Prabhakar R. EP-1502: Dosimetric assessment of brass bolus using radiochromic film. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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41
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Ferrer R, Barzakh A, Bastin B, Beerwerth R, Block M, Creemers P, Grawe H, de Groote R, Delahaye P, Fléchard X, Franchoo S, Fritzsche S, Gaffney LP, Ghys L, Gins W, Granados C, Heinke R, Hijazi L, Huyse M, Kron T, Kudryavtsev Y, Laatiaoui M, Lecesne N, Loiselet M, Lutton F, Moore ID, Martínez Y, Mogilevskiy E, Naubereit P, Piot J, Raeder S, Rothe S, Savajols H, Sels S, Sonnenschein V, Thomas JC, Traykov E, Van Beveren C, Van den Bergh P, Van Duppen P, Wendt K, Zadvornaya A. Towards high-resolution laser ionization spectroscopy of the heaviest elements in supersonic gas jet expansion. Nat Commun 2017; 8:14520. [PMID: 28224987 PMCID: PMC5322538 DOI: 10.1038/ncomms14520] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [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: 08/25/2016] [Accepted: 01/09/2017] [Indexed: 11/09/2022] Open
Abstract
Resonant laser ionization and spectroscopy are widely used techniques at radioactive ion beam facilities to produce pure beams of exotic nuclei and measure the shape, size, spin and electromagnetic multipole moments of these nuclei. However, in such measurements it is difficult to combine a high efficiency with a high spectral resolution. Here we demonstrate the on-line application of atomic laser ionization spectroscopy in a supersonic gas jet, a technique suited for high-precision studies of the ground- and isomeric-state properties of nuclei located at the extremes of stability. The technique is characterized in a measurement on actinium isotopes around the N=126 neutron shell closure. A significant improvement in the spectral resolution by more than one order of magnitude is achieved in these experiments without loss in efficiency.
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Affiliation(s)
- R Ferrer
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - A Barzakh
- Petersburg Nuclear Physics Institute, NRC Kurchatov Institute, 188300 Gatchina, Russia
| | - B Bastin
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - R Beerwerth
- Helmholtz Institute Jena, Fröbelstieg 3, 07743 Jena, Germany.,Theoretisch-Physikalisches Institut, Friedrich-Schiller-Universität Jena, D-07743 Jena, Germany
| | - M Block
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany.,Helmholtz Institute Mainz, 55099 Mainz, Germany.,Institut für Kernchemie, Johannes Gutenberg-Universität Mainz, Fritz-Strassmann-Weg 2, 55128 Mainz, Germany
| | - P Creemers
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - H Grawe
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - R de Groote
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - P Delahaye
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - X Fléchard
- Normandie Univ, ENSICAEN, UNICAEN, CNRS/IN2P3, LPC Caen, 14000 Caen, France
| | - S Franchoo
- Institute de Physique Nucléaire (IPN) d'Orsay, 91406 Orsay Cedex, France
| | - S Fritzsche
- Helmholtz Institute Jena, Fröbelstieg 3, 07743 Jena, Germany.,Theoretisch-Physikalisches Institut, Friedrich-Schiller-Universität Jena, D-07743 Jena, Germany
| | - L P Gaffney
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - L Ghys
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium.,SCK·CEN, Belgian Nuclear Research Center, Boeretang 200, 2400 Mol, Belgium
| | - W Gins
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - C Granados
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - R Heinke
- Institut für Physik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | - L Hijazi
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - M Huyse
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - T Kron
- Institut für Physik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | - Yu Kudryavtsev
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - M Laatiaoui
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany.,Helmholtz Institute Mainz, 55099 Mainz, Germany
| | - N Lecesne
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - M Loiselet
- Université catholique de Louvain, Centre de Ressources du Cyclotron, B-1348 Louvain-la-Neuve, Belgium
| | - F Lutton
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - I D Moore
- Department of Physics, University of Jyväskylä, PO Box 35 (YFL), Jyväskylä FI-40014, Finland
| | - Y Martínez
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium.,CERN, CH-1211 Genève, Switzerland
| | - E Mogilevskiy
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium.,Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, Leninskie gory, 1, 119992 Moscow, Russia
| | - P Naubereit
- Institut für Physik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | - J Piot
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - S Raeder
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - S Rothe
- CERN, CH-1211 Genève, Switzerland
| | - H Savajols
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - S Sels
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - V Sonnenschein
- Department of Physics, University of Jyväskylä, PO Box 35 (YFL), Jyväskylä FI-40014, Finland
| | - J-C Thomas
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - E Traykov
- GANIL, CEA/DRF-CNRS/IN2P3, B.P. 55027, 14076 Caen Cedex 05, France
| | - C Van Beveren
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - P Van den Bergh
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - P Van Duppen
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - K Wendt
- Institut für Physik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | - A Zadvornaya
- KU Leuven, Instituut voor Kern-en Stralingsfysica, Celestijnenlaan 200D, B-3001 Leuven, Belgium
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Kron T, Ungureanu E, Antony R, Hardcastle N, Clements N, Ukath J, Fox C, Lonski P, Wanigaratne D, Haworth A. Patient specific quality control for Stereotactic Ablative Body Radiotherapy (SABR): it takes more than one phantom. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/777/1/012017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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43
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Heinke R, Kron T, Raeder S, Reich T, Schönberg P, Trümper M, Weichhold C, Wendt K. High-resolution in-source laser spectroscopy in perpendicular geometry. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s10751-016-1386-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keehan S, Taylor ML, Smith RL, Dunn L, Kron T, Franich RD. DOSE AND GAMMA-RAY SPECTRA FROM NEUTRON-INDUCED RADIOACTIVITY IN MEDICAL LINEAR ACCELERATORS FOLLOWING HIGH-ENERGY TOTAL BODY IRRADIATION. Radiat Prot Dosimetry 2016; 172:327-332. [PMID: 26598738 DOI: 10.1093/rpd/ncv480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/15/2015] [Accepted: 10/17/2015] [Indexed: 06/05/2023]
Abstract
Production of radioisotopes in medical linear accelerators (linacs) is of concern when the beam energy exceeds the threshold for the photonuclear interaction. Staff and patients may receive a radiation dose as a result of the induced radioactivity in the linac. Gamma-ray spectroscopy was used to identify the isotopes produced following the delivery of 18 MV photon beams from a Varian 21EX and an Elekta Synergy. The prominent radioisotopes produced include 187W, 63Zn, 56Mn, 24Na and 28Al in both linac models. The dose rate was measured at the beam exit window (12.6 µSv in the first 10 min) following 18 MV total body irradiation (TBI) beams. For a throughput of 24 TBI patients per year, staff members are estimated to receive an annual dose of up to 750 μSv at the patient location. This can be further reduced to 65 μSv by closing the jaws before re-entering the treatment bunker.
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Affiliation(s)
- S Keehan
- School of Applied Sciences, RMIT University, Melbourne, Australia
| | - M L Taylor
- School of Applied Sciences, RMIT University, Melbourne, Australia
| | - R L Smith
- School of Applied Sciences, RMIT University, Melbourne, Australia
- William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Australia
| | - L Dunn
- Australian Clinical Dosimetry Service, ARPANSA, Yallambie, Australia
| | - T Kron
- School of Applied Sciences, RMIT University, Melbourne, Australia
- Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - R D Franich
- School of Applied Sciences, RMIT University, Melbourne, Australia
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Oates R, Brown A, Tan A, Foroudi F, Lim Joon M, Schneider M, Herschtal A, Kron T. Real-time Image-guided Adaptive-predictive Prostate Radiotherapy using Rectal Diameter as a Predictor of Motion. Clin Oncol (R Coll Radiol) 2016; 29:180-187. [PMID: 27780695 DOI: 10.1016/j.clon.2016.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 09/13/2016] [Accepted: 09/19/2016] [Indexed: 11/28/2022]
Abstract
AIMS To investigate a relationship between maximum rectal diameter (MRD) on pre-treatment cone beam computed tomography (CBCT) and intra-fraction prostate motion, in the context of an adaptive image-guided radiotherapy (IGRT) method. MATERIALS AND METHODS The MRD was measured on 2125 CBCTs from 55 retrospective patient datasets and related to prostate displacement from intra-fraction imaging. A linear regression model was developed to determine a threshold MRD associated with a high probability of small prostate displacement. Standard and reduced adaptive margin plans were created to compare rectum and bladder normal tissue complication probability (NTCP) with each method. RESULTS A per-protocol analysis carried out on 1910 fractions from 51 patients showed with 90% confidence that for a MRD≤3 cm, prostate displacement will be ≤5 mm and that for a MRD≤3.5 cm, prostate displacement will be ≤5.5 mm. In the first scenario, if adaptive therapy was used instead of standard therapy, median reductions in NTCP for rectum and bladder were 0.5% (from 9.5% to 9%) and 1.3% (from 6.6% to 5.3%), respectively. In the second scenario, the NTCP for rectum and bladder would have median reductions of 1.1% and 2.6%, respectively. CONCLUSIONS We have identified a potential method for adaptive prostate IGRT based upon predicting small prostate intra-fraction motion by measuring MRD on pre-treatment CBCT.
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Affiliation(s)
- R Oates
- Radiation Therapy Services, Peter MacCallum Cancer Centre, Bendigo, Victoria, Australia; Medical Imaging & Radiation Sciences, Monash University, Melbourne, Victoria, Australia.
| | - A Brown
- Radiation Oncology, Townsville Cancer Centre, Townsville, Queensland, Australia
| | - A Tan
- Radiation Oncology, Townsville Cancer Centre, Townsville, Queensland, Australia; College of Medicine and Dentistry, James Cook University, Queensland, Australia
| | - F Foroudi
- Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Lim Joon
- Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Schneider
- Medical Imaging & Radiation Sciences, Monash University, Melbourne, Victoria, Australia
| | - A Herschtal
- Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - T Kron
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia; Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Siva S, Pham D, Tan T, Lam J, Bressel M, Price J, Gill S, Shaw M, Tai K, Violet J, Lau E, Parameswaran B, Chesson B, Lawrentschuck N, Goad J, Murphy D, Kron T, Foroudi F. Principal Analysis of a Phase Ib Trial of Stereotactic Body Radiation Therapy (SBRT) for Primary Kidney Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gandhidasan S, Bressel M, Kron T, Shaw M, Chu J, Chander S, Wheeler G, Plumridge N, Chesson B, Haworth A, David S, Ball D, Siva S. Single-Fraction Stereotactic Ablative Body Radiation Therapy as an Effective Management of Oligometastasis: Results From 133 Consecutive Patients. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ramachandran P, Tajaldeen A, Taylor D, Wanigaratne D, Roozen K, Esen N, Geso M, Kron T. SU-F-T-558: ArcCheck for Patient Specific QA in Stereotactic AblativeRadiotherapy. Med Phys 2016. [DOI: 10.1118/1.4956743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bawazeer O, Sarasanandarajah S, Herath S, Kron T, Deb P. SU-F-T-263: Dosimetric Characteristics of the Cine Acquisition Mode of An A-Si EPID. Med Phys 2016. [DOI: 10.1118/1.4956403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Franich R, Supple J, Siva S, Taylor M, Kron T. EP-1908: An image processing technique for simulating CT image sets for IGRT quality assurance. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33159-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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