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Traverso A, Hosni Abdalaty A, Hasan M, Tadic T, Patel T, Giuliani M, Kim J, Ringash J, Cho J, Bratman S, Bayley A, Waldron J, O'Sullivan B, Irish J, Chepeha D, De Almeida J, Goldstein D, Jaffray D, Wee L, Dekker A, Hope A. PO-1549: Non-invasive prediction of lymph node risk in oral cavity cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01567-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Traverso A, Kazmierski M, Shi Z, Weiss J, Fiset S, Wee L, Dekker A, Jaffray D, Han K. PO-0959 Robust features selection in Apparent Diffusion Coefficient (ADC) maps of cervix cancer patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31379-9] [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: 11/16/2022]
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Traverso A, Kazmierski M, Wee L, Dekker A, Welch M, Hosni A, Jaffray D, Hope A. PV-0314 Machine learning helps identifying relations and confounding factors in radiomics-based models. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30734-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Stanescu T, Jaffray D. Technical Note: Harmonic analysis applied to MR image distortion fields specific to arbitrarily shaped volumes. Med Phys 2018; 45:3705-3712. [PMID: 29799634 DOI: 10.1002/mp.13000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/26/2018] [Accepted: 05/15/2018] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Magnetic resonance imaging is expected to play a more important role in radiation therapy given the recent developments in MR-guided technologies. MR images need to consistently show high spatial accuracy to facilitate RT-specific tasks such as treatment planning and in-room guidance. The present study investigates a new harmonic analysis method for the characterization of complex three-dimensional (3D) fields derived from MR images affected by system-related distortions. METHODS An interior Dirichlet problem based on solving the Laplace equation with boundary conditions (BCs) was formulated for the case of a 3D distortion field. The second-order boundary value problem (BVP) was solved using a finite elements method (FEM) for several quadratic geometries - that is, sphere, cylinder, cuboid, D-shaped, and ellipsoid. To stress-test the method and generalize it, the BVP was also solved for more complex surfaces such as a Reuleaux 9-gon and the MR imaging volume of a scanner featuring a high degree of surface irregularities. The BCs were formatted from reference experimental data collected with a linearity phantom featuring a volumetric grid structure. The method was validated by comparing the harmonic analysis results with the corresponding experimental reference fields. RESULTS The harmonic fields were found to be in good agreement with the baseline experimental data for all geometries investigated. In the case of quadratic domains, the percentage of sampling points with residual values larger than 1 mm was 0.5% and 0.2% for the axial components and vector magnitude, respectively. For the general case of a domain defined by the available MR imaging field of view, the reference data showed a peak distortion of about 1 mm and 79% of the sampling points carried a distortion magnitude larger than 1 mm (tolerance intrinsic to the experimental data). The upper limits of the residual values after comparison with the harmonic fields showed max and mean of 1.4 and 0.25 mm, respectively, with only 1.5% of sampling points exceeding 1 mm. CONCLUSIONS A novel harmonic analysis approach relying on finite element methods was introduced and validated for multiple volumes with surface shape functions ranging from simple to highly complex. Since a boundary value problem is solved the method requires input data from only the surface of the desired domain of interest. It is believed that the harmonic method will facilitate (a) the design of new phantoms dedicated for the quantitation of MR image distortions in large volumes and (b) an integrative approach of combining multiple imaging tests specific to radiotherapy into a single test object for routine imaging quality control.
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Affiliation(s)
- T Stanescu
- Princess Margaret Cancer Centre & The Techna Institute, University Health Network, Toronto, ON, M5G 2M9, Canada
- Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - D Jaffray
- Princess Margaret Cancer Centre & The Techna Institute, University Health Network, Toronto, ON, M5G 2M9, Canada
- Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
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Hamilton JL, Foxcroft S, Moyo E, Cooke-Lauder J, Spence T, Zahedi P, Bezjak A, Jaffray D, Lam C, Létourneau D, Milosevic M, Tsang R, Wong R, Liu FF. Strategic planning in an academic radiation medicine program. Curr Oncol 2017; 24:e518-e523. [PMID: 29270061 DOI: 10.3747/co.24.3725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In this paper, we report on the process of strategic planning in the Radiation Medicine Program (rmp) at the Princess Margaret Cancer Centre. The rmp conducted a strategic planning exercise to ensure that program priorities reflect the current health care environment, enable nimble responses to the increasing burden of cancer, and guide program operations until 2020. Methods Data collection was guided by a project charter that outlined the project goal and the roles and responsibilities of all participants. The process was managed by a multidisciplinary steering committee under the guidance of an external consultant and consisted of reviewing strategic planning documents from close collaborators and institutional partners, conducting interviews with key stakeholders, deploying a program-wide survey, facilitating an anonymous and confidential e-mail feedback box, and collecting information from group deliberations. Results The process of strategic planning took place from December 2014 to December 2015. Mission and vision statements were developed, and core values were defined. A final document, Strategic Roadmap to 2020, was established to guide programmatic pursuits during the ensuing 5 years, and an implementation plan was developed to guide the first year of operations. Conclusions The strategic planning process provided an opportunity to mobilize staff talents and identify environmental opportunities, and helped to enable more effective use of resources in a rapidly changing health care environment. The process was valuable in allowing staff to consider and discuss the future, and in identifying strategic issues of the greatest importance to the program. Academic programs with similar mandates might find our report useful in guiding similar processes in their own organizations.
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Affiliation(s)
- J L Hamilton
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - S Foxcroft
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - E Moyo
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - J Cooke-Lauder
- Health Industry Management Practice, Schulich School of Business, York University, and
| | - T Spence
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - P Zahedi
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - A Bezjak
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - D Jaffray
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - C Lam
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - D Létourneau
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - M Milosevic
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - F F Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
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Van Soest J, Purdie T, Giuliani M, Lindsay P, Hope A, Jaffray D, Dekker A. PV-0239: Validation of lung cancer survival models in a clinical routine SBRT population. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30682-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Islam M, Farrokhkish M, Wang Y, Norrlinger B, Heaton R, Jaffray D. EP-1758: Towards Clinical Implementation of an Online Beam Monitoring System. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32121-7] [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: 10/19/2022]
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Stanescu T, Berlin A, Dawson L, Abed J, Simeonov A, Craig T, Letourneau D, Jaffray D. EP-1761: Workflow development for the clinical implementation of an MR-guided linear accelerator. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32124-2] [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: 10/19/2022]
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Stanescu T, Jaffray D. Investigation of the 4D composite MR image distortion field associated with tumor motion for MR-guided radiotherapy. Med Phys 2016; 43:1550-62. [PMID: 26936738 DOI: 10.1118/1.4941958] [Citation(s) in RCA: 11] [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: 12/25/2022] Open
Abstract
PURPOSE Magnetic resonance (MR) images are affected by geometric distortions due to the specifics of the MR scanner and patient anatomy. Quantifying the distortions associated with mobile tumors is particularly challenging due to real anatomical changes in the tumor's volume, shape, and relative location within the MR imaging volume. In this study, the authors investigate the 4D composite distortion field, which combines the effects of the susceptibility-induced and system-related distortion fields, experienced by mobile lung tumors. METHODS The susceptibility (χ) effects were numerically simulated for two specific scenarios: (a) a full motion cycle of a lung tumor due to breathing as depicted on ten phases of a 4D CBCT data set and (b) varying the tumor size and location in lung tissue via a synthetically generated sphere with variable diameter (4-80 mm). The χ simulation procedure relied on the segmentation and generation of 3D susceptibility (χ) masks and computation of the magnetic field by means of finite difference methods. A system-related distortion field, determined with a phantom and image processing algorithm, was used as a reference. The 4D composite distortion field was generated as the vector summation of the χ-induced and system-related fields. The analysis was performed for two orientations of the main magnetic field (B0), which correspond to several MRIgRT system configurations. Specifically, B0 was set along the z-axis as in the case of a cylindrical-bore scanner and in the (x,y)-plane as for a biplanar MR. Computations were also performed for a full revolution at 15° increments in the case of a rotating biplanar magnet. Histograms and metrics such as maximum, mean, and range were used to evaluate the characteristics of the 4D distortion field. RESULTS The χ-induced field depends on the change in volume and shape of the moving tumor as well as the local surrounding anatomy. In the case of system-related distortions, the tumor experiences increased field perturbations as it moves further away from the MR isocenter. For a mobile lung tumor, the 4D composite field, corresponding to a 1.5 T field and a readout gradient of 5 mT/m, amounts to 3.0 and 2.8 mm for the MRIgRT system designs featuring B0 oriented along the z-axis (cylindrical-bore scanner) and in the (x,y)-plane (biplanar scanner), respectively. For a rotating biplanar scanner, the composite distortion field varied nonlinearly with the rotation angle. Overall, the dominant contribution to the composite field was from the system-related distortion field. The tumor centroid experienced a systematic shift of 2 mm and showed a negligible perturbation for different B0 values. The dependency on the tumor size was also investigated, namely the max values varied from 1.2 to 2.5 mm for spherical volumes with a diameter between 4 and 80 mm. CONCLUSIONS The composite distortion field requires adequate quantification for lung radiation therapy applications such as treatment planning, pretreatment patient setup verification, and real-time treatment delivery guidance. For certain scenarios such as small tumor volumes, the spatial distortions may be corrected by applying systematic shifts derived from a single tumor motion phase. In the case of high readout gradients common to fast imaging applications, the χ distortions were found to be less than 1 mm irrespective of scanner configuration.
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Affiliation(s)
- T Stanescu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario M5G 2M9, Canada and Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada
| | - D Jaffray
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario M5G 2M9, Canada and Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada
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Malkov V, Rogers D, Jaffray D. TH-AB-BRA-05: Lung Cannot Be Treated as Homogeneous in Radiation Transport Simulations in Magnetic Fields. Med Phys 2016. [DOI: 10.1118/1.4958056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Keller H, Kueng R, Shek T, Driscoll B, Yeung I, Milosevic M, Jaffray D. WE-H-207A-06: Hypoxia Quantification in Static PET Images: The Signal in the Noise. Med Phys 2016. [DOI: 10.1118/1.4958011] [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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Stanescu T, Breen S, Dickie C, Letourneau D, Jaffray D. OC-0543: Technical development and clinical implementation of an MR-guided radiation therapy environment. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31793-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Coleman CN, Formenti SC, Chao N, Grover S, Rodin D, Petereit DG, Vikram B, Pistenmaa DA, Mohiuddin M, Williams TR, Wendling N, Roth L, Gospodarowicz M, Jaffray D. Establishing global health cancer care partnerships across common ground: bridging nuclear security, equitable access, education, outreach, and mentorship. The Lancet Global Health 2016. [DOI: 10.1016/s2214-109x(16)30019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Jung J, Farrokhkish M, Norrlinger B, Wang Y, Heaton R, Jaffray D, Islam M. SU-E-T-354: Efficient and Enhanced QA Testing of Linear Accelerators Using a Real-Time Beam Monitor. Med Phys 2015. [DOI: 10.1118/1.4924715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Stewart J, Lindsay P, Jaffray D. WE-EF-BRA-07: High Performance Preclinical Irradiation Through Optimized Dual Focal Spot Dose Painting and Online Virtual Isocenter Radiation Field Targeting. Med Phys 2015. [DOI: 10.1118/1.4925986] [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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Ghobadi, Aleman D, Li W, Chung C, Jaffray D. MO-F-CAMPUS-T-03: Continuous Dose Delivery with Gamma Knife Perfexion. Med Phys 2015. [DOI: 10.1118/1.4925459] [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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McNiven A, Jaffray D, Letourneau D. SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results. Med Phys 2015. [DOI: 10.1118/1.4923796] [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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Welch M, Jaffray D. SU-E-T-606: Performance of MR-Based 3D FXG Dosimetry for Preclinical Irradiation. Med Phys 2015. [DOI: 10.1118/1.4924969] [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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Jaffray D. MO-FG-BRB-02: Uniform Access to Radiation Therapy by 2035: Global Task Force on Radiotherapy for Cancer Control. Med Phys 2015. [DOI: 10.1118/1.4925402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Letourneau D, Amin N, Wang K, Norrlinger B, Jaffray D, McNiven A. SU-E-T-160: Characterization and Monitoring of Linear Accelerator Gantry Radiation Isocenter Motion. Med Phys 2015. [DOI: 10.1118/1.4924522] [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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Fotouhi Ghiam A, Keller H, Sharpe M, Millar B, Chung P, Jaffray D, Sahgal A, Létourneau D. Dosimetric Impact of Combined Rotational and Translational Setup Errors on Spinal Cord Dose in Patients Treated With Spine Stereotactic Body Radiation therapy (SBRT) for Spinal Metastasis. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2549] [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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Li W, Cho Y, Hiemstra K, Jaffray D, Chung C. Impact of Immobilization on Intrafraction Motion for Dedicated Cobalt Radiosurgery Unit Using Cone Beam Computed Tomography. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2550] [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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Carlone M, Heaton R, Wouters B, Keller H, Jaffray D. SU-E-J-233: A Facility for Radiobiological Experiments in a Large Magnetic Field. Med Phys 2014. [DOI: 10.1118/1.4888286] [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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Mohan R, Pelc N, Jaffray D, Mackie T. TU-C-BRF-01: Innovation in Medical Physics and Engineering. Med Phys 2014. [DOI: 10.1118/1.4889275] [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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Hahn S, Jaffray D, Chetty I, Benedict S. MO-E-BRF-01: Research Opportunities in Technology for Innovation in Radiation Oncology (Highlight of ASTRO NCI 2013 Workshop). Med Phys 2014. [DOI: 10.1118/1.4889152] [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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Stanescu T, Tadic T, Jaffray D. WE-G-17A-03: MRIgRT: Quantification of Organ Motion. Med Phys 2014. [DOI: 10.1118/1.4889505] [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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Stewart J, Lindsay P, Jaffray D. WE-E-BRE-04: Dual Focal Spot Dose Painting for Precision Preclinical Radiobiological Investigations. Med Phys 2014. [DOI: 10.1118/1.4889433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Driscoll B, Keller H, Jaffray D, Coolens C. Development of a dynamic quality assurance testing protocol for multisite clinical trial DCE-CT accreditation. Med Phys 2014; 40:081906. [PMID: 23927320 DOI: 10.1118/1.4812429] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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 Credentialing can have an impact on whether or not a clinical trial produces useful quality data that is comparable between various institutions and scanners. With the recent increase of dynamic contrast enhanced-computed tomography (DCE-CT) usage as a companion biomarker in clinical trials, effective quality assurance, and control methods are required to ensure there is minimal deviation in the results between different scanners and protocols at various institutions. This paper attempts to address this problem by utilizing a dynamic flow imaging phantom to develop and evaluate a DCE-CT quality assurance (QA) protocol. METHODS A previously designed flow phantom, capable of producing predictable and reproducible time concentration curves from contrast injection was fully validated and then utilized to design a DCE-CT QA protocol. The QA protocol involved a set of quantitative metrics including injected and total mass error, as well as goodness of fit comparison to the known truth concentration curves. An additional region of interest (ROI) sensitivity analysis was also developed to provide additional details on intrascanner variability and determine appropriate ROI sizes for quantitative analysis. Both the QA protocol and ROI sensitivity analysis were utilized to test variations in DCE-CT results using different imaging parameters (tube voltage and current) as well as alternate reconstruction methods and imaging techniques. The developed QA protocol and ROI sensitivity analysis was then applied at three institutions that were part of clinical trial involving DCE-CT and results were compared. RESULTS The inherent specificity of robustness of the phantom was determined through calculation of the total intraday variability and determined to be less than 2.2±1.1% (total calculated output contrast mass error) with a goodness of fit (R2) of greater than 0.99±0.0035 (n=10). The DCE-CT QA protocol was capable of detecting significant deviations from the expected phantom result when scanning at low mAs and low kVp in terms of quantitative metrics (Injected Mass Error 15.4%), goodness of fit (R2) of 0.91, and ROI sensitivity (increase in minimum input function ROI radius by 146±86%). These tests also confirmed that the ASIR reconstruction process was beneficial in reducing noise without substantially increasing partial volume effects and that vendor specific modes (e.g., axial shuttle) did not significantly affect the phantom results. The phantom and QA protocol were finally able to quickly (<90 min) and successfully validate the DCE-CT imaging protocol utilized at the three separate institutions of a multicenter clinical trial; thereby enhancing the confidence in the patient data collected. CONCLUSIONS A DCE QA protocol was developed that, in combination with a dynamic multimodality flow phantom, allows the intrascanner variability to be separated from other sources of variability such as the impact of injection protocol and ROI selection. This provides a valuable resource that can be utilized at various clinical trial institutions to test conformance with imaging protocols and accuracy requirements as well as ensure that the scanners are performing as expected for dynamic scans.
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Affiliation(s)
- B Driscoll
- Department of Radiation Physics, Princess Margaret Cancer Center, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada.
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Jaffray D, Stewart J, Weersink R, Lindsay P, Wang K, Shah D, DaCosta R, Hill R. SP-0361: Pre-clinical irradiators: Advancements and applications. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30466-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tadic T, Jaffray D, Stanescu T. A Novel Harmonic Analysis for Quantifying MRI Performance in MRIgRT. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.041] [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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Letourneau D, Wang K, Amin N, Lee P, Pearce J, McNiven A, Keller H, Norrlinger B, Jaffray D. Linear Accelerator Performance Monitoring and Improvement Using Semiautomated Testing and Statistical Process Control. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1530] [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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Foltz W, Stanescu T, Lee J, Simeonov A, Jaffray D, Craig T, Chung P, Ménard C. Improved Geometric Performance of Diffusion-Weighted Imaging for Prostate Tumor Delineation Using a Readout-Segmented Echo-Planar-Imaging Technique. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.448] [Citation(s) in RCA: 2] [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: 11/16/2022]
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Ghobadi K, Aleman D, Jaffray D, Ruschin M. TH-A-137-04: Continuous Path Radiation Therapy Treatment Planning for Gamma Knife Perfexion. Med Phys 2013. [DOI: 10.1118/1.4815686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jia J, Chow J, Leung M, Jaffray D. SU-E-T-506: Modification of the Low-Energy Electron Energy Spectrum in the Presence of Gold Nanoparticle. Med Phys 2013. [DOI: 10.1118/1.4814935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Stanescu T, Tadic T, Marle J, Winter J, Petropoulos L, Sweitzer M, Jaffray D. WE-G-WAB-02: BEST IN PHYSICS (JOINT IMAGING-THERAPY)-MR and Linac Magnetic Field Mutual Decoupling for An MRI-Guided Radiation Therapy System. Med Phys 2013. [DOI: 10.1118/1.4815644] [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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Winter J, Carlone M, Westmore M, Breen S, Stanescu T, Dahan M, Jaffray D. SU-C-103-06: Isocenter Calibration Concept and Feasibility for MR-Guided Radiation Therapy (MRgRT). Med Phys 2013. [DOI: 10.1118/1.4813973] [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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Tadic T, Jaffray D, Winter J, Petropoulos L, Marle J, Sweitzer M, Stanescu T. WE-G-WAB-07: Commissioning of a Novel Integrated Platform for Online MRIgRT. Med Phys 2013. [DOI: 10.1118/1.4815649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hricak H, Jaffray D, Hazle J. MO-C-500-00: President's Symposium: Introduction S Donaldson*, RSNA President. Med Phys 2013. [DOI: 10.1118/1.4815225] [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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Stanescu T, Tadic T, Jaffray D. WE-G-WAB-03: 4D Composite MR Image Distortion Field: Quantification and Applications for MRI-Guided Radiotherapy. Med Phys 2013. [DOI: 10.1118/1.4815645] [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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Alasti H, Islam M, Rink A, Carlone M, Breen S, Jaffray D. SU-E-J-165: Shielding Design for An MR Guided Radiotherapy (MRgRT) Suite. Med Phys 2013. [DOI: 10.1118/1.4814377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Li X, Mayr N, Yan D, Jaffray D. TH-E-137-01: Status of ART in the Clinic. Med Phys 2013. [DOI: 10.1118/1.4815809] [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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Bartolac S, Jaffray D. WE-C-103-02: BEST IN PHYSICS (IMAGING) - Strategies for Fluence Field Modulated CT. Med Phys 2013. [DOI: 10.1118/1.4815551] [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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Zou G, Ren L, Kim J, Jaffray D, Chetty I, Jin J. WE-G-141-07: Feasibility of Using a Grid to Detect and Correct the Geometric Variations in Flat-Panel Based Cone Beam CT. Med Phys 2013. [DOI: 10.1118/1.4815658] [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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Stanescu T, Tadic T, Jaffray D. PO-0890: MRI-guided stereotactic body radiation therapy for liver. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33196-0] [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: 10/23/2022]
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Lee H, Zheng J, Gaddy D, Kirpotin D, Dunne M, Drummond D, Allen C, Jaffray D, Hendriks B, Wickham T. Abstract P4-02-05: A novel 64Cu-liposomal PET agent (MM-DX-929) predicts response to liposomal chemotherapeutics in preclinical breast cancer models. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p4-02-05] [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: 11/16/2022]
Abstract
Abstract
Background: Liposomal anthracyclines (such as pegylated liposomal doxorubicin (PLD) or HER2-targeted liposomal doxorubicin (MM-302)) are being used and/or evaluated for the clinical management of breast cancer, but responses vary from patient to patient. It is hypothesized that variability in the deposition of liposomal therapeutics within tumors leads to differences in drug exposure, thereby directly influencing tumor response. We have developed MM-DX-929, a novel 64Cu-liposomal PET imaging agent, as a clinically-implementable tool to investigate whether image-based quantification of liposome deposition in tumors can predict treatment response to liposomal chemotherapeutics, including PLD, MM-302 and/or liposomal irinotecan (MM-398).
Objectives: Our primary objective is to demonstrate that the extent of tumor uptake of MM-DX-929 is predictive of tumor response to MM-302 in preclinical breast cancer xenograft models. A secondary objective is to enable clinical translation of MM-DX-929 to enable incorporation into existing therapeutic trials.
Methods: Mice bearing BT474-M3 mammary and subcutaneous tumors were injected intravenously with MM-DX-929 prior to dosing with MM-302. PET/CT imaging was performed at 16h post MM-DX-929 injection, and tumor uptake was determined. Response to treatment was quantified as tumor volume changes measured over a 2-month period by MRI.
Results: Tumor deposition of MM-DX-929 administration correlated well with treatment response to MM-302 (Spearman correlation coefficient of −0.891 and a p-value of 0.0004). MM-DX-929 accumulation in tumors prior to the start of the MM-302 treatment successfully predicted improved tumor growth inhibition following MM-302 treatment.
Conclusion: These findings support trials of MM-DX-929 as a predictive imaging agent to select patients who are most likely to respond to liposomal therapies. The clinical development of MM-DX-929 for identification of breast cancer patients likely to respond to liposomal therapeutics is currently being pursued.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-02-05.
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Affiliation(s)
- H Lee
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - J Zheng
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - D Gaddy
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - D Kirpotin
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - M Dunne
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - D Drummond
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - C Allen
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - D Jaffray
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - B Hendriks
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
| | - T Wickham
- Merrimack Pharmaceuticals, Boston, MA; Princess Margaret Hospital, University Health Network, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, ON, Canada
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Lamey M, Carlone M, Alasti H, Bissonnette JP, Borg J, Breen S, Coolens C, Heaton R, Islam M, van Proojen M, Sharpe M, Stanescu T, Jaffray D. Poster - Thur Eve - 05: Safety systems and failure modes and effects analysis for a magnetic resonance image guided radiation therapy system. Med Phys 2012; 39:4625. [DOI: 10.1118/1.4740112] [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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