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Hu J, Schild SE, Liu W, Li J, Fatyga M. Improving Dose Volume Histogram (DVH) Based Analysis of Clinical Outcomes Using Modern Statistical Techniques: A Systematic Answer to Multiple Comparisons Concerns. Int J Radiat Oncol Biol Phys 2023; 117:S20. [PMID: 37784451 DOI: 10.1016/j.ijrobp.2023.06.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) DVH constraints are essential in the clinical practice of radiation therapy. Historically, DVH constraints were found through sparse sampling of all possible DVH indices to find one that appeared to be most predictive for clinical toxicity. This approach can lead to inconsistent results among studies and to multiple comparison concerns. We aim to solve both problems by examining a full array of DVH indices using statistical methods that account for strong correlations among DVH indices and incorporate radiobiological knowledge constraints. MATERIALS/METHODS We extracted a dense array of V%_D indices from a treatment planning system using ESAPI interface, with V%_D corresponding to the volume fraction irradiated to dose D, or higher. We used Fused Lasso as the base model to compensate for correlations among DVH indices because it applies a penalty on the difference between DVH variables with adjacent dose. The base model was augmented with additional constraints based on radiobiological considerations: the positivity constraint (beta_i > 0) which assumes that any tissue irradiation cannot reduce the risk of toxicity, and monotonicity constraint (beta_i+1 > = beta_i) which assumes that higher dose to a fixed volume fraction cannot be associated with a lower risk of toxicity. We called the hybrid model KC-Lasso (Knowledge Constrained Lasso) and applied it to two clinical examples: grade 2 acute rectal toxicity in conventionally fractionated RT for 79 prostate cancer patients (77.4 Gy + MR based boost to 81-83 Gy) and cardiac toxicity in conventionally fractionated RT for 119 locally advanced Non-small Cell Lung Cancer (NSCLC) patients (Median prescribed dose 62 Gy). We further examined alternative data driven models to determine the importance of knowledge constraints. RESULTS KC-Lasso detected two distinct dose thresholds for grade 2 rectal toxicity, at 35 Gy and 78 Gy. A threshold of 51 Gy was detected for reduced overall survival due to cardiac irradiation in NSCLC patients. An examination of KC-Lasso models at varying step size suggested that a single mid-range index can be used as a treatment planning constraint while full model can be used for confirmatory, final plan evaluation. Alternative models which lack knowledge constraints show patterns of negative and isolated coefficients which are difficult to interpret and are not likely to be generalizable. CONCLUSION A more systematic approach to the analysis of correlations between DVH constraints and clinical toxicity can lead to greater consistency of results among different studies, better understanding of true dose thresholds and results which are more generalizable.
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Affiliation(s)
- J Hu
- Arizona State university, Tempe, AZ
| | - S E Schild
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - W Liu
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - J Li
- Georgia Institute of Technology, Atlanta, GA
| | - M Fatyga
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
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Ding Y, Holmes J, Li B, Vargas CE, Vora SA, Wong WW, Fatyga M, Foote RL, Patel SH, Liu W. Patient-Specific 3D CT Images Reconstruction from 2D KV Images Via Vision Transformer-Based Deep-Learning. Int J Radiat Oncol Biol Phys 2023; 117:e660. [PMID: 37785958 DOI: 10.1016/j.ijrobp.2023.06.2095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In some proton therapy facilities, patient alignment relies on two 2D orthogonal kV images, taken at fixed, oblique angles, as no 3D on-the-bed-imaging is available. The visibility of the tumor in kV images is limited since the patient's 3D anatomy is projected onto a 2D plane, especially when the tumor is behind a high-density structure such as bone. This can lead to a large patient setup error. A solution to this problem is to reconstruct the 3D CT image from the kV images obtained in the treatment position. MATERIALS/METHODS An asymmetric autoencoder-like network built with vision-transformer blocks was developed. The data was collected from a head and neck patient: 2 orthogonal kV images (1024X1024 voxels), 1 3D CT with padding (512X512X512) acquired from the in-room CT-on-rails before kVs were taken and 2 digitally-reconstructed-radiograph (DRR) images (512X512) based on the CT. We resampled kV images every 8 voxels and DRR and CT every 4 voxels, thus formed a dataset consisting of 262,144 samples, in which the images had a dimension of 128 for each direction. The value of each voxel in CT was normalized to range 0-1 with a uniform shift of 1000 and a denominator of 4000. For kV and DRR, we ranked all voxels value in an ascending order and normalized the values of the first 80% voxels to range 0-0.8 and the rest to range 0.8-1, thus yielding a quasi-Gaussian distribution, which was favorable by the deep neural networks. We further cropped kV and DRR images with a self-supervised bitmap based on the voxels' gradients. In training, both kV and DRR were utilized, and the encoder was encouraged to learn the same feature maps for kV images and its corresponding DRR images with mean-absolute-error (MAE) as the similarity loss. Then the decoder would reconstruct the 3D CT image from the feature maps of the kV images with the CT-on-rails as ground-truth (gCT) and MAE as the reconstruction loss. In testing, only independent kV images were used. The full-size synthetic CT (sCT) was achieved by concatenating the sCTs generated by the model according to their spatial information. The image quality of the sCT was evaluated using MAE and per-voxel-absolute-CT-number-difference volume histogram (CDVH). The proposed network was implemented with PyTorch deep learning library and both distributed data parallel (DDP) and automatic mixed precision (AMP) were applied to saving memory and accelerating the training speed. We used the AdamW optimizer with β1 = 0.9 and β2 = 0.999 and a cosine annealing learning rate scheduler with an initial learning of 1e-7 and 20 warm-up epochs. RESULTS The model achieved a MAE of <40HU and the CDVH showed that <5% of the voxels had a per-voxel-absolute-CT-number-difference larger than 185HU. The profile of a typical gCT slice and its corresponding sCT slice exhibited a high agreement, indicating the high similarity between the gCT and sCT. CONCLUSION A patient-specific vision-transformer-based network was developed and shown to be accurate and efficient to reconstruct 3D CT images from kV images.
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Affiliation(s)
- Y Ding
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - J Holmes
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - B Li
- Arizona State University, Tempe, AZ
| | - C E Vargas
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - S A Vora
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - W W Wong
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - M Fatyga
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - R L Foote
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - S H Patel
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - W Liu
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
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Kang Y, Bues M, Halyard M, McGee L, Vern-Gross T, Vargas C, Keole S, Wong W, Archuleta J, Ridgway A, Lara P, Fatyga M. Dose Reproducibility for PBS Proton Treatment of Breast Cancer Patients with and without Mask Immobilization. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2222] [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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Hobbis D, Yaddanapudi S, Brooks J, Pafundi D, Jackson A, Tryggestad E, Moseley D, Routman D, Stish B, Lucido J, Ma J, Fatyga M, Anand A, Rong Y, Foote R, Patel S. Comparisons of Clinical and Reference Standard Contours to AI Auto-Segmentation: An Evaluation of 5 Commercial Models in Head and Neck Organ at Risk Delineation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.888] [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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Yang Y, Muller O, Shiraishi S, Harper M, Amundson A, Wong W, McGee L, Rwigema J, Schild S, Bues M, Fatyga M, Anderson J, Patel S, Foote R, Liu W. Empirical Relative Biological Effectiveness (RBE) for Mandible Osteoradionecrosis (ORN) in Head and Neck Cancer Patients Treated with Pencil-Beam-Scanning Proton Therapy (PBSPT): A Retrospective, Case-Matched Cohort Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Anderson J, Fatyga M, Schild S, Li J, Hu J. Impact of Cardiac Dose on Overall Survival in Lung Stereotactic Body Radiotherapy (SBRT) Compared to Conventionally Fractionated Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.10.174] [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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Yang Y, Vargas C, Bhangoo R, Wong W, Schild S, Daniels T, Keole S, Rwigema J, Glass J, Shen J, DeWees T, Liu T, Bues M, Fatyga M, Liu W. Exploratory Investigation of Dose-Linear Energy Transfer (LET) Volume Histogram (DLVH) for Adverse Events Study in Intensity-Modulated Proton Therapy (IMPT). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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Anderson J, Hu J, Li J, Daniels T, Schild S, Fatyga M. Association Between Radiation Heart Dose and Overall Survival in Lung Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1218] [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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Yang Y, Patel S, Bridhikitti J, Wong W, Halyard M, McGee L, Rwigema J, Schild S, Vora S, Liu T, Bues M, Fatyga M, Foote R, Liu W. Seed Spots Analysis to Characterize Linear Energy Transfer (LET) Effect in the Adverse Event Regions of Head and Neck Cancer Patients Treated by Intensity Modulated Proton Therapy (IMPT). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1133] [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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Fatyga M, Schild S, Niska J, Herman M, Liu X, Li J. High Doses to the Heart Are Associated with Reduced Overall Survival in Stage III Non-Small Cell Lung Cancer Patients Undergoing Radiation Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1328] [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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Erikson A, Yu N, DeWees T, Daniels T, Ashman J, Sharma A, Porter A, Mrugala M, Golafshar M, Mastorakos G, Patel N, Bendok B, Gagneur J, Fatyga M, Clouser E, Schild S, Ezzell G, Vora S, Sio T. Clinical Outcomes of Single or Multi-Fractionated, Single-Isocenter, Multi-Arc Volumetric Modulated Radiotherapy (VMAT) for Stereotactic Radiosurgery (SRS) for Palliation of Multiple Brain Metastases. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fatyga M, Schild S, Niska J, Herman M, Li J, Liu X. PO-0768 High Heart Dose Affects Overall Survival in Lung Cancer Patients Undergoing Radiation Therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31188-0] [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: 11/30/2022]
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Liu X, Li J, Schild SE, Schild MH, Wong W, Vora S, Herman MG, Fatyga M. Modeling of Acute Rectal Toxicity to Compare Two Patient Positioning Methods for Prostate Cancer Radiotherapy: Can Toxicity Modeling be Used for Quality Assurance? ACTA ACUST UNITED AC 2019; 7. [PMID: 30775161 PMCID: PMC6376967 DOI: 10.4172/2167-7964.1000302] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose: Intensity Modulated Radiation Therapy (IMRT) allows for significant dose reductions to organs at risk in prostate cancer patients. However, the accurate delivery of IMRT plans can be compromised by patient positioning errors. The purpose of this study was to determine if the modeling of grade ≥ 2 acute rectal toxicity could be used to monitor the quality of IMRT protocols. Materials and Methods: 79 patients treated with Image and Fiducial Markers Guided IMRT (FMIGRT) and 302 patients treated with trans-abdominal ultrasound guided IMRT (USGRT) was selected for this study. Treatment plans were available for the FMIGRT group, and hand recorded dosimetric indices were available for both groups. We modeled toxicity in the FMIGRT group using the Lyman Kutcher Burman (LKB) and Univariate Logistic Regression (ULR) models, and we modeled toxicity in USGRT group using the ULR model. We performed Receiver Operating Characteristics (ROC) analysis on all of the models and compared the Area under the ROC curve (AUC) for the FMIGRT and the USGRT groups. Results: The observed Incidence of grade ≥ 2 rectal toxicity was 20% in FMIGRT patients and 54% in USGRT patients. LKB model parameters in the FMIGRT group were TD50=56.8 Gy, slope m=0.093, and exponent n=0.131. The most predictive indices in the ULR model for the FMIGRT group were D25% and V50 Gy. AUC for both models in the FMIGRT group was similar (AUC=0.67). The FMIGRT URL model predicted less than a 37% incidence of grade ≥ 2 acute rectal toxicity in the USGRT group. A fit of the ULR model to USGRT data did not yield a predictive model (AUC=0.5). Conclusion: Modeling of acute rectal toxicity provided a quantitative measure of the correlation between planning dosimetry and this clinical endpoint. Our study suggests that an unusually weak correlation may indicate a persistent patient positioning error.
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Affiliation(s)
- X Liu
- School of Computing, Informatics and Decision Systems Engineering, Arizona State University, USA
| | - J Li
- School of Computing, Informatics and Decision Systems Engineering, Arizona State University, USA
| | - S E Schild
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - M H Schild
- Department of Pathology, Duke University School of Medicine, USA
| | - W Wong
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - S Vora
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - M G Herman
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - M Fatyga
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
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Latalski M, Danielewicz-Bromberek A, Fatyga M, Latalska M, Kröber M, Zwolak P. Current insights into the aetiology of adolescent idiopathic scoliosis. Arch Orthop Trauma Surg 2017; 137:1327-1333. [PMID: 28710669 PMCID: PMC5602042 DOI: 10.1007/s00402-017-2756-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Indexed: 02/02/2023]
Abstract
Scoliosis occurs in about 0.2-0.6% of the general population. In the majority of cases the cause of this entity remains mostly unidentified. The search for the causes covers almost all aspects of its possible origin. We collected and systematised the contemporary theories and concepts concerning the aetiology of adolescent idiopathic scoliosis. Genetic and hereditary factors are commonly accepted as possible causes; however, the identification of the single gene responsible for the development of this condition seems impossible, which suggests multifactorial mechanism of its formation. Dysfunctions of the nervous system are recognised risks related to the development of scoliosis, but they are classified as belonging to a separate aetiological category. Scoliosis develops at the quickest rate during the child's growth spurt, which prompted the research on the role of the growth hormone in scoliosis aetiology. Melatonin is another hormone that is studied as a possible factor involved in development of this entity. In cases of progressive scoliosis, increased activity of calmodulin-a protein that regulates the levels of calcium ions-has been observed. The scientists have characterised numerous qualitative and quantitative changes in the composition of the tissue of intervertebral discs, spinal ligaments and paraspinal muscles. Some of the theories, explaining the nature of this entity, presented in this review seem to have only a purely theoretical value; their proliferation only confirms the fact that the actual nature of this condition has not been unveiled yet, and suggests its multifactorial aetiology.
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Affiliation(s)
- Michal Latalski
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland.
| | - A Danielewicz-Bromberek
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
| | - M Fatyga
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
| | - M Latalska
- Department of Vitreoretinal Surgery, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland
| | - M Kröber
- Department of Orthopaedics, Trauma und Spine Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany
| | - P Zwolak
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
- Department of Orthopaedics, Trauma und Spine Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany
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Liu X, Fatyga M, Herman M, Vora S, Wong W, Schild S, Schild M, Li J, Wu T. SU-D-204-03: Comparison of Patient Positioning Methods Through Modeling of Acute Rectal Toxicity in Intensity Modulated Radiation Therapy for Prostate Cancer. Does Quality of Data Matter More Than the Quantity? Med Phys 2016. [DOI: 10.1118/1.4955608] [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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Ding X, Liu W, Fatyga M, Anand A, Shen J, Stoker J, Bues M. A Fast Method to Calculate RBE Weighted Dose Distribution. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1996] [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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Fatyga M, Schild S, Vora S, Schild M, Wong W, Liu X, Li J, Wu T. SU-E-T-803: Verification of QUANTEC Lyman Kutcher Burman (LKB) Model for Grade>=2(2+) Late Rectal Complication Rates Using a Database of 79 Prostate Patients Treated with IMRT. Med Phys 2015. [DOI: 10.1118/1.4925167] [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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Liu X, Fatyga M, Li J, Schild M, Schild S, Vora S, Wong W, Wu T. TH-AB-304-02: Fitting Grade>=2(2+) Acute Rectal Complication Rates in Prostate Cancer Patients to Lyman Kutcher Burman (LKB) and Logistic Regression NTCP Models Using Dosimetry and Patient Specific Characteristics. Med Phys 2015. [DOI: 10.1118/1.4926117] [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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Dogan N, Padgett K, Evans J, Sleeman W, Song S, Fatyga M. SU-E-J-68: Adaptive Radiotherapy of Head and Neck Cancer: Re-Planning Based On Prior Dose. Med Phys 2015. [DOI: 10.1118/1.4924155] [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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Fatyga M, Gao F, Wu T, Liu W. SU-E-T-482: Development and Systematic Testing of Dose Analysis Engine for Research and Clinical Applications Using API Interface of Varian Eclipse Treatment Planning System. Med Phys 2014. [DOI: 10.1118/1.4888815] [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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Fatyga M, Li J, Liu X, Schild M, Schild S, Wu T, Gao F. SU-D-16A-05: Fitting Grade>=2(2+) Rectal Complication Rates to Lyman Kutcher Burman (LKB) Model with a Database of 81 Prostate Patients Treated with IMRT. Med Phys 2014. [DOI: 10.1118/1.4887861] [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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Chungbin S, Fatyga M. SU-E-T-260: Pediatric Total Body Irradiation Calculations and In-Vivo Dosimetry Using Diodes and OSLD' s. Med Phys 2014. [DOI: 10.1118/1.4888591] [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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Asher D, Evans J, Schutzer M, Dogan N, Fatyga M, Sleeman F, Song S. Bite Blocks Can Reduce Setup Uncertainty Related to Weight Loss During Head and Neck IMRT: Preliminary Results of a 3-Modality Image Guidance Protocol. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1813] [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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Dogan N, Sleeman W, Asher D, Fatyga M, Schutzer M, Song S. SU-E-J-94: Assessment of Dose Accumulation with Different Deformable Image Registration Algorithms for Image-Guided Radiotherapy of Head and Neck Cancer. Med Phys 2013. [DOI: 10.1118/1.4814306] [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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Fatyga M, Dogan N, Sleeman W, Williamson J, Schutzer M, Song S. WE-G-BRCD-09: Assessment of Quantitative Differences Between Different Deformable Image Registration Algorithms for Image Guided Radiotherapy of Head and Neck Cancer Patients. Med Phys 2012; 39:3966. [PMID: 28519614 DOI: 10.1118/1.4736186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE DIR algorithms differ by physical principles employed in their design which in turn determines complexity of the transformation that the algorithm allows. Indiscriminate application of different algorithms without regard for their limitations may lead to significant discrepancies in research results and in clinical procedures. We compare two different algorithms in Head and Neck (H&N) patients to assess what aspects of DIR use are most sensitive to differences between algorithms. METHODS H&N patients are enrolled in a protocol which acquires weekly FBCT and daily double CBCT. Each FBCT study is contoured by the same physician. Two DIR algorithms are compared: Small Deformation Inverse-Consistent Linear Elastic (SICLE), and the ITK Diffeomorphic Demons (ITKDD) as implemented in the ITK package. Both algorithms employ significantly different physical principles in their design and consequently impose different restrictions on the complexity of transformation they allow. We compare Jacobian Volume Histograms (JVH), Spatial Discrepancy Volume Histograms (SDVH), BED and physical dose accumulation results and resulting plan evaluation indices. RESULTS Analysis of mean Jacobian shows that both algorithms are able to detect changes in structure volumes, though they differ quantitatively from one another and from the ground truth as established by the analysis of changes in contours. Width of Jacobian distributions is very different indicating that Jacobian should not be used as a measure of volume change at a voxel level without independent validation. Analysis of SDVHs shows that dose lookup points implied by both algorithms are separated by 5mm - 10mm over approximately 30% of most volumes. These differences translate into clearly visible though not very significant differences in BED and dose accumulation. We further observe that physical dose accumulation in external beam H&N patients is a good proxy for direct BED accumulation. CONCLUSIONS Different DIR algorithms may have to be applied selectively in different areas of treatment planning. Acknowledgments: Supported by NIH Grant P01 CA11602.
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Affiliation(s)
- M Fatyga
- Virginia Commonwealth University, Richmond, VA
| | - N Dogan
- Virginia Commonwealth University, Richmond, VA
| | - W Sleeman
- Virginia Commonwealth University, Richmond, VA
| | | | - M Schutzer
- Virginia Commonwealth University, Richmond, VA
| | - S Song
- Virginia Commonwealth University, Richmond, VA
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Balik S, Hugo G, Weiss E, Jan N, Roman N, Sleeman W, Fatyga M, Christensen G, Murphy M, Lu J, Keall P, Williamson J. MO-F-BRA-02: Evaluation of 4D CT to 4D Cone-Beam CT Deformable Image Registration for Lung Cancer Adaptive Radiation Therapy. Med Phys 2012; 39:3875. [PMID: 28518270 DOI: 10.1118/1.4735821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate two deformable image registration (DIR) algorithms for the purpose of contour mapping to support image guided adaptive radiotherapy (IGART) with 4D cone beam CT (4DCBCT). METHODS Eleven locally advanced non-small cell lung cancer (NSCLC) patients underwent one planning 4D fan- beam CT (4DFBCT) and seven weekly 4DCBCT scans. Gross tumor volume (GTV) and carina were delineated by a physician in all 4D images. For day to day registration, the end of inspiration 4DFBCT phase was deformably registered to the corresponding phase in each 4DCBCT image. For phase to phase registration, the end of inspiration phase from each 4D image was registered to end of expiration phase. The delineated contours were warped using the resulting transforms and compared to the manual contours through Dice similarity coefficient (DSC), false positive and false negative indices, and, for carina, target registration error (TRE). Two DIR algorithms were tested: 1) small deformation, inverse consistent linear elastic (SICLE) algorithm and 2) Insight Toolkit diffeomorphic demons (DEMONS). RESULTS For day to day registrations, the mean DSC was 0.59 ± 0.16 after rigid registration, 0.72 ± 0.13 with SICLE and to 0.66 ± 0.18 with DEMONS. SICLE and DEMONS reduced TRE to 4.1 ± 2.1 mm and 5.8 ± 3.7 mm respectively, from 6.2 ± 3.5 mm; and reduced false positive index to 0.27 and 0.26 respectively from 0.46. Registration with the cone beam as the fixed image resulted in higher DSC than with the fan beam as fixed (p < 0.001). SICLE and DEMONS increased the DSC on average by 10.0% and 8.0% and reduced TRE by 2.8 mm and 2.9 mm respectively for phase to phase DIR. CONCLUSIONS DIR achieved more congruent mapping of target structures to delineations than rigid registration alone, although DIR performance varied with algorithm and patient. This work was supported by National Cancer Institute Grant No. P01 CA 116602.
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Affiliation(s)
- S Balik
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - G Hugo
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - E Weiss
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - N Jan
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - N Roman
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - W Sleeman
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - M Fatyga
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - G Christensen
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - M Murphy
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - J Lu
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - P Keall
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
| | - J Williamson
- Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,Virginia Commonwealth University, Richmond, VA.,University of Iowa.,Virginia Commonwealth University, Richmond, VA.,SUNY Upstate Medical Univ, Syracuse, NY.,University of Sydney, Sydney, NSW.,Virginia Commonwealth University, Richmond, VA
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Zhang B, Fatyga M, Sleeman W, Dogan N. SU-E-T-32: An Integrated IGART Planning Environment. Med Phys 2011. [DOI: 10.1118/1.3611982] [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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Fatyga M, Dogan N, Wijesooriya K, Sleeman W, Zhang B, Christensen G. SU-E-T-278: Volume Based Comparison of Deformable Image Registration Algorithms Using Spatial Discrepancy Volume Histograms. Med Phys 2011. [DOI: 10.1118/1.3612229] [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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Dogan N, Sleeman W, Fatyga M, Hugo G, Christensen G, Weiss E. SU-E-J-46: Evaluation of Inter-Fraction Deformable Registration of 4DCT Scans: Direct vs. Composed Registration. Med Phys 2011. [DOI: 10.1118/1.3611814] [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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Dogan N, Sleeman W, Fatyga M, Lehman W, Weiss E, Christensen G, Williamson J. Evaluation of Dosimetric Effects of Use of Deformably-Mapped Contours for Lung IMRT Treatment Planning. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1686] [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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31
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Zhang B, Sleeman W, Fatyga M, Dogan N. SU-GG-T-261: An Integrated Software Environment for Image Guided Adaptive Radiation Therapy Research. Med Phys 2010. [DOI: 10.1118/1.3468653] [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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32
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Dogan N, Sleeman W, Fatyga M, Lehman W, Christensen G, Wu J, Weiss E, Zhang B, Williamson J. SU-GG-J-47: Verification of a Deformable Image Registration Algorithm for Head and Neck Cancer Therapy. Med Phys 2010. [DOI: 10.1118/1.3468271] [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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Fatyga M, Williamson JF, Dogan N, Todor D, Siebers JV, George R, Barani I, Hagan M. A comparison of HDR brachytherapy and IMRT techniques for dose escalation in prostate cancer: a radiobiological modeling study. Med Phys 2009; 36:3995-4006. [PMID: 19810472 PMCID: PMC2738740 DOI: 10.1118/1.3187224] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 07/06/2009] [Accepted: 07/06/2009] [Indexed: 01/02/2023] Open
Abstract
A course of one to three large fractions of high dose rate (HDR) interstitial brachytherapy is an attractive alternative to intensity modulated radiation therapy (IMRT) for delivering boost doses to the prostate in combination with additional external beam irradiation for intermediate risk disease. The purpose of this work is to quantitatively compare single-fraction HDR boosts to biologically equivalent fractionated IMRT boosts, assuming idealized image guided delivery (igIMRT) and conventional delivery (cIMRT). For nine prostate patients, both seven-field IMRT and HDR boosts were planned. The linear-quadratic model was used to compute biologically equivalent dose prescriptions. The cIMRT plan was evaluated as a static plan and with simulated random and setup errors. The authors conclude that HDR delivery produces a therapeutic ratio which is significantly better than the conventional IMRT and comparable to or better than the igIMRT delivery. For the HDR, the rectal gBEUD analysis is strongly influenced by high dose DVH tails. A saturation BED, beyond which no further injury can occur, must be assumed. Modeling of organ motion uncertainties yields mean outcomes similar to static plan outcomes.
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Affiliation(s)
- M Fatyga
- Department of Radiation Oncology, Virginia Commonwealth University Medical Center, 401 College Street, Richmond, Virginia 23298, USA.
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Dogan N, Sleeman W, Yan C, Fatyga M, Zhang B, Song S, Christensen G. ASSESSMENT OF AUTOMATIC HEAD-AND-NECK ANATOMY SEGMENTATION USING A DEFORMABLE IMAGE REGISTRATION ALGORITHM. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72904-3] [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: 11/25/2022]
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Fatyga M, Williamson J. TH-D-BRD-05: Replacement for Generalized Equivalent Dose in Phenomenological NTCP Models. Med Phys 2009. [DOI: 10.1118/1.3182659] [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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36
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Dogan N, Sleeman W, Yan C, Fatyga M, Wu J, Christensen G, Hugo G, Weiss E, Williamson J. MO-FF-A3-03: Quantitative Assessment of Automatic Anatomy Segmentation of 4D CT Images Using a Deformable Image Registration Algorithm. Med Phys 2009. [DOI: 10.1118/1.3182291] [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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37
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Sleeman W, Dogan N, Siebers J, Murphy M, Williamson J, Fatyga M. SU-GG-T-388: Design and Implementation of a Computing Framework for An Image Guided Adaptive Radiotherapy Research Program. Med Phys 2008. [DOI: 10.1118/1.2962138] [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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38
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Dogan N, Saleh H, Fatyga M, Bartee C, Siebers J. SU-GG-T-148: Quantification of IMRT Patient Dose Deviations Due to Daily MLC-Leaf Positional Variations. Med Phys 2008. [DOI: 10.1118/1.2961899] [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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39
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Keall P, Wijesooriya K, Fatyga M, Weiss E. Are Automatically Generated Contours in 4D CTs Reliable for Treatment Planning? A Respiration-Correlated IMRT Dosimetric Comparison Based on Manual and Auto Contours in Lung Cancer Radiotherapy. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1740] [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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40
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Weiss E, Ramsey C, Fatyga M, Wu Y, Keall P. Simultaneous Integrated Volume-Adapted Boost (SIVAB) Allows Dose Escalation to Shrinking Tumors in Lung Cancer Radiotherapy. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1743] [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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41
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Fatyga M, Williamson J, Dogan N, Todor D, Siebers J, George R, Hagan M, Barani I. TH-C-M100F-08: HDR Brachytherapy and Online Image-Guided Adaptive IMRT for Dose Escalation in Prostate Cancer: Comparison of Brachytherapy and IMRT Boosts. Med Phys 2007. [DOI: 10.1118/1.2761686] [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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42
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Mihaylov IB, Lerma FA, Fatyga M, Siebers JV. Quantification of the impact of MLC modeling and tissue heterogeneities on dynamic IMRT dose calculations. Med Phys 2007; 34:1244-52. [PMID: 17500456 DOI: 10.1118/1.2712413] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This study quantifies the dose prediction errors (DPEs) in dynamic IMRT dose calculations resulting from (a) use of an intensity matrix to estimate the multi-leaf collimator (MLC) modulated photon fluence (DPE(IGfluence) instead of an explicit MLC particle transport, and (b) handling of tissue heterogeneities (DPE(hetero)) by superposition/convolution (SC) and pencil beam (PB) dose calculation algorithms. Monte Carlo (MC) computed doses are used as reference standards. Eighteen head-and-neck dynamic MLC IMRT treatment plans are investigated. DPEs are evaluated via comparing the dose received by 98% of the GTV (GTV D 98%), the CTV D 95%, the nodal D 90%, the cord and the brainstem D 02%, the parotid D 50%, the parotid mean dose (D (Mean)), and generalized equivalent uniform doses (gEUDs) for the above structures. For the MC-generated intensity grids, DPE(IGfluence) is within +/- 2.1% for all targets and critical structures. The SC algorithm DPE(hetero) is within +/- 3% for 98.3% of the indices tallied, and within +/- 3.4% for all of the tallied indices. The PB algorithm DPE(hetero) is within +/- 3% for 92% of the tallied indices. Statistical equivalence tests indicate that PB DPE(hetero) requires a +/- 3.6% interval to state equivalence with the MC standard, while the intervals are < 1.5% for SC DPE(hetero) and DPE(IGfluence). Overall, these results indicate that SC and MC IMRT dose calculations which use MC-derived intensity matrices for fluence prediction do not introduce significant dose errors compared with full Monte Carlo dose computations; however, PB algorithms may result in clinically significant dose deviations.
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Affiliation(s)
- I B Mihaylov
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA
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Lu L, Barani I, Cuttino L, Dogan N, Du W, Fatyga M, Siebers J, Song S, Wu Y, Murphy M. 2432. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.842] [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: 10/24/2022]
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Lu L, Cuttino L, Barani I, Song S, Fatyga M, Murphy M, Keall P, Siebers J, Williamson J. SU-FF-J-85: Inter-Observer Variation In The Planning Of Head/Neck Radiotherapy. Med Phys 2006. [DOI: 10.1118/1.2240862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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45
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Lasio G, Williamson J, Du W, Fatyga M. SU-EE-A4-03: Spatial Resolution-Matched Comparison Between Fan-Beam and Cone-Beam X-Ray CT Images. Med Phys 2006. [DOI: 10.1118/1.2240235] [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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46
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Fatyga M. SU-FF-T-69: A Tool for Graphical Display of TCP Information in Regions of Dose Inhomogeneity. Med Phys 2006. [DOI: 10.1118/1.2240995] [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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47
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Skwarcz A, Majcher P, Fatyga M. Internal fixation of the spine in the surgical treatment of scoliosis. Ortop Traumatol Rehabil 2000; 2:74-76. [PMID: 18034146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Progressive idiopathic scoliosis, despite the good effects of treatment by kinesitherapy and corrective corsets, continues to pose a complicated problem in planning surgical procedure. On the one hand, the steady growth and improvement of systems for three-plane correction and fixation of scoliosis improves the radiological and clinical outcome; on the other hand, three arises the necessity to choose the surgical procedure and system of implants appropriate for the given type, localization, and angular dimensions of the curvature. The problems faced by the operating surgeon include not only making the right choice of implants, but also arranging the transpedicular screws and hooks at the proper strategic points along the curvature of the spine.<br /> On the basis of clinical material from 200 patients surgically treated for idiopathic scoliosis, the authors present surgical solutions and analyze various implant systems (CD-HORIZON, DERO, STRYKER), made of steel or titanium, for three-plane correction and fixation of the spine. Attention is called to the application in the lumbar spine of transpedicular screws, which improve the correction and fixation of the spine and reduce the amount of instrumentation needed, while assuring the essential horizontal arrangement of the lower lumbar vertebrae.<br /> The authors' own experience shows that modern systems for three-plane correction and fixation of the spine in scoliosis exceeding 750, despite spondylodesis, do not assure the proper correction and biomechanical value, in comparison to the Wisconsin method, which combines BW distraction with Luque intersegmentary fixation.
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Affiliation(s)
- A Skwarcz
- Katedra i Klinika Rehabilitacji, Akademia Medyczna, Lublin
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Majcher P, Fatyga M, Skwarcz A. Internal fixation systems in the surgical treatment of spondylolisthesis. Ortop Traumatol Rehabil 2000; 2:65-68. [PMID: 18034123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The authors of this article describe the surgical procedure for fixation of spondylolisthesis using transpedicular fixation, and offer a comparative evaluation of the DERO, CD, C-CD, SOCON, and STRYKER systems.<br /> The evaluation involved 36 patients operated in the Rehabilitation Clinic at the Lublin Academy of Medicine during the period 1994-2000. In 11 cases the DERO fixation system was used; in 5 cases, fixation with CD or C-CD instrumentation; in 15 cases, using the SOCON system; and in 5 cases with the STRYKER instrumentation.<br /> Indications for surgery included pain and symptoms of nerve root irritation with sciatic neuralgia. The concomitant neurological symptoms resulted from the displacement into the vertebral canal of fragments of the nucleus pulposus, or from bone-related stenosis of the vertebral canal and intervertebral foramina.<br /> Surgical treatment involved decompression of the nerve elements and internal fixation. In all the cases reported here posterior and postero-lateral spondylodesis was performed, while in 20 cases interbody spondylodesis was additionally performed, in 14 cases using interbody plugs.<br /> The authors analyze the reasons for complications, such implants working loose and fatigue fractures.
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Affiliation(s)
- P Majcher
- Katedra i Klinika Rehabilitacji, Akademia Medyczna, Lublin
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Melian E, Fatyga M, Lam P, Steinberg M, Reddy SP, Petruzzelli GJ, Glasgow GP. Effect of metal reconstruction plates on cobalt-60 dose distribution: a predictive formula and clinical implications. Int J Radiat Oncol Biol Phys 1999; 44:725-30. [PMID: 10348305 DOI: 10.1016/s0360-3016(99)00065-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE We sought to create a predictive formula for the dose perturbations caused by head and neck reconstruction plates in the delivery of postoperative radiotherapy with 60Co beams. MATERIALS AND METHODS The dose perturbation effects of Vitallium and Titanium reconstruction plates and flat metal plates of aluminum (13Al), stainless steel (26Fe), tin (50Sn) and lead (82Pb) irradiated with a 60Co beam were measured in polystyrene phantoms using a film dosimetry system. We then used these results to create formulas to predict the effect of a metal reconstruction plate dependent upon its effective atomic number. RESULTS Percentage dose increases secondary to back scattering were 10% at 1 mm in front of the Vitallium plate and 40% at the plate while the percentage dose decrease was 29% at the plate and 10% 1 mm behind the plate. For the Titanium plate, the percentage dose increase was 5% at 1 mm in front the plate and 25% at the plate while the percentage dose decrease was 20% at the plate and 5% 1 mm behind the plate. For flat plates the percentage dose increases and decreases, respectively, at the plate surfaces were: 13Al (8%, 6%), 26Fe (35%, 16%), 50Sn (60%, 24%), and 82Pb (85%, 13%). A second order polynomial predicting the back scatter and shadowing effects was created, Y = a + bZ + cZ2, where Z is the effective atomic number of the plate while a, b, and c are the following constants: for back scatter a = 0.854 +/- 0.082, b = 0.0212 +/- 0.0044, c = -0.00011 +/- 0.00004 and for shadowing a = 1.108 +/- 0.021, b = -0.0141 +/- 0.0011, c = 0.00014 +/- 0.00001. CONCLUSIONS It is possible to predict the effect of a metal reconstruction plate upon the delivered postoperative radiotherapy dose. The dose perturbations around the plate only exist for a few millimeters, but this is substantially greater than the thickness of a normal tissue or tumor cell. Perhaps a coating of a low effective atomic number, biologically inert, substance might allow for greater dose homogeneity and decrease the risks of plate failure or tumor recurrence.
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Affiliation(s)
- E Melian
- Department of Radiotherapy of Loyola University Medical Center and the Edward Hines Jr. Veterans Affairs Hospital, Maywood, IL 60153, USA.
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