Purpose: To study the localization accuracy of two commercial surface imaging (SI) systems used for intrafraction motion monitoring during stereotactic radiosurgery (SRS) and quantify the difference in accuracy due to skin tone.
Methods: Using a publicly available CT dataset, anthropomorphic phantoms were 3D printed using filament in four skin tones: rose tan, light brown, medium brown, and dark brown (3DUniverse, Chicago, IL, USA). Three SI systems from two vendors were utilized to measure the SI-reported offsets of the stationary phantoms in various gantry and couch configurations to create SRS-like conditions, including when the gantry obscured one camera pod.
J Appl Clin Med Phys
July 2025
Purpose: The adaption of radiotherapy (RT) plans in response to anatomical and physiological changes during treatment marks a significant shift toward personalized cancer care. However, the complexity of Online Adaptive Radiotherapy (OART) procedures often leads to variability in treatment quality across institutions. The development of planning templates, particularly through the Ethos treatment planning system (TPS) and Intelligent Optimization Engine (IOE) (Varian Medical Systems, Palo Alto, CA), plays a crucial role in standardizing and streamlining OART.
View Article and Find Full Text PDFBackground: Currently, no definitive method reliably differentiates pseudoprogression from true progression. Misclassification can either halt effective therapy or prolong ineffective treatment. We hypothesized that the diagnostic accuracy could be improved using quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) after error correction via point-of-care portable perfusion phantoms (P4s).
View Article and Find Full Text PDFMedical research institutions are increasingly leveraging artificial intelligence (AI) to enhance the processing and analysis of medical imaging data. However, scaling AI-driven medical image analysis often requires specialized expertise and infrastructure that individual labs may lack. A centralized solution is to establish a core facility-a shared institutional resource-dedicated to Automated Medical Image Processing and Analysis (AMIPA).
View Article and Find Full Text PDFPurpose: Robustness evaluation is critical for proton beam therapy (PBT) planning, but ideal robustness criteria are not clearly defined. Here, we compared robustness of PBT plans to published intensity-modulated radiation therapy (IMRT)-derived clinical target volume (CTV) robustness benchmarks and assessed the dosimetric impact of meeting IMRT-derived benchmarks on adjacent organs at risk.
Patients And Methods: Patients receiving PBT to 70 GyE in 28 fractions to the prostate alone from 2021 to 2022 at our institution were evaluated.
Purpose Adjuvant radiation therapy for atypical meningiomas (AMs) aids in local control following surgery and salvage after recurrence. The role of fractionated stereotactic radiosurgery (FSRT) in this population remains an area of active study with many unanswered clinical questions. This single-institution retrospective study evaluates the local control, marginal control, and toxicity of FSRT in treating AM.
View Article and Find Full Text PDFLimited research has compared cognition of people with non-central nervous system metastatic cancer (NCM) metastatic brain cancer (BM). This prospective cross-sectional study was comprised 37 healthy controls (HC), 40 NCM, and 61 BM completing 10 neuropsychological tests. The NCM performed below HCs on processing speed and executive functioning tasks, while the BM group demonstrated lower performance across tests.
View Article and Find Full Text PDFJ Neurosurg
September 2024
Objective: Radiation therapy (RT) is used selectively for patients with low-grade glioma (LGG) given the concerns for potential cognitive effects in survivors, but prior cognitive outcome studies among LGG survivors have had inconsistent findings. Translational studies that characterize changes in brain anatomy and physiology after treatment of LGG may help to both contextualize cognitive findings and improve the overall understanding of radiation effects in normal brain tissue. This study aimed to investigate the hypothesis that patients with LGG who are treated with RT will experience greater brain volume loss than those who do not receive RT.
View Article and Find Full Text PDFPurpose: AT-101 is an oral bcl-2 family protein inhibitor (Bcl-2, Bcl-XL, Mcl-1, Bcl-W) and potent inducer of proapoptotic proteins. A prior study of the parent compound, racemic gossypol, demonstrated objective and durable responses in patients with malignant glioma. AT-101 has demonstrated synergy with radiation in animal models.
View Article and Find Full Text PDFPurpose: Robustness evaluation is increasingly used in particle therapy planning to assess clinical target volume (CTV) coverage in the setting of setup and range uncertainty. However, no clear standard exists as to an acceptable degree of plan robustness. The aim of this study is to quantify x-ray robustness parameters, as this could inform proton planning when held to a similar standard.
View Article and Find Full Text PDFBackground And Objectives: There is wide variation in treatment planning strategy for central nervous system (CNS) stereotactic radiosurgery. We sought to understand what relationships exist between intratumor maximum dose and local control (LC) or CNS toxicity, and dosimetric effects of constraining hotspots on plan quality of multiple metastases volumetric modulated arc therapy radiosurgery plans.
Methods: We captured brain metastases from 2015 to 2017 treated with single-isocenter volumetric modulated arc therapy radiosurgery.
Purpose: To commission and assess the clinical performance of a new commercial surface imaging (SI) system by analyzing intra-fraction motion from the initial cohort of patients treated with frameless stereotactic radiosurgery (fSRS).
Methods: The IDENTIFY SI system was commissioned for clinical use on an Edge (Varian Medical Systems, Palo Alto, CA) linear accelerator. All patients who received intracranial radiotherapy with HyperArc (Varian Medical Systems, Palo Alto, CA) were immobilized with the Encompass (Qfix, Avondale, PA) thermoplastic mask and monitored for intra-fraction motion with SI.
Purpose: Stereotactic body radiation therapy (SBRT) is increasingly used as a definitive treatment option for patients with prostate adenocarcinoma. The aim of this study was to assess the late toxicity, patient-reported quality of life outcomes, and biochemical recurrence rates after prostate SBRT with simultaneous integrated boost (SIB) targeting lesions defined by magnetic resonance imaging (MRI).
Methods And Materials: Patients were eligible if they had biopsy-proven low- or intermediate-risk prostate adenocarcinoma, one or more focal lesions on MRI, and an MRI-defined total prostate volume of <120 mL.
Background: Glioblastoma (GBM) is the most common malignant primary brain tumor. Emerging reports have suggested that racial and socioeconomic disparities influence the outcomes of patients with GBM. No studies to date have investigated these disparities controlling for isocitrate dehydrogenase (IDH) mutation and O-6-methylguanine-DNA methyltransferase (MGMT) status.
View Article and Find Full Text PDFAdv Radiat Oncol
March 2023
Purpose: The aim of this work was to describe the design and implementation of a more robust workflow for communicating outcomes from a peer-review chart rounds conference. We also provide information regarding cycle times, plan revisions, and other key metrics that we have observed since initial implementation.
Methods And Materials: A multidisciplinary team of stakeholders including physicians, physicists, and dosimetrists developed a revised peer-review workflow that addressed key needs to improve the prior process.
Purpose: Online Adaptive Radiation Therapy (oART) follows a different treatment paradigm than conventional radiotherapy, and because of this, the resources, implementation, and workflows needed are unique. The purpose of this report is to outline our institution's experience establishing, organizing, and implementing an oART program using the Ethos therapy system.
Methods: We include resources used, operational models utilized, program creation timelines, and our institutional experiences with the implementation and operation of an oART program.
Therapeutic resistance to immune checkpoint blockers (ICBs) in melanoma patients is a pressing issue, of which tumor loss of IFN-γ signaling genes is a major underlying mechanism. However, strategies of overcoming this resistance mechanism have been largely elusive. Moreover, given the indispensable role of tumor-infiltrating T cells (TILs) in ICBs, little is known about how tumor-intrinsic loss of IFN-γ signaling (IFNγR1) impacts TILs.
View Article and Find Full Text PDFBackground: There are a limited data examining the effects of prior hemorrhage on outcomes after stereotactic radiosurgery (SRS). The goal of this study was to identify risk factors for arteriovenous malformation (AVM) rupture and compare outcomes, including post-SRS hemorrhage, between patients presenting with ruptured and unruptured AVMs.
Methods: A retrospective review of consecutive patients undergoing SRS for intracranial AVMs between 2009 and 2019 at our institution was conducted.
J Cancer Policy
December 2021
Background: The rapid growth in cancer research continues expanding the literature. Text mining approaches help make sense of large bodies of scientific literature and integrate the mounting data into the health care delivery system. Our objective is to generate a comprehensive understanding of the themes and trends in cancer research.
View Article and Find Full Text PDFPurpose: Primary Central Nervous System Lymphoma (PCNSL) is an aggressive tumor that is confined to the CNS. Although the provision of high-dose methotrexate (HD-MTX) has remarkably improved outcomes in PCNSL patients, the optimal treatment regimens and standard MTX dose for induction therapy have been largely controversial. Herein, we sought to explore the impact of adjuvant rituximab and different dosages of induction HD-MTX on survival outcomes of immunocompetent patients with PCNSL.
View Article and Find Full Text PDFBackground: Stereotactic radiosurgery (SRS) is particularly useful for treatment of deep arteriovenous malformations (AVMs) in eloquent territory with a high associated surgical risk. Prior studies have demonstrated high rates of AVM obliteration with SRS (60%-80%) in a latency period of 2-4 years for complete obliteration. Studies have identified several factors associated with successful obliteration of the AVM nidus; however, these present inconsistent and conflicting data.
View Article and Find Full Text PDFWorld Neurosurg
February 2022
Objectives: Seizure control after stereotactic radiosurgery (SRS) for arteriovenous malformations (AVMs) is an area of growing interest, with previous studies reporting up to 70% seizure freedom after treatment. The goals of this study were to identify specific patient and AVM characteristics associated with seizure presentation and seizure outcomes after SRS treatment.
Methods: A retrospective review of consecutive patients undergoing SRS for brain AVMs between 2009 and 2019 at our institution was conducted.