Radiation exposure of breast tissue in lymphoma radiotherapy: a systematic review of breast dose metrics published since 2000.

Background And Purpose: We present a systematic review of breast dose metrics reported in lymphoma patients receiving radiotherapy and provide reporting recommendations for breast dose in future publications.

Methods And Materials: Studies reporting breast doses in lymphoma radiotherapy published between January 2000 and May 2023 were included. Frequency of reporting factors likely to affect breast dose were calculated.

External validation of deep learning-derived 18F-FDG PET/CT delta biomarkers for loco-regional control in head and neck cancer.

Background And Purpose: Delta biomarkers that reflect changes in tumour burden over time can support personalised follow-up in head and neck cancer. However, their clinical use can be limited by the need for manual image segmentation. This study externally evaluates a deep learning model for automatic determination of volume change from serial 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans to stratify patients by loco-regional outcome.

Artificial intelligence in breast cancer radiotherapy: Insights from the Toolbox Consortium Delphi study.

Artificial intelligence (AI) is being incorporated in several breast cancer care domains, including for radiation therapy (RT). Herein we provide a review about AI for the management and planning of RT for breast cancer, which is part of the Toolbox-3 project's multidisciplinary Delphi study, including a literature review of studies related to the topic raised by the Delphi questionnaire. Our review shows that available evidence mainly consists of small single institutional studies, often at least partly supported by commercial companies.

Repositioning Radiation Oncology at the centre of integrated oncology care: A manifesto of the European Society for Radiotherapy and Oncology (ESTRO).

Modern oncology increasingly relies on integrated, multimodality care, yet radiation oncology remains undervalued in strategic frameworks despite its central therapeutic role. This ESTRO manifesto calls for a repositioning of radiation oncology as a core discipline in cancer care, scientifically, clinically, and politically. The field now extends beyond beam delivery to encompass systemic therapy integration, personalised strategies based on biology and imaging, and active participation in clinical decision-making and guideline development.

Positioning in deep inspiration breath-hold is comparable to free breathing in paediatric patients.

•The TEDDI trial investigated deep inspiration breath-hold (DIBH) in children.•Setup reproducibility for DIBH or free breathing (FB) was assessed.•Translations were significantly smaller for DIBH vs.

Cone beam CT dose optimisation: A review and expert consensus by the 2022 ESTRO Physics Workshop IGRT working group.

Image guided radiotherapy (IGRT) using kilovoltage cone-beam CT (CBCT) has become an indispensable tool to ensure the geometric accuracy of radiotherapy treatment delivery. Although significant technical advances have been made in reducing imaging dose, the repeated imaging procedures can still accumulate significant dose to healthy tissues. Despite the widespread use, we still lack clear guidance for optimisation and widely accepted frameworks for evaluating the quality and suitability of CBCT imaging protocols.

Quantifying the dosimetric impact of online daily adaptation for MR-guided RT in cervical cancer.

Purpose: This study assessed the inter- and intra-fractional dosimetric impact of MR-Linac-based adaptive radiotherapy for cervical cancer (CC).

Methods: A retrospective analysis of five node-negative, locally advanced cervical cancer patients treated under the MOMENTUM study (NCT04075305) using adapt-to-shape (ATS) on an Elekta Unity MR-Linac. Assessing the dosimetric impact of daily online adaptations: (1) comparing dose between daily adapted (MR-adapted) and non-adapted (MR-guided) plans, by quantifying dose differences relative to reference plans (by 2 and 5%) and evaluating adaptation frequency; (2) performing intra-fraction dose evaluations.

Cone-beam computed tomography reconstruction for a commercial proton beam therapy system.

Background & Purpose: Cone-beam computed tomography (CBCT) images are used in image-guided radiotherapy to track anatomical changes throughout treatment and to set up patients to ensure accurate delivery of therapeutic radiation at each treatment session. An offline method of CBCT reconstruction workflow, operating on 2D projection images and specific to the imaging system in question, is needed for many image optimisation studies. Here we present a methodology to reconstruct CBCT images from these data for a commercial proton beam therapy machine, accounting for the variation in exposure and beam hardening from filtration due to gantry rotation during CBCT acquisition.

A neural network to create super-resolution MR from multiple 2D brain scans of pediatric patients.

Background: High-resolution (HR) 3D MR images provide detailed soft-tissue information that is useful in assessing long-term side-effects after treatment in childhood cancer survivors, such as morphological changes in brain structures. However, these images require long acquisition times, so routinely acquired follow-up images after treatment often consist of 2D low-resolution (LR) images (with thick slices in multiple planes).

Purpose: In this work, we present a super-resolution convolutional neural network, based on previous single-image MRI super-resolution work, that can reconstruct a HR image from 2D LR slices in multiple planes in order to facilitate the extraction of structural biomarkers from routine scans.

Identifying paediatric patients at risk of severe hearing impairment after treatment for malignancies of the H&N/CNS with proton therapy.

Background And Purpose: A risk calculation model was presented in 2021 by Keilty et al. for determining the likelihood of severe hearing impairment (HI) for paediatric patients treated with photon radiation therapy. This study aimed to validate their risk-prediction model for our cohort of paediatric patients treated with proton therapy (PT) for malignancies of the head and neck (H&N) or central nervous system (CNS).

Breast cancer and cardiovascular health.

Modern cancer therapies greatly improve clinical outcomes for both early and advanced breast cancer patients. However, these advances have raised concerns about potential short- and long-term toxicities, including cardiovascular toxicities. Therefore, understanding the common risk factors and underlying pathophysiological mechanisms contributing to cardiovascular toxicity is essential to ensure best breast cancer outcomes.

Artificial intelligence-generated targets and inter-observer variation in online adaptive radiotherapy of bladder cancer.

Background And Purpose: Daily target re-delineation in online adaptive radiotherapy (oART) introduces uncertainty. The aim of this study was to evaluate artificial intelligence (AI) generated contours and inter-observer target variation among radiotherapy technicians in cone-beam CT (CBCT) guided oART of bladder cancer.

Materials And Methods: For each of 10 consecutive patients treated with oART for bladder cancer, one CBCT was randomly selected and retrospectively included.

CT- and MR-based image-based data mining are consistent in the brain.

Purpose: Image-based data mining (IBDM) is a voxel-based analysis technique to investigate dose-response. Most often, IBDM uses radiotherapy planning CTs because of their broad accessibility, however, it was unknown whether CT provided sufficient soft tissue contrast for brain IBDM. This study evaluates whether MR-based IBDM improves upon CT-based IBDM for studies of children with brain tumours.

Incidence of alopecia in brain tumour patients treated with pencil scanning proton therapy and validation of existing NTCP models.

Background And Purpose: Radiation-induced alopecia (RIA) is one of the most frequent and upsetting cosmetic side effects after radiotherapy (RT) for brain cancer. We report the incidence of RIA in a cohort of brain tumours patients treated with Proton Therapy (PT) and externally validate published NTCP models of grade 2 (G2) RIA for their implementation in clinical practice.

Methods: Data for patients treated for brain tumours with scanning beam PT between 2018 and 2022 were extracted.

Proton beam therapy and dentofacial development in paediatric cancer patients: A scoping review.

Purpose: It is known that radiation to dentofacial structures during childhood can lead to developmental disturbances. However, this appears to be a relatively subordinated research subject. For this reason, this review aims to establish the current evidence base on the effect of PBT on dentofacial development in paediatric patients treated for cancer in the head and neck region.

Dynamic anthropomorphic thorax phantom for quality assurance of motion management in radiotherapy.

Background And Purpose: Motion management techniques are important to spare the healthy tissue adequately. However, they are complex and need dedicated quality assurance. The aim of this study was to create a dynamic phantom designed for quality assurance and to replicate a patient's size, anatomy, and tissue density.

Radiotherapy intensification for atypical and malignant meningiomas: A systematic review.

Background: The outcomes of nonbenign (WHO Grades 2 and 3 [G2, G3]) meningiomas are suboptimal and radiotherapy (RT) dose intensification strategies have been investigated. The purpose of this review is to report on clinical practice and outcomes with particular attention to RT doses and techniques.

Methods: The PICO criteria (Population, Intervention, Comparison, and Outcomes) were used to frame the research question, directed at outlining the clinical outcomes in patients with G2-3 meningiomas treated with RT.