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Intraoperative radiation therapy (IORT) involves delivering high doses of radiation directly to tumors while sparing healthy tissues in a surgical setting. Current IORT systems are limited in their lack of image guidance and variable needs for shielded operating rooms. They also lack the capability to deliver non-uniform therapeutic radiation to irregular shaped clinical targets. We developed a scanning beam IORT system (SBIORT) to overcome these limitations. SBIORT consists of a low energy x-ray source, a custom compact dynamic x-ray collimator system, a robotic arm, and a 3D surface imaging module. Here we describe the design and validation of the compact dynamic x-ray collimator system and the 3D surface imaging module for use in SBIORT. The proposed collimator can achieve a leaf position accuracy of ± 0.25 mm (95% confidence interval). Phantom studies indicated the 3D surface-imaging module has an accuracy of 1.0 ± 0.6 mm with ability to obtain high resolution surface image within 5 seconds. SBIORT is a novel approach to deliver conformal intensity-modulated intraoperative radiation therapy.
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http://dx.doi.org/10.1109/EMBC.2017.8037813 | DOI Listing |
J Neurosurg Case Lessons
September 2025
Department of Neurosurgery, University of Kentucky, Lexington, Kentucky.
Background: Single-position prone transpsoas lateral lumbar interbody fusion (PTP-LLIF) is an evolving minimally invasive surgery technique that merges the biomechanical and anatomical advantages of prone positioning with the LLIF approach. While PTP-LLIF enhances lumbar lordosis restoration and operative efficiency by eliminating patient repositioning, it presents unique ergonomic and visualization challenges for surgeons. This technical report describes a novel modification of the technique using the Teligen camera to improve intraoperative visualization and reduce surgeon fatigue.
View Article and Find Full Text PDFNeuro Oncol
September 2025
Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
Background: Disruption of the blood-brain barrier (BBB) in high-grade brain tumors is characterized by contrast accumulation on diagnostic imaging. This window of opportunity study correlates contrast imaging features with the tumor distribution of BBB-permeable (levetiracetam) and -impermeable (cefazolin) drugs.
Methods: Patients with a clinical diagnosis of a high-grade brain tumor underwent MRI for surgical planning.
Pediatr Blood Cancer
September 2025
Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK.
Background: Local control strategies in pediatric oncology are guided by disease-specific considerations. Effective communication of the goals of surgical procedure and associated intraoperative events plays a crucial role in shaping subsequent treatment decisions. However, accurately and comprehensively documenting these findings remains challenging, with considerable variability across different tumor types.
View Article and Find Full Text PDFSurg Oncol
September 2025
Department of Breast Surgery at Northwestern Medical Group, USA.
Importance: Breast-conserving therapy (BCT) results in reoperation in ∼20 % of cases due to positive margins, and a 7-13 % recurrence risk at 5 years persists despite negative margins and radiation. Enhancing margin treatment is critical to reducing local recurrence and improving survival.
Objective: To optimize and evaluate the performance of a Saline-coupled Intraoperative Radiofrequency Ablation (SIRA) device in producing uniform 1 cm ablations in lumpectomy cavities and compare it to prior-generation RFA technology in previous clinical studies.
Cancer
September 2025
Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada.
Background: The objective of this study was to evaluate whether dosimetric sparing of uninvolved normal tissues, including skin/subcutaneous flaps, affects acute and late toxicities in preoperative image-guided intensity-modulated radiation therapy (IG-IMRT) for lower extremity soft tissue sarcomas (LE-STS).
Methods: Patients with LE-STS from a phase 2 preoperative IG-IMRT trial (flap-sparing-IMRT, 2005-2009) and a prospectively maintained institutional database (standard-IMRT, 2005-2020) were propensity matched by age, sex, tumor size, grade, location, wound closure, and interval from IG-IMRT to surgery; all received 50 Gy in 25 fractions preoperatively. The primary outcome was major wound complication (MWC).