| 31. |
- Ceberg, Crister, et al.
(författare)
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Photon activation therapy of RG2 glioma carrying Fischer rats using stable thallium and monochromatic synchrotron radiation.
- 2012
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Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 57:24, s. 8377-8391
-
Tidskriftsartikel (refereegranskat)abstract
- 75 RG2 glioma-carrying Fischer rats were treated by photon activation therapy (PAT) with monochromatic synchrotron radiation and stable thallium. Three groups were treated with thallium in combination with radiation at different energy; immediately below and above the thallium K-edge, and at 50 keV. Three control groups were given irradiation only, thallium only, or no treatment at all. For animals receiving thallium in combination with radiation to 15 Gy at 50 keV, the median survival time was 30 days, which was 67% longer than for the untreated controls (p = 0.0020) and 36% longer than for the group treated with radiation alone (not significant). Treatment with thallium and radiation at the higher energy levels were not effective at the given absorbed dose and thallium concentration. In the groups treated at 50 keV and above the K-edge, several animals exhibited extensive and sometimes contra-lateral edema, neuronal death and frank tissue necrosis. No such marked changes were seen in the other groups. The results were discussed with reference to Monte Carlo calculated electron energy spectra and dose enhancement factors.
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| 32. |
- Ceberg, Crister, et al.
(författare)
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Prediction of stopping-power ratios in flattening-filter free beams.
- 2010
-
Ingår i: Medical Physics. - : Wiley. - 0094-2405. ; 37:3, s. 1164-1168
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: In recent years, there has been an increasing interest in flattening-filter free (FFF) beams. However, since the removal of the flattening filter will affect both the mean and the variance of the energy spectrum, current beam-quality specifiers may not be adequate for reference dosimetry in such beams. The purpose of this work was to investigate an alternative, more general beam-quality specifier. METHODS: The beam-quality specifier used in this work was a combination of the kerma-weighted mean and the coefficient of variation of the linear attenuation coefficient in water. These parameters can in theory be determined from narrow-beam transmission measurements using a miniphantom "in-air," which is a measurement condition well suited also to small and nonstandard fields. The relation between the Spencer-Attix stopping-power ratios and this novel beam-quality specifier was described by a simple polynomial. For reference, the authors used Monte Carlo calculated spectra and stopping-power data for nine different beams, with and without flattening filter. RESULTS: The polynomial coefficients were obtained by least-squares optimization. For all beams included in this investigation, the average of the differences between the predicted and the Monte Carlo calculated stopping-power ratios was 0.02 +/- 0.17% (1 SD) (including TomoTherapy and CyberKnife example beams). CONCLUSIONS: An alternative dual-parameter beam-quality specifier was investigated. The evaluation suggests that it can be used successfully to predict stopping-power ratios in FFF as well as conventional beams, regardless of filtration.
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| 33. |
- Ceberg, Crister, et al.
(författare)
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The effects of divergence and nonuniformity on the x-ray pencil-beam dose kernel
- 1996
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Ingår i: Medical Physics. - : Wiley. - 0094-2405. ; 23:9, s. 1531-1535
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Tidskriftsartikel (refereegranskat)abstract
- The scattered-photon part of pencil-beam dose kernels for high-energy x-ray beams can be derived experimentally by differentiating the broad-beam scatter-to-primary dose ratio as a function of radius. Formally, this requires a uniform and parallel beam, and the procedure is complicated by the nonideal, actual beam conditions: the primary dose profile is not uniform, the beam quality is not constant, and the distance to the source is not infinite. The experimentally determined scatter-to-primary ratios can be corrected for these effects before they are differentiated to give the pencil-beam kernels. The correction factors were calculated and shown to reach as much as 5% of the true scatter-to-primary ratio. The effect on the pencil beam was evaluated and corrected pencil beams were determined.
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| 34. |
- Chakwizira, Arthur, et al.
(författare)
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Mathematical modelling of the synergistic combination of radiotherapy and indoleamine-2,3-dioxygenase (IDO) inhibitory immunotherapy against glioblastoma
- 2018
-
Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 91:1087
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Recent research has shown that combining radiotherapy and immunotherapy can counteract the ability of cancer to evade and suppress the native immune system. To optimise the synergy of the combined therapies, factors such as radiation dose and fractionation must be considered, alongside numerous parameters resulting from the complexity of cancer-immune system interactions. It is instructive to use mathematical models to tackle this problem. Methods: In this work, we adapted a model primarily to describe the synergistic effect between single-fraction radiotherapy and immunotherapy (1-methyl tryptophan) observed in previous experiments with glioblastoma-carrying rats. We also showed how the model can be used to generate hypotheses on the outcome of other treatment fractionation schemes. Results: The model successfully reproduced the results of the experiments. Moreover, it provided support for the hypothesis that, for a given biologically effective dose, the efficacy of the combination therapy and the synergy between the two therapies are favoured by the administration of radiotherapy in a hypofractionated regime. Furthermore, for a double-fraction irradiation regimen, the synergy is favoured by a short time interval between the treatment fractions. Conclusion: It was concluded that the model could be fitted to reproduce the experimental data well within its uncertainties. It was also demonstrated that the fitted model can be used to form hypotheses to be validated by further pre-clinical experiments. Advances in knowledge: The results of this work support the hypothesis that the synergetic action of combined radiotherapy and immunotherapy is favoured by using a hypofractionated radiation treatment regimen, given over a short time interval.
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| 35. |
- Cheng, Chee-Wai, et al.
(författare)
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Dosimetric comparison of treatment planning systems in irradiation of breast with tangential fields
- 1997
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Ingår i: International Journal of Radiation Oncology, Biology, Physics. - 0360-3016. ; 38:4, s. 835-842
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The objectives of this study are: (1) to investigate the dosimetric differences of the different treatment planning systems (TPS) in breast irradiation with tangential fields, and (2) to study the effect of beam characteristics on dose distributions in tangential breast irradiation with 6 MV linear accelerators from different manufacturers. METHODS AND MATERIALS: Nine commercial and two university-based TPS are evaluated in this study. The computed tomographic scan of three representative patients, labeled as "small", "medium" and "large" based on their respective chest wall separations in the central axis plane (CAX) were used. For each patient, the tangential fields were set up in each TPS. The CAX distribution was optimized separately with lung correction, for each TPS based on the same set of optimization conditions. The isodose distributions in two other off-axis planes, one 6 cm cephalic and the other 6 cm caudal to the CAX plane were also computed. To investigate the effect of beam characteristics on dose distributions, a three-dimensional TPS was used to calculate the isodose distributions for three different linear accelerators, the Varian Clinac 6/100, the Siemens MD2 and the Philips SL/7 for the three patients. In addition, dose distributions obtained with 6 MV X-rays from two different accelerators, the Varian Clinac 6/100 and the Varian 2100C, were compared. RESULTS: For all TPS, the dose distributions in all three planes agreed qualitatively to within +/- 5% for the "small" and the "medium" patients. For the "large" patient, all TPS agreed to within +/- 4% on the CAX plane. The isodose distributions in the caudal plane differed by +/- 5% among all TPS. In the cephalic plane in which the patient separation is much larger than that in the CAX plane, six TPS correctly calculated the dose distribution showing a cold spot in the center of the breast contour. The other five TPS showed that the center of the breast received adequate dose. Isodose distributions for 6 MV X-rays from three different accelerators differed by about +/- 3% for the "small" patient and more than +/- 5% for the "large" patient. For two different 6 MV machines of the same manufacturer, the isodose distribution agreed to within +/- 2% for all three planes for the "large" patient. CONCLUSION: The differences observed among the various TPS in this study were within +/- 5% for both the "small" and the "medium" patients while doses at the hot spot exhibit a larger variation. The large discrepancy observed in the off-axis plane for the "large" patient is largely due to the inability of most TPS to incorporate the collimator angles in the dose calculation. Only six systems involved agreed to within +/- 5% for all three patients in all calculation planes. The difference in dose distributions obtained with three accelerators from different manufacturers is probably due to the difference in beam profiles. On the other hand, the 6 MV X-rays from two different models of linear accelerators from the same manufacturer have similar beam characteristics and the dose distributions are within +/- 2% of each other throughout the breast volume. In general, multi-institutional breast treatment data can be compared within a +/- 5% accuracy.
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| 36. |
- Dalaryd, Mårten, et al.
(författare)
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A Monte Carlo study of a flattening filter-free linear accelerator verified with measurements.
- 2010
-
Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 55:23, s. 7333-7344
-
Tidskriftsartikel (refereegranskat)abstract
- A Monte Carlo model of an Elekta Precise linear accelerator has been built and verified by measured data for a 6 and 10 MV photon beam running with and without a flattening filter in the beam line. In this study the flattening filter was replaced with a 6 mm thick copper plate, provided by the linac vendor, in order to stabilize the beam. Several studies have shown that removal of the filter improves some properties of the photon beam, which could be beneficial for radiotherapy treatments. The investigated characteristics of this new beam included output, spectra, mean energy, half value layer and the origin of scattered photons. The results showed an increased dose output per initial electron at the central axis of 1.76 and 2.66 for the 6 and 10 MV beams, respectively. The number of scattered photons from the accelerator head was reduced by (31.7 ± 0.03)% (1 SD) for the 6 MV beam and (47.6 ± 0.02)% for the 10 MV beam. The photon energy spectrum of the unflattened beam was softer compared to a conventional beam and did not vary significantly with the off-axis distance, even for the largest field size (0-20 cm off-axis).
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| 37. |
- Dalaryd, Mårten, et al.
(författare)
-
Combining tissue-phantom ratios to provide a beam-quality specifier for flattening filter free photon beams.
- 2014
-
Ingår i: Medical Physics. - : Wiley. - 0094-2405. ; 41:11
-
Tidskriftsartikel (refereegranskat)abstract
- There are currently several commercially available radiotherapy treatment units without a flattening filter in the beam line. Unflattened photon beams have an energy and lateral fluence distribution that is different from conventional beams and, thus, their attenuation properties differ. As a consequence, for flattening filter free (FFF) beams, the relationship between the beam-quality specifier TPR20,10 and the Spencer-Attix restricted water-to-air mass collision stopping-power ratios, L̄/ρair (water), may have to be refined in order to be used with equivalent accuracy as for beams with a flattening filter. The purpose of this work was twofold. First, to study the relationship between TPR20,10 and L̄/ρair (water) for FFF beams, where the flattening filter has been replaced by a metal plate as in most clinical FFF beams. Second, to investigate the potential of increasing the accuracy in determining L̄/ρair (water) by adding another beam-quality metric, TPR10,5. The relationship between L̄/ρair (water) and %dd(10)x for beams with and without a flattening filter was also included in this study.
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| 38. |
- Ericsson-Szecsenyi, Rebecka, et al.
(författare)
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Robustness Assessment of Images From a 0.35T Scanner of an Integrated MRI-Linac : Characterization of Radiomics Features in Phantom and Patient Data
- 2022
-
Ingår i: Technology in Cancer Research and Treatment. - : SAGE Publications. - 1533-0346 .- 1533-0338. ; 21
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Radiomics entails the extraction of quantitative imaging biomarkers (or radiomics features) hypothesized to provide additional pathophysiological and/or clinical information compared to qualitative visual observation and interpretation. This retrospective study explores the variability of radiomics features extracted from images acquired with the 0.35 T scanner of an integrated MRI-Linac. We hypothesized we would be able to identify features with high repeatability and reproducibility over various imaging conditions using phantom and patient imaging studies. We also compared findings from the literature relevant to our results. Methods: Eleven scans of a Magphan® RT phantom over 13 months and 11 scans of a ViewRay Daily QA phantom over 11 days constituted the phantom data. Patient datasets included 50 images from ten anonymized stereotactic body radiation therapy (SBRT) pancreatic cancer patients (50 Gy in 5 fractions). A True Fast Imaging with Steady-State Free Precession (TRUFI) pulse sequence was selected, using a voxel resolution of 1.5 mm × 1.5 mm × 1.5 mm and 1.5 mm × 1.5 mm × 3.0 mm for phantom and patient data, respectively. A total of 1087 shape-based, first, second, and higher order features were extracted followed by robustness analysis. Robustness was assessed with the Coefficient of Variation (CoV < 5%). Results: We identified 130 robust features across the datasets. Robust features were found within each category, except for 2 second-order sub-groups, namely, Gray Level Size Zone Matrix (GLSZM) and Neighborhood Gray Tone Difference Matrix (NGTDM). Additionally, several robust features agreed with findings from other stability assessments or predictive performance studies in the literature. Conclusion: We verified the stability of the 0.35 T scanner of an integrated MRI-Linac for longitudinal radiomics phantom studies and identified robust features over various imaging conditions. We conclude that phantom measurements can be used to identify robust radiomics features. More stability assessment research is warranted.
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| 39. |
- Gabel, D, et al.
(författare)
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Pharmacokinetics of Na2B12H11SH (BSH) in patients with malignant brain tumours as prerequisite for a phase I clinical trial of boron neutron capture
- 1997
-
Ingår i: Acta Neurochirurgica. - 0001-6268. ; 139:7, s. 606-612
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Tidskriftsartikel (refereegranskat)abstract
- The disposition of Na2B12H11SH (BSH) in patients with malignant glioma has been investigated, in preparation for a Phase I clinical trial of boron neutron capture therapy. BSH was found to possess a linear disposition over the dosage interval investigated (up to 75 mg/kg). A bi-phasic blood pharmacokinetics was observed. Tumour-to-blood ratios showed variations between patients between 0.08 and 5.1. The data allow the definition of amount of BSH and timing of infusion for a Phase I clinical trial protocol.
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| 40. |
- Gjaldbæk, Bolette W., et al.
(författare)
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Long-term toxicity and efficacy of FLASH radiotherapy in dogs with superficial malignant tumors
- 2024
-
Ingår i: Frontiers in Oncology. - 2234-943X. ; 14, s. 01-09
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: FLASH radiotherapy (RT) has emerged as a promising modality, demonstrating both a normal tissue sparing effect and anticancer efficacy. We have previously reported on the safety and efficacy of single fraction FLASH RT in the treatment of oral tumors in canine cancer patients, showing tumor response but also a risk of radiation-induced severe late adverse effects (osteoradionecrosis) for doses ≥35 Gy. Accordingly, the objective in this study was to investigate if single fraction high dose FLASH RT is safe for treating non-oral tumors. Methods: Privately-owned dogs with superficial tumors or microscopic residual disease were included. Treatment was generally delivered as a single fraction of 15-35 Gy 10 MeV electron FLASH RT, although two dogs were re-irradiated at a later timepoint. Follow-up visits were conducted up to 12 months post-treatment to evaluate treatment efficiency and adverse effects. Results: Fourteen dogs with 16 tumors were included, of which nine tumors were treated for gross disease whilst seven tumors were treated post-surgery for microscopic residual disease. Four treatment sites treated with 35 Gy had ulceration post irradiation, which was graded as severe adverse effect. Only mild adverse effects were observed for the remaining treatment sites. None of the patients with microscopic disease experienced recurrence (0/7), and all patients with macroscopic disease showed either a complete (5/9) or a partial response (4/9). Five dogs were euthanized due to clinical disease progression. Discussion: Our study demonstrates that single fraction high dose FLASH RT is generally safe, with few severe adverse effects, particularly in areas less susceptible to radiation-induced damage. In addition, our study indicates that FLASH has anti-tumor efficacy in a clinical setting. No osteoradionecrosis was observed in this study, although other types of high-grade adverse effects including ulcer-formations were observed for the highest delivered dose (35 Gy). Overall, we conclude that osteoradionecrosis following single fraction, high dose FLASH does not appear to be a general problem for non-oral tumor locations. Also, as has been shown previously for oral tumors, 30 Gy appeared to be the maximum safe dose to deliver with single fraction FLASH RT.
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