| 1. |
- Gagliardi, F. M., et al.
(författare)
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Intra-cavitary dosimetry for IMRT head and neck treatment using thermoluminescent dosimeters in a naso-oesophageal tube
- 2009
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Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 54:12, s. 3649-3657
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Tidskriftsartikel (refereegranskat)abstract
- Complex intensity-modulated radiation therapy (IMRT) treatment plans require rigorous quality assurance tests. The aim of this study was to independently verify the delivered dose inside the patient in the region of the treatment site. A flexible naso-gastric tube containing thermoluminescent dosimeters (TLDs) was inserted into the oesophagus via the sinus cavity before the patient's first treatment. Lead markers were also inserted into the tube in order that the TLD positions could be accurately determined from the lateral and anterior posterior electronic portal images taken prior to treatment. The measured dose was corrected for both daily linac output variations and the estimated dose received from the portal images. The predicted dose for each TLD was determined from the treatment planning system and compared to the measured TLD doses. The results comprise 431 TLD measurements on 43 patients. The mean measured-to-predicted dose ratio was 0.988 +/- 0.011 (95% confidence interval) for measured doses above 0.2 Gy. There was a variation in this ratio when the measurements were separated into low dose (0.2-1.0 Gy), medium dose (1.0-1.8 Gy) and high dose (> 1.8 Gy) measurements. The TLD-loaded, naso-oesophageal tube for in vivo dose verification is straightforward to implement, and well tolerated by patients. It provides independent reassurance of the delivered dose for head and neck IMRT.
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| 2. |
- Prasad, G., et al.
(författare)
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Using motor imagery based brain-computer interface for post-stroke rehabilitation
- 2009
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Ingår i: 2009 4TH INTERNATIONAL IEEE/EMBS CONFERENCE ON NEURAL ENGINEERING. - 9781424420735 ; , s. 251-255
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Konferensbidrag (refereegranskat)abstract
- There is now sufficient evidence that using a rehabilitation protocol involving motor imagery (MI) practice (or mental practice (MP)) in conjunction with physical practice (PP) of goal-directed rehabilitation tasks leads to enhanced functional recovery of paralyzed limbs among stroke sufferers. It is however difficult to ensure patient engagement during MP in the absence of any on-line measure of the MP. Fortunately in an EEG-based brain-computer interface (BCI), an on-line measure of MI activity is used to devise neurofeedback for the BCI user to help him/her focus better on the task. This paper reports a pilot study in which an EEG-based BCI system is used to provide neurofeedback to stroke participants during the MP part of the rehabilitation protocol. This helps patients to undertake the MP with stronger focus. The participants included five chronic stroke sufferers. The trial was undertaken for 12 sessions over a period of 6 weeks. A set of rehabilitation outcome measures including action research arm test (ARAT) and motricity index was made use of in assessing functional recovery. Moderate improvements approaching a minimal clinically important difference (MCID) were observed for the ARAT. Small positive improvements were also observed in other outcome measures. Participants appeared highly enthusiastic about participating in the study and regularly attended all the sessions. Although without a randomized control trial, it is difficult to ascertain whether the enhanced rehabilitation gain is primarily because of BCI neurofeedack, the positive gains in outcome measures demonstrate the potential and feasibility of using BCI for post-stroke rehabilitation.
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