| 1. |
- Qatarneh, Sharif, 1972-
(författare)
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Development of a Whole Body Atlas for Radiation Therapy Planning and Treatment Optimization
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main objective of radiation therapy is to obtain the highest possible probability of tumor cure while minimizing adverse reactions in healthy tissues. A crucial step in the treatment process is to determine the location and extent of the primary tumor and its loco regional lymphatic spread in relation to adjacent radiosensitive anatomical structures and organs at risk. These volumes must also be accurately delineated with respect to external anatomic reference points, preferably on surrounding bony structures. At the same time, it is essential to have the best possible physical and radiobiological knowledge about the radiation responsiveness of the target tissues and organs at risk in order to achieve a more accurate optimization of the treatment outcome.A computerized whole body Atlas has therefore been developed to serve as a dynamic database, with systematically integrated knowledge, comprising all necessary physical and radiobiological information about common target volumes and normal tissues. The Atlas also contains a database of segmented organs and a lymph node topography, which was based on the Visible Human dataset, to form standard reference geometry of organ systems. The reference knowledgebase and the standard organ dataset can be utilized for Atlas-based image processing and analysis in radiation therapy planning and for biological optimization of the treatment outcome. Atlas-based segmentation procedures were utilized to transform the reference organ dataset of the Atlas into the geometry of individual patients. The anatomic organs and target volumes of the database can be converted by elastic transformation into those of the individual patient for final treatment planning. Furthermore, a database of reference treatment plans was started by implementing state-of-the-art biologically based radiation therapy planning techniques such as conformal, intensity modulated, and radiobiologically optimized treatment planning.The computerized Atlas can be viewed as a central framework that contains different forms of optimal treatment plans linked to all the essential information needed in treatment planning, which can be adapted to a given patient, in order to speed up treatment plan convergence. The Atlas also offers a platform to synthesize the results of imaging studies through its advanced geometric transformation and segmentation procedures. The whole body Atlas is anticipated to become a physical and biological knowledgebase that can facilitate, speed up and increase the accuracy in radiation therapy planning and treatment optimization.
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| 2. |
- Romelsjö, Anders, et al.
(författare)
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Dags kräva stopp för utarmat uran i vapen
- 2012
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Ingår i: Goeteborgs - Posten. - 1103-9345.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Vapenprojektiler och pansar dopat med uran kan orsaka cancer, missbildningar och död hos den som hanterar eller utsätts för dem. Svenska folket måste nu få veta om sådana vapen tillverkas av Bofors och om svenska soldater kommit i kontakt med dem. Det är också hög tid för riksdagen att verka för ett förbud mot dessa vapen, skriver bland andra professor Anders Romelsjö.
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| 3. |
- Adamus-Gorka, Magdalena, et al.
(författare)
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An “Effective functional subunit size” model for the dose response of rat spinal cord paralysis
- 2007
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Ingår i: 13th International Congress of Radiation Research, San Fransisco, USA, July 8-12, 2007.
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Konferensbidrag (populärvet., debatt m.m.)abstract
- Background: Radiobiological models for normal tissue complication probability (NTCP) are more and more commonly used in order to estimate the clinical outcome of radiation therapy. A normal tissue complication probability model to be considered a good and reliable one should fulfill the following two requirements: (a) it should predict the sigmoid shape of the dose-response curve as well as possible and (b) it should duly handle the volume effect. In the work from 2005 (IJROBP 61(3):892-900, 2005) P. van Luijk et al. suggest that none of the existing NTCP models is able to describe the volume effects present in the rat spinal cord during irradiation with small proton beams and they indicate the need for developing such new models.Methods: We have used the experimental data from H. Bijl et al. (IJROBP 52(1):205-211, 2002) to try explaining the change in the fifty percent effective dose (ED50) for different field sizes. We initiated this study to evaluate whether the induction of white matter necrosis in rat spinal cord after irradiation with small proton beams could be explained independent of used NTCP model. We therefore introduced a new concept of effective FSU dose, where a convolution of the original dose distribution with a function describing the effective size of a single FSU results in the average doses in a functional subunit. Such procedure allows determining the ED50 in an FSU of a certain size, within the irradiation field. We have also looked at non uniform dose distributions to see whether using a similar method we can explain the so called “bath and shower experiments” (IJROBP 57(1): 274-281, 2003).Results: Using the least square method to compare the effective doses for different sizes of functional subunits with the experimental data we observe the best fit for about 8 mm length. It seems that this length could be understood as an effective size of functional subunits in rat spinal cord, explaining what is otherwise interpreted as a volume effect. For the non uniform dose distributions an effective FSU length of 5 mm gives the optimal fit with the Probit dose-response model.Conclusions: The concept of an effective FSU length seems to explain at least part of the effects seen when small portions of the rat spinal cord are irradiated. The most likely FSU length for the shower and bath experiments is 5 mm according to these calculations.
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| 4. |
- Adamus-Gorka, Magdalena, et al.
(författare)
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Determination of the dose-response relations of thoracic and cervical myelopathy after external beam radiation therapy
- 2007
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Ingår i: 9th Biennial ESTRO Meeting on Physics and Radiation Technology for Clinical Radiotherapy, Barcelona, Spain, 9-13 September 2007.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Following our previous experience, the relative seriality modelwas fitted to two different sets of clinical data for radiation myelitis concerning thoracic spinal cord after radiation treatment of 43 patients with lung carcinoma and cervical spinal cord after treating 248 patients for malignant disease of head and neck.Individual treatment data were suitably fitted by the relative seriality model. The estimated radiobiological parameters of the model indicate that the probability of inducing this complication after radiation therapy is volume dependent only for the cervical part of spinal cord, whereas for the thoracic part no volume effect could be observed.Two different statistical methods applied to the patient material showed that the radiobiological model and the estimated parameters can be used to closely predict the complication rates observed.
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| 5. |
- Adamus-Górka, Magdalena, 1977-
(författare)
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Improved dose response modeling for normal tissue damage and therapy optimization
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present thesis is focused on the development and application of dose response models for radiation therapy. Radiobiological models of tissue response to radiation are an integral part of the radiotherapeutic process and a powerful tool to optimize tumor control and minimize damage to healthy tissues for use in clinical trials. Ideally, the models could work as a historical control arm of a clinical trial eliminating the need to randomize patents to suboptimal therapies. In the thesis overview part, some of the basic properties of the dose response relation are reviewed and the most common radiobiological dose-response models are compared with regard to their ability to describe experimental dose response data for rat spinal cord using the maximum likelihood method. For vascular damage the relative seriality model was clearly superior to the other models, whereas for white matter necrosis all models were quite good except possibly the inverse tumor and critical element models. The radiation sensitivity, seriality and steepness of the dose-response relation of the spinal cord is found to vary considerably along its length. The cervical region is more radiation sensitive, more parallel, expressing much steeper dose-response relation and more volume dependent probability of inducing radiation myelitis than the thoracic part. The higher number of functional subunits (FSUs) consistent with a higher amount of white matter close to the brain may be responsible for these phenomena. With strongly heterogeneous dose delivery and due to the random location of FSUs, the effective size of the FSU and the mean dose deposited in it are of key importance and the radiation sensitivity distribution of the FSU may be an even better descriptor for the response of the organ. An individual optimization of a radiation treatment has the potential to increase the therapeutic window and improve cure for a subgroup of patients.
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| 6. |
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| 7. |
- Andisheh, Bahram, 1967-, et al.
(författare)
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Clinical and radiobiological advantages of single-dose stereotactic light-ion radiation therapy for large intracranial arteriovenous malformations. Technical note
- 2009
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Ingår i: Journal of Neurosurgery. - : Journal of Neurosurgery Publishing Group (JNSPG). - 0022-3085 .- 1933-0693. ; 111:5, s. 919-926
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Tidskriftsartikel (refereegranskat)abstract
- OBJECT:Radiation treatment of large arteriovenous malformations (AVMs) remains difficult and not very effective, even though seemingly promising methods such as staged volume treatments have been proposed by some radiation treatment centers. In symptomatic patients harboring large intracranial AVMs not amenable to embolization or resection, single-session high-dose stereotactic radiation therapy is a viable option, and the special characteristics of high-ionization-density light-ion beams offer several treatment advantages over photon and proton beams. These advantages include a more favorable depth-dose distribution in tissue, an almost negligible lateral scatter of the beam, a sharper penumbra, a steep dose falloff beyond the Bragg peak, and a higher probability of vascular response due to high ionization density and associated induction of endothelial cell proliferation and/or apoptosis. Carbon ions were recently shown to be an effective treatment for skull-base tumors. Bearing that in mind, the authors postulate that the unique physical and biological characteristics of light-ion beams should convey considerable clinical advantages in the treatment of large AVMs. In the present meta-analysis the authors present a comparison between light-ion beam therapy and more conventional modalities of radiation treatment with respect to these lesions.METHODS:Dose-volume histograms and data on peripheral radiation doses for treatment of large AVMs were collected from various radiation treatment centers. Dose-response parameters were then derived by applying a maximum likelihood fitting of a binomial model to these data. The present binomial model was needed because the effective number of crucial blood vessels in AVMs (the number of vessels that must be obliterated to effect a cure, such as large fistulous nidus vessels) is low, making the Poisson model less suitable. In this study the authors also focused on radiobiological differences between various radiation treatments.RESULTS:Light-ion Bragg-peak dose delivery has the precision required for treating very large AVMs as well as for delivering extremely sharp, focused beams to irregular lesions. Stereotactic light-ion radiosurgery resulted in better angiographically defined obliteration rates, less white-matter necrosis, lower complication rates, and more favorable clinical outcomes. In addition, in patients treated by He ion beams, a sharper dose-response gradient was observed, probably due to a more homogeneous radiosensitivity of the AVM nidus to light-ion beam radiation than that seen when low-ionization-density radiation modalities, such as photons and protons, are used.CONCLUSIONS:Bragg-peak radiosurgery can be recommended for most large and irregular AVMs and for the treatment of lesions located in front of or adjacent to sensitive and functionally important brain structures. The unique physical and biological characteristics of light-ion beams are of considerable advantage for the treatment of AVMs: the densely ionizing beams of light ions create a better dose and biological effect distribution than conventional radiation modalities such as photons and protons. Using light ions, greater flexibility can be achieved while avoiding healthy critical structures such as diencephalic and brainstem nuclei and tracts. Treatment with the light ion He or Li is more suitable for AVMs
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| 8. |
- Andisheh, Bahram, 1967-, et al.
(författare)
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Vascular structure and binomial statistics for response modeling in radiosurgery of cerebral arteriovenous malformations
- 2010
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Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 55:7, s. 2057-2067
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Tidskriftsartikel (refereegranskat)abstract
- Radiation treatment of arteriovenous malformations (AVMs) has a slow and progressive vaso-occlusive effect. Some studies suggested the possible role of vascular structure in this process. A detailed biomathematical model has been used, where the morphological, biophysical and hemodynamic characteristics of intracranial AVM vessels are faithfully reproduced. The effect of radiation on plexiform and fistulous AVM nidus vessels was simulated using this theoretical model. The similarities between vascular and electrical networks were used to construct this biomathematical AVM model and provide an accurate rendering of transnidal and intranidal hemodynamics. The response of different vessels to radiation and their obliteration probability as a function of different angiostructures were simulated and total obliteration was defined as the probability of obliteration of all possible vascular pathways. The dose response of the whole AVM is observed to depend on the vascular structure of the intra-nidus AVM. Furthermore, a plexiform AVM appears to be more prone to obliteration compared with an AVM of the same size but having more arteriovenous fistulas. Finally, a binomial model was introduced, which considers the number of crucial vessels and is able to predict the dose response behavior of AVMs with a complex vascular structure.
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| 9. |
- Andreassen, Björn, et al.
(författare)
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Development of a center for advanced tumour imaging and light ion, photon and electron therapy at Karolinska University Hospital.
- 2007
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Ingår i: Gantry Workshop 2007, Verein AUSTRON in the frame of the Interreg IIIA Project.
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Konferensbidrag (populärvet., debatt m.m.)abstract
- This presentation briefly covers the ongoing development of a therapy center with multiple simultaneous radiation modalities at Karolinska university hospital. The hearth of the facility will most likely be a superconducting cyclotron capable of delivering around 400 MeV/u carbon ions simultaneously to two separate excentric gantries who service four treatment rooms each. A number of different stable ions will be available ranging from hydrogen to oxygen but also PET emitting C11 ions and possibly B8 the lightest existing PET emitter. Several treatment rooms will also be equipped for narrow scanned high energy photon and electron beam treatments and a light ion research facility for physics and biology studies will be set up on two separate beamlines. The centre will include an advanced PET-CT and MRSI based diagnostic centre on the same floor and close to both the ion treatment facility and the high energy photon and electron facility. By docking the stereotactic treatment coach both to the treatment units and before and after the treatment to the diagnostic PET-CT units, iso dose delivery can be rapidly examined by imaging the radiation induced C11 and O15 activity produced during the treatment.
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| 10. |
- Andreassen, Björn, 1975-, et al.
(författare)
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Development of an efficient scanning and purging magnet system for IMRT with narrow high energy photon beams
- 2009
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Ingår i: Nuclear Instruments and Methods in Physics Research Section A. - : Elsevier BV. - 0168-9002 .- 1872-9576. ; 612:1, s. 201-208
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Tidskriftsartikel (refereegranskat)abstract
- Due to the clinical advantages of Intensity Modulated Radiation Therapy (IMRT) high flexibility and accuracy in intensity modulated dose delivery is desirable to really maximize treatment outcome. Although it is possible to deliver IMRT by using broad beams in combination with dynamic multileaf collimation the process is rather time consuming and inefficient. By using narrow scanned high energy photon beams the treatment outcome can be improved, the treatment time reduced and accurate 3D in vivo dose delivery monitoring is possible by PET-CT based dose delivery imaging of photo nuclear reactions in human tissues. Narrow photon beams can be produced by directing a low emittance high energy electron beam on a thin target, and then cleaning the therapeutic photon beam from transmitted high energy electrons, and photon generated charged leptons, with a dedicated purging magnet placed directly downstream of the target. To have an effective scanning and purging magnet system the purging magnet should be placed immediately after the bremsstrahlung target to deflect the transmitted electrons to an efficient electron stopper. In the static electron stopper the electrons should be safely collected independent of the desired direction of the therapeutic scanned photon beam. The SID (Source to Isocentre Distance) should preferably be short while retaining the ability to scan over a large area on the patient and consequently there are severe requirements both on the strength and the geometry of the scanning and purging magnets. In the present study an efficient magnet configuration with a purging and scanning magnet assembly is developed for electron energies in the 50-75 MeV range and a SID of 75 cm. For a bremsstrahlung target of 3mm Be these electron energies produce a photon beam of 25-17 mm FWHM (Full Width Half Maximum) at a SID of 75 cm. The magnet system was examined both in terms of the efficiency in scanning the narrow bremsstrahlung beam and the deflection of transmitted and photon generated electrons. The simulations show that its is possible to have a scan area on the patient of up to 43 x 40 cm2 for an incident electron energy of 50 MeV and 28 x 40 cm2 at 75 MeV, while at the same time adequately deflecting the transmitted electron beam.
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