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Biomedical subjects

Joan Roselló

Publications and source records attributed to Joan Roselló.

5 recordsLinked to original sources

Additional dose constraints for analytical beam weighting optimization in IMRT.

This work presents an improvement to an algorithm for analytical beam weighting optimization where a flexible objective function, which considers 'importance factors' for each anatomical region and 'allowed deviations' from the prescribed dose, is defined. This upgrading allows forcing the mean value of the dose distribution to be the desired value, by using Lagrange multipliers. A real case is presented to show the effect of this change.

Algorithms↗

MLC leaf width impact on the clinical dose distribution: a Monte Carlo approach.

PURPOSE: The influence of the multileaf collimator (MLC) leaf width on the dose distribution in patients treated with conformal radiotherapy and intensity-modulated radiotherapy has been analyzed. This study was based on the Monte Carlo simulation with the beams generated by a linac with the double-focused MLC. MATERIALS AND METHODS: The transmission through the leaves and the exact shape of the penumbra regions are difficult to model by treatment planning system algorithms. An accurate assessment of the dose variations due to the leaf width change can be achieved by means of Monte Carlo simulation. The BEAM/EGS4 code was used at the Hospital of the Virgen Macarena to model a Siemens PRIMUS linac, featuring an MLC with a leaf width projecting 1 cm at the isocenter. Based on this real model, a virtual head was designed while allowing for a variation of the leaf width projection. Both the real linac and the virtual linac, with leaves projecting 0.5 cm, were used to obtain the dose distributions for several treatments. A few disease sites, including the prostate, head and neck, and endometrium, were selected for the design of the conformal and intensity-modulated radiotherapy treatments with a forward planning algorithm sensitive to the different shapes of the volumes of interest. Isodose curves, differential matrix, gamma function, and the dose-volume histograms (DVHs) corresponding to both MLC models were obtained for all cases. The tumor control probability and the normal tissue complication probability were derived for those cases studied featuring the greatest differences between results for both MLCs. RESULTS: The impact on the DVHs of changing leaf width projections at the isocenter from 1.0 cm to 0.5 cm was low. Radiobiologic models showed slightly better tumor control probability/normal tissue complication probability values using the virtual MLC with a leaf width projecting 0.5 cm at isocenter in those cases presenting greater differences in the DVHs. CONCLUSIONS: The impact on the clinical dose distribution due to the MLC leaf width change is low based on the design and conditions used in this study.

Abdominal Neoplasms↗

Routine IMRT verification by means of an automated Monte Carlo simulation system.

PURPOSE: A tool to simulate complete intensity-modulated radiation therapy (IMRT) treatments with the Monte Carlo (MC) method has been developed. This application is based on a distribution model to employ as short processing times as possible for an operative verification. MATERIALS AND METHODS: The Clinical Primus-Siemens Linac beam was simulated with MC, using the EGS4 OMEGA-BEAM code package. An additional home-made program prepares the appropriate parameters for the code, using as input the file sent from the planning system to the linac. These parameters are adapted to the simulation code, making physical and clinical subdivisions of the global simulation of the treatment. Each resultant partition is ordered to a client personal computer in a cluster with 47 machines under a Linux environment. The verification procedure starts delivering the treatment on a plastic phantom containing an ionization chamber. If differences are less than 2%, films are inserted at selected planes in the phantom and the treatment is delivered again to evaluate the relative doses. When matching between treatment planning system (TPS), film, and MC is acceptable, a new evaluation of the patient is then performed between TPS and MC. Three different cases are shown to prove the applicability of the verification model. RESULTS: Acceptable agreement between the three methods used was obtained. The results are presented using different analysis tools. The actual time employed to simulate the total treatment in each case was no more than 5 h, depending on the number of segments. CONCLUSIONS: The MC model presented is fully automated, and results can be achieved within the operative time limits. The procedure is a reliable tool to verify any IMRT treatment.

Adenocarcinoma↗

Computer optimization of class solutions designed on a beam segmentation basis.

BACKGROUND AND PURPOSE: A method for analytically solving the optimization of beam weighting in radiotherapy treatments using beam segmentation is presented. PATIENTS AND METHODS: A technique has been elaborated permitting the optimization of a flexible objective function which is defined by considering 'importance factors' for each anatomical region and 'allowed deviations' from the prescribed dose. As any change in these importance factors may lead to very different solutions, a statistical tool has been developed which varies the objective function automatically and iteratively to get the best possible results compatible with the chosen class solution. In addition, the spatial symmetry found in many anatomical sites is taken advantage of. Furthermore, freeware code has been written to run this optimization approach. The guidelines to design the beam segmentation used in our institution using organ avoidance criteria, and hence the suitable class solution for different anatomical sites, are given. A treatment-planning study for three anatomical sites is presented and, for two of them, the results obtained with both the suggested and the classical inverse approach are presented. RESULTS: The work presented might be used for beam weighting optimization in any radiotherapy treatment and furthermore, the suggested procedure may successfully confront the intensity-modulated radiation therapy (IMRT) problem and the obtained dose distributions fit the clinical constraints for all anatomical sites studied. When comparing with the classical inverse approach, both results are comparable in terms of dose distribution, but the suggested technique reduces the integral dose as the total number of monitor units is lower. CONCLUSIONS: The developed code performs the optimization with a very low time cost and in addition, this process can be carried out with a conventional treatment-planning system with no need of dedicated IMRT software.

Breast Neoplasms↗

Cyclooxygenase-1 inhibition corrects endothelial dysfunction in cirrhotic rat livers.

BACKGROUND/AIMS: Cirrhotic livers exhibit endothelial dysfunction that contributes to the increased hepatic vascular resistance. The present study evaluates the role of cyclooxygenase (COX)-derived prostanoids, implicated in the pathogenesis of endothelial dysfunction in other settings, in the pathogenesis of endothelial dysfunction in cirrhotic livers. METHODS: Endothelial dysfunction was evaluated by performing concentration-effect curves to acetylcholine after precontracting the liver with methoxamine in groups of control and CCl(4)-cirrhotic rat livers preincubated either with vehicle, indomethacin, the COX-1 selective inhibitor, SC-560, the COX-2 selective inhibitor, SC-236, the thromboxane A(2) receptor antagonist, SQ 29,548 or the nitric oxide (NO) synthase inhibitor N(G)-nitro-L-arginine. Thromboxane A(2) (TXA(2)) production was determined in samples of the perfusate. RESULTS: Cirrhotic livers exhibited endothelial dysfunction, as shown by the significantly lower relaxation to acetylcholine than control livers, that was totally corrected by indomethacin. COX-1 inhibition and TXA(2) blockade, but not COX-2 inhibition, also corrected endothelial dysfunction. Acetylcholine significantly increased TXA(2) production in cirrhotic but not in control livers. Indomethacin and COX-1 inhibition, but not COX-2 or NO inhibition, prevented the increased production of TXA(2). CONCLUSIONS: An increased production of TXA(2) is involved in the pathogenesis of endothelial dysfunction in cirrhotic rat livers. This is mainly mediated by COX-1, but not by COX-2.

Animals↗