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P Vassal

Publications and source records attributed to P Vassal.

9 recordsLinked to original sources

Patient set-up using portal images: 2D/2D image registration using mutual information.

OBJECTIVE: Conformal radiation therapy requires accurate patient set-up for each fraction delivery. Electronic portal imaging devices allow the acquisition of portal images just before and even during dose delivery. However, the quantitative interpretation of these images in determining and correcting the patient's position remains uncertain, and automated methods are therefore being developed. Such methods must be usable for the different radiation therapy techniques. They must be robust and as automated as possible for use in clinical routines. This work was undertaken to establish the feasibility of 2D/2D registration for portal/portal and portal/simulator images in radiotherapy. MATERIALS AND METHODS: This paper describes an automated method based on the combination of calibration algorithms and pixel-based registration algorithms. We present experiments with the different imaging techniques, some of which use a phantom with and without a gold standard. Preliminary results obtained using patient data are also presented and discussed. RESULTS: The results obtained with a phantom demonstrated that this automated method for 2D/2D registration is fast, accurate, and robust, even in the case of blurred images for small treatment fields. CONCLUSIONS: Mutual information is a feasible method for 2D/2D portal/portal and portal/simulator image registration in radiotherapy.

Algorithms↗

[Image fusion methods for the repositioning of the patient in radiotherapy].

Conformal radiotherapy requires the accurate and reproducible setup of the patient for each fraction delivery. Megavoltage imaging could enable this. This requires the development of image processing and data fusion algorithms. We describe an automated method based on the use of mutual information for registration. Such a method does not require any preliminary segmentation of the images. This method has been extensively tested on phantom as well as on some patient data. The obtained results demonstrated that this automated method for 2D/2D registration is rapid, accurate and robust even in the case of blurred images for small treatment fields.

Humans↗

The use of a semi-customized phantom for verification of conformal plans.

We have developed a technique for inverse treatment planning of prostate therapy designed to improve the degree of conformation between the dose distribution and the target volume. We compared the inverse plan with a "standard" four-field box technique as well as a four-field technique using oblique fields ("cross technique"). We validated the dosimetry of the inverse plan using Fricke gel solution in phantom specifically designed for this purpose. The phantom is a Plexiglas tank with a cross section, which approximates the dimensions of the pelvis. Anatomical data from computed tomography (CT) images of a patient were used to simulate organs in our phantom. This allows us to calculate dose distributions with the external geometry of the phantom and internal anatomy of the patient. Dose-volume histograms (DVHs) for the three different plans were calculated. The phantom containing the Fricke gel was irradiated according to the inverse plan. Magnetic resonance (MR) images was used to determine the dose distribution delivered to the phantom. We observe, on DVHs, that the inverse plan significantly reduces the dose to the rectum and the bladder but slightly increases the inhomogeneity inside the target volume. Correlation is good between isodoses on MR images and calculated isodoses. We conclude that inverse planning software can greatly improve the conformal degree of treatment to the prostate. This technique could be applied to other complex anatomic sites at which dose to organs at risk is a limiting factor and increased dose to the target volume is indicated. Our phantom and the Fricke gel solution are convenient to carry out validation of conformal treatments.

Humans↗

[Multicenter study on sensitization to Alternaria mold].

The reality emerged of a non-negligible frequency of positive tests to "Alternaria". This was conducted by the inclusion of this mould in the standard allergy assessment, especially if a summer predominance of symptoms was known. A significant difference emerged between seasonal peaks which had to do with mono or polysensitisation. The highest frequency of positives was found near to humid surroundings or woods.

Adolescent↗

Patient setup optimization for external conformal radiotherapy.

The aim of conformal radiotherapy is to deliver precisely a specific dose of radiation to a planning target volume, concurrently radiating as little healthy tissue and organs as possible. This can be accomplished only with the accurate positioning of the patient with respect to the radiotherapy system. In this paper, we describe a system to achieve a higher overall accuracy in the delivery of a prostatic radiation boost for treatment of carcinoma of the prostate. The system is based on the use of ultrasound images for measuring the actual position of the patient's prostate just before the radiation. Since these images are registered with pretreatment computed tomography or magnetic resonance imaging, the position and orientation of the planning target volume are computed with respect to the radiotherapy system and can be corrected as needed. This system is under clinical evaluation.

Computer Simulation↗

Conformal external radiotherapy of prostatic carcinoma: requirements and experimental results.

The aim of conformal radiotherapy is to deliver, with high precision, a specific dose (which may be a high dose) to a planning target volume, concurrently with irradiating as little as possible healthy tissue and organs at risk. Radiation therapy may suffer from a number of problems that result in both over- or under-sizing the irradiation fields, making over-rough simplifications of the irradiation ballistics and delivering an insufficient tumoral dose (to spare critical organs and reduce toxicity). One of these problems lies in the accurate positioning of the planning target volume with respect to the irradiation system, thence in the correct execution of the ballistics. In this paper, we describe a system aiming at achieving a higher overall accuracy in the delivery of prostatic boost for carcinoma of the prostate. The system is based on the use of ultrasonic images for measuring the actual position of the prostate just before irradiation. Since these images are registered with pre-operative (CT or MR) images, the position and orientation of the planning target volume is computed with respect to the irradiation system, and can be corrected accordingly. First experiments have been performed on dummies, and the results are discussed.

Humans↗