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Biomedical subjects

R Ove

Publications and source records attributed to R Ove.

9 recordsLinked to original sources
PubMed2001

Standardization of prostate brachytherapy treatment plans.

PURPOSE: Whereas custom-designed plans are the norm for prostate brachytherapy, the relationship between linear prostate dimensions and volume calls into question the routine need for customized treatment planning. With the goal of streamlining the treatment-planning process, we have compared the treatment margins (TMs) achieved with one standard plan applied to patients with a wide range of prostate volumes. METHODS AND MATERIALS: Preimplant transrectal ultrasound (TRUS) images of 50 unselected University of Washington patients with T1-T2 cancer and a prostate volume between 20 cc and 50 cc were studied. Patients were arbitrarily grouped into categories of 20-30 cc, 30-40 cc, and 40-50 cc. A standard 19-needle plan was devised for patients in the 30- to 40-cc range, using an arbitrary minimum margin of 5 mm around the gross tumor volume (GTV), making use of inverse planning technology to achieve 100% coverage of the target volume with accentuation of dose at the periphery and sparing of the central region. The idealized plan was applied to each patient's TRUS study. The distances (TMs) between the prostatic edge (GTV) and treated volume (TV) were determined perpendicular to the prostatic margin. RESULTS: Averaged over the entire patient group, the ratio of thickness to width was 1.4, whereas the ratio of length to width was 1.3. These values were fairly constant over the range of volumes, emphasizing that the prostate retains its general shape as volume increases. The idealized standard plan was overlaid on the ultrasound images of the 17 patients in the 30- to 40-cc group and the V100, the percentage of target volume receiving 100% or more of the prescription dose, was 98% or greater for 15 of the 17 patients. The lateral and posterior TMs fell within a narrow range, most being within 2 mm of the idealized 5-mm TM. To estimate whether a 10-cc volume-interval stratification was reasonable, the standard plan generated from the 30- to 40-cc prostate model was applied to 5 patients each from the 20- to 30-cc group and the 40- to 50-cc group. Using the standard plan designed for the 30- to 40-cc group, the TMs were closer to 10 mm than to 5 mm for the smaller volume glands and too small for the larger volume ones, assuming an ideal margin of 5 mm. CONCLUSION: The application of standardized plans to prostate brachytherapy is feasible. Stratifying the volume in 10-cc intervals appears to be adequate, suggesting that the majority of cases appropriate for treatment with brachytherapy might be treated with three standard plans. While the authors believe that the use of a limited number of standard treatment plans is feasible, practical, and medically acceptable, it should be emphasized that the use of a standard plan should always be previewed by computer-aided application to the particular patient's planning images.

Brachytherapy↗
PubMed2000

Preservation of visual fields after peri-sellar gamma-knife radiosurgery.

Radiosurgical treatment of pituitary and peri-sellar tumors has become an increasingly utilized modality as an alternative to conventional radiotherapy and surgery. Such radiosurgery results in a relatively high dose of radiation to the optic chiasm. The clinical data establishing safe single-fraction doses to the chiasm is immature, although taken together previous literature suggests a recommended maximal dose of 8 Gy. Optic neuropathy, when it occurs, tends to take place within 2 years of treatment. We evaluated the visual fields of 20 sequential patients that received significant doses to the optic chiasm by Gamma-knife radiosurgery. There were 17 cases of pituitary adenoma and 3 cases of meningioma, and two patients refused follow-up testing. Preoperative visual field and cranial nerve examinations were done prior to radiosurgery and in follow-up, with a median follow-up of 24 months. There were no cases of quantitative visual field deficit induced by treatment. No patients developed symptomatic visual deterioration. Radiat. Oncol. Invest. 90:343-350, 2000. 2000 Wiley-Liss, Inc.

Adenoma↗
PubMed2000

Postoperative endoscopic retrograde high dose-rate brachytherapy for cholangiocarcinoma.

Cholangiocarcinoma typically presents with disease unlikely to be completely resected, and prognosis remains poor. Improvements in imaging, endoscopy, and stenting have given rise to renewed interest in brachytherapy. Several recent retrospective series suggest a benefit to intraluminal brachytherapy, most commonly delivered by the transhepatic route. We describe a case in which brachytherapy was delivered via the nasobiliary route to address positive margins at the common bile duct stump. A custom catheter was manufactured to make the procedure feasible. Pertinent literature is reviewed, which supports the view that these malignancies benefit from high doses of radiation, if this can be achieved respecting normal tissue tolerance.

Aged↗
PubMed2000

Inverse treatment planning for Gamma Knife radiosurgery.

An inverse treatment planning system for Gamma Knife radiosurgery has been developed using nonlinear programming techniques. The system optimizes the shot sizes, locations, and weights for Gamma Knife treatments. In the patient's prescription, the user can specify both the maximum number of shots of radiation and a minimum isodose line that must surround the entire treatment volume. After satisfying all of the constraints included in the prescription, the system maximizes the conformity of the dose distribution. This automated approach to treatment planning has been applied retrospectively to a series of patient cases, and each optimized plan has been compared to the corresponding manual plan produced by an experienced user. The results demonstrate that this tool can often improve the tumor dose homogeneity while using fewer shots than were included in the original plan. Therefore, inverse treatment planning should improve both the quality and the efficiency of Gamma Knife treatments.

Algorithms↗
PubMed1999

Delayed expression of hpS2 and prolonged expression of CIP1/WAF1/SDI1 in human tumour cells irradiated with X-rays, fission neutrons or 1 GeV/nucleon Fe ions.

PURPOSE: Differences in gene expression underlie the phenotypic differences between irradiated and unirradiated cells. The goal was to identify late-transcribed genes following irradiations differing in quality, and to determine the RBE of 1 GeV/n Fe ions. MATERIALS AND METHODS: Clonogenic assay was used to determine the RBE of Fe ions. Differential hybridization to cDNA target clones was used to detect differences in expression of corresponding genes in mRNA samples isolated from MCF7 cells irradiated with iso-survival doses of Fe ions (0 or 2.5 Gy) or fission neutrons (0 or 1.2 Gy) 7 days earlier. Northern analysis was used to confirm differential expression of cDNA-specific mRNA and to examine expression kinetics up to 2 weeks after irradiation. RESULTS: Fe ion RBE values were between 2.2 and 2.6 in the lines examined. Two of 17 differentially expressed cDNA clones were characterized. hpS2 mRNA was elevated from 1 to 14 days after irradiation, whereas CIP1/WAF1/SDI1 remained elevated from 3 h to 14 days after irradiation. Induction of hpS2 mRNA by irradiation was independent of p53, whereas induction of CIP1/WAF1/SDI1 was observed only in wild-type p53 lines. CONCLUSIONS: A set of coordinately regulated genes, some of which are independent of p53, is associated with change in gene expression during the first 2 weeks post-irradiation.

Cell Survival↗
PubMed1999

Tomographic convolutional dosimetry of interstitial brachytherapy implants.

A method for approximation of the dose distribution generated by an interstitial brachytherapy implant is introduced. The method employs convolution of raw tomographic data, as a measurement of attenuation of CT pencil beams by the metallic substrate and casing of radioactive seeds. A convolution kernel is introduced in the algorithm for CT image reconstruction such that the tomographic computation results in an approximation of absorbed dose. Error estimates are discussed, and limitations of the method and the domain of validity are discussed. Equivalence with a technique of employing convolution methods to the CT image itself is demonstrated. Calibration and testing on phantom implants is underway.

Artifacts↗