Biomedical subjects

Trevor Ackerly

Publications and source records attributed to Trevor Ackerly.

3 recordsLinked to original sources

PubMed2006

A prospective study to evaluate the impact of FDG-PET on CT-based radiotherapy treatment planning for oesophageal cancer.

BACKGROUND AND PURPOSE: This prospective study sought to determine how the use of combined PET/CT for radiotherapy treatment planning of oesophageal cancer would alter the delineation of tumour volumes compared to CT alone if PET/CT is assumed to more accurately represent true disease extent. PATIENTS AND METHODS: All patients underwent FDG-PET/CT scanning in the radiotherapy treatment position. For each patient, two separate gross tumour volumes (GTV) were defined, one based on CT images alone (GTV-CT) and another based on combined PET/CT data (GTV-PET). Corresponding planning target volumes (PTV) were generated, and separate treatment plans were then produced. For each patient, volumetric analysis of GTV-CT, PTV-CT and GTV-PET was performed to quantify the proportion of PET-avid disease that was not included in the GTV and PTV (geographic miss) if CT data alone were used for radiotherapy planning. Assessment of the cranial and caudal extent of the primary oesophageal tumour as defined by CT alone vs PET/CT was also compared. RESULTS: The addition of PET information altered the clinical stage in 8 of 21 eligible patients enrolled on the study (38%); 4 patients had distant metastatic disease and 4 had unsuspected regional nodal disease. Sixteen patients proceeded to the radiotherapy planning phase of the study and received definitive chemoradiation planned with the PET/CT data set. The GTV based on CT information alone excluded PET-avid disease in 11 patients (69%), and in five patients (31%) this would have resulted in a geographic miss of gross tumour. The discordance between CT and PET/CT was due mainly to differences in defining the longitudinal extent of disease in the oesophagus. The cranial extent of the primary tumour as defined by CT vs PET/CT differed in 75% of cases, while the caudal extent differed in 81%. CONCLUSIONS: This study demonstrates that if combined PET/CT is used for radiotherapy treatment planning, there may be alterations to the delineation of tumour volumes when compared to CT alone, with the potential to avoid a geographic miss of tumour.

Esophageal Neoplasms↗

PubMed2004

Improving radiochromic film's sensitivity by wrapping it with UV phosphor.

The main advantage of radiochromic-film dosimeters is the coupling of rapid full planar-acquisition, high-spatial resolution and dose linearity. Their main limitation, however, is their low radiation sensitivity. This precludes their application to measuring doses below a few Gy. Radiochromic films are sensitive to ultraviolet radiation. In this note the results of exposing radiochromic films to x rays through an UV imaging cassette, which converts and amplifies x rays to UV radiation, are presented. These results indicate a clear increase (around 50%) in radiochromic film's sensitivity to MV x rays (6, 10, and 18 MV) when exposed through the UV phosphor.

Equipment Design↗

PubMed2003

Exploring the effect of marked normal structure volume on normal tissue complication probability.

Radiation therapy dosimetry software now frequently incorporates biological predictions of the probability of normal tissue complications. This study investigates whether the length of normal structure outlined affects a normal tissue complication probability (NTCP) for that structure. It also researches the effect of any change in the dose parameter used to produce a 50% probability of a complication (the TD50) on the calculated NTCP, as this is related to the clinical observations. An NTCP was calculated for rectum and bladder on a sample of prostate cases receiving external beam radiation therapy. The length of the organs at risk was varied and the NTCP recalculated for each different length using the same treatment plan. Large variations of up to 80% in NTCP for different delineated lengths of organ for a given TD50 were observed. Changing the TD50 dose altered the calculated NTCP and the relative size of the variation in the values. This parameter will need further investigation; a standardized delineated length of 2 cm beyond the beam edge for normal structures is recommended. Interpatient and interinstitution plan comparison using dose volume histograms and/or normal tissue complication probabilities will be compromised until such standardization occurs.

Humans↗