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Biomedical subjects

Yulong Yan

Publications and source records attributed to Yulong Yan.

9 recordsLinked to original sources
PubMed2006

Dosimetric comparison of helical tomotherapy and Gamma Knife stereotactic radiosurgery for single brain metastasis.

BACKGROUND: Helical Tomotherapy (HT) integrates linear accelerator and computerized tomography (CT) technology to deliver IMRT. Targets are localized (i.e. outlined as gross tumor volume [GTV] and planning target volume [PTV]) on the planning kVCT study while daily MVCT is used for correction of patient's set-up and assessment of inter-fraction anatomy changes. Based on dosimetric comparisons, this study aims to find dosimetric equivalency between single fraction HT and Gamma Knife stereotactic radiosurgery (GKSRS) for the treatment of single brain metastasis. METHODS: The targeting MRI data set from the GKSRS were used for tomotherapy planning. Five patients with single brain metastasis treated with GKSRS were re-planned in the HT planning station using the same prescribed doses. There was no expansion of the GTV to create the PTV. Sub-volumes were created within the PTV and prescribed to the maximum dose seen in the GKSRS plans to imitate the hot spot normally seen in GKSRS. The PTV objective was set as a region at risk in HT planning using the same prescribed dose to the PTV periphery as seen in the corresponding GKSRS plan. The tumor volumes ranged from 437-1840 mm(3). RESULTS: Conformality indices are inconsistent between HT and GKSRS. HT generally shows larger lower isodose line volumes, has longer treatment time than GKSRS and can treat a much larger lesion than GKSRS. Both HT and GKSRS single fraction dose-volume toxicity may be prohibitive in treating single or multiple lesions depending on the number and the sizes of the lesions. CONCLUSION: Based on the trend for larger lower dose volumes and more constricted higher dose volumes in HT as compared to GKSRS, dosimetric equivalency was not reached between HT and GKSRS.

Brain Neoplasms↗
PubMed2005

An assessment of biologically-based optimization (BORT) in the IMRT era.

The purpose of this study was to investigate the role of biological-based IMRT (BORT) in treatment planning development; more specifically, to assess the possible advantages of BORT over the classic 3-dimensional conformal radiation therapy (3DRT) and dose-based IMRT based on quantitative and qualitative indices. Three clinical cases are presented to evaluate the differences of BORT, IMRT, and 3DRT. 3DRT, IMRT, and BORT plans were generated for each case using a commercially available treatment planning system (Pinnacle by Philips). The plans were compared by evaluating biological endpoints such as tumor control probability (TCP), normal tissue control probability (NTCP), and uncomplicated tumor control probability (P+), as well as isodose line distribution, dose-volume histograms (DVHs), and dose uniformity. In all cases of this study, BORT yielded improved isodose coverage and P+. Our preliminary results suggest that BORT could play an important role in treatment planning optimization, especially as biological models and predictive assays become more accurate. Further case studies are needed to establish a definitive role for this type of optimization.

Brain Neoplasms↗
PubMed2005

Feasibility of cranio-spinal axis radiation with the Hi-Art tomotherapy system.

BACKGROUND AND PURPOSE: Helical tomotherapy can eliminate the need for junction lines. The goal of this study is to evaluate tomotherapy in the delivery of CSA radiation and measurement of plan quality using physical parameters in comparing conventional (CSA-RT) and helical tomotherapy (CSA-TOMO) plans. PATIENTS AND METHODS: CSA-TOMO and CSA-RT plans were created for dosimetric comparison. Integral dose values were calculated. The ratios D50% (dose received by 50% of the organ at risk's volume) and D10% (dose received by 10% of the organ at risk's volume) were calculated representing large volumes and small volumes of organs at risk receiving significant dose. RESULTS: When considering D50% and D10%, CSA-TOMO has a dosimetric advantage over CSA-RT for most organs at risk. The body integral dose was higher for the CSA-TOMO plan by approximately 6.5%. CONCLUSIONS: Tomotherapy is a feasible alternative for treatment of CSA. Analysis shows that tomotherapy improves dose ratios over conventional radiation for most organs at risk. The impact of a small increase in whole body integral dose is unknown. Long-term follow-up will be needed to answer this question as others have argued of the possibility of increased risk of secondary malignancies due to delivery of radiotherapy with IMRT.

Brain↗
PubMed2005

Fast radiographic film calibration procedure for helical tomotherapy intensity modulated radiation therapy dose verification.

Film dosimetry offers an advantageous in-phantom planar dose verification tool in terms of spatial resolution and ease of handling for quality assurance (QA) of intensity modulated radiation therapy (IMRT) plans. A critical step in the success of such a technique is that the film calibration be appropriately conducted. This paper presents a fast and efficient film calibration method for a helical tomotherapy unit using a single sheet of film. Considering the unique un-flattened cone shaped profile from a helical tomotherapy beam, a custom leaf control file (sinogram) was created, to produce a valley shaped intensity pattern. There are eleven intensity steps in the valley pattern, representing varying dose values from 38 to 265 cGy. This dose range covers the most commonly prescribed doses in fractionated IMRT treatments. An ion chamber in a solid water phantom was used to measure the dose in each of the eleven steps. For daily film calibration the whole procedure, including film exposure, processing, digitization and analysis, can be completed within 15 min, making it practical to use this technique routinely. This method is applicable to film calibration on a helical tomotherapy unit and is particularly useful in IMRT planar dose verification due to its efficiency and reproducibility. In this work, we characterized the dose response of the KODAK EDR2 ready-pack film which was used to develop the step valley dose maps and the IMRT QA planar doses. A comparison between the step valley technique and multifilm based calibration showed that both calibration methods agreed with less than 0.4% deviation in the clinically useful dose ranges.

Calibration↗
PubMed2004

Intensity-modulated radiation therapy reduces the dose to normal tissue in T2N0M0 squamous cell carcinoma of the glottic larynx.

The purpose of this paper was to compare intensity-modulated radiation therapy (IMRT) and conventional planning for T2N0M0 squamous cell carcinoma (SQCC) of the glottic larynx. Three patients with T2N0M0 SQCC are presented who were treated with IMRT. Conventional plans were also generated for comparison purposes. Isodose distributions and dose-volume histograms (DVHs) were generated for all the plans to evaluate the fitness of the plan as well as the differential benefit of IMRT vs. conventional treatment. The isodose distributions that were obtained by the IMRT plan are much more conformal to the planning target volume (PTV) and clearly show that less healthy tissue is subjected to a high-dose level, thus reducing toxicity. IMRT offers better comformality without compromising the PTV coverage and delivers less dose to normal tissues as compared to conventional radiation therapy in T2N0M0 SQCC of the glottic larynx. With an increase in conformality, it is expected to have an increase in the therapeutic ratio.

Aged↗
PubMed2004

Application of intensity-modulated radiation therapy for pediatric malignancies.

Novel radiation therapy delivery techniques have moved very slowly in the field of pediatric oncology. Some collaborative groups allow new radiation therapy delivery techniques in their trials. In many instances, the option of using these techniques is not addressed. These newer techniques of radiation delivery have the potential to reduce the probability of the common late effects of radiation and at the same time, potentially improve upon control and survival. The purpose of this study is to show the feasibility of IMRT in pediatric patients. No treatment results or toxicities will be presented. Five patients with a variety of pediatric malignancies received intensity-modulated radiation therapy (IMRT) at our institution as part of their disease management. A rigid immobilization device was developed for each patient and a computed tomography (CT) simulation was performed in the treatment position. In 3 of the patients, magnetic resonance imaging (MRI) scans were coregistered with the planning CT to facilitate target and critical structure delineation. In all but 1 patient, coplanar beam arrangements were used in the IMRT planning process. All IMRT plans exhibited a high degree of conformality. Dose homogeneity inside the tumor and rapid dose falloff outside the target volume is characteristic of IMRT plans, which allows for improved normal tissue sparing. Dose distributions were obtained for all plans, as well as dose and volume relationship histograms, to evaluate the fitness of the plans. IMRT is a viable alternative to conventional treatment techniques for pediatric cancer patients. The improved dose distributions coupled with the ease of delivery of the IMRT fields make this technique very attractive, especially in view of the potential to increase local control and possibly improve on survival.

Adult↗
PubMed2003

A vectorized Monte Carlo code for radiotherapy treatment planning dose calculation.

How to speed up Monte Carlo (MC) simulation in dose calculation without losing its intrinsic accuracy is one of the key issues of making a clinical MC dose engine. In this study we intensively investigated a special parallel computation technique, the vectorization technique, to boost simulation efficiency on a personal computer (PC) without extra hardware investment. A MC code, dose planning method (DPM), was extensively modified into a vectorized code, V-DPM, using the streaming single-instruction-multiple-data extension (SSE) parallel computation model. Comparative simulations were conducted for typical simulation cases in both DPM and V-DPM codes. We found that in every case the V-DPM code runs 1.5 times faster than the DPM code with variance of 0.6%.

Algorithms↗
PubMed2002

An investigation of a video-based patient repositioning technique.

PURPOSE: We have investigated a video-based patient repositioning technique designed to use skin features for radiotherapy repositioning. We investigated the feasibility of the clinical application of this system by quantitative evaluation of performance characteristics of the methodology. METHODS AND MATERIALS: Multiple regions of interest (ROI) were specified in the field of view of video cameras. We used a normalized correlation pattern-matching algorithm to compute the translations of each ROI pattern in a target image. These translations were compared against trial translations using a quadratic cost function for an optimization process in which the patient rotation and translational parameters were calculated. RESULTS: A hierarchical search technique achieved high-speed (compute correlation for 128 x 128 ROI in 512 x 512 target image within 0.005 s) and subpixel spatial accuracy (as high as 0.2 pixel). By treating the observed translations as movements of points on the surfaces of a hypothetical cube, we were able to estimate accurately the actual translations and rotations of the test phantoms used in our experiments to less than 1 mm and 0.2 degrees with a standard deviation of 0.3 mm and 0.5 degrees respectively. For human volunteer cases, we estimated the translations and rotations to have an accuracy of 2 mm and 1.2 degrees. CONCLUSION: A personal computer-based video system is suitable for routine patient setup of fractionated conformal radiotherapy. It is expected to achieve high-precision repositioning of the skin surface with high efficiency.

Algorithms↗