A5026048145- Advanced Radiotherapy Techniques
- Advances in Oncology and Radiotherapy
- Lung Cancer Diagnosis and Treatment
- Radiation Therapy and Dosimetry
- Radiomics and Machine Learning in Medical Imaging
- Head and Neck Cancer Studies
- Lung Cancer Treatments and Mutations
- Management of metastatic bone disease
- Medical Imaging Techniques and Applications
- Prostate Cancer Diagnosis and Treatment
- Endometrial and Cervical Cancer Treatments
- Radiation Dose and Imaging
- Advanced X-ray and CT Imaging
- Cancer Genomics and Diagnostics
- Effects of Radiation Exposure
- Biomedical and Engineering Education
- Glioma Diagnosis and Treatment
- Pharmacy and Medical Practices
- Electronic Health Records Systems
- Artificial Intelligence in Healthcare and Education
- Breast Cancer Treatment Studies
- Electrical and Bioimpedance Tomography
- Prostate Cancer Treatment and Research
- Healthcare Operations and Scheduling Optimization
- Dysphagia Assessment and Management
UC San Diego Health System
2021-2025
University of California, San Diego
2019-2024
Moores Cancer Center
2019
Implementing new online adaptive radiation therapy technologies is challenging because extra clinical resources are required particularly expert contour review. Here, we provide the first assessment of Varian's Ethos™ platform for prostate cancer using no manual edits after auto-segmentation to minimize this impact on efficiency.Twenty-five patients previously treated at our clinic were re-planned an emulator. Clinical target volumes (CTV) included intact and proximal seminal vesicles. The...
Evaluate a cone-beam computed tomography (CBCT)-based daily adaptive platform in cervical cancer for multiple endpoints: (1) physics contouring accuracy of CTVs, (2) CTV coverage with adapted plans and reduced PTV margins versus non-adapted standard-of-care (SOC) margins, (3) dosimetric improvements to organs-at-risk (OARs), (4) on-couch time.Using Varian Ethos™ emulator KV-CBCT scans, we simulated the doses 15 retrospective patients would have received with/without online adaptation five...
Online adaptive radiotherapy platforms present a unique challenge for commissioning as guidance is lacking and specialized equipment, such deformable phantoms, are rare. We designed novel process consisting of end-to-end tests using standard clinical resources. These were to simulate anatomical changes regularly observed at patient treatments. The test results will inform users the magnitude uncertainty from on-treatment during workflow limitations their systems. implemented these cone-beam...
The Adaptive Radiation Therapy Individualized Approach-Cervix clinical trial uses predefined directive templates (CDTs) combined with RapidPlan dose-volume histogram estimations (DVHe) to guide plan optimization in the Ethos treatment planning system. dosimetric scorecard is a scoring tool that quantifies improvements quality after physicians have precisely expressed their complete intent. To our knowledge, this first study use tune an CDT improve resulting quality.
Abstract Purpose Daily online adaptive radiotherapy (ART) improves dose metrics for gynecological cancer patients, but the on‐treatment process is resource‐intensive requiring longer appointments and additional time from entire team. To optimize resource allocation, we propose a model to identify high‐priority patients. Methods For 49 retrospective cervical endometrial calculated two initial plans: treated standard‐of‐care (Initial SOC ) reduced margin plan ART adapting with Ethos treatment...
Abstract Background Precision medicine incorporating genetic profiling is becoming a standard of care in medical oncology. However, the field radiation oncology there limited use and impact germline biomarkers on radiosensitivity, radioresistance, or patient outcomes after therapy poorly understood. In HNSCC, toxicity associated with treatment can cause delays early cessation which has been worse outcomes. Identifying potential help predict toxicity, as well response to treatment,...
Abstract Purpose The focal radiotherapy (RT) boost technique was shown in the FLAME trial to improve prostate cancer outcomes without increasing toxicity. This relies on accurate delineation of tumors MRI. ReIGNITE RT Boost study evaluated radiation oncologists’ accuracy when asked delineate MRI and demonstrated high variability tumor contours. We sought evaluate impact contour inaccuracy predicted clinical outcomes. hypothesized that inaccuracies would yield meaningfully worse Materials...
Online adaptive radiotherapy (OART) is a promising technique for delivering stereotactic accelerated partial breast irradiation (APBI), as lumpectomy cavities vary in location and size between simulation treatment. However, OART resource-intensive, increasing planning treatment times decreasing machine throughput compared to the standard of care (SOC). Thus, it pertinent identify high-yield candidates best allocate resources.
Motion management of tumors within the lung and abdomen is challenging because it requires balancing tissue sparing with accuracy hitting target, while considering treatment delivery efficiency. Physicists can play an important role in analyzing four-dimensional computed tomography (4DCT) data to recommend optimal respiratory gating parameters for a patient. The goal this work was develop standardized procedure making recommendations regarding planning margins gastrointestinal stereotactic...
Abstract Background Optimizing the therapeutic ratio for radiation therapy (RT) in head and neck squamous cell carcinoma (HNSCC) is uniquely challenging owing to high rates of early late toxicity involving nearby organs at risk. These toxicities have a profound impact on treatment compliance quality life. Emerging evidence suggests that RT dose alone cannot fully account variable severity RT-related adverse events (rtAEs) observed HNSCC patients. Next-generation sequencing has become an...
Abstract Introduction Quality assurance (QA) of treatment plans in clinical trials improves protocol compliance and patient outcomes. Retrospective use knowledge-based-planning (KBP) has demonstrated improved plan quality consistency. We report the results prospective KBP for real-time QA TROG 15.03 FASTRACK II trial, which evaluates efficacy stereotactic ablative body radiotherapy (SABR) kidney cancer. Methods A model was generated based on single institution data. For each phase (open to...
Abstract Objective . Adaptive Radiotherapy (ART) is an emerging technique for treating cancer patients which facilitates higher delivery accuracy and has the potential to reduce toxicity. However, ART also resource-intensive, Requiring extra human machine time compared standard treatment methods. In this analysis, we sought predict subset of node-negative cervical with greatest benefit from ART, so resources might be properly allocated highest-yield patients. Approach CT images, initial plan...
Abstract Purpose Establish and compare two metrics for monitoring beam energy changes in the Halcyon platform evaluate accuracy of these across multiple linacs. Method The first metric is derived from diagonal normalized flatness (F DN ), which defined as ratio average measurements at a fixed off‐axis equal distance along open profiles diagonals to measurement central axis with an ionization chamber array (ICA). second comes area (AR) quad wedge (QW) measured QW on top ICA. Beam changed by...
Abstract Purpose The Varian Halcyon™ electronic portal imaging detector is always in‐line with the beam and automatically acquires transit images for every patient full‐field coverage. These could be used “every patient, monitor unit” quality assurance (QA) eventually adaptive radiotherapy. This study evaluated imager’s sensitivity to potential clinical errors day‐to‐day variations from exit images. Methods Open modulated fields were delivered each error. To evaluate output changes, units...