SU-GG-J-76: Dosimetric Consequences of Patient Setup Decisions in Image-Guided Procedures Based On Soft-Tissue Fiducials for Imaging

2008 ◽  
Vol 35 (6Part6) ◽  
pp. 2696-2696 ◽  
Author(s):  
S Dieterich ◽  
A Schlaefer
Keyword(s):  
Soft Tissue ◽  
Image Guided ◽  
Patient Setup

Vector analysis of bladder cancer patient setup utilizing a magnetic resonance image-guided radiation therapy (MR-IGRT) system.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 412-412
Author(s):  
Benjamin Walker Fischer-Valuck ◽  
Olga L Green ◽  
Hiram Alberto Gay ◽  
Sasa Mutic ◽  
Jeff M. Michalski
Keyword(s):  
Bladder Cancer ◽  
Radiation Therapy ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Mr Imaging ◽  
Magnetic Resonance Image ◽  
Normal Tissue ◽  
Image Guided ◽  
Patient Setup ◽  
Vector Shift

412 Background: Inter and intra-fraction anatomy changes in patients undergoing radiation therapy (RT) for bladder cancer (BC) are common but have thus far been studied with implanted fiducial markers, limited quality 2-D orthogonal films and computed tomography (CT). The adverse impact of daily set-up variation could be more significant than appreciated. Our goal was to employ the soft tissue imaging capabilities of an integrated magnetic resonance image-guided RT (MR-IGRT) system to analyze daily positioning. Methods: Fourteen patients with BC were treated on a MR-IGRT system. Patient setup was performed via volumetric MR imaging with a resolution of 0.15 x 0.15 cm. Alignment was performed according to skin marks then shifts assessed by comparing the treatment volume from the planning CT to the daily MR image. 240 pretreatment MR images were analyzed and 3 shifts were recorded for each image. A vector shift was calculated by combining the square root of the combined sum of the shifts squared. Number of times that the vector of combined shifts would have exceeded the planning tumor volume (PTV) was recorded. Results: Daily volumetric MR imaging allowed for accurate alignment and daily monitoring of bladder volume and normal tissue anatomy. Recorded shifts of the treated volume were 0.9±0.5 cm in the right/left direction, 0.7±0.3 cm in the anterior/posterior direction, and 0.7±0.4 cm in the cranio-caudal direction. In 66 (28%) of cases the vector shift was initially greater than the PTV margin. For 2 patients, pre-treatment MR imaging revealed the tumor reduced in size and dose to the bowel would have exceeded constraints, and treatment adaptation was performed to reduce normal tissue toxicity. Using CTCAE criteria, no grade 3 or higher toxicities have been reported. Conclusions: Accurate and reproducible treatment delivery is required to avoid marginal misses to the target volume as well as excess dose to normal tissue. MR-IGRT allows for excellent soft tissue visualization which enables for the avoidance of potential setups errors by allowing daily alignment changes to ensure the target is included in the PTV. It also allows the ability to make treatment changes based on anatomy variations.

scholarly journals Image-Guided Biopsy for Relapsed Neuroblastoma: Focus on Safety, Adequacy for Genetic Sequencing, and Correlation of Tumor Cell Percent With Quantitative Lesion MIBG Uptake

2021 ◽  
pp. 275-285
Author(s):  
Andrew Samoyedny ◽  
Abhay Srinivasan ◽  
Lisa States ◽  
Yael P. Mosse ◽  
Emma Alai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Tumor Cell ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Mibg Uptake ◽  
Genetic Sequencing ◽  
Image Guided ◽  
Guided Biopsy

PURPOSE Many novel therapies for relapsed and refractory neuroblastoma require tumor tissue for genomic sequencing. We analyze our experience with image-guided biopsy in these patients, focusing on safety, yield, adequacy for next-generation sequencing (NGS), and correlation of tumor cell percent (TC%) with quantitative uptake on 123I-meta-iodobenzylguanidine (MIBG) single-photon emission computed tomography with computed tomography (SPECT/CT). MATERIALS AND METHODS An 11-year retrospective review of image-guided biopsy on 66 patients (30 female), with a median age of 8.7 years (range, 0.9-49 years), who underwent 95 biopsies (55 bone and 40 soft tissue) of relapsed or refractory neuroblastoma lesions was performed. RESULTS There were seven minor complications (7%) and one major complication (1%). Neuroblastoma was detected in 88% of MIBG- or fluorodeoxyglucose-avid foci. The overall NGS adequacy was 69% (64% in bone and 74% in soft tissue, P = .37). NGS adequacy within neuroblastoma-positive biopsies was 88% (82% bone and 96% soft tissue, P = .11). NGS-adequate biopsies had a greater mean TC% than inadequates (51% v 18%, P = .03). NGS-adequate biopsies had a higher mean number of needle passes (7.5 v 3.4, P = .0002). The mean tissue volume from NGS-adequate soft-tissue lesions was 0.16 cm3 ± 0.12. Lesion:liver and lesion:psoas MIBG uptake ratios correlated with TC% (r = 0.74, r = 0.72, and n = 14). Mean TC% in NGS-adequate samples was 51%, corresponding to a lesion:liver ratio of 2.9 and a lesion:psoas ratio of 9.0. Thirty percent of biopsies showed an actionable ALK mutation or other therapeutically relevant variant. CONCLUSION Image-guided biopsy for relapsed or refractory neuroblastoma was safe and likely to provide NGS data to guide therapy decisions. A lesion:liver MIBG uptake ratio of ≥ 3 or a lesion:psoas ratio of > 9 was associated with a TC% sufficient to deliver NGS results.

Image guided radiotherapy: Current status of soft tissue imaging

Radiography ◽  
2014 ◽  
Vol 20 (2) ◽  
pp. 158-161 ◽  
Author(s):  
Helen A. McNair ◽  
Mark Elsworthy ◽  
June Dean ◽  
Charlotte Beardmore
Keyword(s):  
Soft Tissue ◽  
Tissue Imaging ◽  
Current Status ◽  
Image Guided Radiotherapy ◽  
Image Guided

scholarly journals Diagnosis and Planning in the Management of Musculoskeletal Tumors - A Review

2017 ◽  
Vol 11 (2) ◽  
pp. 81-85
Author(s):  
Md Hafizur Rahman ◽  
Md Maiyeen Uddin
Keyword(s):  
Soft Tissue ◽  
Imaging Techniques ◽  
Surgical Techniques ◽  
Soft Tissue Tumors ◽  
Chemotherapeutic Drugs ◽  
Prognostic Information ◽  
Image Guided ◽  
Musculoskeletal Tumors ◽  
The Past ◽  
Appropriate Treatment

The prognosis of patients with musculoskeletal tumors has improved markedly because of the advent of new chemotherapeutic drugs and regimens and as a result of advances in imaging and surgical techniques. Limb-salvage operations can currently be performed with better outcomes, while in the past; limbs with tumors were treated only with amputation. Accurate preoperative surgical staging of musculoskeletal tumors is currently possible because imaging techniques provide prognostic information and aid clinicians in choosing the most appropriate treatment option for the patient. The aim of this article is to outline the presentation, imaging, and staging of the primary and metastatic bone and soft tissue tumors. Some of the image-guided interventions for these tumors are also presented.Faridpur Med. Coll. J. Jul 2016;11(2): 81-85

Image-guided percutaneous core needle biopsy of soft-tissue masses in the pediatric population

2016 ◽  
Vol 46 (8) ◽  
pp. 1173-1178 ◽  
Author(s):  
Terrence Metz ◽  
Amer Heider ◽  
Ranjith Vellody ◽  
Marcus D. Jarboe ◽  
Joseph J. Gemmete ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Pediatric Population ◽  
Core Needle ◽  
Image Guided ◽  
Percutaneous Core Needle Biopsy ◽  
Soft Tissue Masses
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