SU-G-JeP4-11: Prospective Treatment Plan-Specific Action Limits for Real-Time Intrafractional Monitoring in Surface Image Guided Radiosurgery

2016 ◽  
Vol 43 (6Part28) ◽  
pp. 3683-3684
Author(s):  
A Yock ◽  
T Pawlicki ◽  
G Kim
Keyword(s):  
Real Time ◽  
Treatment Plan ◽  
Image Guided ◽  
Surface Image

SU-E-J-76: Clinical Use of a Real-Time Surface Image-Guided Positioning and Tracking System in Proton Therapy

2012 ◽  
Vol 39 (6Part7) ◽  
pp. 3670-3670
Author(s):  
W Hsi ◽  
Y Kang ◽  
X Ding ◽  
A Mascia ◽  
E Ramirez ◽  
...  
Keyword(s):  
Real Time ◽  
Proton Therapy ◽  
Tracking System ◽  
Clinical Use ◽  
Image Guided ◽  
Surface Image

Real-time 3D surface-image-guided beam setup in radiotherapy of breast cancer

2004 ◽  
Vol 32 (1) ◽  
pp. 65-75 ◽  
Author(s):  
David Djajaputra ◽  
Shidong Li
Keyword(s):  
Breast Cancer ◽  
Real Time ◽  
Image Guided ◽  
3D Surface ◽  
Surface Image

Characterization of a real-time surface image-guided stereotactic positioning system

2010 ◽  
Vol 37 (10) ◽  
pp. 5421-5433 ◽  
Author(s):  
Jean L. Peng ◽  
Darren Kahler ◽  
Jonathan G. Li ◽  
Sanjiv Samant ◽  
Guanghua Yan ◽  
...  
Keyword(s):  
Real Time ◽  
Positioning System ◽  
Image Guided ◽  
Surface Image

A Real Time Control Architecture for Continuously Managing Patients in a Care Unit

1995 ◽  
Vol 34 (05) ◽  
pp. 475-488
Author(s):  
B. Seroussi ◽  
J. F. Boisvieux ◽  
V. Morice
Keyword(s):  
Real Time ◽  
Linear Time ◽  
Treatment Plan ◽  
Control Architecture ◽  
Real Time Control ◽  
Time Representation ◽  
Time Control ◽  
Continuous Support ◽  
Definition Of ◽  
Computerized System

Abstract:The monitoring and treatment of patients in a care unit is a complex task in which even the most experienced clinicians can make errors. A hemato-oncology department in which patients undergo chemotherapy asked for a computerized system able to provide intelligent and continuous support in this task. One issue in building such a system is the definition of a control architecture able to manage, in real time, a treatment plan containing prescriptions and protocols in which temporal constraints are expressed in various ways, that is, which supervises the treatment, including controlling the timely execution of prescriptions and suggesting modifications to the plan according to the patient’s evolving condition. The system to solve these issues, called SEPIA, has to manage the dynamic, processes involved in patient care. Its role is to generate, in real time, commands for the patient’s care (execution of tests, administration of drugs) from a plan, and to monitor the patient’s state so that it may propose actions updating the plan. The necessity of an explicit time representation is shown. We propose using a linear time structure towards the past, with precise and absolute dates, open towards the future, and with imprecise and relative dates. Temporal relative scales are introduced to facilitate knowledge representation and access.

397 Intra-tumor immunotherapy injections utilizing image guidance in interventional radiology: clinical trial experience at a tertiary care cancer center

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A422-A422
Author(s):  
Ravi Murthy ◽  
Rahul Sheth ◽  
Alda Tam ◽  
Sanjay Gupta ◽  
Vivek Subbiah ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Interventional Radiology ◽  
Real Time ◽  
Image Guidance ◽  
Tertiary Care ◽  
Cancer Center ◽  
Imaging Guidance ◽  
Image Guided ◽  
Real Time Image ◽  
Time Image

BackgroundImage guided intra-tumor administration of investigational immunotherapeutic agents represents an expanding field of interest. We present a retrospective review of the safety, feasibility & technical nuances of real-time image guidance for injection & biopsy across a spectrum of extracranial solid malignancies utilizing the discipline of Interventional Radiology.MethodsPatients who were enrolled in image guided intratumoral immunotherapy injection (ITITI) clinical trials over a 6 year period (2013–19) at a single tertiary care cancer center were included in this analysis. Malignancy, location, imaging guidance utilized for ITITI & biopsy for injected (adscopal) & non-injected (abscopal) lesions were determined and categorized. Peri-procedural adverse events were noted.Results262 pts (146 female, 61 yrs median) participating in 29 immunotherapeutic clinical trials (TLR & STING agonists, gene therapy, anti CD-40, viral/bacterial/metabolic oncolytics) met study criteria. Malignancies included melanoma 88, sarcoma 32, colorectal 29, breast 23, lung 17, head & neck 15, ovarian 8, neuroendocrine 7, pancreatic adenocarcinoma 6, 3 each (cholangioCA, endometrial, bladder, GI tract), 2 each (RCC, thymicCA, lymphoma, merkel cell, prostate) & others 1 each (CUP, GIST, dermatofibrosarcoma, DSRT, neuroblastoma, thyroid). All 169 & 93 patients received the intended 1371 ITITI in parietal (abdominal/chest wall, extremity, neck, pelvis) or visceral (liver, lung, peritoneum, adrenal) locations respectively; 83 patients received lymph node injections within either location. Imaging guidance was US in 68% of the cohort (US 161, CT+US 19); CT was used in 30% (81) & MRI in 1 patient. Median diameter of the ITITI lesion was 32 mm (8–230 mm). Median volume of the ITITI therapeutic material/session was 2 ml (1–6.9 ml). Lesions were accessed using a coaxial technique. ITITI delivery needles used at operator preference & tailored to lesion characteristics were either a 21G/22G Chiba, 21G Profusion (Cook Medical), 22G Morrison (AprioMed), 25G hypodermic (BD) & 18G Quadrafuse (Rex Medical). 2840 core biopsies (>18G Tru-cut core, Mission, Bard Medical) were performed in 237 patients during 690 procedures; biopsy sessions were often concurrent & of the ITITI site. 137 patients also underwent biopsy of a non-ITITI site (89 parietal location). Dimensions of the non-ITITI lesion were median 10 mm (7–113 mm); US image guidance was used in 97 patients (72%) to obtain a total of 1257, >18G Tru-core samples. 1.3% of injections resulted in SAE (NCI CTC AE >3) and 0.5% of 4097 biopsies developed major complications (SIR Criteria); both categories were manageable.ConclusionsUtilizing real time image guidance, ITITI to the administration of a myriad of investigational immunotherapeutic agents with concomitant biopsy procedures to date are associated with a high technical success rate & favorable safety profile.AcknowledgementsJoshua Hein, Mara Castaneda, Jyotsna Pera, Yunfang Jiang,Shuang Liu, Holly Liu and Anna LuiTrial RegistrationN/AEthics ApprovalThe study was approved by Institution’s Ethics Board, approval number 2020-0536: A retrospective study to determine the safety, feasibility and technical challenges of real-time image guidance for intra-tumor injection and biopsy across multiple solid tumors.Consent2020-0536 Waiver of Informed ConsentReferenceSheth RA, Murthy R, Hong DS, et al. Assessment of image-guided intratumoral delivery of immunotherapeutics in patients with cancer. JAMA Netw Open 2020;3(7):e207911. doi:10.1001/jamanetworkopen.2020.7911

scholarly journals Transient ICD malfunctions during oncologic radiotherapy: a multi-centre, randomized, in-vitro study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Di Girolamo ◽  
M Appignani ◽  
N Furia ◽  
M Marini ◽  
P De Filippo ◽  
...  
Keyword(s):  
Real Time ◽  
Treatment Plan ◽  
Low Energy ◽  
In Vivo Dosimetry ◽  
Implantable Cardioverter Defibrillators ◽  
Shock Delivery ◽  
Transient Electromagnetic ◽  
Direct Exposure

Abstract Background Direct exposure of implantable cardioverter-defibrillators (ICDs) during radiotherapy is still considered potentially harmful, or even unsafe, by manufacturers and current recommendations. The effects of photon beams on ICDs are unpredictable, depending on multiple factors, and malfunctions may present during exposure. Purpose To evaluate transient ICD malfunctions by direct exposure to doses up to 10 Gy during low-energy RT, forty-three contemporary wireless-enabled ICDs, with at least 4 months to elective replacement indicator (ERI) were evaluated in a real-time in-vitro session in three different centres. Methods All ICDs had baseline interrogation. Single chamber devices were programmed to the VVI/40 mode and dual or triple chamber devices were programmed to the DDD/40 mode. Rate response function and antitachycardia therapies were disabled, with the ventricular tachycardia (VT)/ventricular fibrillation (VF) detection windows still active. A centring computed tomography was performed to build the corresponding treatment plan and the ICDs were blinded randomized to receive either 2-, 5- or 10-Gy exposure by a low photon-energy linear accelerator (6MV) in a homemade water phantom (600 MU/min). The effective dose received by the ICDs was randomly assessed by an in-vivo dosimetry. During radiotherapy, the ICDs were observed in a real-time session using manufacturer specific programmer, and device function (pacing, sensing, programmed parameters, arrhythmia detections) was recorder by the video camera in the bunker throughout the entire photon exposure. All ICDs had an interrogation session immediately after exposure. Results During radiotherapy course, almost all ICDs (93%) recorded major or minor transient electromagnetic interferences. On detail, sixteen ICDs (37.2%) reported atrial and/or ventricular oversensing, with base-rate-pacing inhibition and VT/VF detection. Twenty-four ICDs (55.8%) recorded non clinically relevant noise, and no detections were observed. Only three ICDs (7%) reported neither transient malfunction nor minor noise, withstanding direct radiation exposure. At immediate post-exposure interrogation, the ICDs that recorded major real-time malfunctions had VT/VF detections stored in the device memory. In none of the ICDs spontaneous changes in parameter settings were reported. Malfunctions occurred regardless of either 2-, 5- or 10-Gy photon beam exposure. Conclusions Transient electromagnetic interferences were observed in most of the contemporary ICDs during radiotherapy course, regardless of photon dose. To avoid potentially life-threatening ICD malfunctions such as pacing inhibition or inappropriate shock delivery, magnet application on the pocket site or ICD reprogramming to the asynchronous mode are still suggested in ICD patients ongoing even low energy radiotherapy exposure. Funding Acknowledgement Type of funding source: None

Real-time motion tracking in image-guided oral implantology

2008 ◽  
Vol 4 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Xiaojun Chen ◽  
Yanping Lin ◽  
Yiqun Wu ◽  
Chengtao Wang
Keyword(s):  
Real Time ◽  
Motion Tracking ◽  
Image Guided ◽  
Time Motion ◽  
Oral Implantology
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