bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of adverse reactions to injections of Chinese materia medica
Authors: Bian Zhaoxiang , Shang Hongcai , Cheng Chungwah , Wu Taixiang , Li Youping , Zhang Boli 
Published: April 2010

AbstractUsing Chinese Materia Medica (CM) as injections is an innovation that is proving effective in extensive clinical use in Mainland China. However, recent reports have focused on adverse reactions, ignoring the considerable successes of these preparations. In order to achieve balance in the media and in the minds of the public, we suggest the first step is to clarify the concepts of and differences between adverse drug reactions (ADR) and adverse events (AE) for all concerned—the public, medical practitioners, government officials, and lawmakers. Second, the State Food and Drug Administration should raise the requirements for Chinese Materia Medica Injection (CMI) registration and license approval and emphasize the importance of evidence‐based CMI development and evidence‐based CMI license approval. Thirdly, drug companies and institutions should reinforce basic research about the quality control of herbs and CMI‐drug interactions. Fourth, the Government should clarify the legal responsibilities for CMI approval agencies, CMI developers, medical doctors, and patients. Fifth, the medical association and Government should enhance training for health care professionals concerning the usage of CMIs. And finally sixth, State Food and Drug Administration should monitor the content and quality of the directions for use of CMI.
SU‐DD‐A1‐05: Study of VMAT Plan QA Using Film, Diode Based, and Ion Chamber Based QA Systems
Authors: Cao D , Chen F , Rao M , Afghan M , Ye J , Shepard D 
Published: April 2010

Purpose: With the commercial introduction of delivery control systems for Volumetric Modulated Arc Therapy (VMAT), the need has arisen for reliable and efficient techniques for performing patient specific VMAT quality assurance (QA). In this work, we have studied three patient specific QA techniques for VMAT: ion chamber with film, 2D diode array, and a 2D ion chamber array. Materials and Methods: The three QA techniques we have utilized are: (1) a stack of solid water slabs with an inserted ion chamber and film sandwiched between two slabs; (2) a 2D diode array (MapCHECK™ device inserted into a MapPHAN™ phantom); and (3) a 2D ion chamber array (MatriXX™ inserted into a MULTICube™ Phantom). Ten VMAT plans were delivered to all three QA systems on an Elekta Synergy linac. Results: With the highest spatial resolution among all three systems, film measurements can provide very good QA results when analyzed in relative mode. Absolute dose comparisons were performed for both the MapCHECK™ and MatriXX™ systems. The average passing rate in gamma analysis were 95.0% and 98.5% using 3%/3mm criteria for the above two systems, respectively. The slightly lower passing rate for MapCHECK™ QA may be attributed to the angular and dose rate dependence of the diode response. It is also observed that the MapCHECK™ QA is more sensitive to the tongue‐&‐groove effect when diodes fall between two leaves. The MatriXX™ system provides slightly higher QA passing rates. However it may be less sensitive to large dose variation within small regions due to its 7.62mm detector grid size. Conclusions: All three systems can be used for VMAT plan QA provided users are attentive about the strengths and limitations of the QA device.Research sponsored by Elekta Corporation.
SU‐DD‐A3‐02: Quantification of Heterogeneous Tumor Blood Volume as Early Predictors for Treatment Outcome in Advanced Head‐And‐Neck Cancer
Authors: Wang P , Popovtzer A , Eisbruch A , Cao Y 
Published: April 2010

Purpose: To evaluate the predicting values of metrics that quantify poorly perfused tumor volumes in patients with advanced head‐and‐neck cancer (HNC) treated with chemo‐radiation therapy (chemo‐RT) for outcomes. Materials and Method: Dynamic contrast‐enhanced (DCE) MRI scans were acquired for thirteen patients treated with concomitant chemo‐RT for advanced HNC, before therapy and 2 weeks after start of therapy. Blood volume (BV) maps were computed from the DCE MRI. Fuzzy C‐means clustering analysis (FCM), a segmentation method for partitioning a dataset into multiple clusters by minimizing the intracluster distance among members, was utilized to analyze heterogeneous BV in primary tumor volumes. The pre‐treatment tumor BV (TBV) values from all patients were used as training data and partitioned into 2, 3, or 4 clusters using FCM; and the resulting prototype vectors were adopted to partition each individual TBV before and during therapy. The volumes of the clusters with the lowest BV values were tested for their associations with treatment outcome. In addition, the cut‐off BV values for the lowest 1 cc, 2 cc, or 5 cc primary tumor sub‐volumes were calculated at both time points; and their predicting values for treatment outcome were evaluated. Results: Four of the 13 patients had local failure. Eight metrics differentiate local failure vs. local control significantly: pre‐treatment cut‐off TBV for the lowest 5 cc (p=0.03); average cut‐off TBVs of the lowest 2 cc (p=0.01) or 5 cc (p=0.04) over pre‐ and during‐ treatment; the volumes of the lowest TBV cluster at pre‐treatment (p=0.02), during‐treatment (p⩽0.03), as well as the average value over pre‐ and during‐ treatment (p⩽0.03). Conclusion: Our results suggest that poorly perfused sub‐volumes of the tumor before and/or early after start of treatment differentiate local failure vs. local control. The metrics discovered here will be candidates for future larger studies.Supported by NIHP01CA59827.
SU‐EE‐A1‐05: Dosimetric Evalualtion of a Commercial Compensator for Spatially Fractionated Radiation Therapy
Authors: Stathakis S , Buckey C , Gutiérrez A , Mavroidis P , Esquivel C , Shi C , Mihailidis D , Papanikolaou N 
Published: April 2010

Purpose: Spatially fractionated GRID therapy is utilized to treat large tumors by irradiating the volume through isolated small openings. The technique has shown high efficacy for bulky tumors, but it is used at relatively few facilities. In this study, we exploit the use of a prototype brass GRID, which could make GRID therapy more attractive to physicians and more widely available to patients. Method and Materials: A prototype GRID compensator was constructed by milling divergent holes of 1 cm diameter at the isocenter in a cube of brass. The GRID block is manufactured so that it can irradiate a maximum field size of 25×25cm2. Measurements for the characterization of the dosimetric properties of the GRID were performed using a Varian 23Ex linac, in a solid water phantom at 100cm SSD, for both 6MV and 18MV. Radiographic films were placed perpendicular to the beam axis to obtain lateral profiles, and parallel to the beam axis to find the percent depth doses (PDDs). A pinpoint ion chamber under the central hole was used to find the output factors. Results: The profiles have an obvious peak and valley pattern, with transmissions under the solid portion of the block of approximately 15% for 6MV and 30% for 18MV. The PDDs are less penetrating than their open‐field counterparts, for both 6MV and 18MV when compared against the 10×10cm2 open field. Conclusion: This prototype brass GRID compensator is a viable alternative to the cerrobend compensators or MLC‐based fields currently in use. Its ease of creation and use give it decided advantages. We believe this compensator can be put to clinical use, and will allow more centers to offer GRID therapy to their patients.Research sponsored by .decimal corporation.
SU‐EE‐A3‐05: Mutual Information for Beams‐Eye‐View Lung Tumor Tracking Without Radiopaque Markers
Authors: Rottmann J , Aristophanous M , Park S , Berbeco R 
Published: April 2010

Purpose: To keep safety margins in lung stereotactic body radiation therapy (SBRT) small and provide retrospective calculation of the delivered dose, the tumor motion should be monitored. We propose a tumor tracking algorithm that can estimate the tumor location from portal images taken during the treatment without the help of fiducial markers. Method and Materials: An algorithm based on a normalized mutual information technique was developed for tumor tracking. First a tumor template and a search region are identified on a DRR set reconstructed from a 4DCT acquired prior to the treatment. The set consists of 10 images relating to 10 equally sized breathing phase bins. The template is then used to track the tumor over the sequence of portal images. To estimate the tracking precision a dynamic thorax phantom was employed. Results: The phantom study showed a sub millimeter tracking accuracy in the superior‐ inferior direction for anterior‐posterior and lateral fields. In a preliminary retrospective patient study the algorithm was able to track the tumor motion throughout the whole image sequence. Manual verification yielded a tracking magnitude error of xy = (3.4 ± 0.8) mm. Furthermore the algorithm's robustness was tested with portal image sequences from two other patients with different tumor motion amplitude and contrast. The accuaracy was estimated by comparison with manual tracking and yielded xy = (1.7 ± 1.9) mm and xy = (1.2 ± 0.8) mm, respectively. Conclusion: The algorithm has shown great potential for markerless lung tumor tracking. First test results showed that it can perform tumor tracking on portal images and DRRs even if the tracking template was defined in the other modality respectively.Conflict of Interest: Varian Medical Systems, Inc.
SU‐FF‐I‐48: Optimization of Image Acquisition Parameters for Patient Setup Using Megavoltage Cone‐Beam Digital Tomosynthesis
Authors: Descovich M , Kanner M , Morin O , Faddegon B , Cheung J , Sawkey D , Aubin M , Maltz J , Bani‐Hashemi A , Pouliot J 
Published: April 2010

Purpose/Objective(s): Digital Tomosynthesis (DT) is an imaging technique for reconstructing multiple tomograms from 2D projections acquired over a limited gantry arc (20°–40°). This study evaluates the use of megavoltage cone‐beam (MVCB) DT images acquired with a high contrast imaging beam line for patient setup. The objective is to determine the optimal parameters (gantry arc, imaging dose) resulting in the least dose to normal tissue while maximizing the positioning accuracy, as compared with MVCBCT. Method and Materials: Coronal and sagittal DT tomograms of prostate (3), head and neck (2), spine (2) and lung (2) patients were reconstructed from a limited subset of projection data, and registered to the planning‐CT. The translational shifts required for patient alignment were calculated and compared with those provided by MVCBCT‐CT registration. The registration was guided by gold markers for prostate patients, bony landmark for head and neck and spine patients, bones and air cavities for lung patients. Online DT images were acquired on an anthropomorphic female thorax phantom to evaluate the applicability of DT imaging to breast patient setup. The imaging dose was measured with thermoluminescent dosimeters on the ipsilateral and contralateral breast. The measurements were compared with dose calculations. Results: DT provides positioning accuracy comparable to CBCT, with positioning difference of ⩽0.1 cm for prostate patients and ⩽0.3 cm for the other sites. Forty degrees arc DT provides the best alignment precision. Phantom studies show that DT images acquired with doses as low as 0.3 cGy are suitable for patient alignment, and the dose to the contralateral breast is negligible. Conclusion: DT is a viable alternative to CBCT for patient setup. Due to the low imaging dose and the sparing of the contralateral breast, DT has potential in breast patient setup.Conflict of Interest: Research sponsored by Siemens OCS.
SU‐FF‐I‐52: Comprehensive CT Dosimetry Database for Pediatric and Adult Reference Males and Females: A Monte Carlo Study
Authors: Lee C , Kim K , Bolch W 
Published: April 2010

Purpose: To establish an organ dose database for pediatric and adult male and female reference individuals undergoing computed tomography (CT) examinations and to develop software providing the dose information within a graphical user interface (GUI). Methods and Material: A series of hybrid computational human phantoms was developed at the University of Florida by using realistic patient CT images and flexible Non‐Uniform Rational B‐Spline (NURBS) surfaces. The phantoms include newborn, 1, 5, 10, 15, and adult male and female matched to the four reference data: reference organ mass from ICRP Publication 89, anthropometric data from CDC, tissue composition from ICRU Report 46, and intestine models of ICRP Publication 100. The 12 reference phantoms were ported into MCNPX2.5 code where helical fan beams from SOMATOM Sensation 16 helical multi‐slice CT scanner were modeled. Organ absorbed doses were calculated for Head, Chest, Abdomen, Pelvis, CAP examinations. Software was developed to provide the dosimetry database with GUI. The scanner matching algorithm was employed from the commercial software CT‐EXPO to take different scanner parameters from different scanner models into account. Results: Normalized values of organ absorbed dose (mGy/100 mAs) were calculated for 25 organs in the 12 phantoms undergoing CT examinations were calculated. The comprehensive CT dose database was incorporated into GUI‐supported software to provide realistic and consistent dosimetry information to end‐user. The dose results were compared with those from CT‐EXPO and significant differences were shown in major organ absorbed doses which were mainly caused by the anatomical difference between UF hybrid phantoms and limited stylized and old voxel phantoms in CT‐EXPO. Conclusion: The software developed in this study significantly improved accuracy and consistency of organ dose assessments in CT examinations which have not been implemented in a couple of previous CT dose evaluation software.This work is funded by the NCI Radiation Epidemiology Branch
SU‐FF‐I‐94: Study of Image Registration Methods Based On the Pelvic Bone and Its Contour for Prostate Cancer Treatment
Authors: Qi P 
Published: April 2010

Purpose: Because of different imaging contrasts in the MVCBCT and the planning CT, image registration between the two modalities may introduce additional uncertainties in image guided radiotherapy (IGRT). For a group of ten prostate patients concurrently treated with the pelvic lymph nodes, we compared two alignment methods: one directly aligns the pelvic bone from the MVCBCT to that of the planning CT; the other aligns the pelvic bone from the MVCBCT to the contour of the pelvic bone from the planning CT. Method and Materials: On the first day of treatment, the treatment positions for all patients were verified with an extended field of view (FOV) MVCBCT to include the entire pelvic bone. Subsequently, the reduced FOV‐MVCBCT was used daily to localize the prostate with implanted markers. Only the FOV‐MVCBCT was used to identify uncertainties in patient positioning. For each patient, the MVCBCT was manually registered with the two alignment methods. Each alignment method was repeated three times by a single observer in three separate times. Results: For each patient, the difference of mean shift along the left‐right (X), anterior‐posterior (Y), and inferior‐posterior (Z) directions was small between two alignment methods. The mean standard deviation of 10 patient measurements for the contour based and bone based registration were 0.6 mm vs. 0.7 mm, 1.2 mm vs. 1.2 mm, and 0.6 mm vs. 1.6 mm along the X, Y, and Z directions, respectively. Particularly, more large deviations (> 2mm), 4 out of 10 patients, were observed in the Z direction with the bone based registration method. Conclusion: The contour based image registration method achieved more consistent measurement than the bone based registration in verification of the treatment position for prostate patients concurrently treated with pelvic lymph nodes.Research is supported by Siemens Corporation.
SU‐FF‐I‐133: Assessing the Magnetic Resonance Imaging Performance of Gadolinium‐Hyaluronic Acid Polymer Contrast Agents in Phosphate Buffered Saline
Authors: Kasraie Nima , Clarke G , Oviatt H 
Published: April 2010

The aim was to investigate HA as a potential contrast agent for first‐pass myocardial perfusion imaging*, and to assess the imaging performance of gadolinium‐hyaluronic acid (HA) polymer complexes from HA‐ligand constructs by determining the proton longitudinal relaxivities and accurate relaxation rates in saline solutions at 10.72 MHz. Imaging of same solutions in well defined dialysis tubing at 3T using a constructed phantom was then used to measure the rate of diffusion to determine if the Gd‐complex polymer conjugate would have a sufficiently large hydrodynamic size to prevent immediate perfusion through vascular wall‐like conditions to account for leaks from the intravascular to interstitial space.Samples denoted as HW02‐18 Sample A and HW02‐18 Sample B were successfully prepared by coupling an amine functionalized DTPA with HA via EDC/NHS coupling methods. These produced the highest relaxation rates and relaxivities at 10.72 MHz compared to the other preparation methods. Twenty four hours post‐injection, Gadodiamide showed a signal to noise ratio of unity, while HW‐147 continued to retain some degree of contrast relative to the background. The slope of the logarithmic fit corresponding to HW01‐147 was estimated at −0.006 compared to −0.01 of Gadodiamide, a much steeper drop indicating smaller molecular size and faster perfusion rate across the dialysis membranes. This is demonstrative of the Gd ion's relative freedom to influence the R1 of extracellular water molecules, while the molecular size of the Gd‐polymer complex has a molecular radius that is sufficiently large to prevent vascular‐like perfusion. This is a necessary prerequisite for HA bound Gd as a contrast agent for first‐pass myocardial perfusion imaging.
SU‐FF‐I‐170: Control, Acquisition, Processing, and Image Display System (CAPIDS) for the Solid‐State X‐Ray Image Intensifier (SSXII)
Authors: Wang Weiyuan , Keleshis C , Kuhls‐Gilcrist A , Ionita C , Bednarek D , Hoffmann K , Rudin S 
Published: April 2010

Purpose: A new control, acquisition, processing, and image display system (CAPIDS) for the Solid‐State X‐Ray Image Intensifier (SSXII) was developed and implemented using Laboratory Virtual Instrumentation Engineering Workbench (LabVIEW). Method and Materials: The SSXII is an EMCCD‐based x‐ray detector that was designed to satisfy the high‐resolution and real‐time needs of neurovascular imaging. The SSXII includes a CsI(Tl) scintillator and a fiber‐optic taper (FOT) coupled to an EMCCD camera with fiber‐optic input window. The SSXII can be mounted on and used with a clinical fluoroscopic c‐arm unit (Toshiba Infinix). The new CAPIDS provides controls for several radiographic imaging modes including: fluoroscopy, roadmapping, radiography, and digital‐subtraction‐angiography (DSA). Complete functionality of the SSXII is also provided in research mode, including the ability to modify the detector‐element binning, exposure time, video gain, and electron‐multiplying gain of the camera. A camera control‐panel window can be accessed using a keyboard shortcut; this window shows the status parameters of the camera and allows control for all functions. Status words are saved to a text file for reference by the system control program. Results: The CAPIDS provides a user‐friendly interface that allows control of several clinical radiographic imaging modes using the SSXII including: fluoroscopy, roadmapping, radiographic mode, and DSA. Examples of each mode will be demonstrated. Additional features, including recursive filtering, contrast enhancement, patient registry and image archival have been implemented and should facilitate the clinical use of the new EMCCD‐based detector system. Conclusion: The control, acquisition, and display capabilities along with the electron multiplication gain (1–2000×), high‐resolution, high‐sensitivity and real‐time imaging capabilities of the SSXII should provide angiographers and interventionalists with an improved ability to visualize details of small vessels and endovascular devices (such as stents), making diagnoses and image‐guided interventions more accurate.(Research partially supported by: NIH Grants R01‐EB008425, R01‐EB002873)
SU‐FF‐J‐17: Image‐Guided Radiotherapy Using Nanotube Stantionary Tomosynthesis Technology
Authors: Chang S , Frederick B , Liu X , Tracton G , Lawrence M , Lalush D , Pizer S 
Published: April 2010

Purpose: To develop image guidance approaches for clinical application of Nanotube Stationary Tomosynthesis (NST), a nanotechnology‐based online image‐guided radiotherapy (IGRT) technology that is capable of unprecedented temporal‐resolution and imaging speed. Method and Materials: NST is an accelerator gantry‐mounted multi‐source array kV imaging technology under development by Siemens. Using a single image panel, the patient can be imaged by 50 x‐ray sources on the array in the treatment volume within ∼ 2 sec before and even during treatment. However, translating the NST's imaging acquisition strengths into real clinical benefits requires significant software development including new image registration tools that take full advantage of the real‐time aspects of tomosynthesis imaging while minimizing its intrinsic resolution limitation. We propose a fast, versatile image registration approach that: integrates information from the large field‐of‐view projection images, the high‐temporal resolution tomosynthesis images, and the high spatial‐resolution planning 3D CT image; has tradeoffs to balance the user's needs of quality vs. speed; and potentially extracts a daily image deformation from NST tomosynthesis image for soft tissue based IGRT and treatment course dose accumulation. Results: We have developed the initial image registration approaches for clinical testing of the first protocol type NST IGRT system. In this presentation we will describe the proposed NST IGRT image registration approaches in lung and prostate treatments and discuss imaging dose and imaging dose reduction approaches. Other aspects of the NST technology including system design, NST reconstruction, image registration, and imaging geometry may be presented separately in the meeting. Conclusion: We have demonstrated that Nanotube Stationary Tomosynthesis technology has the potential to offer temporal resolution and imaging speed ‐ important features that have not been adequately addressed by the existing IGRT technology today.Conflict of Interest: This work is partially funded by a grant from Siemens Oncology Care System.