SGRT London 2021
Josh Naylor, Imaging Lead Principal Physicist, University Hospitals Dorset, UK
Deborah Branson, Technique Development Lead, University Hospitals Dorset, UK
CBCT acquires 3D volumetric image data using a cone-shaped x-ray beam and area detector that rotates around the patient. It involves x-ray generation, detection, and image reconstruction from projection data. Key factors influencing image quality and radiation dose include field of view, voxel size, number of projections, and exposure settings. Proper patient preparation and use of optimized protocols are important for clinical applications of CBCT imaging.
Multi-atlas based segmentation is an approach that requires little or no interaction from the user. It has been evaluated with high accuracy and consistent reproducibility in different anatomical structures. In this method, multiple atlases identify the location of one or more structures in the patient volume. The label volumes of the atlases are transformed taking the coordinate transformation obtained from image registration of each atlas to the target volume. A stochastic gradient descent optimisation is performed for the desired metric during the process. Since multiple structures are segmentation targets in the VISCERAL benchmark, a hierarchical selection of the registrations improves the segmentations of all the structures. A global affine registration is followed by individual affine registrations using a local binary mask to enforce the spatial correlation of each anatomical structure separately. These masks are obtained from the morphological dilation of the output labels of the different atlases registered in the previous step. The method is repeated for the non-rigid registration. The registrations of the bigger structures are used as a starting point for the closely related smaller structures, which are harder to segment. Most of the registrations of the initial
bigger structures (liver, lungs, urinary bladder) will be reused in the method which makes it faster than segmenting each structure individually from the start. Also the creation of regions-of-interest with the local masks speeds up the image registrations and improves the output estimations. The labels from the different atlases are fused using a per-voxel majority voting threshold in a single label volume that provides a final estimate location of the structures in the target volume. The images are downsampled in all but the final step to increase even more the speed of the algorithm. The method was tested with contrast-enhanced computed tomography images and 10 different anatomical structures: liver, spleen, kidneys, lungs, urinary bladder, trachea, lumbar vertebra and gallbladder. It can be then applied to any modality and any anatomical structure using a relatively small training set.
study and evaluate setup uncertainty in radiotherapyMajoVJJose
Image-Guided Radiotherapy (IGRT): Revolutionizing Precision in Cancer Treatment
Introduction
Image-Guided Radiotherapy (IGRT) represents a pivotal advancement in the field of cancer treatment, offering enhanced precision and accuracy in delivering radiation therapy. This approach integrates cutting-edge imaging technologies with radiotherapy, providing clinicians with real-time visualization of the tumor and surrounding tissues. By allowing for adjustments during treatment sessions, IGRT significantly improves the therapeutic ratio, optimizing tumor control while minimizing damage to healthy tissues. In this comprehensive exploration, we delve into the principles, techniques, clinical applications, challenges, and future prospects of Image-Guided Radiotherapy.
1. Principles of Image-Guided Radiotherapy
IGRT is grounded in the fundamental principle of incorporating imaging data to guide and refine the delivery of radiation therapy. The technique recognizes that the position and shape of a tumor can vary between treatment sessions due to factors such as organ motion, respiratory motion, and changes in anatomy. Therefore, IGRT aims to provide a dynamic and adaptive treatment approach that accommodates these variations.
2. Imaging Modalities in IGRT
Various imaging modalities play a crucial role in IGRT, enabling clinicians to visualize tumors and surrounding structures with high precision. X-ray imaging, including cone-beam computed tomography (CBCT), is commonly employed for its real-time imaging capabilities. Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) are also utilized, offering additional insights into soft tissue and metabolic activity, respectively. The choice of imaging modality depends on factors such as the tumor type, location, and the information needed for accurate treatment planning.
3. Integration of Imaging into Treatment Planning
One of the key aspects of IGRT is its integration into the treatment planning process. Imaging data obtained before or during treatment sessions is fused with the initial planning CT scans. This enables clinicians to precisely align the patient and target volumes, ensuring that radiation is delivered with maximal accuracy. Adaptive planning strategies may be employed to account for changes in anatomy and optimize treatment parameters dynamically.
4. Clinical Applications of IGRT
IGRT has found widespread applications across various cancer types, demonstrating its versatility and efficacy. In prostate cancer treatment, IGRT allows for precise targeting of the prostate, minimizing radiation exposure to neighboring critical structures. In lung cancer, where respiratory motion can impact accuracy, IGRT helps track tumor movement during breathing cycles. Head and neck cancers benefit from IGRT's ability to adapt to changes in patient anatomy, enhancing targeting accuracy. These examples underscore the broad spectrum of clinical scenarios where IGRT plays a crucial role in imp
This document discusses the basics of cone beam computed tomography (CBCT). It describes how CBCT units have evolved over time to become smaller and allow for upright patient positioning. CBCT provides 3D imaging through the use of a cone-shaped x-ray beam and reconstruction software. Key aspects of the imaging process discussed are the field of view, basis image capture during rotation, and reconstruction software. CBCT has numerous applications in dentistry for evaluation of dental and jaw structures.
SGRT can eliminate the need for tattoos and reduce setup time for SBRT lung cancer treatments compared to traditional tattoo-based localization. A study of 10 patients treated with SGRT and 10 with tattoos found that SGRT had smaller average post-match shifts (0.25-0.34 cm vs 0.50-0.60 cm) and shorter average setup time (7 minutes vs 10 minutes). SGRT provides more accurate localization than tattoos and is more efficient by reducing time spent on patient setup and localization.
This document discusses advances in technical aspects of deep brain stimulation surgery. It covers developments in preoperative imaging including optimized MRI sequences, stereotactic frames such as the STarFix and NexFrame systems, stereotactic atlases, planning software, and intraoperative techniques like microelectrode recordings and the use of robotics. Precise targeting and lead placement have been improved through these technical innovations.
The document discusses the Global Positioning System (GPS). It describes GPS as a satellite-based navigation system that provides location and time information anywhere on Earth. The three segments of GPS are: 1) the space segment of satellites, 2) the control segment of ground stations that monitor the satellites, and 3) the user segment of GPS receivers. GPS has many applications including navigation, tracking, mapping, and timing. It provides advantages such as accuracy, global coverage, and no subscription fees.
CBCT acquires 3D volumetric image data using a cone-shaped x-ray beam and area detector that rotates around the patient. It involves x-ray generation, detection, and image reconstruction from projection data. Key factors influencing image quality and radiation dose include field of view, voxel size, number of projections, and exposure settings. Proper patient preparation and use of optimized protocols are important for clinical applications of CBCT imaging.
Multi-atlas based segmentation is an approach that requires little or no interaction from the user. It has been evaluated with high accuracy and consistent reproducibility in different anatomical structures. In this method, multiple atlases identify the location of one or more structures in the patient volume. The label volumes of the atlases are transformed taking the coordinate transformation obtained from image registration of each atlas to the target volume. A stochastic gradient descent optimisation is performed for the desired metric during the process. Since multiple structures are segmentation targets in the VISCERAL benchmark, a hierarchical selection of the registrations improves the segmentations of all the structures. A global affine registration is followed by individual affine registrations using a local binary mask to enforce the spatial correlation of each anatomical structure separately. These masks are obtained from the morphological dilation of the output labels of the different atlases registered in the previous step. The method is repeated for the non-rigid registration. The registrations of the bigger structures are used as a starting point for the closely related smaller structures, which are harder to segment. Most of the registrations of the initial
bigger structures (liver, lungs, urinary bladder) will be reused in the method which makes it faster than segmenting each structure individually from the start. Also the creation of regions-of-interest with the local masks speeds up the image registrations and improves the output estimations. The labels from the different atlases are fused using a per-voxel majority voting threshold in a single label volume that provides a final estimate location of the structures in the target volume. The images are downsampled in all but the final step to increase even more the speed of the algorithm. The method was tested with contrast-enhanced computed tomography images and 10 different anatomical structures: liver, spleen, kidneys, lungs, urinary bladder, trachea, lumbar vertebra and gallbladder. It can be then applied to any modality and any anatomical structure using a relatively small training set.
study and evaluate setup uncertainty in radiotherapyMajoVJJose
Image-Guided Radiotherapy (IGRT): Revolutionizing Precision in Cancer Treatment
Introduction
Image-Guided Radiotherapy (IGRT) represents a pivotal advancement in the field of cancer treatment, offering enhanced precision and accuracy in delivering radiation therapy. This approach integrates cutting-edge imaging technologies with radiotherapy, providing clinicians with real-time visualization of the tumor and surrounding tissues. By allowing for adjustments during treatment sessions, IGRT significantly improves the therapeutic ratio, optimizing tumor control while minimizing damage to healthy tissues. In this comprehensive exploration, we delve into the principles, techniques, clinical applications, challenges, and future prospects of Image-Guided Radiotherapy.
1. Principles of Image-Guided Radiotherapy
IGRT is grounded in the fundamental principle of incorporating imaging data to guide and refine the delivery of radiation therapy. The technique recognizes that the position and shape of a tumor can vary between treatment sessions due to factors such as organ motion, respiratory motion, and changes in anatomy. Therefore, IGRT aims to provide a dynamic and adaptive treatment approach that accommodates these variations.
2. Imaging Modalities in IGRT
Various imaging modalities play a crucial role in IGRT, enabling clinicians to visualize tumors and surrounding structures with high precision. X-ray imaging, including cone-beam computed tomography (CBCT), is commonly employed for its real-time imaging capabilities. Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) are also utilized, offering additional insights into soft tissue and metabolic activity, respectively. The choice of imaging modality depends on factors such as the tumor type, location, and the information needed for accurate treatment planning.
3. Integration of Imaging into Treatment Planning
One of the key aspects of IGRT is its integration into the treatment planning process. Imaging data obtained before or during treatment sessions is fused with the initial planning CT scans. This enables clinicians to precisely align the patient and target volumes, ensuring that radiation is delivered with maximal accuracy. Adaptive planning strategies may be employed to account for changes in anatomy and optimize treatment parameters dynamically.
4. Clinical Applications of IGRT
IGRT has found widespread applications across various cancer types, demonstrating its versatility and efficacy. In prostate cancer treatment, IGRT allows for precise targeting of the prostate, minimizing radiation exposure to neighboring critical structures. In lung cancer, where respiratory motion can impact accuracy, IGRT helps track tumor movement during breathing cycles. Head and neck cancers benefit from IGRT's ability to adapt to changes in patient anatomy, enhancing targeting accuracy. These examples underscore the broad spectrum of clinical scenarios where IGRT plays a crucial role in imp
This document discusses the basics of cone beam computed tomography (CBCT). It describes how CBCT units have evolved over time to become smaller and allow for upright patient positioning. CBCT provides 3D imaging through the use of a cone-shaped x-ray beam and reconstruction software. Key aspects of the imaging process discussed are the field of view, basis image capture during rotation, and reconstruction software. CBCT has numerous applications in dentistry for evaluation of dental and jaw structures.
SGRT can eliminate the need for tattoos and reduce setup time for SBRT lung cancer treatments compared to traditional tattoo-based localization. A study of 10 patients treated with SGRT and 10 with tattoos found that SGRT had smaller average post-match shifts (0.25-0.34 cm vs 0.50-0.60 cm) and shorter average setup time (7 minutes vs 10 minutes). SGRT provides more accurate localization than tattoos and is more efficient by reducing time spent on patient setup and localization.
This document discusses advances in technical aspects of deep brain stimulation surgery. It covers developments in preoperative imaging including optimized MRI sequences, stereotactic frames such as the STarFix and NexFrame systems, stereotactic atlases, planning software, and intraoperative techniques like microelectrode recordings and the use of robotics. Precise targeting and lead placement have been improved through these technical innovations.
The document discusses the Global Positioning System (GPS). It describes GPS as a satellite-based navigation system that provides location and time information anywhere on Earth. The three segments of GPS are: 1) the space segment of satellites, 2) the control segment of ground stations that monitor the satellites, and 3) the user segment of GPS receivers. GPS has many applications including navigation, tracking, mapping, and timing. It provides advantages such as accuracy, global coverage, and no subscription fees.
Clinical implementation of Surface Guided Radiotherapy (SGRT) for palliative ...SGRT Community
Jack Hannant
Senior Radiographer
The Christie at Oldham NHS Foundation Trust
UK
Helen Squibbs
Superintendent Radiographer
The Christie at Oldham NHS Foundation Trust
UK
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Clinical implementation of Surface Guided Radiotherapy (SGRT) for palliative ...SGRT Community
Jack Hannant
Senior Radiographer
The Christie at Oldham NHS Foundation Trust
UK
Helen Squibbs
Superintendent Radiographer
The Christie at Oldham NHS Foundation Trust
UK
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
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• Evidence-based strategies to address health misinformation effectively
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• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Bringing SGRT to Every NHS patient, Every Fraction in Rural Dorset
1. Bringing SGRT to every NHS patient,
every fraction - in rural Dorset…
Josh Naylor (Principal Physicist)
Debbie Branson (Technique Development Radiographer)
25. Thanks!
• All radiotherapy staff involved in the
commissioning and routine service
• Robert White legacy fund / UHD for
funding
• Ben Waghorn for patient pathway slide
• Siobhan Gorman for data analysis
Contact for questions: joshua.naylor@uhd.nhs.uk