Dattoli Cancer Center

Getting treatment planning systems to work faster and adding AI

Published on:09/19/2022

AI is a powerful tool that helps doctors find better ways to treat patients and make more accurate diagnoses. It can access and match millions of diagnostic resources and add to a doctor's knowledge of how to treat patients. Because of this, it could mean less need for doctors. But there are a lot of problems that come with using AI in health care.

AI is being used increasingly, but there are still some problems. Organizations need to reach digital maturity to deal with these problems. This means making sure there is good data management and governance. Also, they have to use modern software development methods like Agile and DevOps. The "last mile" problem is also a big problem from a scale point of view. To solve this problem, organizations should think about taking a few key steps to make AI as easy to use as possible.

Most likely, the first companies to use AI will be big ones with a lot of digital experience. Most likely, these companies will be able to use the data, digital skills, and technical skills they already have. Most likely, the industries that invest in AI will grow the fastest.

AI is a helpful tool in radiotherapy, and putting it to use in this area can help patients do better. A recent study published in Medical Physics shows how AI can quickly and accurately recalculate radiation doses based on how a patient's body is built. Recalculating with traditional methods can take up to ten minutes, but AI can come up with the best plan in as little as five minutes.

AI is still in its early stages of being used in radiation therapy, but it can improve the accuracy, personalization, and speed of treatments. But there are still a lot of problems to solve before this technology is widely used. One of the biggest problems is teaching AI to do complicated tasks and making sure it works well in clinical settings. AI has a lot of potential uses in radiotherapy, and the industry needs to keep looking into them.

When smaller companies put in place treatment planning systems, they have to deal with a number of problems. They must not only figure out how to use a new system but also how to keep quality standards high. The EPA recently gave 30 small companies a total of $3,089,894 to help them come up with new technologies. These include systems that automatically sort trash at the point of disposal, a way to find and kill viruses and bacteria in the air and a way to keep track of methane emissions and concentrations.

Clinical decision support systems (CDSS) that help doctors make decisions have been around for 40 years. But the way these systems have been used in the real world has been a mixed bag. One thing that has increased interest in AI is that doctors are learning more about it. This should make it easier to add AI to clinical workflows.

For example, AI can help doctors find more accurate ways to treat cancer than ever before. AI can help experts learn more about how tumors work and make predictions about how well new drugs might work. AI can also help find cancer by looking for changes in how a person's body works.

But there are several problems that need to be fixed before AI can be helpfully used in medicine. For example, it is still tough to find gene mutations in cancer patients using noninvasive methods. But the NCI recently helped a team of experts from different fields develops a way to use MRI images to find IDH mutations in gliomas. In the future, it might be easier to find gene mutations if AI keeps getting better.

Researchers are looking into how AI can help find and treat cancer by recognizing specific gene mutations in tumors. AI can be taught to find these mutations in tumor images, and some researchers are using the technology to develop ways that don't involve surgery.

AI has many uses in healthcare, from improving workflows to developing new treatments and therapies. AI can also help predict whether a patient will need to go to the hospital and find cancer early. The report discusses some of these possible uses and some of the problems and opportunities healthcare providers need to consider when using AI in healthcare.

AI-based treatment planning systems can better use genomic data to help doctors develop new ways to treat cancer quickly. Doctors can't tell how likely a disease is to happen by looking at molecular phenotypes, but AI can find these traits and use them to make personalized treatments for patients.

The Future of Bladder Cancer Radiation Therapy

Published on: 09-06-2022

Future research will look at possible tumor markers such as MRE11, a protein that plays an important role in the cellular response to radiation-induced DNA damage. These findings might aid doctors in developing techniques to maintain the bladder following radiation therapy. This will be especially beneficial for patients because bladder removal can have serious effects on the patient's life.

For IMRT therapy of bladder cancer, the target volume was a CTV that included the tumor and bladder wall, as well as vascular systems in the pelvis and obturator lymph nodes. Non-isotropic margins are characterized as such. For the initial phase of treatment, the clinical target volume was roughly 15 cm centered around the tumor. A multileaf collimator was then used to sculpt the treatment field.

During therapy, the bladder volume altered considerably. This was critical for researchers attempting to assess if IMRT might minimize the amount of traditional chemoradiation. In their research, CRT or IMRT was used to treat 116 individuals with muscle-invasive bladder cancer. Patients were reviewed by phone after therapy.

Radiation therapy is a medical method used to treat cancer. Radiation treatment kills cancer cells by using high-energy x-rays or other particles. Several treatments are normally scheduled over a set length of time. Treatment is frequently administered before or following surgery. The objective of therapy is to keep cancer from coming back or spreading.

The research enrolled 270 people. There were 28 individuals with upper tract tumors and 232 with lower tract tumors. 61 of these patients have previously had TC or nephroureterectomy.

Patients with advanced bladder cancer may benefit from intravenous chemotherapy. It entails inserting a medicinal medication directly into the bladder through a catheter. For a few weeks, the therapy might be administered once or numerous times each week. The bladder will need to be emptied following the procedure.

Treatment for bladder cancer often includes a combination of therapies, including chemotherapy. Intravesical treatments are frequently used for up to six weeks. Patients may require further booster treatments, such as immunotherapy or BCG, as well as maintenance therapy after the first treatment. If the cancer extends beyond the bladder, surgery is advised.

Intravesical chemotherapy is often administered as an outpatient treatment, but it can be administered as part of a surgical operation. Patients are often encouraged to empty their bladders prior to the procedure to prevent foreign objects from being lodged in the bladder. Once the bladder is empty, the healthcare expert will place a sterile catheter into the urethra (the tube that connects the bladder to the rest of the body) and inject the drugs. During the operation, male patients may get an erection out of reflex. This can be stopped by taking deep breaths or thinking about something else.

In bladder cancer, MRI tumor characterization can assist the doctor in making an accurate diagnosis. It employs a variety of imaging methods, including T2-weighted spin-echo sequences and diffusion-tensor imaging (DCE). The initial step will be for the doctor to examine the MRI tumor signal. The doctor can use this to identify the tumor's size, shape, and configuration.

MRI is a useful tool for tumor definition, but it is not a substitute for other diagnostic procedures. Transurethral resection biopsy, for example, is still the most precise approach to identify the extent of the tumor. In addition to MRI, other diagnostic techniques such as CT urography and cystoscopy may be utilized to diagnose malignancy in addition to MRI.

An MRI of the bladder reveals a polypoid tumor in the left trigone. On T2-weighted SE, this mass shows a hypo signal, with the trigone wall and surrounding fat space disturbed. This shows a tumor that has infiltrated the muscles and fat but not the ureter.

Patients with bladder cancer may benefit from partial bladder irradiation. The radiation dose is reduced, and the tumor margins can be protected. Furthermore, image-guided radiation decreases toxicity and accidental amounts of radiation to nodes. This technique is not good for all patients, though, because there is no proof that it improves survival or local control.

Patients with bladder cancer might get chemotherapy in addition to radiation treatment. These medications are frequently administered through an IV or tablet. Because the medications travel via the circulation, they have the potential to destroy cancer cells outside of the bladder. They appear in cycles, and the therapy might last for several months.

Consequences of Radiation Therapy

Published On: 08-22-2022

A physician may recommend a cancer patient radiation. However, there are associated hazards. For example, you may encounter adverse effects such as neurocognitive dysfunction generated by radiation or an increased risk of swallowing issues. Therefore, your oncologist will plan your radiation treatment using the information acquired during the diagnostic process. Additionally, they may order additional tests to establish the size, location, and body area to be treated. Finally, the oncologist will determine the required total dose and number of different treatments.
Even though radiation is a known and safe treatment, side effects may arise. The severity of these adverse effects depends on the individual's overall health. Possible early side effects include skin changes and tiredness. Additionally, patients may develop hair loss. Occasionally, rectum bleeding can occur. Long after therapy has been completed, adverse effects may manifest. Patients should consult their physician regarding adverse effects and strategies to mitigate them in such instances.
The adverse effects of radiation differ amongst patients and are often transitory. Some adverse effects subside within a few weeks of treatment, although others may last for months or even years. Before therapy begins, the patient will be provided information on the long-term effects before therapy begins. Additionally, the treatment may produce skin irritation or fatigue in the treated area. However, the long-term results will vary depending on the type of cancer removed.
After receiving radiation, patients displayed global and domain-specific neurocognitive impairment. The incidences of these deficiencies varied between 7.3% and 30.9%. The most affected domains were language, attention/concentration, and language. Most patients had a stable neurocognitive function at baseline, whereas a few demonstrated improvement. However, posttreatment cognitive losses were frequently minor.
The study comprised 70 patients who possessed all pertinent characteristics. Before treatment, the patients performed cognition evaluations. At least one domain declined in at least 25 cases. Nonetheless, two patients decreased in multiple disciplines. Five patients were able to finish the examinations. There were complete baseline and posttreatment neurocognitive data for 55 of the 70 patients. Overall, the study demonstrated that radiation might aggravate cognitive impairment in certain patients.
Recent epidemiological research has examined the risk of radiation-induced neurocognitive impairment following radiotherapy. It has been established that radiation-induced neurocognitive impairment is associated with cognitive deficits months to years following radiation therapy. It is believed that IR alters the structure and function of blood vessels and glial cell populations in the brain, as well as the capacity of neurons to conduct cognitive activities.
The loss of neural stem cells in the subventricular zone of the hippocampus was the earliest aetiology of RICD. Recent research has presented a neuroanatomical target hypothesis, which argues that different brain regions have varying radiation damage thresholds. Despite rising evidence, it is critical to highlight that RICD is still a diagnosis-of-exclusion syndrome, and no single study has conclusively identified its cause.
Cancer patients who have received radiation therapy are generally aware that swallowing might be impacted. Multiple nerves and muscles collaborate to aid in food digestion. Chewing breaks down food and creates saliva, which makes swallowing easier. These tissues form a bolus that we then consume. However, you should consult your doctor if you have difficulties swallowing after radiation treatment.
Radiation is a well-known carcinogen, and despite being a vital component of multimodality therapy for various cancers, it also raises the risk of subsequent malignant neoplasms. Radiation exposure increases the chance of subsequent cancer development in addition to age, environmental variables, hormonal influences, and genetic predispositions. It appears that modern radiation treatments have altered this association. Practitioners should be aware of this risk regardless of whether patients are presently having treatment or have recently completed radiation.
Radiation therapy is a recognized cause of childhood cancer. Numerous studies have examined the likelihood of developing bone cancer following radiation. In addition, Neuhaus, S. J., Burton, H. S., Potok, M. H., and Winter, D. L., have studied the risk of second malignancies in children treated for various forms of cancer. Other studies have likewise revealed an increased incidence of soft-tissue sarcoma following radiation.
Radiation exposure reduces the skin's antimicrobial defences, increasing the likelihood of bacterial infection. Staphylococcus aureus is the most prevalent bacterial infection related to radiation exposure. Therefore, bacterial culture should be acquired for diagnostic purposes if a patient exhibits infection-related symptoms. Radiation dermatitis is associated with severe negative consequences on quality of life, and the severity of the skin condition correlates with the magnitude of these effects.

    Pinnacle Dynamic Planning Module for Re-Irradiation

    Published on: 08/02/2022

    The pinnacle Dynamic Planning Module for re-irradiation is the most popular adaptable method in brachytherapy. Its patented Dynamic Planning Module can help the clinician make better decisions and stop the treatment earlier if necessary. Its RayStation combines the power of group-sequential designs with an adaptive module for early treatment stoppage. The module is available for download on the company's website.
    The new Pinnacle Dynamic Planning Module for irradiation enables the re-planning process by minimizing accumulated dose to critical organs and normal tissue. This tool is also able to evaluate accumulated dose to a patient's critical organs. Moreover, it has a high acceptance rate in our department. In addition, this software allows you to evaluate the dose accumulated in critical organs before starting the treatment.
    The Pinnacle Dynamic Planning Module for irradiation was initially designed to improve the workflow from simulation to 3D treatment planning. It includes features such as target and OAR contouring, stereotactic planning, and 3D conformal dose computation. Additionally, the Pinnacle Evolution supports DICOM images and structures, as well as dose objects. The software also helps users work with images and records associated with the primary image set.
    A re-irradiation treatment plan can be designed to maximize patient benefit. In addition, Pinnacle 3 Auto-Planning module is able to evaluate multiple treatment parameters for accurate planning. The Auto-Planning module was also evaluated, comparing its performance to an in-house script. The results showed that the Pinnacle Dynamic Planning Module was better able to estimate the re-irradiation dose than the manual-planning system.Pinnacle RayStation
    A recent study compared the performance of two radiation therapy planning systems: the Eclipse and Pinnacle. In that study, the RayStation TPS produced plans with similar accuracy and dose calculation. In the other study, Sutton et al. assessed the commissioning experience of Pinnacle v9.2 with the Eclipse TPS. These two systems also performed similarly in dosimetry planning.
    A few limitations of both software modules were identified. Both systems had issues with electron contamination. The RayStation radiation treatment software does not include an MLC-based electron contamination model that can adapt to buildup. It was unable to account for the inverse square law of TERMA, a key determinant of treatment success. The analysis also revealed inconsistency in the estimation of radiation dose.
    Unlike MIM software, Pinnacle does not provide dose deformation based on non-rigid image registration. This is problematic for patients. The Pinnacle RayStation software module provides a better estimate of the dosimetry impact of anatomical changes. Its results can be used in planning radiotherapy treatments for patients with lung cancer. The study also included the analysis of the dose distributions of a number of other types of tumors.Pinnacle scuda
    To achieve the desired goals of adaptive radiotherapy, a new tool must be used. Adaptive planning software is becoming available from commercial vendors to help hospitals and radiology centers streamline dose accumulation between CT data sets. One such software is the Pinnacle Dynamic Planning Module from Philips Radiation Oncology Systems. This software module can be used to adjust the treatment plan in real time, estimate the pretreatment dose before re-irradiation, and provide tools to manage patient changes.
    Online adaptive planning takes 19.6 min, not including image acquisition and the virtual Mobius-based QA procedure. Although this may seem like a large difference, it should still be worth noting that in-room time for five patients treated with adaptive H&N was 7.4 min shorter. However, the remote-access emulator suffers from operator input lag and the resulting variability in patient time must be factored into the calculation.
    The Dynamic Planning Module has high acceptability among physicians and medical physicists. The tool is widely used and was requested in approximately 20% of patients treated each year. The tool was particularly helpful in 58% of re-irradiation cases and was primarily used in thoracic cases. The software evaluated the accumulated dose to critical organs during RT treatments. It was also helpful in 76% of the scheduled cases.

      Advantages of Radiotherapy Adaptive Planning Method for Prostate Cancer

      Published On: 06/09/2022

      As per Dattoli Cancer Center, adaptive planning for radiotherapy is a potential technique for delivering a clinically-acceptable dosage to the target and surrounding organs during radiation treatment. The strategy is based on the usage of a personalized engine that decreases the time required for planning. In a recent research, the mean total time, including human inputs, loop optimization procedures, and computation durations, was less than seven minutes for the low-risk prostate and less than fifteen minutes for the high-risk prostate. This huge decrease in planning time presents new opportunities for real-time adaptive radiotherapy. In addition, the prostate may migrate independently of pelvic lymph nodes, which might negate the benefits of VMAT.

      Significantly less time was required for the planning of the target's treatment as a consequence of the AP algorithm. In the low-risk patient group, the centralized server architecture generated Pers plans within seven to fifteen minutes, whereas the high-risk patient cohort required 45 to 60 minutes. Prior to implementation, the plans were evaluated by undertaking pre-treatment dosage verification for each target location. The overall passing percentage for all strategies and plans was better than 95 percent.

      The adaptive planning approach for radiotherapy let clinicians to utilize a planning CT to determine prostate CM placements and then produce fresh treatment plans for each one. In the case provided, a prostate CM displacement of around 0.5 cm was simulated. Afterwards, this CM shift was compared to a simulated CM position. Each time the CM position changed, the adaptive technique developed a new treatment plan.

      Dattoli Cancer Center explains, isodose lines are drawn on a pelvic slice using a six-fraction technique. On the patient's coronal and axial planes, the dosage distribution is then projected. The increased coronal projection revealed a cold area that resulted in a lower-than-prescribed dosage. The adaptive planning approach produced dose distributions on the pelvic slice as well as in the patient's axial and coronal planes.

      By adapting for the patient's anatomy, the adaptive radiotherapy planning approach decreases the radiation to the OARs. Simulations of CBCT illustrate the dosage distribution across each of the 160 treatment options. A high-scoring region of a patient's anatomy is a red signal for a clinical mistake; hence, the approach may be employed as a precaution. There are, however, significant restrictions involved with the use of this approach for radiation.

      The present research reveals that the three adaption approaches restored the dosimetric objectives of the prostate SBRT regimen. The three methods significantly enhanced the penalty score and the treatment volume. Standard dose-volume metrics, penalty scores, and overlap-volumes might be used to determine the variations in dosimetric benefit. On reasonable request, the corresponding author will provide access to the datasets used in the work. This research emphasizes once again the potential advantages of this unique technique.

      In Dattoli Cancer Center’s opinion, the Adaptive planning approach for radiotherapy is a potential instrument for establishing the appropriate dosage plan for each individual patient. In prostate cancer patients with and without nodal irradiation, the engine was effectively implemented. In addition, the algorithm consistently provided high-quality treatment regimens for these individuals. This approach has a lot of drawbacks, but it is promising overall.

      The capacity to adapt intra-fraction changes in malignancies is one of the primary benefits of this method. The adaptive planning method minimizes the radiation to the rectum as well. In a clinical example of prostate cancer, adaptive planning patients exhibited less rectum damage than those who got conventional therapy. In both investigations, the adaptive planning technique was more precise and enabled adequate coverage of the target organs.

      Pers designs enhanced compliance and reduced the quantity of healthy tissue irradiation. It dramatically decreased the rectal and bladder mean doses by 11,3 Gy and 7,5 Gy, respectively. In addition, 11 to 16 percent of the integrated dosage was lowered. In addition, between seven and fifteen minutes of preparation time was drastically decreased. It also passed the 3-percent-by-2-millimeter-g-analysis. Then, is this procedure superior to others?