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17 pages, 5649 KiB

Open AccessEditor’s ChoiceArticle

deepPERFECT: Novel Deep Learning CT Synthesis Method for Expeditious Pancreatic Cancer Radiotherapy

by Hamed Hooshangnejad, Quan Chen, Xue Feng, Rui Zhang and Kai Ding

Cancers 2023, 15(11), 3061; https://doi.org/10.3390/cancers15113061 - 5 Jun 2023

Cited by 16 | Viewed by 2776

Major sources of delay in the standard of care RT workflow are the need for multiple appointments and separate image acquisition. In this work, we addressed the question of how we can expedite the workflow by synthesizing planning CT from diagnostic CT. This idea is based on the theory that diagnostic CT can be used for RT planning, but in practice, due to the differences in patient setup and acquisition techniques, separate planning CT is required. We developed a generative deep learning model, deepPERFECT, that is trained to capture these differences and generate deformation vector fields to transform diagnostic CT into preliminary planning CT. We performed detailed analysis both from an image quality and a dosimetric point of view, and showed that deepPERFECT enabled the preliminary RT planning to be used for preliminary and early plan dosimetric assessment and evaluation. Full article

(This article belongs to the Special Issue Radiation Therapy for Pancreatic Cancer)

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15 pages, 3071 KiB

Open AccessReview

The Judicious Use of Stereotactic Radiosurgery and Hypofractionated Stereotactic Radiotherapy in the Management of Large Brain Metastases

by Tyler Gutschenritter, Vyshak A. Venur, Stephanie E. Combs, Balamurugan Vellayappan, Anoop P. Patel, Matthew Foote, Kristin J. Redmond, Tony J. C. Wang, Arjun Sahgal, Samuel T. Chao, John H. Suh, Eric L. Chang, Richard G. Ellenbogen and Simon S. Lo

Cancers 2021, 13(1), 70; https://doi.org/10.3390/cancers13010070 - 29 Dec 2020

Cited by 20 | Viewed by 5387

Abstract

Brain metastases are the most common intracranial malignant tumor in adults and are a cause of significant morbidity and mortality for cancer patients. Large brain metastases, defined as tumors with a maximum dimension >2 cm, present a unique clinical challenge for the delivery of stereotactic radiosurgery (SRS) as patients often present with neurologic symptoms that require expeditious treatment that must also be balanced against the potential consequences of surgery and radiation therapy—namely, leptomeningeal disease (LMD) and radionecrosis (RN). Hypofractionated stereotactic radiotherapy (HSRT) and pre-operative SRS have emerged as novel treatment techniques to help improve local control rates and reduce rates of RN and LMD for this patient population commonly managed with post-operative SRS. Recent literature suggests that pre-operative SRS can potentially half the risk of LMD compared to post-operative SRS and that HSRT can improve risk of RN to less than 10% while improving local control when meeting the appropriate goals for biologically effective dose (BED) and dose-volume constraints. We recommend a 3- or 5-fraction regimen in lieu of SRS delivering 15 Gy or less for large metastases or resection cavities. We provide a table comparing the BED of commonly used SRS and HSRT regimens, and provide an algorithm to help guide the management of these challenging clinical scenarios. Full article

(This article belongs to the Section Cancer Therapy)

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