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Recurrent infection is more common after endovascular versus open repair of infected abdominal aortic aneurysm: Systematic review and meta-analysis.

J Vasc Surg 2021 Sep 6. Epub 2021 Sep 6.

Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA; Division of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, VA.

Objective: There remains a controversy regarding the use of endovascular aneurysm repair (EVAR) versus open aneurysm repair (OAR) for infected abdominal aortic aneurysms (AAA). This study aimed to investigate the comparative outcomes of EVAR and OAR for the treatment of infected AAAs.

Methods: We conducted a systematic review and meta-analysis using MEDLINE and EMBASE databases through May 2021. Read More

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September 2021

Effective Organs-at-Risk Dose Sparing in Volumetric Modulated Arc Therapy Using a Half-Beam Technique in Whole Pelvic Irradiation.

Front Oncol 2021 18;11:611469. Epub 2021 Aug 18.

Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea.

Background: Although there are some controversies regarding whole pelvic radiation therapy (WPRT) due to its gastrointestinal and hematologic toxicities, it is considered for patients with gynecological, rectal, and prostate cancer. To effectively spare organs-at-risk (OAR) doses using multi-leaf collimator (MLC)'s optimal segments, potential dosimetric benefits in volumetric modulated arc therapy (VMAT) using a half-beam technique (HF) were investigated for WPRT.

Methods: While the size of a fully opened field (FF) was decided to entirely include a planning target volume in all beam's eye view across arc angles, the HF was designed to use half the FF from the isocenter for dose optimization. Read More

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Dosimetric benefits of daily treatment plan adaptation for prostate cancer stereotactic body radiotherapy.

Radiat Oncol 2021 Aug 4;16(1):145. Epub 2021 Aug 4.

Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Background: Hypofractionation is increasingly being applied in radiotherapy for prostate cancer, requiring higher accuracy of daily treatment deliveries than in conventional image-guided radiotherapy (IGRT). Different adaptive radiotherapy (ART) strategies were evaluated with regard to dosimetric benefits.

Methods: Treatments plans for 32 patients were retrospectively generated and analyzed according to the PACE-C trial treatment scheme (40 Gy in 5 fractions). Read More

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Impact of daily plan adaptation on organ-at-risk normal tissue complication probability for adrenal lesions undergoing stereotactic ablative radiation therapy.

Radiother Oncol 2021 Jul 31;163:14-20. Epub 2021 Jul 31.

Department of Radiation Oncology, Amsterdam University Medical Centers - Location VUmc, Amsterdam, The Netherlands.

Introduction: Stereotactic ablative radiotherapy (SABR) can achieve good local control for metastatic adrenal lesions. Magnetic resonance (MR)-guidance with daily on-table plan adaptation can augment the delivery of SABR with greater dose certainty. The goal of this study was to quantify the potential clinical benefit MR-guided daily-adaptive adrenal SABR using the normal tissue complication probability (NTCP) framework. Read More

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The predictive value of segmentation metrics on dosimetry in organs at risk of the brain.

Med Image Anal 2021 Oct 13;73:102161. Epub 2021 Jul 13.

ARTORG Center for Biomedical Research, University of Bern, Bern, Switzerland. Electronic address:

Background: Fully automatic medical image segmentation has been a long pursuit in radiotherapy (RT). Recent developments involving deep learning show promising results yielding consistent and time efficient contours. In order to train and validate these systems, several geometric based metrics, such as Dice Similarity Coefficient (DSC), Hausdorff, and other related metrics are currently the standard in automated medical image segmentation challenges. Read More

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October 2021

Determination of the optimal range for virtual monoenergetic images in dual-energy CT based on physical quality parameters.

Med Phys 2021 Jul 21. Epub 2021 Jul 21.

Radiation Oncology Department, Hospital del Mar, Barcelona, Spain.

Purpose: Virtual monoenergetic images (VMI) obtained from Dual-Energy Computed Tomography (DECT) with iodinated contrast are used in radiotherapy of the Head and Neck to improve the delineation of target volumes and organs at-risk (OAR). The energies used to vary from 40 to 70 keV, but noise at low keV and the use of Single Energy CT (SECT) at low kV settings may shrink this interval. There is no guide about how to find out the optimal range where VMI has a significant improvement related to SECT images. Read More

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Outcomes of and Treatment Planning Considerations for A Hybrid Technique Delivering Proton Pencil-Beam Scanning Radiation to Women with Metal-Containing Tissue Expanders Undergoing Post-Mastectomy Radiation.

Radiother Oncol 2021 Jul 16. Epub 2021 Jul 16.

Department of Radiation Oncology, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD 21201Outcomes of and Treatment Planning Considerations for A Hybrid Technique Delivering Proton Pencil-Beam Scanning Radiation to Women with Metal-Containing Tissue Expanders Undergoing Post-Mastectomy Radiation.

Background: Following mastectomy, immediate breast reconstruction often involves the use of temporary tissue expanders (TEs). TEs contain metallic ports (MPs), which complicate proton pencil-beam scanning (PBS) planning. A technique was implemented for delivering PBS post-mastectomy radiation (PMRT) to patients with TEs and MPs. Read More

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Ag(I) Pyridine-Amidoxime Complex as the Catalysis Activity Domain for the Rapid Hydrolysis of Organothiophosphate-Based Nerve Agents: Mechanistic Evaluation and Application.

ACS Appl Mater Interfaces 2021 Jul 19;13(29):34428-34437. Epub 2021 Jul 19.

Key Laboratory of Functional Polymer Materials, Ministry of Education, Institute of Polymer Chemistry, College of Chemistry and Frontier Science Center for the Creation of New Organic Substances, Nankai University, Tianjin 300071, China.

Two novel Ag(I) complexes containing synergistic pyridine and amidoxime ligands (Ag-DPAAO and Ag-PAAO) were first designed as complex monomers. Taking advantage of the molecular imprinting technique and solvothermal method, molecular imprinted porous cross-linked polymers (MIPCPs) were developed as a robust platform for the first time to incorporate Ag-PAAO into a polymer material as a recyclable catalyst. Advantageously, the observed pseudo first-order rate constant () of MIPCP-Ag-PAAO-20% for ethyl-parathion () hydrolysis is about 1. Read More

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Endovascular aortic repair is a cost-effective option for in-hospital patients with abdominal aortic aneurysm.

J Chin Med Assoc 2021 Sep;84(9):890-899

Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.

Background: To investigate the cost-effectiveness of endovascular aortic repair (EVAR) versus open aortic repair (OAR) for abdominal aortic aneurysm (AAA) using incremental costs per decreased in-hospital mortality rate gained through our patients' cohort.

Methods: Medical records and healthcare costs of patients with AAA hospitalized between 2010 and 2015 were extracted from the National Health Insurance Research Database (NHIRD) of Taiwan. Multiple regression analysis was applied to adjust for confounding factors and to compare the differences in postoperative clinical outcomes between patients who received EVAR and OAR. Read More

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September 2021

Improved Ipsilateral Breast and Chest Wall Sparing With MR-Guided 3-fraction Accelerated Partial Breast Irradiation: A Dosimetric Study Comparing MR-Linac and CT-Linac Plans.

Adv Radiat Oncol 2021 May-Jun;6(3):100654. Epub 2021 Jan 22.

Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Purpose: External beam accelerated partial breast irradiation (APBI) is subject to treatment uncertainties that must be accounted for through planning target volume (PTV) margin. We hypothesize that magnetic resonance-guided radiation therapy with reduced PTV margins enabled by real-time cine magnetic resonance image (MRI) target monitoring results in better normal tissue sparing compared with computed tomography (CT)-guided radiation therapy with commonly used clinical PTV margins. In this study, we compare the plan quality of ViewRay MRIdian Linac forward planned intensity modulated radiation therapy and TrueBeam volumetric modulated arc therapy for a novel 3-fraction APBI schedule. Read More

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January 2021

High-dose-rate brachytherapy using inverse planning optimization with tandem and ovoid applicators for locally advanced cervical cancer: a simulation study.

Radiol Phys Technol 2021 Sep 2;14(3):262-270. Epub 2021 Jun 2.

Department of Radiological Technology, Faculty of Health Sciences, Hokkaido University of Science, 7-15-4-1 Maeda, Teine, Sapporo, Hokkaido, 006-8585, Japan.

The purpose of this study was to evaluate the dosimetric advantage of inverse planning optimization (IPO) in locally advanced cervical cancer using high-dose-rate (HDR) brachytherapy (BT). IPO was compared with point A plan and geometric optimization (GO). The three planning methods were evaluated using doses to the virtual organ-at-risk (OAR) and D90 (the minimum dose covering of 90% of the volume) to the virtual high-risk clinical target volume (HR-CTV) based on quantitative analysis. Read More

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September 2021

Dosimetric feasibility on hypofractionated intensity-modulated radiotherapy and simultaneous integrated boost for locally advanced unresectable pancreatic cancer with helical tomotherapy.

J Gastrointest Oncol 2021 Apr;12(2):496-506

Department of Radiotherapy, Air Force Medical Center of PLA, Beijing, China.

Background: This dosimetric study on locally advanced pancreatic cancer (LAPC) and the surrounding gastrointestinal organs at risk (OARs) aimed at exploring the potential of further improving the internal dose and reducing the fractionation number by concurrent hypofractionated simultaneous integrated boost (SIB) radiotherapy using helical tomotherapy (HT).

Methods: We collected computed tomography positioning images from a LAPC study of 17 consecutive patients. Gross tumor volume (GTV)1, GTV2, and GTV3 were defined as the GTV minus a margin of 3, 6, and 9 mm from the external part in all directions, respectively. Read More

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Evaluation of Optimal Combination of Planning Parameters (Field Width, Pitch, and Modulation Factor) in Helical Tomotherapy for Bilateral Breast Cancer.

J Med Phys 2020 Oct-Dec;45(4):234-239. Epub 2021 Feb 2.

Department of Radiotherapy, Health Care Global Enterprises Ltd., Bengaluru, Karnataka, India.

Aim: The aim of the study was to find the most balanced plan with an optimal combination of planning parameters in helical tomotherapy (HT) for bilateral breast irradiation by evaluating dosimetric indices and time factors. In particular, we investigated the best combination of field width (FW), pitch, and modulation factor (MF).

Materials And Methods: A total of 90 plans (18 plans for each patient) was created in this study, with different combination of planning parameters (FW: 2. Read More

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February 2021

Contribution of Imaging to Organs at Risk Dose during Lung Stereotactic Body Radiation Therapy.

J Biomed Phys Eng 2021 Apr 1;11(2):125-134. Epub 2021 Apr 1.

PhD, Department of Radiation Oncology, Tenon Hospital, 75020 Paris, France.

Background: The use of imaging is indispensable in modern radiation therapy, both for simulation and treatment delivery. For safe and sure utilization, dose delivery from imaging must be evaluated.

Objective: This study aims to investigate the dose to organ at risk (OAR) delivered by imaging during lung stereotactic body radiation therapy (SBRT) and to evaluate its contribution to the treatment total dose. Read More

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Quality assurance of radiotherapy in the ongoing EORTC 1420 "Best of" trial for early stage oropharyngeal, supraglottic and hypopharyngeal carcinoma: results of the benchmark case procedure.

Radiat Oncol 2021 May 1;16(1):81. Epub 2021 May 1.

University Hospital of Bern, Bern, Switzerland.

Introduction: The current phase III EORTC 1420 Best-of trial (NCT02984410) compares the swallowing function after transoral surgery versus intensity modulated radiotherapy (RT) in patients with early-stage carcinoma of the oropharynx, supraglottis and hypopharynx. We report the analysis of the Benchmark Case (BC) procedures before patient recruitment with special attention to dysphagia/aspiration related structures (DARS).

Materials And Methods: Submitted RT volumes and plans from participating centers were analyzed and compared against the gold-standard expert delineations and dose distributions. Read More

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Sexual Dysfunction Before and after Treatment of Infrarenal Aortic Aneurysm Patients.

Ann Vasc Surg 2021 Apr 24. Epub 2021 Apr 24.

Department of Heart- and Vascular Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany.

Objective: Sexual dysfunction is supposed to be one major complication after treatment of infrarenal aortic aneurysms. It is still controversial how many patients suffer from a sexual dysfunction already before their operation and if there are any procedure-specific differences in postoperative sexual function depending on the operative procedure performed, for example, open (OAR) or endovascular aortic repair (EVAR).

Methods: To answer these questions we conducted this prospective unicentric study using the International Index of Erectile Function (IIEF) and analyzed the sexual function of 56 male patients with an infrarenal aortic aneurysm before as well as 3, 6, and 12 months after their operation. Read More

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Evaluation of image quality of a novel computed tomography metal artifact management technique on an anthropomorphic head and neck phantom.

Phys Imaging Radiat Oncol 2021 Jan 21;17:111-116. Epub 2021 Feb 21.

Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 607, Houston, TX 77030, United States.

Background And Purpose: Artefacts caused by dental amalgam implants present a common challenge in computed tomography (CT) and therefore treatment planning dose calculations. The goal was to perform a quantitative image quality analysis of our Artifact Management for Proton Planning (AMPP) algorithm which used gantry tilts for managing metal artefacts on Head and Neck (HN) CT scans and major vendors' commercial approaches.

Materials And Methods: Metal artefact reduction (MAR) algorithms were evaluated using an anthropomorphic phantom with a removable jaw for the acquisition of images with and without (baseline) metal artifacts. Read More

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January 2021

Comparative Transcriptome Analysis of Key Genes and Pathways Activated in Response to Fat Deposition in Two Sheep Breeds With Distinct Tail Phenotype.

Front Genet 2021 8;12:639030. Epub 2021 Apr 8.

State Key Laboratory of Sheep Genetic Improvement and Healthy Production, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China.

Fat tail in sheep presents a valuable energy reserve that has historically facilitated adaptation to harsh environments. However, in modern intensive and semi-intensive sheep industry systems, breeds with leaner tails are more desirable. In the present study, RNA sequencing (RNA-Seq) was applied to determine the transcriptome profiles of tail fat tissues in two Chinese sheep breeds, fat-rumped Altay sheep and thin-tailed Xinjiang fine wool (XFW) sheep, with extreme fat tail phenotype difference. Read More

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Lutetium-177-PSMA-617 in Low-Volume Hormone-Sensitive Metastatic Prostate Cancer: A Prospective Pilot Study.

Clin Cancer Res 2021 Jul 21;27(13):3595-3601. Epub 2021 Apr 21.

Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, the Netherlands.

Purpose: [Lu]Lu-PSMA-617 radioligand therapy (Lu-PSMA) is a novel treatment for metastatic castration-resistant prostate cancer (mCRPC), which could also be applied to patients with metastatic hormone-sensitive prostate cancer (mHSPC) with PSMA expression. In this prospective study (NCT03828838), we analyzed toxicity, radiation doses, and treatment effect of Lu-PSMA in pateints with low-volume mHSPC.

Patients And Methods: Ten progressive patients with mHSPC following local treatment, with a maximum of ten metastatic lesions on [Ga]Ga-PSMA-11 PET/diagnostic-CT imaging (PSMA-PET) and serum PSA doubling time <6 months received two cycles of Lu-PSMA. Read More

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Effect of treatment planning system parameters on beam modulation complexity for treatment plans with single-layer multi-leaf collimator and dual-layer stacked multi-leaf collimator.

Br J Radiol 2021 Jun 29;94(1122):20201011. Epub 2021 Apr 29.

Medical Physics Service, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Hull, UK.

Objective: High levels of beam modulation complexity (MC) and monitor units (MU) can compromise the plan deliverability of intensity-modulated radiotherapy treatments. Our study evaluates the effect of three treatment planning system (TPS) parameters on MC and MU using different multi-leaf collimator (MLC) architectures.

Methods: 192 volumetric modulated arc therapy plans were calculated using one virtual prostate phantom considering three main settings: (1) three TPS-parameters (Convergence; Aperture Shape Controller, ASC; and Dose Calculation Resolution, DCR) selected from Eclipse v15. Read More

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Dosimetric analysis of cervical cancer stage IIB patients treated with volumetric modulated arc therapy using plan uncertainty parameters module of Varian Eclipse treatment planning system.

Biomed Phys Eng Express 2021 Apr 28;7(3). Epub 2021 Apr 28.

Department of Radiation Oncology, Dr B L Kapur Memorial Hospital, Delhi, India.

. The present study aims to investigate the dosimetric and radiobiological impact of patient setup errors (PSE) on the target and organs at risk (OAR) of the cervix carcinoma stage IIB patients treated with volumetric-modulated arc therapy (VMAT) delivery technique using plan uncertainty parameters module of Varian Eclipse treatment planning system and in-house developed DVH Analyzer program.. Read More

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Complications of endo-vascular aortic repair for abdominal aortic aneurysm: A retrospective single-centre experience.

Ann Med Surg (Lond) 2021 Apr 23;64:102219. Epub 2021 Mar 23.

Department of Surgery, Department of Vascular, Jordan University of Science and Technology, Irbid, Jordan.

Background: Endovascular aortic repair (EVAR) is obviously less invasive than open aortic repair (OAR) for the treatment of infra-renal abdominal aortic aneurysm (AAA). However, it is not free of complications which can potentially result in severe morbidity or even mortality. The purpose of this study was to share our single-center experience with stent-graft related and systemic complications associated with EVAR. Read More

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Evaluation of treatment plan quality for head and neck IMRT: a multicenter study.

Med Dosim 2021 Autumn;46(3):310-317. Epub 2021 Apr 8.

Clinical Oncology Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address:

Intensity-modulated radiotherapy (IMRT) treatment planning for head and neck cancer is challenging and complex due to many organs at risk (OAR) in this region. The experience and skills of planners may result in substantial variability of treatment plan quality. This study assessed the performance of IMRT planning in Malaysia and observed plan quality variation among participating centers. Read More

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Dosimetric impact of range uncertainty in passive scattering proton therapy.

J Appl Clin Med Phys 2021 May 2;22(5):6-14. Epub 2021 Apr 2.

Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA.

Purpose: The objective of this study was to investigate the dosimetric impact of range uncertainty in a large cohort of patients receiving passive scatter proton therapy.

Methods: A cohort of 120 patients were reviewed in this study retrospectively, of which 61 were brain, 39 lung, and 20 prostate patients. Range uncertainties of ±3. Read More

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Analysis of prostate intensity- and volumetric-modulated arc radiation therapy planning quality with PlanIQ.

J Appl Clin Med Phys 2021 Apr 25;22(4):132-142. Epub 2021 Mar 25.

Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.

Purpose: The purpose of this study was to assess the quality of treatment planning using the PlanIQ software and to investigate whether it is possible to improve the quality of treatment planning using the "Feasibility dose-volume histogram (DVH) " implemented in the PlanIQ software.

Methods: Using the PlanIQ software, we retrospectively analyzed the learning curve regarding the quality of the treatment plans for 148 patients of prostate intensity-modulated radiation therapy and volumetric-modulated radiation therapy performed at our institution over the past eight years. We also sought to examine the possibility of improving treatment planning quality by re-planning in 47 patients where the quality of the target dose and the dose limits for organs at risk (OARs) were inadequate. Read More

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A predictive model for determining rectum and bladder dose constraints in prostate volumetric modulated arc therapy.

Med Dosim 2021 Autumn;46(3):269-273. Epub 2021 Mar 13.

Nepean Cancer Care Centre, Nepean Hospital, Kingswood, New South Wales, 2747, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia.

Generic dose-volume constraints of the rectum/bladder (R/B) are used in inverse planning to reduce doses to these organs for patients undergoing prostate radiotherapy. A retrospective study was undertaken to assess correlations between the overlap of the R/B with the planning target volume (PTV) and the dose received during planning to organs at risk (OARs). Data for 105 prostate cancer patients who had volumetric modulated arc therapy (VMAT) to the intact prostate and proximal seminal vesicles at Nepean Cancer Care Centre from 2011 to 2015 were analyzed. Read More

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Optimizing Adjuvant Stereotactic Radiotherapy of Motor-Eloquent Brain Metastases: Sparing the nTMS-Defined Motor Cortex and the Hippocampus.

Front Oncol 2021 26;11:628007. Epub 2021 Feb 26.

Department of Neurosurgery, Saarland University Medical Centre and Saarland University Faculty of Medicine, Homburg, Germany.

Brain metastases can effectively be treated with surgical resection and adjuvant stereotactic radiotherapy (SRT). Navigated transcranial magnetic stimulation (nTMS) has been used to non-invasively map the motor cortex prior to surgery of motor eloquent brain lesions. To date, few studies have reported the integration of such motor maps into radiotherapy planning. Read More

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February 2021

Aortoduodenal fistulas after endovascular abdominal aortic aneurysm repair and open aortic repair.

J Vasc Surg 2021 09 5;74(3):711-719.e1. Epub 2021 Mar 5.

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of vascular surgery, Berlin, Germany.

Objective: In the present study, we have reported and compared aortoduodenal fistulas (ADFs) after endovascular abdominal aortic aneurysm repair (EVAR) vs after open aortic repair (OAR).

Methods: We retrospectively analyzed the data from patients treated for ADFs from January 2015 to May 2020 in our hospital. The clinical data, diagnostic procedures, and surgical options were evaluated. Read More

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September 2021

A Probability-Based Investigation on the Setup Robustness of Pencil-beam Proton Radiation Therapy for Skull-Base Meningioma.

Int J Part Ther 2021 28;7(3):34-45. Epub 2021 Jan 28.

Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Introduction: The intracranial skull-base meningioma is in proximity to multiple critical organs and heterogeneous tissues. Steep dose gradients often result from avoiding critical organs in proton treatment plans. Dose uncertainties arising from setup errors under image-guided radiation therapy are worthy of evaluation. Read More

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January 2021

Proton versus Photon Breath-Hold Radiation for Left-Sided Breast Cancer after Breast-Conserving Surgery: A Dosimetric Comparison.

Int J Part Ther 2021 31;7(3):24-33. Epub 2020 Dec 31.

Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USAOAR.

Purpose: Radiation to breast, chest wall, and/or regional nodes is an integral component of breast cancer management in many situations. Irradiating left-sided breast and/or regional nodes may be technically challenging because of cardiac tolerance and subsequent risk of long-term cardiac complications. Deep inspiratory breath-hold (DIBH) technique physically separates cardiac structures away from radiation target volume, thus reducing cardiac dose with either photon (Ph) or proton beam therapy (PBT). Read More

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December 2020