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  Tumor Locations Impact on Cardiac Toxicity in Women that Received Partial Breast Irradiation

  Sara Diltz, Muayad Almahariq, and Joshua Dilworth

  Publication Date: 5-2023

  Accelerated partial breast irradiation (APBI) is an appropriate modality for select women with low-risk breast cancer. While APBI delivers radiation dose to a smaller volume of breast tissue compared to whole breast irradiation, dose to the heart and coronary vessels may be relatively high, depending on the proximity of the treatment device to these structures. The primary goal of this study is to determine if the risk of adverse cardiac events depends on tumor location in women receiving APBI.

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  High Dose Rate Brachytherapy monotherapy versus External Beam Radiotherapy with HDR Brachytherapy Boost for Unfavorable Intermediate Prostate Cancer Patients

  Doyle Lang, Benjamin Willen, Daniel J. Krauss, and Sirisha R. Nandalur

  Publication Date: 5-2023

  Prostate cancer is the most common male malignancy by incidence in the world. Treatment differs by the patient’s risk stratification. For the treatment of unfavorable intermediate-risk prostate cancer, external beam radiotherapy with high-dose-rate brachytherapy boost was the accepted treatment but high-dose-rate brachytherapy as monotherapy has been proposed as a potentially viable treatment option. External beam radiotherapy treatment involves shooting high-energy photons or particle radiation through normal healthy tissue to hit the tumor directly. High-dose-rate brachytherapy involves inserting radioactive seeds into the tumor. Studies are needed to compare toxicity profiles and relative outcomes between the two treatment options.

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  Outcomes of Locally Advanced Lung Cancer Patients Treated with 60 Gy vs. 70 Gy

  Batoul Nasser, Muyad Almahariq, and Inga Grills

  Publication Date: 5-2023

  The standard form of treatment for locally advanced lung cancer is to prescribe the conventional dose of 60 Gy radiation therapy (RT) concurrently with chemotherapy. However, five-year overall survival is still less than 20%. These outcomes remain poor due to both distant and local regional recurrence. The literature suggests that local regional control and overall survival is strongly associated with doses of radiotherapy that are higher than 60 Gy. However, when escalating radiation dose was prescribed exceeding 70 Gy, the overall survival rates plateaued. The primary goal of this study is to determine if there is a marked difference in clinical outcomes (i.e., mortality, disease progression, local recurrence) when administering varying RT doses – standard 60 Gy vs. simulated integrated boost (SIB) to 70 Gy – in concordance with chemotherapy, to patients with locally advanced lung cancer. A secondary goal is to determine if our findings support of contradict the results of previous studies that examined escalating doses of radiotherapy.

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  Dose to the Left Anterior Descending Artery Correlates With Cardiac Events After Irradiation for Breast Cancer

  Brittany Silverman, Andrew Zureick, Vincent Grzywacz, Muayad Almahariq, Aleksander Vayntraub, and Joshua Dilworth

  Publication Date: 5-2023

  Although global heart dose has been associated with late cardiac toxic effects in patients who received radiation therapy for breast cancer, data detailing the clinical significance of cardiac substructure dosimetry are limited. We investigated whether dose to the left anterior descending artery (LAD) correlates with adverse cardiac events.

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  Influence of Pretreatment Magnetic Resonance Imaging on Local Therapy Decisions for Intermediate-Risk Prostate Cancer Patients

  Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, and Daniel Krauss

  Publication Date: 5-2023

  Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. With minimal data regarding utility on diagnosis and treatment planning for intermediate-risk prostate cancer, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer.

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  The Prognostic Significance of Glucose-6-Phosphate Dehydrogenase as a Biomarker in Head and Neck Squamous Cell Carcinomas Treated with Conventional Chemoradiation

  Kenneth H. Barker, Barbara L. Pruetz, Jessica D. Arden, Thomas J. Quinn, and George D. Wilson

  Publication Date: 5-2-2022

  INTRODUCTION
  The prognosis of patients with head and neck squamous cell carcinoma (HNSCC) treated with chemoradiation can be predicted using p16 as a surrogate biomarker of Human Papilloma Virus (HPV) status, but a subset of patients continues to do poorly despite a positive or negative p16 status. This project attempted to identify another biomarker, glucose-6-phosphate dehydrogenase (G6PD) as a marker for prognosis in HNSCC patients. Radiation induces oxidative damage to destroy tumor cells, and G6PD is a key enzyme involved in protecting cells from oxidative damage. The goal of this project was to identify a prognostic biomarker that would aid in recognizing patients who would not respond well to chemoradiation and potentially respond better to other therapeutic measures.

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  Functional Lung Segmentation from Computed Tomography Images using Deep Learning

  Duyen M. Quach, Evan Porter, and Thomas M. Guerrero

  Publication Date: 5-2-2022

  INTRODUCTION
  Functional avoidance treatment planning allows radiation oncologists to intentionally minimize radiation dose to higher-functioning lung areas while favoring radiation dose towards lower-functioning regions. This treatment planning method has been shown to reduce pulmonary toxicity for patients receiving radiation therapy. Functional lung information, traditionally ventilation or perfusion SPECT scans, is required to plan for functional avoidance.

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  Evaluating the Impact of Software Distortion Correction on Target Doses in Cranial Stereotactic Radiosurgery

  Sharjil Shamim and Zachary Seymour

  Publication Date: 5-2-2022

  INTRODUCTION
  Brainlab’s Elements suite proposed a novel MR distortion correction method based on CT imaging. This involves registration of sub-volumes from MR imaging to generate single continuous deformation field maps, creating a corrected MR image set. No literature currently exists studying the impact of software correction on target dose for cranial stereotactic radiosurgery. In this study, we aim to evaluate the impact of Brainlab distortion correction on radiation target dose compared to original treatment plans without distortion correction.

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  Fluoroscopic Demonstration of Thoracic Tumor Immobilization with High Frequency Percussive Ventilation

  Cristian Solano, Ina M. Sala, Beverly Maurer, Ronald Levitin, and Thomas M. Guerrero

  Publication Date: 5-2-2022

  INTRODUCTION
  High frequency percussive ventilation (HFPV) is a novel immobilization technique that utilizes high frequency low tidal volume ventilation to produce endotracheal percussion. In a previous departmental study of chest wall motion immobilization, it was found that volunteers were able to tolerate HFPV for varying lengths of time – from a few to tens of minutes. By investigating a novel process to immobilize the chest wall, and thus thoracic tumors, it can allow for more localized radiation delivery and reduction of healthy tissue irradiation.

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  Development of A Deep Neural Network for Synthesis of Non-Contrast Cranial T1-Weighted Magnetic Resonance Imaging

  Agueda M. Taylor, Evan Porter, and Thomas Guerrero

  Publication Date: 5-2-2022

  INTRODUCTION
  Although 122 out of 1000 people in the US have MRI’s done each year, there are over 4 million with contraindications that subsequently forgo the diagnostic benefits. Studies in recent years have implemented artificial intelligence (AI) algorithms such as deep neural networks (DNN) for production of synthetic medical imaging. The goals of this project are to develop a DNN, specifically a Generative Adversarial Network (GAN) that will predict synthetic Cranial T1 Weighted MRI from non-contrast CT, and to evaluate the model quality.