Day 2 :
Keynote Forum
Leonhard Karsch
University of Dresden and HZDR, Germany
Keynote: Laser plasma accelerated particle beams for radiation therapy and their radiobiological characterization
Biography:
Leonhard Karsch has completed his PhD in Physics from Technical University in Dresden. Since ten years, he has been working in the Medical Faculty in translation of laser plasma accelerators to radiation therapy with protons. He has published more than 40 papers in reputed journals.
Abstract:
The long-term aim of developing laser based particle acceleration towards clinical application requires substantial technological progress as well as comprehensive research on the radiobiological consequences of ultra-short radiation pulses with high pulse dose rate. Within the joint research project “on COOPtics” extensive in vitro studies with several human tumor and normal tissue cells were already performed revealing comparable radiobiological effects of laser driven and conventional electron and proton beams. In a second translational step, in vivo experiments were established. Although the experiments were motivated by future proton therapy, first attempts were performed with electrons at the laser system JETI for simplification and establishing the experimental setup and procedure. A full scale animal experiment was realized for the HNSCC FaDu grown on nude mice ear. The radiation induced tumor growth delay was determined and compared to those obtained after similar treatment at a conventional clinical LINAC. Again, no significant difference in the radiation response to both radiation qualities was revealed, whereas the successful performance of such a comprehensive experiment campaign underlines the stability and reproducibility of all implemented methods. During this experiment campaign, the changing tumor take rate and a high rate of secondary tumors were identified as limitations of the model that have to be improved before proton experiments and tumor control studies can be performed. An overview of the experiments as well as the results of this optimization process and the status of the animal experiments with laser driven protons at the laser system DRACO will be presented.
Break: Networking & Refreshment Break 10:50-11:10 @ Foyer
- Tomography | Clinical Physics and Patient Safety | Therapeutic Nuclear Medicine | Dosimetry | Clinical Nuclear Medicine | Therapeutic Nuclear Medicine | Radiography | Radiation Oncology
Location: Appia 1+2
Session Introduction
Yuan-Hao Lee
Taipei Medical University, Taiwan
Title: A phantom study of eye shieldingfor different CT scanners and imaging protocols
Time : 11:15-11: 40
Biography:
Yuan-Hao Lee has completed her PhD from University of Texas Health Science Center at San Antonio and Postdoctoral studies from Mitchell Cancer Institite (Univ. of South Alabama) and University of Hawaii Cancer Center. She is currently being trained in the field of Medical Physics at the Wanfang Hospital, a JCR-accrediated medical center. She has published more than 10 peer-review and proceeding papers as well as served as an Editorial Board Member of Journal of Medical and Clinical Oncology.
Abstract:
Background: Computed tomography (CT) scan of the brain is a good method for investigating cranial lesions. Given that chronic accumulation of oxidative stress in the eyes induces carcinogenesis and cataract, we aimed to protect the eyes during CT scans by understanding the effects of non-latex barium sulfate shields on image quality and radiation dose to lens of the eye.
Materials & Methods: A human head phantom was scanned either by a 16-slice CT scanner at a fixed tube current of 300 mAs or by a 256-slice Dual-Source CT (DSCT) scanner with automatic tube current modulation. For the assessment of image quality and radiation dose, various tube voltages were applied with or without eye shielding under clinical settings. Pencil-shaped
ionization chambers were implemented for measuring air kerma close to the eye. CT images at slices that exibit zygomatic, orbital and nasal bones were used for the calculation of signal-to-noise and contrast-to-noise ratios.
Results: The signal-to-noise and contrast-to-noise ratios of DSCT images maintained relatively consistent with the increasing number of barium sulfate shield(s). On the contrary, the ratios of 16-slice CT images deviated or elevated along with the shield increment, leading to greater reduction in image quality upon the application of one shield. Similarly, radiation dose decreased with decreasing tube voltage and the increasing number of shields. The application of two shields on the 16-slice CT scan reduced up to 52% of dose close to the eye.
Conclusion: Results of this study indicate that tube current modulation should be considered for acquiring better image quality with eye shielding.
Anil Kumar Khambampati
Jeju National University, South Korea
Title: Analytical boundary element method to monitor bladder volume using electrical impedance tomography
Time : 11:40-12:05
Biography:
Anil Kumar Khambampati received his PhD from Department of Electronics Engineering, Jeju National University. He has published more than 30 papers and has been working as a Research Professor in the Institute for Nuclear Science and Technology, Jeju National University, South Korea.
Abstract:
Information regarding the amount of urine or size of the bladder can help in the medical diagnosis of patients with paraplegia or overactive bladder. The bladder volume increases with amount of urine, thus it displaces the surrounding tissues and extends upward towards the abdomen wall. It is necessary to find an accurate and efficient method for estimating bladder
volume by considering the impedance and movement of surrounding organ tissues. Electrical impedance tomography is a non intrusive and radiation free method that can provide the bladder size at a given time from the measurements recorded on the surface of the pelvis. The electrodes are placed around the pelvic region and current is injected into the body through these
electrodes. The corresponding voltage is measured that quantifies the internal impedance distribution. This paper presents an analytical boundary element method for detecting changes in the size of the bladder. The boundary is represented using truncated Fourier Series and the changes in boundary voltages are measured for full and empty bladder. Numerical results with
pelvic shaped boundary are performed and the results show that with bladder size change the boundary voltage is changed and it can be used to detect the size and shape of bladder boundary.
Farzad Dehghani Sani
Razavi Hospital, Iran
Title: Clinical comparison of F18-FET vs. F18-FDG in patients with low and high grade glioblastoma
Time : 12:05-12:30
Biography:
Farzad Dehghani Sani is a Nuclear Medicine Technologist at Razavi Hospital, Iran. He did his MS and BSc in Nuclear Medicine Technology, and MSc of Biophysics at Islamic Azad University of Mashhad in December 2016. His research interests include both Nuclear Imaging Physics and Nuclear Medicine Education. He has many publications, abstracts and presentations combined.
Abstract:
FDG is an available PET tracer for brain imaging. Malignant brain tumors show increased glucose metabolism reflected on FDG-PET imaging. FDG-PET imaging of brain tumors provides information on tumor grade and prognosis. Moreover, FDG-PET imaging has limitations for brain tumor detection because of the high background glucose metabolism of normal gray matter structures. MRI combined FDG-PET images is essential for accurate evaluation of brain tumors. FDG-PET is also useful for evaluating residual or recurrent tumor. One limitation of FDG-PET is the occasional inability to distinguish radiation
necrosis from recurrent high-grade tumor. A second limitation is that FDG-PET is less sensitive than contrast-enhanced MRI for detecting intracranial metastases. Meanwhile, other radiotracers such as 11C-MET and FET can accumulate in brain tumors and have the advantage of low background cortical activity. The aim of the current study was to compare the diagnostic
value of PET using 18F-FDG and 18F-FET in patients with brain lesions of gliomas. Numerous studies have demonstrated that gliomas has increased 18F-FET uptake in 86% and increased 18F-FDG uptake in 35% of the lesions. 18F-FET PET provided useful delineation of tumor while this was impractical with 18F-FDG due to high tracer uptake in the gray matter. 18F-FET PET is superior to 18F-FDG for biopsy lesions and also grading of gliomas. Therefore, amino acids like 18F-FET are the preferred PET tracers for the clinical management of gliomas.
Mkimel Mounir
Laboratory of Technology and Medical Science, Morocco
Title: Evaluation of the dose delivered to patients in CT using the platform (GEANT4 / GATE)
Time : 12:30-12:55
Biography:
Mkimel Mounir has research interest in Medical/Radiation Physics and Dosimetry for Radiotherapy. He has attended many scientific meetings with publications in conference proceedings and journals.
Abstract:
Nowadays, medical physics becomes a research field of a growing importance at Moroccan universities. This fact can be explained on one hand by the increasing number of purchases in medical imaging devices by the hospitals and of the number of PhD students and researchers becoming interested to medical physics studies on the other hand. Computed tomography (CT) is a medical imaging modality that produces cross-sectional images representing the X-ray attenuation properties of the body. However, it still represents the most irradiating technique used in radio-diagnostic that can increase cancer likelihood. It is therefore imperative to have a good estimation of the dose based on the acquisition parameters and the morphology of the patients (diameter). To achieve this goal, a CTDI phantom was used to calculate the doses. This phantom represents a standard PMMA phantom for head and body. Monte Carlo simulation methods represent an important tool for the study of processes involved in emission tomography and the development of devices dedicated to this purpose. GATE (GEANT4 Application for Tomographic Emission) is a Monte Carlo based platform which allows simulating accurately a large range medical applications. In this paper, we exhibit the validation of a GATE model of CT Siemens SOMATOM Emotion 16 Slices using the CTDI phantom. In one hand, the comparison between the simulated and experimental data shows a good agreement. On the other hand, we observe that the values of CTDI increase when the kV and mAs increase. However when we increase the phantom diameter the CTDI values decrease.
Maharaj Masha
Netcare Umhlanga Hospital, South Africa
Title: Stability and efficacy of a therapeutic dose of lu-dotatate prepared at a remote centralized radiopharmacy: The initial clinical results
Time : 13:55-14:20
Biography:
Maharaj Masha did her MBBCh through Wits University, in Johannesburg. She was specialized at Tygerberg Hospital in Cape Town where she obtained qualifications through the College of Nuclear Physicians of SA (FCNP), thereafter obtaining her Master’s in Nuclear Medicine (MMED) through Stellenbosch University. In May2015, she participated in the 1st World Theranostics Academy (WTA) held in Innsbruck, Austria. She is the only South African with this certification.
Abstract:
Background: Lu Dotatate therapy has established its role in the management of patients with inoperable or metastasized neuroendocrine tumours. To our knowledge the clinical stability of Lu Dotatate therapy doses prepared at a centralized radiopharmacy and transported to a remote therapy centre has never been analysed or reported.
Aim & Objectives: To assess the stability in using Lu Dotatate prepared from a centralized radiopharmacy then transported to a remote therapy centre. This may create therapy opportunities for many remote centres in different countries with no direct access to onsite production.
Methods: The current radiopharmacy, NTP Radioisotopes, is situated in Pelindaba, 634.5 km (approximately 394 miles) from the Therapy Centre (Umhlanga, Kwa-Zulu Natal). Pelindaba receives the Lu-177 on a Wednesday morning (from ITG in Germany), labels it with Dotatate using protocols obtained from two sources in Germany. The protocols are adapted to suit our
conditions and the product is then suitably stabilised. This process is usually completed by 09h00. Standard doses of 7400 MBq are prepared. The doses are then taken by NTP Logistics to the airport (OR Tambo International Airport) for clearance for the scheduled flight (duration of flight one hour). In Durban (King Shaka International airport), NTP logistics wait on site for the labelled product to be cleared and it is taken directly to the practice for administration. We analysed 19 therapies to determine the stability of the product from preparation to injection. The following were used for analysis: biodistribution of post therapy imaging vs diagnostic scan lesion uptake, and clinical therapeutic response. Injection, therapy and imaging protocols were standardized.
Results: The mean time from production to injection was 4.93 hours (+/- 1.07 SD). The mode was 4.5 hours. The longest time between preparation and injection was 7.33 hours. The interim clinical evaluation of 6 patients who received Lu Dotatate therapy: 16% complete response (CR), 33% partial response (PR), 50% stable disease (SD).
Conclusion: Our Centre experience with Lu Dotatate received from a central radiopharmacy suggests that the labelled compound remains stable both in vivo and in vitro with good target delivery and effective clinical outcomes.
Simeon Chinedu Aruah
National Hospital Abuja, Nigeria
Title: A prospective study on chemotherapy induced anemia in cancer patients undergoing treatment using serial hemoglobin measurement at the National Hospital Abuja, Nigeria
Time : 14:20-14:45
Biography:
Simeon Chinedu Aruah graduated in 2004 from University of Nigeria Nsukka (UNN) where he obtained MBBS Nigeria, and enrolled for residency training in Radiation Oncology at the National Hospital Abuja, Nigeria, qualified in 2014 and got inducted as a Fellow of West African College of Surgeons (FWACS) Radiation Oncology in March 2015. He won National Hospital Abuja Research Grant 2013 during his dissertation work. He has a Master’s degree in Public Health (MPH) from University of Nigeria Nsukka (UNN). He found an NGO Pathfinder Healthcare Foundation (PHF) to create cancer awareness among rural dwellers. He is currently working at the National Hospital Abuja, Nigeria as a Researcher and Consultant Radiation Oncologist with interest in Public Health.
Abstract:
Introduction: Anemia is a common complication of myelo-suppressive chemotherapy. Severe anemia is usually treated with red blood cell transfusion, however, mild-to-moderate anemia most often are managed conservatively. There is no universally established benchmark of hemoglobin of patients selected for cancer chemotherapy to inform a global best practice and increase patients treatment outcome and quality of life.
Objective: The objective of this study is to examine the change in Hb level of cancer patients undergoing chemotherapy using serial Hb measurement.
Materials & Methods: A total of 100 voluntary patients with solid malignancies were recruited within a period of eight months. Baseline demographic characteristics and type of tumors were obtained. Pre-treatment Hb level was measured on first day of consultation and repeated every 2 weeks during the therapy until after three consecutive Hb readings.
Results & Analysis: Data collected was analyzed using SPSS version 10. Out of the 100 cancer patients, 88% were female. Breast 68% (68) was commonest site of tumour. Prevalence of anemia in the study was 72%, and majority of patients had their Hb at the end of therapy within the range of 9.60 g/dl to 10.62 g/dl. At P-value>0.05, there was no statistical significance on distribution of mean hemoglobin, standard deviation based on sex and treatment type.
Conclusion/Recommendation: Chemotherapy has no significant effect on Hb especially in patients with high baseline Hb level between 11 g/dl to 12 g/dl in our study. Prevalence of anemia in the studied patients was 72%. We recommend a benchmark of Hb of 11 g/dl minimum for any patient being selected for chemotherapy in Nigeria.
Hamody Agbaria
Ben Gurion University of the Negev, Israel
Title: Distinguishing between bacterial and viral infections based on peripheral human blood tests using infrared microscopy and multivariate analysis
Time : 14:45-15:10
Biography:
Hamody Agbaria has completed his MSc from Beer-Sheva, Israel, Dept. of Physics, Faculty of Natural Sciences under the supervision of Prof. Ilana Bar with the title of thesis: "Studying Photodissociation of Molecules by Velocity Map Imaging of Ions via Electrostatic Lenses". He is pursuing his PhD in Ben-Gurion University of the Negev, under the supervision of Prof. Daniel H Rich, Prof. Shaul Mordechai and Prof. Mahmud Hulihel.
Abstract:
Viral and bacterial infections are responsible for variety of diseases. These infections have similar symptoms. Thus, physicians may encounter difficulties in distinguishing between viral and bacterial infections based on these symptoms. Bacterial infections differ from viral infections in many other important respects regarding the response to various medications and the
structure of the organisms. In many cases, it is difficult to know the origin of the infection. The physician orders a "culture test" methods to diagnose the infection type when it is necessary. Using these methods to diagnose the infection type is typically too long (> 24 hours). Blood was collected from 80 patients with confirmed viral infection and 80 with confirmed bacterial infection. White blood cells (WBCs) and plasma were isolated and deposited on a zinc selenide slide, dried and measured under a Fourier transform infrared (FTIR) microscope to obtain their infrared absorption spectra. The obtained spectra of WBCs and plasma were analyzed to differentiate between the two groups of infections. In this study, the potential of FTIR microscopy in tandem with multivariate analysis, was evaluated for the identification of the agent that causes the human infection during 20-30 minutes (including blood separation preparation). The differentiating between the investigated groups were obtained due to minute spectral changes in several bands of the FTIR spectra of WBCs. Employing feature extraction with linear discriminant analysis (LDA), a accuracy of ~92% and sensitivity of ~87% for infection type diagnosis was achieved. This study suggest that FTIR spectroscopy of WBCs is a feasible tool for the diagnosis of infection type.
Ati Moncef
University Hospital, Algeria
Title: Clinical comparison of internal absorbed doses by standard and optimization protocol administrated activity in bone nuclear medicine studies
Time : 15:10-15:35
Biography:
Ati Moncef is a student from the University Hospital, Algeria. His research interests include both Medical Physics and Nuclear Medicine Education. He has many publications, abstracts and presentations combined.
Abstract:
Internal absorbed dose in kidneys in the case of bone scintigraphy studies has been estimated for 14 patients in two different groups with 20 patients in each group respectively. The first group is administrated with an activity equal to 20 mCi of 99mTc-MDA radiopharmaceutical. In the second group, patients are benefited with a protocol of optimization for the administrated activity under a range of (10 mCi to 19 mCi) was used as a function of the width for each patient. The measurement data in the present study was acquired with an e-cam gamma camera under a Low Energy High Resolution (LEHR) collimator. Finally, results of the kidney organ absorbed dose were compared to the previous techniques. Our preliminary results suggest that the optimization protocol decreases the absorbed dose in the different organs by a factor that tends towards ~2. In another case, a good image quality obtained with the proposed optimization is compared to the standard administrated on the used activity. That may be the best radiation safety to patient and staff in the nuclear medicine studies.
Poorya Heydari
Sahand University of Technology, Iran
Title: The function principles of modern radiation therapy system, cyberknife & tomotherapy
Time : 15:35-16:00
Biography:
Poorya Heydari is pursuing her BS in Biomedical Engineering at Sahand University of Technology, Tabriz. Her research interests include both Meidal Physics and cyberknife and tomotherapy Education. She has many publications, abstracts and presentations combined.
Abstract:
Taking advantage of science and technology to improve human life is one of the best and most beautiful knowledge applications. In today's world there are humanitarian applications of high-tech knowledge in the whole world, especially the developed countries. In this case, the health and treatment field is so important. To use the increasing development of technology for the treatment of chronic diseases, many efforts have been made. Cancer is one among them. With several years of efforts by researchers and scientists, today a small number of patients lose their lives due to cancer. Creating advanced
equipment such as Linear Accelerators for the non-invasive treatment of tumors is a great achievement to treatment of cancer. With the passage of time and researcher’s activities, high-tech equipment such as cyberknife and tomotherapy system, have come to help cancer patients. The advent of these equipment is so effective and successful step in the treatment of cancer. In
this project addition of the cancer and the treatment options such as Brachytherapy, Gamma Knife, X-Knife, Radiotherapy and Stereotactic Radiosurgery, etc., tried to investigate completely the function principle of modern Radiation therapy system. As well as the Synchrony–Cyberknife Respiratory Technology, Monte Carlo Dose Calculation and Automated Patient Positioning System (RoboCouch) are such important parts of the project.