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211 results on '"Chuong, Michael D."'

1. Radiation Therapy Quality Assurance Analysis of Alliance A021501: Preoperative mFOLFIRINOX or mFOLFIRINOX Plus Hypofractionated Radiation Therapy for Borderline Resectable Adenocarcinoma of the Pancreas

Author

Tchelebi, Leila T., Segovia, Diana, Smith, Koren, Shi, Qian, Fitzgerald, T.J., Chuong, Michael D., Zemla, Tyler J., O'Reilly, Eileen M., Meyerhardt, Jeffrey A, Koay, Eugene J., Lowenstein, Jessica, Shergill, Ardaman, Katz, Matthew H.G., and Herman, Joseph M.

Published
2024
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5. Stereotactic MR-guided on-table adaptive radiation therapy (SMART) for borderline resectable and locally advanced pancreatic cancer: A multi-center, open-label phase 2 study

Author

Chuong, Michael D., Lee, Percy, Low, Daniel A., Kim, Joshua, Mittauer, Kathryn E., Bassetti, Michael F., Glide-Hurst, Carri K., Raldow, Ann C., Yang, Yingli, Portelance, Lorraine, Padgett, Kyle R., Zaki, Bassem, Zhang, Rongxiao, Kim, Hyun, Henke, Lauren E., Price, Alex T., Mancias, Joseph D., Williams, Christopher L., Ng, John, Pennell, Ryan, Raphael Pfeffer, M., Levin, Daphne, Mueller, Adam C., Mooney, Karen E., Kelly, Patrick, Shah, Amish P., Boldrini, Luca, Placidi, Lorenzo, Fuss, Martin, and Jitendra Parikh, Parag

Published
2024
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10. A Multi-Institutional Phase 2 Trial of Ablative 5-Fraction Stereotactic Magnetic Resonance-Guided On-Table Adaptive Radiation Therapy for Borderline Resectable and Locally Advanced Pancreatic Cancer

Author

Parikh, Parag Jitendra, Lee, Percy, Low, Daniel A., Kim, Joshua, Mittauer, Kathryn E., Bassetti, Michael F., Glide-Hurst, Carri K., Raldow, Ann C., Yang, Yingli, Portelance, Lorraine, Padgett, Kyle R., Zaki, Bassem, Zhang, Rongxiao, Kim, Hyun, Henke, Lauren E., Price, Alex T., Mancias, Joseph D., Williams, Christopher L., Ng, John, Pennell, Ryan, Pfeffer, M. Raphael, Levin, Daphne, Mueller, Adam C., Mooney, Karen E., Kelly, Patrick, Shah, Amish P., Boldrini, Luca, Placidi, Lorenzo, Fuss, Martin, and Chuong, Michael D.

Published
2023
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17. Patterns of utilization and clinical adoption of 0.35 Tesla MR-guided radiation therapy in the United States – Understanding the transition to adaptive, ultra-hypofractionated treatments

Author

Chuong, Michael D., Clark, Mary Ann, Henke, Lauren E., Kishan, Amar U., Portelance, Lorraine, Parikh, Parag J., Bassetti, Michael F., Nagar, Himanshu, Rosenberg, Stephen A., Mehta, Minesh P., Refaat, Tamer, Rineer, Justin M., Smith, Adam, Seung, Steven, Zaki, Bassem I., Fuss, Martin, and Mak, Raymond H.

Published
2023
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24. Quality assurance of an established online adaptive radiotherapy program: patch and software upgrade.

Author

Bassiri, Nema, Bayouth, John, Chuong, Michael D., Kotecha, Rupesh, Weiss, Yonatan, Mehta, Minesh P., Gutierrez, Alonso N., and Mittauer, Kathryn E.

Subjects
SOFTWARE upgrades, QUALITY assurance, COMPUTER software installation, USER interfaces, IONIZATION chambers
Abstract

Introduction: The ability to dynamically adjust target contours, derived Boolean structures, and ultimately, the optimized fluence is the end goal of online adaptive radiotherapy (ART). The purpose of this work is to describe the necessary tests to perform after a software patch installation and/or upgrade for an established online ART program. Methods: A patch upgrade on a low-field MR Linac system was evaluated for post-software upgrade quality assurance (QA) with current infrastructure of ART workflow on (1) the treatment planning system (TPS) during the initial planning stage and (2) the treatment delivery system (TDS), which is a TPS integrated into the delivery console for online ART planning. Online ART QA procedures recommended for post-software upgrade include: (1) user interface (UI) configuration; (2) TPS beam model consistency; (3) segmentation consistency; (4) dose calculation consistency; (5) optimizer robustness consistency; (6) CT density table consistency; and (7) end-to-end absolute ART dose and predicted dose measured including interruption testing. Differences of calculated doses were evaluated through DVH and/or 3D gamma comparisons. The measured dose was assessed using an MR-compatible A26 ionization chamber in a motion phantom. Segmentation differences were assessed through absolute volume and visual inspection. Results: (1) No UI configuration discrepancies were observed. (2) Dose differences on TPS pre-/post-software upgrade were within 1% for DVH metrics. (3) Differences in segmentation when observed were small in general, with the largest change noted for small-volume regions of interest (ROIs) due to partial volume impact. (4) Agreement between TPS and TDS calculated doses was 99.9% using a 2%/2-mm gamma criteria. (5) Comparison between TPS and online ART plans for a given patient plan showed agreement within 2% for targets and 0.6 cc for organs at risk. (6) Relative electron densities demonstrated comparable agreement between TPS and TDS. (7) ART absolute and predicted measured end-to-end doses were within 1% of calculated TDS. Discussion: An online ART QA program for post-software upgrade has been developed and implemented on an MR Linac system. Testing mechanics and their respective baselines may vary across institutions, but all necessary components for a post-software upgrade QA have been outlined and detailed. These outlined tests were demonstrated feasible for a low-field MR Linac system; however, the scope of this work may be applied and adapted more broadly to other online ART platforms. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Letter to the Editor

Author

Chuong, Michael D., Hosni, Ali, Kharofa, Jordan, Reyngold, Marsha, Sanford, Nina, Rubio Rodriguez, Mamen, and Dawson, Laura

Published
2024
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28. AAPM Medical Physics Practice Guideline 14.a: Yttrium‐90 microsphere radioembolization.

Author

Busse, Nathan C., Al‐Ghazi, Muthana S. A. L., Abi‐Jaoudeh, Nadine, Alvarez, Diane, Ayan, Ahmet S., Chen, Erli, Chuong, Michael D., Dezarn, William A., Enger, Shirin A., Graves, Stephen A., Hobbs, Robert F., Jafari, Mary Ellen, Kim, S. Peter, Maughan, Nichole M., Polemi, Andrew M., and Stickel, Jennifer R.

Subjects
MEDICAL physics, POSITRON emission tomography computed tomography, RADIOEMBOLIZATION, LIVER tumors, FAILURE mode & effects analysis, RADIATION exposure
Abstract

Radioembolization using Yttrium‐90 (90Y) microspheres is widely used to treat primary and metastatic liver tumors. The present work provides minimum practice guidelines for establishing and supporting such a program. Medical physicists play a key role in patient and staff safety during these procedures. Products currently available are identified and their properties and suppliers summarized. Appropriateness for use is the domain of the treating physician. Patient work up starts with pre‐treatment imaging. First, a mapping study using Technetium‐99m (Tc‐99m) is carried out to quantify the lung shunt fraction (LSF) and to characterize the vascular supply of the liver. An MRI, CT, or a PET‐CT scan is used to obtain information on the tumor burden. The tumor volume, LSF, tumor histology, and other pertinent patient characteristics are used to decide the type and quantity of 90Y to be ordered. On the day of treatment, the appropriate dose is assayed using a dose calibrator with a calibration traceable to a national standard. In the treatment suite, the care team led by an interventional radiologist delivers the dose using real‐time image guidance. The treatment suite is posted as a radioactive area during the procedure and staff wear radiation dosimeters. The treatment room, patient, and staff are surveyed post‐procedure. The dose delivered to the patient is determined from the ratio of pre‐treatment and residual waste exposure rate measurements. Establishing such a treatment modality is a major undertaking requiring an institutional radioactive materials license amendment complying with appropriate federal and state radiation regulations and appropriate staff training commensurate with their respective role and function in the planning and delivery of the procedure. Training, documentation, and areas for potential failure modes are identified and guidance is provided to ameliorate them. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Accelerated Hypofractionated Magnetic Resonance Guided Adaptive Radiation Therapy for Ultracentral Lung Tumors.

Author

La Rosa, Alonso, Mittauer, Kathryn E., Bassiri, Nema, Rzepczynski, Amy E., Chuong, Michael D., Yarlagadda, Sreenija, Kutuk, Tugce, McAllister, Nicole C., Hall, Matthew D., Gutierrez, Alonso N., Tolakanahalli, Ranjini, Mehta, Minesh P., and Kotecha, Rupesh

Subjects
LUNG tumors, LUNGS, RADIOTHERAPY, STEREOTACTIC radiotherapy, MAGNETIC resonance, TUMOR treatment
Abstract

Radiotherapy for ultracentral lung tumors represents a treatment challenge, considering the high rates of high-grade treatment-related toxicities with stereotactic body radiation therapy (SBRT) or hypofractionated schedules. Accelerated hypofractionated magnetic resonance-guided adaptive radiation therapy (MRgART) emerged as a potential game-changer for tumors in these challenging locations, in close proximity to central organs at risk, such as the trachea, proximal bronchial tree, and esophagus. In this series, 13 consecutive patients, predominantly male (n = 9), with a median age of 71 (range (R): 46–85), underwent 195 MRgART fractions (all 60 Gy in 15 fractions) to metastatic (n = 12) or primary ultra-central lung tumors (n = 1). The median gross tumor volumes (GTVs) and planning target volumes (PTVs) were 20.72 cc (R: 0.54–121.65 cc) and 61.53 cc (R: 3.87–211.81 cc), respectively. The median beam-on time per fraction was 14 min. Adapted treatment plans were generated for all fractions, and indications included GTV/PTV undercoverage, OARs exceeding tolerance doses, or both indications in 46%, 18%, and 36% of fractions, respectively. Eight patients received concurrent systemic therapies, including immunotherapy (four), chemotherapy (two), and targeted therapy (two). The crude in-field loco-regional control rate was 92.3%. No CTCAE grade 3+ toxicities were observed. Our results offer promising insights, suggesting that MRgART has the potential to mitigate toxicities, enhance treatment precision, and improve overall patient care in the context of ultracentral lung tumors. [ABSTRACT FROM AUTHOR]

Published
2024
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34. 3141: Evaluation of On-table Adaptive Plan Quality from the Multi-Center Phase 2 SMART Pancreas Trial.

Author

Kim, Joshua P., Chuong, Michael D., Parikh, Parag J., Lee, Percy, Low, Daniel A., Bassetti, Michael F., Glide-Hurst, Carri K., Raldow, Ann C., Yang, Yingli, Portelance, Lorraine, Padgett, Kyle R., Zaki, Bassem, Zhang, Rongxiao, Kim, Hyun, Henke, Lauren E., Price, Alex T., Mancias, Joseph D., Williams, Christopher L., Ng, John, and Pennell, Ryan

Published
2024
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35. Evidence-based Review on the Use of Proton Therapy in Lymphoma From the Particle Therapy Cooperative Group (PTCOG) Lymphoma Subcommittee

Author

Tseng, Yolanda D., Cutter, David J., Plastaras, John P., Parikh, Rahul R., Cahlon, Oren, Chuong, Michael D., Dedeckova, Katerina, Khan, Mohammad K., Lin, Shinn-Yn, McGee, Lisa A., Shen, Eric Yi-Liang, Terezakis, Stephanie A., Badiyan, Shahed N., Kirova, Youlia M., Hoppe, Richard T., Mendenhall, Nancy P., Pankuch, Mark, Flampouri, Stella, Ricardi, Umberto, and Hoppe, Bradford S.

Published
2017
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37. Multi-institutional analysis of radiation modality use and postoperative outcomes of neoadjuvant chemoradiation for esophageal cancer

Author

Lin, Steven H., Merrell, Kenneth W., Shen, Jincheng, Verma, Vivek, Correa, Arlene M., Wang, Lu, Thall, Peter F., Bhooshan, Neha, James, Sarah E., Haddock, Michael G., Suntharalingam, Mohan, Mehta, Minesh P., Liao, Zhongxing, Cox, James D., Komaki, Ritsuko, Mehran, Reza J., Chuong, Michael D., and Hallemeier, Christopher L.

Published
2017
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39. Proton Beam Therapy and Photon-Based Magnetic Resonance Image-Guided Radiation Therapy: The Next Frontiers of Radiation Therapy for Hepatocellular Carcinoma.

Author

Zaki, Peter, Chuong, Michael D., Schaub, Stephanie K., Lo, Simon S., Ibrahim, Mariam, and Apisarnthanarax, Smith

Subjects
IMAGE-guided radiation therapy, PROTON therapy, INTENSITY modulated radiotherapy, EXTERNAL beam radiotherapy, MAGNETOTHERAPY
Abstract

External beam radiation therapy (EBRT) has increasingly been utilized in the treatment of hepatocellular carcinoma (HCC) due to technological advances with positive clinical outcomes. Innovations in EBRT include improved image guidance, motion management, treatment planning, and highly conformal techniques such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT). Moreover, proton beam therapy (PBT) and magnetic resonance image-guided radiation therapy (MRgRT) have expanded the capabilities of EBRT. PBT offers the advantage of minimizing low- and moderate-dose radiation to the surrounding normal tissue, thereby preserving uninvolved liver and allowing for dose escalation. MRgRT provides the advantage of improved soft tissue delineation compared to computerized tomography (CT) guidance. Additionally, MRgRT with online adaptive therapy is particularly useful for addressing motion not otherwise managed and reducing high-dose radiation to the normal tissue such as the stomach and bowel. PBT and online adaptive MRgRT are emerging technological advancements in EBRT that may provide a significant clinical benefit for patients with HCC. [ABSTRACT FROM AUTHOR]

Published
2023
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48. Initial clinical experience with magnetic resonance-guided radiotherapy in pediatric patients: Lessons learned from a single institution with proton therapy.

Author

Hall, Matthew D., Mittauer, Kathryn E., Herrera, Roberto, Von Werne, Katherine, Kotecha, Rupesh, Kalman, Noah S., McCulloch, James, Alvarez, Diane, McAllister, Nicole C., Doty, Delia G., Rzepczynski, Amy E., Deere, Will, Gutierrez, Alonso N., and Chuong, Michael D.

Subjects
CHILD patients, PROTON therapy, STEREOTACTIC radiotherapy, NON-small-cell lung carcinoma, BRAIN tumors, IMAGE fusion, NEUROBLASTOMA
Abstract

Purpose/Objectives: Magnetic resonance-guided radiotherapy (MRgRT) is increasingly used in a variety of adult cancers. To date, published experience regarding the use of MRgRT in pediatric patients is limited to two case reports. We report on the use of MRgRT for pediatric patients at our institution during a four-year period and describe important considerations in the selection and application of this technology in children. Materials/Methods: All patients treated with MRgRT since inception at our institution between 4/2018 and 4/2022 were retrospectively reviewed. We also evaluated all pediatric patients treated at our institution during the same period who received either imaging or treatment using our magnetic resonanceguided linear accelerator (MR Linac). We summarize four clinical cases where MRgRT was selected for treatment in our clinic, including disease outcomes and toxicities and describe our experience using the MR Linac for imaging before and during treatment for image fusion and tumor assessments. Results: Between 4/2018 and 4/2022, 535 patients received MRgRT at our center, including 405 (75.7%) with stereotactic ablative radiotherapy (SABR). During this period, 347 distinct radiotherapy courses were delivered to pediatric patients, including 217 (62.5%) with proton therapy. Four pediatric patients received MRgRT. One received SABR for lung metastasis with daily adaptive replanning and a second was treated for liver metastasis using a nonadaptive workflow. Two patients received fractionated MRgRT for an ALKrearranged non-small cell lung cancer and neuroblastoma. No Grade 2 or higher toxicities were observed or reported during MRgRT or subsequent follow-up. Twelve patients underwent MR imaging without contrast during treatment for brain tumors to assess for tumor/cystic changes. Two patients treated with other modalities underwent MR simulation for target volume delineation and organ at risk sparing due to anatomic changes during treatment or unexpected delays in obtaining diagnostic MR appointments. Conclusions: In four pediatric patients treated with MRgRT, treatment was well tolerated with no severe acute effects. At our center, most pediatric patients are treated with proton therapy, but the cases selected for MRgRT demonstrated significant organ at risk sparing compared to alternative modalities. In particular, MRgRT may provide advantages for thoracic/abdominal/pelvic targets using gated delivery and adaptive replanning, but selected patients treated with fractionated radiotherapy may also benefit MRgRT through superior organ at risk sparing. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Multi-Institutional Outcomes of Patients Aged 75 years and Older With Pancreatic Ductal Adenocarcinoma Treated With 5-Fraction Ablative Stereotactic Magnetic Resonance Image-Guided Adaptive Radiation Therapy (A-SMART).

Author

Bryant, J. M., Palm, Russell F., Herrera, Roberto, Rubens, Muni, Hoffe, Sarah E, Kim, Dae Won, Kaiser, Adeel, Ucar, Antonio, Fleming, Jason, Zarraga, Fernando De, Hodul, Pamela, Aparo, Santiago, Asbun, Horacio, Malafa, Mokenge, Jimenez, Ramon, Denbo, Jason, Frakes, Jessica M, and Chuong, Michael D.

Published
2023
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