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S Shalev

Publications and source records attributed to S Shalev.

At least 37 records · Page 2Linked to original sources
PubMed1991

The objective evaluation of alternative treatment plans: II. Score functions.

A series of six patients with adenocarcinoma of the prostate, Stages A2, B1, or B2, were planned for treatment using a four-field box technique at 25 MV. Plans were prepared by three techniques: composite, mid-plane, and conformal. The dose distributions at the central plane and at two planes offset by +/- 2 cm were evaluated by means of score functions which quantify the magnitude of regret for target dose gradient, target over- and under-dose, non-target tissue overdose, and for overdose to the rectum, bladder, and femoral heads. The score functions are normalized to give values in the range from 10 (ideal) to zero (limit of acceptability), with negative values indicating unacceptable deviations from the prescribed dose limits. The scores for off-axis conformal plans were found to be essentially the same as for mid-plane plans on the central plane. However, mid-plane planning was shown to be totally inadequate for off-axis planes, where the average target gradient and underdose scores were reduced by 10 units. Composite planning resulted in adequate target coverage on all planes, but at the expense of unacceptable overdose to non-target tissue. The effect of reducing the posterior beam weight to half that of the other three beams was to reduce the target gradient score by 1.6 +/- 0.5 units and to increase the rectal score by 0.9 +/- 0.3 units.

Adenocarcinoma↗
PubMed1990

Treatment planning for protocol-based radiation therapy.

Many protocol studies are conducted in which patients are assigned to alternative treatment regimens. Typically the dosimetric specifications will define the maximal and minimal target doses and maximal doses to specified critical normal structures, and the success of the study will depend upon the consistency and reliability with which these dose specifications are applied. We have investigated the use of dose-area histograms to ensure complete adherence to protocol dose specifications. A dose prescription is prepared that defines upper and lower target doses as well as normal tissue dose tolerance levels for all organs of interest. In addition, dose-volume histograms are derived which provide quantitative measures of the extent to which each dose limit has been met. This technique can be used during treatment planning to prevent protocol violations of pre-defined severity, or for retroactive correlation of local tumor recurrence and treatment-related morbidity with dose levels in the target and normal tissues. An example is presented for a protocol study of ca prostate, stages A and B, in which seven treatments were evaluated at the mid-plane for protocol violations.

Clinical Trials as Topic↗
PubMed1990

An adaptive technique for digital noise suppression in on-line portal imaging.

Two complementary approaches to the noise suppression problem in on-line portal imaging have been analysed. Temporal filtering by image summation can substantially reduce the amount of noise in an image. In many cases, however, movements of the patient or the radiation source limit the time period over which the averaging can be done. Any remaining noise has to be dealt with by applying spatial filtering. The adaptive Lee filter is particularly suitable for portal imaging applications. It preserves a crisp definition of edges while removing noise in flat regions of the image. It can be used to obtain images of satisfactory quality with short radiation exposure of the patient. We have proposed a modification to the basic Lee technique which permits the calculation of the noise variance locally by utilising the information contained in intermediate images acquired during frame averaging. Unlike the original Lee formulation, no a priori knowledge of the noise variance is required, and in contrast to Mastin's approach (Mastin 1985), the variance may vary with position in the image. The tests of performance of the modified Lee filter, carried out using on-line images, have shown its superiority in comparison with the original Lee technique as well as with conventional averaging and median filters.

Filtration↗
PubMed1989

Digital contrast enhancement for online portal imaging.

Seven digital contrast enhancement algorithms were implemented and evaluated for application to images obtained with an online video portal imaging system. An objective quantitative comparison shows that superior contrast enhancement is obtained using histogram modification techniques. Additional tests made on an image of a humanoid phantom indicate that local (adaptive) histogram modification methods can produce a better contrast in detail than their global counterparts, if the original image is nonuniform in intensity.

Algorithms↗
PubMed1988

The objective evaluation of alternative treatment plans: I. Images of regret.

An innovative approach to treatment planning is described in which a planned dose distribution is evaluated in terms of prescribed limits of acceptability, and any discrepancies (referred to as "regions of regret") are displayed in the form of a contour diagram in which colors are used to represent different types and degrees of regret. A commercial treatment planning system has been modified to display images of regret in addition to conventional isodose plots, and is used for the comparison of alternative plans in terms of adequate target coverage and minimal irradiation of sensitive organs. Required tumor dose levels and organ-specific tolerance doses are prepared in advance by the clinician for each site and stored in a prescription file for use in the planning process. The method is found to expedite the optimization procedure, is objective and reproducible, and provides clear documentation of the selection process.

Computer Graphics↗
PubMed1988

Treatment planning using images of regret.

The lack of well-defined criteria for evaluating alternative treatment plans introduces a degree of subjectivity into the planning process. The complexity of conventional isodose charts causes further difficulty in making rapid and reliable evaluations of a plan. An objective method is described, using a prescription file to define the clinician's requirements in terms of the area of each organ which may be treated to predefined tolerance doses. The computer program OSCAR then compares the predicted dose distribution with the prescribed limits, and displays regions of noncompliance as colored "areas of regret." In addition, score functions are used to provide a quantitative measure of the acceptability of dose distributions within the target and each organ at risk. An example is described in which a plan for the treatment of ca esophagus is evaluated using both images of regret and score functions.

Esophageal Neoplasms↗
PubMed1987

Colour visualization as an aid to the comparison of treatment plans for prostatic carcinoma.

The conventional treatment plan is usually presented as a longitudinal set of axial cross-sections showing the patient contour and selected anatomical features, together with a set of isodose lines. It is difficult to interpret the correlation between dose, target and organs at risk, and the comparison of several plans is time-consuming and highly subjective. This procedure has been improved by modifying a treatment planning system to provide 'images of regret', in which regions are shown in appropriate colour if the planned dose distribution is at variance with prescribed conditions defining limits of acceptability. The method has been used for planning treatment for localized prostatic cancer, and found to be useful for the rapid selection of the optimal treatment plan from a set of alternatives.

Adenocarcinoma↗
PubMedDate not supplied

Video techniques for on-line portal imaging.

The application of on-line portal imaging techniques to the verification of treatment precision is reviewed. The design parameters for a video portal imaging system are described, and the optimization of image quality is discussed with particular emphasis on photon noise. On-line images are presented for a head phantom imaged on a 4 MV linac, and compared with a conventional portal film. The relative advantages of an on-line system are compared with conventional portal film analysis.

Humans↗
PubMedDate not supplied

Venous thromboembolism, factor V Leiden, and methylenetetrahydrofolate reductase in a sickle cell anemia patient.

Vaso-occlusive crisis is the most common cause of morbidity in patients with sickle cell anemia (SCA). Central nervous system involvement that leads to hemiplegia is the most frequent neurological complication in those patients. Peripheral deep venous thromboembolism was not reported in SCA patients. Activated protein C resistance is associated with an increased risk of thrombophilia. The authors report an SCA patient with recurrent cerebrovascular accident and deep venous thrombosis. Activated protein C resistance due to factor V Leiden heterozygous and heterozygocity for the methylenetetrahydrofolate reductase were diagnosed and suspected to be the risk factors that contribute to the development of the deep vein thrombosis in this SCA patient.

Activated Protein C Resistance↗
PubMedDate not supplied

Development of a tissue-equivalent phantom for diaphanography.

A phantom is proposed for quality control and calibration of instruments used for transillumination of the breast for early detection of cancer. A container is filled with a material having optical properties very similar to those of breast tissue, and internal objects are viewed by transmitted light. The phantom can be used to optimize operating conditions for the visualization of small or deep-seated lesions.

Breast Neoplasms↗
PubMedDate not supplied

A study on the efficacy of digital enhancement of on-line portal images.

A novel method for evaluation of observer performance with portal images has been developed, in which the observer is required to identify and localize predefined anatomical landmarks in digital portal images. The method was employed to compare the spatial accuracy and decision time for landmark localization in unenhanced on-line portal images and images enhanced digitally by selective adaptive histogram modification. The results indicate that anatomical landmarks were more readily identified in the enhanced images, leading to significantly higher accuracy in landmark localization.

Evaluation Studies as Topic↗
PubMedDate not supplied

The enhancement of radiotherapy verification images by an automated edge detection technique.

Adaptive histogram equalization techniques are known to be effective for the enhancement of contrast in portal images acquired during radiotherapy treatments. A significant drawback is the loss of definition on the edges of the treatment field. Analysis of this problem shows that it can be remedied by separating the treatment field from the background prior to the enhancement, and using only the pixels within the field boundary in the enhancement procedure. An edge extraction algorithm has been developed for delineating the treatment field in portal images, and consists of four modules that are applied to the original portal image in sequence. In the first step, edges are enhanced with a derivative of Gaussian operator that assures high response to the field edges relative to anatomical or other edges in the image. Pixels for which the response of the edge operator was the strongest are subsequently connected by an edge following algorithm to produce a raw contour of the field. In the last two steps the contour is refined by converting it into straight line segments and appending to the contour any parts of the field edge that might have been missed out during the initial edge following. The final contour encloses exclusively those pixels that belong to the treatment field, and the adaptive histogram equalization is applied selectively to this region. The combination of edge detection and selective enhancement was shown to produce images of superior contrast on the patient's anatomical features as well as accurate definition of treatment field edges.

Algorithms↗
PubMedDate not supplied

A rho-theta technique for treatment verification in radiotherapy and its clinical applications.

A new technique based on a rho-theta coordinate system for determining differences in patient position between portal and simulator images is presented. Unlike the conventional point matching method, which requires the fiducial points to be labeled in pairs before the registration, the rho-theta technique avoids this manual procedure. It accomplishes the treatment verification in two major steps; image alignment and field displacement analysis. For the same number of fiducial points in the simulator and portal images, it first finds the corresponding paired points if the points are not distributed symmetrically about their centroid. This is followed by alignment of these paired points using the least squares matching method to find the optimal two-dimensional rigid body transformation parameters (shift, rotation, and scaling factor). The transformation parameters are then used to transform the portal field edge into the simulator image, so that the portal field can be compared with the prescribed field on the simulator image. A number of parameters were explored to describe the field displacement errors, including treatment field size, under/over irradiated size, the shift in center of gravity of the field, the field edge shift, and rotation of the field. The rho-theta technique as implemented is both fast and accurate. Experiments on the registration of radiological phantom portal images acquired with an on-line portal imaging system mounted on a linear accelerator indicate an accuracy on the order of 1 mm in detecting the shift of the field's center of gravity and approximately 1 degree in detecting the field rotation. The results of a clinical trial are also presented.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMedDate not supplied

Monte Carlo optimization of metal/phosphor screens at megavoltage energies.

The physics of imaging with metal/phosphor (Gd2O2S:Tb on brass) screens at megavoltage energies has been investigated using Monte Carlo simulation. It has been found that pair production is a significant contributor to energy deposition for Bremsstrahlung beams with energies greater than 6 MV. The effects of different thicknesses of phosphor and metal have been studied, and it is shown that the metal plays a significant role in establishing electronic equilibrium in the phosphor. The transport of optical photons through the phosphor has been modeled, and was found that only 10% to 20% of the light created in the phosphor escapes from the surface, with much of the loss being due to total internal reflection at the surface. Calculated results have been compared with experimental measurements of screen brightness for different phosphor and metal thicknesses. The SNR of a video electronic portal imaging device (VEPID) has been calculated as a function of x-ray and optical photon detection efficiency. The non-Poisson distribution of energy deposition in the phosphor is an important contributor to the SNR. The results of this paper should serve as a useful guide to the engineering design of future electronic portal imaging systems.

Biophysical Phenomena↗