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Aquilion lb

Manufactured by Toshiba
Sourced in Japan

The Aquilion LB is a computed tomography (CT) imaging system developed by Toshiba. It is designed to provide high-quality imaging for a variety of medical applications. The system uses advanced technology to capture detailed images of the body, which can be used by healthcare professionals for diagnosis and treatment planning.

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21 protocols using aquilion lb

1

Prone Position Radiotherapy for Pelvic Tumors

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Patients were immobilized in the prone position using a belly board. Computed tomography (simCT, Aquilion-LB; Toshiba, Tokyo, Japan) images were obtained using a 3-mm slice thickness without intravenous and oral contrast. The entire pelvis, from the upper abdomen to 2 cm below the scrotum, was included in the images.
In each patient, the primary tumor region was contoured as the gross tumor volume (GTV) with the help of positron emission tomography-computed tomography and pelvic magnetic resonance images. Clinical tumor volume-1 (CTV-1) was obtained by adding 20-mm margins in all directions to the GTV. CTV-2 contained regional lymph nodes (internal iliac, external iliac, and presacral lymph nodes) in addition to CTV-1. Fivemillimeter margins were added in all directions to create planning target volume-1 (PTV-1) and PTV-2. Bladder, bilateral femoral heads, and small intestines surrounding the PTV-2 were outlined as organs at risk (OARs). There was a testis cavity on belly board and testes were contoured in the scrotum to assess the doses that were exposed.
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2

Radiotherapy Planning and Contouring Protocol

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For radiotherapy planning, CT was performed at slice thicknesses of 3 or 5 mm using a CT scanner (Hi-Speed Dxi; GE Healthcare, Buckinghamshire, UK) (Aquilion LB; TOSHIBA Medical Systems, Tochigi, JP). The clinical target volume (CTV) was contoured on the individual axial CT slices from each patient. The overall CTV included both the primary CTV and nodal CTV, including the pelvic and para-aortic lymph nodes. The pelvic lymph nodes were delineated on the planning CT in accordance with the Japan Clinical Oncology Group Gynecologic Cancer Study Group (JCOG-GCSG) consensus guidelines for the delineation of CTV for pelvic lymph nodes [13 (link)]. The CTV in the para-aortic region was contoured as the region between the psoas muscles, superiorly above the level of the renal artery (to the level of median T12/L1), and anteriorly encompassed the aorta and inferior vena cava with at least a 0.7-cm margin. The CTV was isotropically expanded by 7 mm to create the planning target volume (PTV). In addition, organs at risk (OARs), including the small bowel (contoured as a peritoneal space), rectum, bladder (both contoured as a whole organ), both kidneys, and spinal cord were delineated according to normal tissue contouring guidelines [14 (link),15 (link)]. No margin was added to the contoured OAR.
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3

Phantom Imaging for Brachytherapy Treatment

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Axial CT images of the phantom were obtained at 1 mm slice thickness using the same large-bore CT scanner (Aquilion LB; Toshiba, Tokyo, Japan) used for image-guided brachytherapy treatment at our institute, as well as the sequence used clinically for the pelvic imaging (135 kV, 250 mA, displayed field of view [DFOV] of 550 mm, gantry rotation of 0.5 s). T2-weighted MRI images were acquired using the 3D fast spin-echo technique (FSE) on a 3-T system (Philips Achieva dStream; Koninklijke Philips N.V., Amsterdam, The Netherlands) with a pelvic surface coil and the following settings: repetition time of 2,500 ms, echo time of 245 ms (DFOV of 480 mm). The axial reconstruction thickness was 1 mm, with an intersection gap of 1 mm.
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4

Contouring and Artifact Exclusion in CT Imaging

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PGs and SMGs were delineated on pre-treatment planning CTs (Toshiba Aquilion/LB, 120 kV, voxel size: 1.074 × 1.074 × 3.0 mm3) according to the same contouring protocols as van Dijk et al. [35] (link), [36] .
To avoid analysing CT intensity values that do not correspond to tissue densities [37] (link), [38] (link), van Dijk et al excluded 33 % of their patients as they presented with metal artefacts on their CT scans. Implementing the same approach in our cohort, would have resulted in the exclusion of 95 % (104/109) of the patients and was therefore not undertaken. This difference is remarkable and the proportion of patients with dental implants in our cohort is similar to the one reported by the NIH National Institute of Dental and Craniofacial Research with 92 % of adults who have had dental caries in their permanent teeth [39] .
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5

CT Imaging of Left-Sided Breast Cancer

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Ten patients (age 65 ± 6 years) with left-sided breast cancer without nodal involvement were selected in this retrospective study. The study was approved by the Research Ethics Committee of Northern Savo Hospital District. The patients were imaged with a CT scanner (Toshiba Aquilion LB, Toshiba Medical Systems Co., Tochigi, Japan) in treatment position (supine, arms up). CT images were acquired from the level of mandible to the basis of lungs with a slice thickness of 2 mm.
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6

Bilateral Breast Cancer Radiotherapy Planning

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The patients were imaged with a CT scanner (Toshiba Aquilion LB, Toshiba Medical Systems Co., Tochigi, Japan) in the treatment position on the breast board-in supine position with both hands raised above the head. CT data was acquired from the mandible to the 4 th lumbar vertebra, with a slice thickness of 3 mm during normal breathing. These CT images were then transferred online to the Eclipse (v15.4, Varian Medical Systems, Palo Alto, CA) Treatment Planning System (TPS). In the first step, Planning Target volumes (PTV) of (right and left breasts) were delineated on the CT data according to the department guidelines. The organs at risk (OAR) were contoured, including the heart and both lungs.
The plans were generated by two techniques, i.e. field-in-field (FiF) and VMAT, to a total dose of 40.05 Gy in 15 fractions to both breast, thoracic wall and supraclavicular areas.
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7

Daily CT Imaging for Prostate Cancer Radiotherapy

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This study used the original planning CT images and the daily in‐room CT images for 23 patients who underwent the prostate cancer treatment at the Fukui Prefectural Hospital Proton Therapy Center. Daily in‐room CT images were acquired by a self‐propelled CT scanner on rails (Aquilion LB, Toshiba Medical Systems, Tochigi, Japan). The number of daily CT sets acquired per patient was 36–40, with 21 consecutive sets from the first treatment session used in accordance with the protocol for this study. A total of 483 sets of daily CT were used in the analysis. This study was approved by the institutional review board.
All patients were immobilized in the supine position using a suction‐type fixed bag and a thermoplastic shell (RSF‐19Gl and ESS‐25, ESFORM; Engineering System Co., Ltd., Nagano, Japan). The bladder volume was as full as possible at the time of the planning CT and daily CT. The daily bladder volume was monitored by ultrasound scans to ensure that the volume was similar to that in the planning CT, and patients were instructed to drink water when the bladder was not sufficiently distended. The planning CT scan protocol was 120 kV, 480 mA, and the daily CT scan protocol 120 kV, 150 mA. The CT images were reconstructed with a slice thickness of 2 mm and a transversal pixel size of 1.07 × 1.07 mm2.18
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8

Lung Tumor Characterization by CT Imaging

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Images of the lung tumors were taken using a 64 multislice CT (Light Speed VCT, GE Medical Systems, Milwaukee, WI,) and 16 multislice CT (Aquilion LB, Toshiba Medical Systems, Tokyo, Japan). Raw CT data were reconstructed into an axial CT image with 2.5 mm slice thicknesses according to the JCOG0201 definition.9 (link) The CT image was displayed with a window level of −600 Hounsfield unit (HU) and a window width of 2000 HU as the lung image. Based on the JCOG0201 study, ground-glass opacity was defined as an area of a slight, homogenous increase in density that did not obscure any underlying vascular markings, and was considered to be tumor.9 (link) The solid tumor component was defined as an area of increased opacification that completely obscured any underlying vascular markings. The diameters of the whole tumor and solid tumor component were measured by thin-slice CT using the SYNAPSE VINCENT software program (Fujifilm Medical, Tokyo, Japan). Peripheral and central types were distinguished to determine whether the tumor was located in the “no-fly zone”—2 cm around the proximal airway, as defined in the Radiation Therapy Oncology Group 0236 trial.10 (link) Measurements of tumor diameter and tumor location were determined from the CT data without accompanying clinical data by two different radiologists.
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9

Carbon-Ion Scanning Beam Treatment Protocol

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Two patients, one with a parotid gland tumor and the second with prostate cancer, were randomly selected from our patients undergoing carbon-ion scanning beam treatment. All patients were informed of the contents of the study and gave consent to participate, and the study was approved by the institutional review board of our institution. All patients were fixed by immobilization with a shell device to improve positional reproducibility [9 (link)]. CT data were acquired in helical mode with a multi-slice CT (Aquilion LB, Toshiba Medical Systems, Japan) under free-breathing conditions. The reconstructed slice thickness was 2.0 mm with 16 detectors owing to the slice collimation of 2.0 mm.
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10

Prostate HDR Brachytherapy Procedure at SCGH

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The following briefly describes the established HDR prostate brachytherapy treatment procedure at Sir Charles Gairdner Hospital (SCGH), Perth, Western Australia. The prescribed dose of 19.5 Gy is delivered over three fractions as a boost following external beam radiation therapy. The time between fractions is at least 6 h. In an operating theatre, 15–20 titanium 16 gauge afterloading catheters are inserted transperineally into the prostate under TRUS and fluoroscopy guidance. Four fiducial gold markers are also inserted transperineally into the prostate (two at the base and two at the apex of the prostate) using a biopsy needle. A silicone catheter is inserted through the urethra, and radiopaque packing is inserted into the rectum. CT images are obtained with the Toshiba Aquilion LB after the patient's recovery from anaesthesia. The SCGH HDR brachytherapy protocol is followed, that is helical scan, 2 mm slice thickness, 32 cm diameter field of view (FOV). A CTV and OARs (rectum and urethra) are contoured and fiducial markers and catheters are identified with the treatment planning system BrachyVision™ (version 10 and later version 13.7, Varian Medical Systems, Palo Alto, CA, USA). The dose is delivered with a single Ir‐192 source through the titanium catheters with the GammaMedplus™ iX HDR/PDR Brachytherapy Afterloader (Varian Medical Systems, Palo Alto, CA, USA).
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