After obtaining institutional ethics approval (Lawson Approval Number: R‐23‐086), ten (10) patients with early‐stage NSCLC treated with a hypofractionated treatment scheme using a free‐breathing VMAT technique were retrospectively analyzed in the treatment planning system Eclipse v15.6 (Varian Medical Systems, Palo Alto, USA). Seven patients were treated with an ablative dose defined by a BED10 > 100 Gy, while three were retreatment scenarios with a reduced dose per fraction. 4D‐CT and DIBH scans of all patients were acquired on a Philips Brilliance Big Bore CT Scanner (Philips Medical Systems, Cleveland, USA), with the 4D‐CT datasets binned into 10 phases labeled from 0% to 90% based on the portion of the respiratory cycle. The 0% phase corresponds to end‐inhale and the 50% phase corresponding to end‐exhale. Patient specific breathing traces were obtained simultaneously using the Varian Respiratory Gating for Scanners (RGSC) system (Varian Medical Systems, Palo Alto, USA). Patient and tumor characteristics are summarized in Table 1 .
Brilliance big bore ct scanner
Manufactured by Philips
Sourced in United States, Netherlands
The Brilliance Big Bore CT scanner is a computed tomography (CT) imaging system designed for a wide range of clinical applications. It features a large bore size, enabling the scanning of patients with a variety of body types and sizes. The scanner captures high-quality, detailed images of the internal structures of the body, providing valuable diagnostic information to healthcare professionals.
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Lab products found in correlation
Eclipse 8, by Agilent Technologies (3 mentions)
Ge advantage 4d software, by GE Healthcare (3 mentions)
O mar, by Philips (2 mentions)
Matlab, by MathWorks (2 mentions)
Brilliance big bore 16 ct scanner, by Philips (2 mentions)
Gammex rmi, by Sun Nuclear (2 mentions)
Eclipse v15, by Agilent Technologies (1 mentions)
Gafchromic film, by Ashland (1 mentions)
Real time position management rpm system, by Agilent Technologies (1 mentions)
Biograph mct, by Siemens (1 mentions)
Discovery rx, by GE Healthcare (1 mentions)
Velocity software, by Agilent Technologies (1 mentions)
Oncentra, by Elekta (1 mentions)
Raystation, by RaySearch Laboratories (1 mentions)
Lightspeed pro 16 ct, by GE Healthcare (1 mentions)
Bellows system, by Philips (1 mentions)
Brilliance ct big bore oncology configuration, by Philips (1 mentions)
Eclipse treatment planning system, by Agilent Technologies (1 mentions)
Raystation 6, by RaySearch Laboratories (1 mentions)
Pinnacle treatment planning system, by Philips (1 mentions)
53 protocols using brilliance big bore ct scanner
1
Hypofractionated VMAT for Early-Stage NSCLC
2
Radiomics Analysis of CT Scans for Treatment Planning
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All cases were subjected to free-breathing CT scans using a Philips Brilliance Big Bore CT scanner (Philips Medical Systems, Inc., Cleveland, OH) to develop treatment plans. The following parameters were used in CT scans: tube current (200 mA), voltage (120 kVp), pixel size (0.911 mm), slice thickness (5 mm), and image matrices (X: 768, Y: 768). This work utilized the Pyradiomics library in Python for extracting radiomic features. One hundred five Original features were extracted, including 18 first-order features, 14 shape features, and 73 texture analysis features (Gray Level Concurrence/Run Length/Size Zone/Dependence Matrix [GLCM/GLRLM/GLSZM/GLDM features, Neighborhood gray-tone difference matrix [NGTDM] features) were extracted. A total of 1183 transformation features based on shape and first order were extracted. Eight wavelet filters (LHL, HLL, LLH, LHH, HHH, HLH, LLL, and HHL) and five Image algorithms (square root, square, gradient, exponential, logarithm) were used. Prior to calculating radiomics features, each image was resampled (size: 3 × 3 × 3) and normalized (normalize Scale:100). We obtained 2576 features in PTV and lungs by performing the above operations.
3
Elemental Analysis of Spine Fixation Device
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A spine fixation device, shown in Fig. 1(a) , was utilized in this study. A sample of the device was sent to and analyzed by the University of New South Wales Analytical Centre, using the laser ablation inductively coupled plasma mass spectrometry (ICP‐MS) technique to determine the elemental composition by weight.
An in‐house water phantom was constructed to fix the device in water and allow the Gafchromic films (Ashland Inc., Covington KY) to be inserted in the sagittal and frontal orientations, as shown inFigs. 1(b) and (c) . The phantom acts as a surrogate for the spinal region of a patient.
The phantom was scanned with a Philips Brilliance Big Bore CT scanner (Philips Health Care, Cleveland, OH). Images were acquired with 16‐bit depth at 50 mAs, 120 kVp, with133 × 133 mm 2 1024 × 1024 pixels ∼ 0.13 × 0.13 mm 2
An in‐house water phantom was constructed to fix the device in water and allow the Gafchromic films (Ashland Inc., Covington KY) to be inserted in the sagittal and frontal orientations, as shown in
The phantom was scanned with a Philips Brilliance Big Bore CT scanner (Philips Health Care, Cleveland, OH). Images were acquired with 16‐bit depth at 50 mAs, 120 kVp, with
4
NSCLC SABR Treatment Planning Study
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A total of 10 patients with medically inoperable early‐stage NSCLC were enrolled in this retrospective planning study. These patients were chosen based on criteria of motion greater than 0.5 cm, and internal target volume (ITV) in the range of 4.4 − 53.1 cm 3 Table 1 .
Four‐dimensional computed tomography (4D CT) scans, reconstructed into 10 phases, were acquired for each patient using Varian's Real‐time Position Management (RPM) system (Varian
Medical Systems) in the Philips Brilliance Big Bore CT scanner (Philips Medical Systems). The gross target volume, (GTV), was contoured on each of the 10 respiratory phases and motion encompassing internal target volume, (ITV), was created by summing the 10 individual GTVs. Consecutively, the planning target volume (PTV) was created by adding a 5 mm expansion to the ITV in the untagged average 4D CT. Target volumes and contours of the critical structures were imported onto the untagged average 4D CT and employed for treatment planning across different techniques.
Four‐dimensional computed tomography (4D CT) scans, reconstructed into 10 phases, were acquired for each patient using Varian's Real‐time Position Management (RPM) system (Varian
Medical Systems) in the Philips Brilliance Big Bore CT scanner (Philips Medical Systems). The gross target volume, (GTV), was contoured on each of the 10 respiratory phases and motion encompassing internal target volume, (ITV), was created by summing the 10 individual GTVs. Consecutively, the planning target volume (PTV) was created by adding a 5 mm expansion to the ITV in the untagged average 4D CT. Target volumes and contours of the critical structures were imported onto the untagged average 4D CT and employed for treatment planning across different techniques.
5
PSMA-Targeted PET/CT Imaging for SABR
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Patients were imaged for clinical treatment simulation using a Brilliance Big Bore CT scanner (Philips Medical Systems, Cleveland, OH) with 2-mm slice thickness. PSMA-targeted PET/CT was acquired before SABR and at 6 months postrandomization using the radio-labeled PSMA-targeted ligand 18F-DCFPyL.13 (link) PET/CT images were acquired 1 hour after injection using either a Biograph mCT (Siemens, Erlangen, Germany) or Discovery RX (GE Health care, Waukesha, WI) scanner. PET images had isotropic 4-mm voxel dimensions. The initial PET/CT scan was rigidly registered to the simulation CT using Velocity software (Varian Medical Systems, Palo Alto, CA), ensuring optimal registration in the region to be treated.
6
Radiation Therapy for Locally Advanced Cervical Carcinoma
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A total of 20 patients with locally advanced cervical carcinoma were selected for this planning study. These patients were randomly enrolled in this study between 2019 and 2020 in the department. Age ranged from 46 to 64 years, with a median age of 50 years. According to the International Federation of Gynecology and Obstetrics, [ 9 ] the clinical stage was as follows: stage IIA, five patients (25%) and Stage IIB, 15 patients (75%).
All the patients received a planning computed tomography (CT) scan (Brilliance Big Bore CT scanner, Philips Healthcare, Cleveland, OH, USA) in a supine treatment position with arms elevated above the head. CT images were reconstructed using a 0.3 cm thickness. Each patient's images were sent for contouring (Oncentra, Elekta AB, Stockholm, Sweden) and planning (HT, Tomotherapy Inc., Madison, WI, USA). The clinical target volume (CTV) was contoured according to the Radiation Therapy Oncology Group reports.[ 10 ] The CTV was defined as the cervix, uterus, upper half of the vagina, and pelvic lymph nodes. The planning target volume (PTV) was defined as the CTV plus 0.5-1.0 cm margins. The OARs include the rectum, bladder, intestine, spinal cord, bone, and femoral head. The mean volume of the CTV was 700.6 ± 40.6 cm 3 (range, 529.5-895.2 cm 3 ), and PTV was 1272.6 ± 60.2 cm 3 (range, 1020.8-1596.6 cm 3 ).
All the patients received a planning computed tomography (CT) scan (Brilliance Big Bore CT scanner, Philips Healthcare, Cleveland, OH, USA) in a supine treatment position with arms elevated above the head. CT images were reconstructed using a 0.3 cm thickness. Each patient's images were sent for contouring (Oncentra, Elekta AB, Stockholm, Sweden) and planning (HT, Tomotherapy Inc., Madison, WI, USA). The clinical target volume (CTV) was contoured according to the Radiation Therapy Oncology Group reports.[ 10 ] The CTV was defined as the cervix, uterus, upper half of the vagina, and pelvic lymph nodes. The planning target volume (PTV) was defined as the CTV plus 0.5-1.0 cm margins. The OARs include the rectum, bladder, intestine, spinal cord, bone, and femoral head. The mean volume of the CTV was 700.6 ± 40.6 cm 3 (range, 529.5-895.2 cm 3 ), and PTV was 1272.6 ± 60.2 cm 3 (range, 1020.8-1596.6 cm 3 ).
7
Anthropomorphic Phantom Imaging and Planning
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A whole body anthropomorphic phantom (PBU-60, Kyoto Kagaku Hyohon Co.) was used in this study. The phantom was imaged using a Brilliance Big Bore CT scanner (Philips). Arbitrary targets were delineated in the brain, the nasal cavity and the lung of the phantom. The treatment planning was performed with RayStation (Raysearch Laboratories Inc.). For each target, a single beam angle was used for planning. A lateral beam was used for the brain case and an anterior beam was used for the nasal cavity and lung cases.
8
Comparison of Dose Prescriptions for HN Cancer
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Forty HN cancer patients with various tumor sites and stages treated at our institution (two different facilities) were retrospectively studied. All patients underwent a planning computed tomography (CT) scan on Philips Brilliance Big Bore CT scanner (Philips, Cleveland, OH) with 2 mm slice thickness. Two different prescriptions were used in this study: (1) three prescription dose levels (3R×): a total dose of 70 Gy over 35 fractions to the primary tumor, and a simultaneous integrated boost (SIB) of 63 Gy to regions with microscopic disease and 56 Gy to the low‐risk nodal region; (2) two prescription dose levels (2R×): a total dose of 70 Gy over 35 fractions to the primary tumor, and a SIB of 54 Gy to the microscopic disease and low‐risk nodal region. Table 1 lists the tumor locations and characteristics for all patients used in this study.
9
CT Imaging of Cancer Cohorts
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The CT images of the training cohort were obtained from the Brilliance Big Bore CT scanner (Philips Electronics, Eindhoven, Netherlands) in Hangzhou Cancer Hospital. The scanning voltage and tube currents were 120 kVp and 406 mAs. The slice thickness ranged from 3 to 5 mm. The CT images in the validation cohort were scanned from the LightSpeed Pro 16 CT (GE Medical Systems, Milwaukee) in the First Affiliated Hospital of Wenzhou Medical College, with 120 kVp and 150 mAs. The slice thickness was 3–8 mm.
10
Early-Stage NSCLC Chest Wall Proximity
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A total of 28 patients with early-stage peripheral NSCLC treated at the First Hospital of Jilin University between 2017 and 2021 were retrospectively included. The distances between the PTV and the chest wall were <0.5 cm for 12 patients, 0.5−1.0 cm for 6 patients, 1.0−1.5 cm for 6 patients, and >1.5 cm for 4 patients. Patients were immobilized with custom-made negative-pressure vacuum cushions in supine position. Four-dimensional computed tomography (4D-CT) scan was acquired on a Philips Brilliance Big Bore CT scanner with a bellows system (Philips Healthcare, Cleveland, OH, USA). The 4D-CT datasets were reconstructed as 10 respiratory phases with 1.5-mm slice thickness and then transferred to the Varian Eclipse 15.6 TPS.
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