A fast and robust constraint-based online re-optimization approach for automated online adaptive intensity modulated proton therapy in head and neck cancer

Objective. In head-and-neck cancer intensity modulated proton therapy, adaptive radiotherapy is currently restricted to offline re-planning, mitigating the effect of slow changes in patient anatomies. Daily online adaptations can potentially improve dosimetry. Here, a new, fully automated online re-optimization strategy is presented. In a...

Predicting HPV status in oropharyngeal carcinoma using multiparametric MRI and clinical variables

Background: Histopathological examination in the diagnostic workflow of oropharyngeal squamous cell carcinoma (OPSCC) is essential. We aimed to develop a machine learning pipeline to predict human papillomavirus (HPV) status in OPSCC patients based on clinical variables and multiparametric magnetic resonance imaging (MRI). <br/>Methods: In a...

Robust optimization in intensity modulated proton therapy treatment planning

Intensity modulated proton therapy is an advanced radiotherapy technique that is used to treat cancer patients. In order to successfully treat a patient, sufficient dose to the tumor is required. However, during the fractionated treatment, multiple errors can cause a difference between the planned and actual dose delivery. To ensure adequate...

Detection of metastatic lymph nodes with multiparametric PET/MR in head and neck imaging

Detection of lymph node involvement has a significant negative impact on the treatment outcome for patients with head and neck squamous-cell carcinomas (SCC). Metastatic lymph nodes can be detected with high sensitivity by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET). However, 18F-FDG uptake is not only increased in...

PTV-based VMAT vs. robust IMPT for head-and-neck cancer: A probabilistic uncertainty analysis of clinical plan evaluation with the Dutch model-based selection

Background and purpose: In the Netherlands, head-and-neck cancer (HNC) patients are referred for proton therapy (PT) through model-based selection (MBS). However, treatment errors may compromise adequate CTV dose. Our aims are: (i) to derive probabilistic plan evaluation metrics on the CTV consistent with clinical metrics; (ii) to evaluate...

Dosimetric verification of murine proton irradiations and in vitro analysis of DNA damage repair modulators and FLASH irradiations

With almost 900.000 new patients per year suffering from head and neck squamous cell carcinomas (HNSCC), who after radiotherapy treatments experience severe side effects, the focus is drawn to proton therapy. Proton therapy results to less side effects since healthy tissues surrounding the tumour receive less radiation dose. This results from...

An online adaptive plan library approach for intensity modulated proton therapy for head and neck cancer

Background and purpose: In intensity modulated proton therapy (IMPT), the impact of setup errors and anatomical changes is commonly mitigated by robust optimization with population-based setup robustness (SR) settings and offline replanning. In this study we propose and evaluate an alternative approach based on daily plan selection from...

ExPEERience: Designing for Patient Empowerment for Head and Neck Cancer Patients in the Follow-up Phase

In this graduation thesis I investigate how to design for patient empowerment in the context of head and neck cancer (HNC) patients in their follow-up phase (the first 5 years after treatment). This project is set up with the Erasmus MC and was initiated to elaborate on their current service called the Healthcare Monitor (HM). The HM is a...

Experimental study on needle insertion force to minimize tissue deformation in tongue tissue

This study reports on the effects of insertion velocity, needle tip geometry and needle diameter on tissue deformation and maximum insertion force. Moreover, the effect of multiple insertions with the same needle on the maximum insertion force is reported. The tissue deformation and maximum insertion force strongly depend on the insertion...