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3. 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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8. 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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10. Nonoperative Rectal Cancer Management With Short-Course Radiation Followed by Chemotherapy: A Nonrandomized Control Trial

Author

Kim, Hyun, Pedersen, Katrina, Olsen, Jeffrey R., Mutch, Matthew G., Chin, Re-I, Glasgow, Sean C., Wise, Paul E., Silviera, Matthew L., Tan, Benjamin R., Wang-Gillam, Andrea, Lim, Kian-Huat, Suresh, Rama, Amin, Manik, Huang, Yi, Henke, Lauren E., Park, Haeseong, Ciorba, Matthew A., Badiyan, Shahed, Parikh, Parag J., Roach, Michael C., and Hunt, Steven R.

Published
2021
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12. Reply

Author

Chapman, William C., Jr, Parikh, Parag, and Hunt, Steven

Published
2022
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13. PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response

Author

Fowler, Kathryn J, Maughan, Nichole M, Laforest, Richard, Saad, Nael E, Sharma, Akash, Olsen, Jeffrey, Speirs, Christina K, and Parikh, Parag J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Clinical Research, Clinical Trials and Supportive Activities, Cancer, Digestive Diseases, Biomedical Imaging, Colo-Rectal Cancer, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Adult, Aged, Aged, 80 and over, Brachytherapy, Female, Humans, Liver Neoplasms, Magnetic Resonance Imaging, Male, Microspheres, Middle Aged, Multimodal Imaging, Positron-Emission Tomography, Treatment Outcome, Yttrium Radioisotopes, Radioembolization, Dosimetry, Imaging, PET, Liver/hepatic, Cardiorespiratory Medicine and Haematology, Nuclear Medicine & Medical Imaging, Cardiovascular medicine and haematology
Abstract

PurposeThe purpose of our study is to determine if there is a relationship between dose deposition measured by PET/MRI and individual lesion response to yttrium-90 ((90)Y) microsphere radioembolization.Materials and methods26 patients undergoing lobar treatment with (90)Y microspheres underwent PET/MRI within 66 h of treatment and had follow-up imaging available. Adequate visualization of tumor was available in 24 patients, and contours were drawn on simultaneously acquired PET/MRI data. Dose volume histograms (DVHs) were extracted from dose maps, which were generated using a voxelized dose kernel. Similar contours to capture dimensional and volumetric change of tumors were drawn on follow-up imaging. Response was analyzed using both RECIST and volumetric RECIST (vRECIST) criteria.ResultsA total of 8 hepatocellular carcinoma (HCC), 4 neuroendocrine tumor (NET), 9 colorectal metastases (CRC) patients, and 3 patients with other metastatic disease met inclusion criteria. Average dose was useful in predicting response between responders and non-responders for all lesion types and for CRC lesions alone using both response criteria (p

Published
2016

16. Intrafraction Motion Management With MR-Guided Radiation Therapy

Author

Radiotherapie, Experimentele klinische fysica, Cancer, Circulatory Health, Fast, Martin F., Cao, Minsong, Parikh, Parag, Sonke, Jan Jakob, Radiotherapie, Experimentele klinische fysica, Cancer, Circulatory Health, Fast, Martin F., Cao, Minsong, Parikh, Parag, and Sonke, Jan Jakob

Published
2024

17. MR-guided stereotactic radiotherapy of infra-diaphragmatic oligometastases:Evaluation of toxicity and dosimetric parameters

Author

van Overeem Felter, Mette, Møller, Pia Krause, Josipovic, Mirjana, Bekke, Susanne Nørring, Bernchou, Uffe, Serup-Hansen, Eva, Madsen, Kasper, Parikh, Parag J., Kim, Joshua, Geertsen, Poul, Behrens, Claus P., Vogelius, Ivan R., Pøhl, Mette, Schytte, Tine, Persson, Gitte Fredberg, van Overeem Felter, Mette, Møller, Pia Krause, Josipovic, Mirjana, Bekke, Susanne Nørring, Bernchou, Uffe, Serup-Hansen, Eva, Madsen, Kasper, Parikh, Parag J., Kim, Joshua, Geertsen, Poul, Behrens, Claus P., Vogelius, Ivan R., Pøhl, Mette, Schytte, Tine, and Persson, Gitte Fredberg

Abstract

Background and purposeThe SOFT trial is a prospective, multicenter, phase 2 trial investigating magnetic resonance (MR)-guided stereotactic ablative radiotherapy (SABR) for abdominal, soft tissue metastases in patients with oligometastatic disease (OMD) (clinicaltrials.govID NCT04407897). We present the primary endpoint analysis of 1-year treatment-related toxicity (TRAE).Materials and methodsPatients with up to five oligometastases from non-hematological cancers were eligible for inclusion. A risk-adapted strategy prioritized fixed organs at risk (OAR) constraints over target coverage. Fractionation schemes were 45–67.5 Gy in 3–8 fractions. The primary endpoint was grade ≥ 4 TRAE within 12 months post-SABR. The association between the risk of gastrointestinal (GI) toxicity and clinical and dosimetric parameters was tested using a normal tissue complication probability model.ResultsWe included 121 patients with 147 oligometastatic targets, mainly located in the liver (41 %), lymph nodes (35 %), or adrenal glands (14 %). Nearly half of all targets (48 %, n = 71) were within 10 mm of a radiosensitive OAR. No grade 4 or 5 TRAEs, 3.5 % grade 3 TRAEs, and 43.7 % grade 2 TRAEs were reported within the first year of follow-up. We found a significant association between grade ≥ 2 GI toxicity and the parameters GI OAR D0.1cc, D1cc, and D20cc.ConclusionIn this phase II study of MR-guided SABR of oligometastases in the infra-diaphragmatic region, we found a low incidence of toxicity despite half of the lesions being within 10 mm of a radiosensitive OAR. GI OAR D0.1cc, D1cc, and D20cc were associated with grade ≥ 2 GI toxicity., Background and purpose: The SOFT trial is a prospective, multicenter, phase 2 trial investigating magnetic resonance (MR)-guided stereotactic ablative radiotherapy (SABR) for abdominal, soft tissue metastases in patients with oligometastatic disease (OMD) (clinicaltrials.gov ID NCT04407897). We present the primary endpoint analysis of 1-year treatment-related toxicity (TRAE). Materials and methods: Patients with up to five oligometastases from non-hematological cancers were eligible for inclusion. A risk-adapted strategy prioritized fixed organs at risk (OAR) constraints over target coverage. Fractionation schemes were 45–67.5 Gy in 3–8 fractions. The primary endpoint was grade ≥ 4 TRAE within 12 months post-SABR. The association between the risk of gastrointestinal (GI) toxicity and clinical and dosimetric parameters was tested using a normal tissue complication probability model. Results: We included 121 patients with 147 oligometastatic targets, mainly located in the liver (41 %), lymph nodes (35 %), or adrenal glands (14 %). Nearly half of all targets (48 %, n = 71) were within 10 mm of a radiosensitive OAR. No grade 4 or 5 TRAEs, 3.5 % grade 3 TRAEs, and 43.7 % grade 2 TRAEs were reported within the first year of follow-up. We found a significant association between grade ≥ 2 GI toxicity and the parameters GI OAR D0.1cc, D1cc, and D20cc. Conclusion: In this phase II study of MR-guided SABR of oligometastases in the infra-diaphragmatic region, we found a low incidence of toxicity despite half of the lesions being within 10 mm of a radiosensitive OAR. GI OAR D0.1cc, D1cc, and D20cc were associated with grade ≥ 2 GI toxicity.

Published
2024

18. The transformation of radiation oncology using real-time magnetic resonance guidance: A review

Author

Hall, William A., Paulson, Eric S., van der Heide, Uulke A., Fuller, Clifton D., Raaymakers, B.W., Lagendijk, Jan J.W., Li, X. Allen, Jaffray, David A., Dawson, Laura A., Erickson, Beth, Verheij, Marcel, Harrington, Kevin J., Sahgal, Arjun, Lee, Percy, Parikh, Parag J., Bassetti, Michael F., Robinson, Clifford G., Minsky, Bruce D., Choudhury, Ananya, Tersteeg, Robert J.H.A., and Schultz, Christopher J.

Published
2019
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20. Stereotactic body radiotherapy plus rucosopasem in locally advanced or borderline resectable pancreatic cancer: GRECO-2 phase II study design

Author

Hoffe, Sarah E, primary, Aguilera, Todd A, additional, Parikh, Parag J, additional, Ghaly, Maged M, additional, Herman, Joseph M, additional, Caster, Joseph M, additional, Kim, Dae Won, additional, Costello, James, additional, Malafa, Mokenge P, additional, Moser, Elizabeth C, additional, Kennedy, Eugene P, additional, Terry, Kara, additional, and Kurman, Michael, additional

Published
2024
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24. 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., primary, Lee, Percy, additional, Low, Daniel A., additional, Kim, Joshua, additional, Mittauer, Kathryn E., additional, Bassetti, Michael F, additional, Glide-Hurst, Carri K., additional, Raldow, Ann C., additional, Yang, Yingli, additional, Portelance, Lorraine, additional, Padgett, Kyle R., additional, Zaki, Bassem, additional, Zhang, Rongxiao, additional, Kim, Hyun, additional, Henke, Lauren E., additional, Price, Alex T., additional, Mancias, Joseph D., additional, Williams, Christopher L., additional, Ng, John, additional, Pennell, Ryan, additional, Raphael Pfeffer, M., additional, Levin, Daphne, additional, Mueller, Adam C., additional, Mooney, Karen E., additional, Kelly, Patrick, additional, Shah, Amish P., additional, Boldrini, Luca, additional, Placidi, Lorenzo, additional, Fuss, Martin, additional, and Jitendra Parikh, Parag, additional

Published
2023
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25. 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, primary, Lee, Percy, additional, Low, Daniel A., additional, Kim, Joshua, additional, Mittauer, Kathryn E., additional, Bassetti, Michael F., additional, Glide-Hurst, Carri K., additional, Raldow, Ann C., additional, Yang, Yingli, additional, Portelance, Lorraine, additional, Padgett, Kyle R., additional, Zaki, Bassem, additional, Zhang, Rongxiao, additional, Kim, Hyun, additional, Henke, Lauren E., additional, Price, Alex T., additional, Mancias, Joseph D., additional, Williams, Christopher L., additional, Ng, John, additional, Pennell, Ryan, additional, Pfeffer, M. Raphael, additional, Levin, Daphne, additional, Mueller, Adam C., additional, Mooney, Karen E., additional, Kelly, Patrick, additional, Shah, Amish P., additional, Boldrini, Luca, additional, Placidi, Lorenzo, additional, Fuss, Martin, additional, and Chuong, Michael D., additional

Published
2023
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28. Pancreatic gross tumor volume contouring on computed tomography (CT) compared with magnetic resonance imaging (MRI): Results of an international contouring conference

Author

Hall, William A., Heerkens, Hanne D., Paulson, Eric S., Meijer, Gert J., Kotte, Alexis N., Knechtges, Paul, Parikh, Parag J., Bassetti, Michael F., Lee, Percy, Aitken, Katharine L., Palta, Manisha, Myrehaug, Sten, Koay, Eugene J., Portelance, Lorraine, Ben-Josef, Edgar, and Erickson, Beth A.

Published
2018
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31. Two-and-a-half-year clinical experience with the world's first magnetic resonance image guided radiation therapy system

Author

Fischer-Valuck, Benjamin W., Henke, Lauren, Green, Olga, Kashani, Rojano, Acharya, Sahaja, Bradley, Jeffrey D., Robinson, Clifford G., Thomas, Maria, Zoberi, Imran, Thorstad, Wade, Gay, Hiram, Huang, Jiayi, Roach, Michael, Rodriguez, Vivian, Santanam, Lakshmi, Li, Harold, Li, Hua, Contreras, Jessika, Mazur, Thomas, Hallahan, Dennis, Olsen, Jeffrey R., Parikh, Parag, Mutic, Sasa, and Michalski, Jeff

Published
2017
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33. Utility of a multidisciplinary tumor board in the management of pancreatic and upper gastrointestinal diseases: an observational study

Author

Brauer, David G., Strand, Matthew S., Sanford, Dominic E., Kushnir, Vladimir M., Lim, Kian-Huat, Mullady, Daniel K., Tan, Benjamin R., Jr., Wang-Gillam, Andrea, Morton, Ashley E., Ruzinova, Marianna B., Parikh, Parag J., Narra, Vamsi R., Fowler, Kathryn J., Doyle, Majella B., Chapman, William C., Strasberg, Steven S., Hawkins, William G., and Fields, Ryan C.

Published
2017
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34. A prospective study of differences in duodenum compared to remaining small bowel motion between radiation treatments: Implications for radiation dose escalation in carcinoma of the pancreas

Author

Singh, Anurag K, Tierney, Ryan M, Low, Daniel A, Parikh, Parag J, Myerson, Robert J, Deasy, Joseph O, Wu, Catherine S, Pereira, Gisele C, Wahab, Sasha H, Mutics, Sasa MS, Grigsby, Perry W, and Hope, Andrew J

Subjects
Cancer, Rare Diseases, Pancreatic Cancer, Biomedical Imaging, Digestive Diseases, Clinical Research, Dose-Response Relationship, Radiation, Duodenum, Female, Humans, Intestine, Small, Male, Motion, Pancreatic Neoplasms, Prospective Studies, Radiation Dosage, Radiotherapy, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

PurposeAs a foundation for a dose escalation trial, we sought to characterize duodenal and non-duodenal small bowel organ motion between fractions of pancreatic radiation therapy.Patients and methodsNine patients (4 women, 5 men) undergoing radiation therapy were enrolled in this prospective study. The patients had up to four weekly CT scans performed during their course of radiation therapy. Pancreas, duodenum and non-duodenal small bowel were then contoured for each CT scan. On the initial scan, a four-field plan was generated to fully cover the pancreas. This plan was registered to each subsequent CT scan. Dose-volume histogram (DVH) analyses were performed for the duodenum, non-duodenal small bowel, large bowel, and pancreas.ResultsWith significant individual variation, the volume of duodenum receiving at least 80% of the prescribed dose was consistently greater than the remaining small bowel. In the patient with the largest inter-fraction variation, the fractional volume of non-duodenal small bowel irradiated to at least the 80% isodose line ranged from 1% to 20%. In the patient with the largest inter-fraction variation, the fractional volume of duodenum irradiated to at least the 80% isodose line ranged from 30% to 100%.ConclusionThe volume of small bowel irradiated during four-field pancreatic radiation therapy changes substantially between fractions. This suggests dose escalation may be possible. However, dose limits to the duodenum should be stricter than for other segments of small bowel.

Published
2006

45. Surgical outcomes after neoadjuvant ablative dose radiation among patients with borderline resectable and locally advanced pancreas cancer from the multi-institutional phase 2 Stereotactic MR-Guided Adaptive Radiation Therapy (SMART) trial.

Author

Parikh, Parag, primary, Asbun, Domenech, additional, Chuong, Michael David, additional, Portelance, Lorraine, additional, Datta, Jashodeep, additional, Bassetti, Michael F., additional, Weber, Sharon M., additional, Zaki, Bassem I., additional, Smith, Kerrington D., additional, Raldow, Ann C., additional, Donahue, Timothy R., additional, Kim, Hyun, additional, Hawkins, William G., additional, Kelly, Patrick, additional, Low, Daniel, additional, Lee, Percy, additional, Fuss, Martin, additional, and Kwon, David S., additional

Published
2023
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46. Greco-2: A randomized, phase 2 study of stereotactic body radiation therapy (SBRT) in combination with rucosopasem (GC4711) in the treatment of locally advanced or borderline resectable nonmetastatic pancreatic cancer.

Author

Aguilera, Todd Anthony, primary, Parikh, Parag, additional, Ghaly, Maged, additional, Hoffe, Sarah E., additional, Herman, Joseph M., additional, Caster, Joseph Michael, additional, Kim, Dae Won, additional, Costello, James, additional, Malafa, Mokenge Peter, additional, Beg, Muhammad S., additional, Moser, Elizabeth Charlotte, additional, Kennedy, Eugene Paul, additional, Terry, Kara, additional, and Kurman, Michael, additional

Published
2023
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