American Oncology Institute

Hyderabad andhra Pradesh, India

American Oncology Institute

Hyderabad andhra Pradesh, India

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Gopalkrishna Murthy K.P.,American Oncology Institute and Citizens Hospitals | Kashyap R.,American Oncology Institute | Tadimeti H.,American Oncology Institute and Citizens Hospitals | Peyyeti M.,American Oncology Institute and Citizens Hospitals
Journal of Clinical Imaging Science | Year: 2015

Positron emission tomography with computed tomography (PET-CT) is an integral part of oncology practice in the current-day scenario. The hybrid anatomical and metabolic imaging information in this imaging modality provides access to a wealth of incidental findings which can have implications in the management of the patient, especially when surgical options are being considered. In this pictorial essay, we present incidentally detected mediastinal vascular anomalies on PET-CT, along with a review of associated literature. Copyright: © 2015 Murthy PSG.


PubMed | American Oncology Institute and Citizens Hospitals and American Oncology Institute
Type: | Journal: Journal of clinical imaging science | Year: 2015

Positron emission tomography with computed tomography (PET-CT) is an integral part of oncology practice in the current-day scenario. The hybrid anatomical and metabolic imaging information in this imaging modality provides access to a wealth of incidental findings which can have implications in the management of the patient, especially when surgical options are being considered. In this pictorial essay, we present incidentally detected mediastinal vascular anomalies on PET-CT, along with a review of associated literature.


Burgess M.,University of Pittsburgh | Gorantla V.,American Oncology Institute | Weiss K.,University of Pittsburgh | Tawbi H.,University of Pittsburgh
Current Oncology Reports | Year: 2015

Immunologic approaches to cancer are over a century old. Over the years, the strategy has been fine-tuned from inciting infections in subjects to inhibiting negative regulatory signals from the innate immune system. Sarcomas are among the first tumors to be considered for immune interventions. From Coley’s toxin to cytokine-based therapies to adoptive cell therapy, there have been numerous immunotherapeutic investigations in this patient population. A promising strategy includes adoptive T cell therapy which has been studied in small cohorts of synovial sarcoma, a subtype that is known to widely express the cancer testis antigen, NY-ESO-1. Additionally, recent data in metastatic melanoma and renal cell carcinoma demonstrate the utility and tremendous efficacy of immune checkpoint blockade with increased rates of durable responses compared to standard therapies. Responses in traditionally “non-immunogenic” tumors, such as lung and bladder cancers, provide ample rationale for the study of immune checkpoint inhibitors in sarcoma. While immunotherapy has induced some responses in sarcomas, further research will help clarify optimal patient selection for future clinical trials and new combinatorial immunotherapeutic strategies. © 2015, Springer Science+Business Media New York.


Kashyap R.,American Oncology Institute | Ali M.,Oncology and Radiotherapy Institute | Nagaraju M.,Oncology and Radiotherapy Institute | Muntimadugu B.,Oncology and Radiotherapy Institute
Indian Journal of Nuclear Medicine | Year: 2014

Hypertrophic pulmonary osteoarthropathy is manifested by clubbing and periostitis of bones. We present a very rare documentation of increased F18-sodium fluoride uptake in the distal phalanges of both hands correlating to clubbing of the fingers in a 55-year-old female patient with carcinoma of lung in whom bone positron emission tomography was performed for metastatic work-up.


PubMed | American Oncology Institute
Type: Journal Article | Journal: Journal of medical physics | Year: 2015

To study the behavior of Acuros XB algorithm for flattening filter free (FFF) photon beams in comparison with the anisotropic analytical algorithm (AAA) when applied to homogeneous and heterogeneous phantoms in conventional and RapidArc techniques. Acuros XB (Eclipse version 10.0, Varian Medical Systems, CA, USA) and AAA algorithms were used to calculate dose distributions for both 6X FFF and 10X FFF energies. RapidArc plans were created on Catphan phantom 504 and conventional plans on virtual homogeneous water phantom 30 30 30 cm(3), virtual heterogeneous phantom with various inserts and on solid water phantom with air cavity. Dose at various inserts with different densities were measured in both AAA and Acuros algorithms. The maximum % variation in dose was observed in (-944 HU) air insert and minimum in (85 HU) acrylic insert in both 6X FFF and 10X FFF photons. Less than 1% variation observed between -149 HU and 282 HU for both energies. At -40 HU and 765 HU Acuros behaved quite contrarily with 10X FFF. Maximum % variation in dose was observed in less HU values and minimum variation in higher HU values for both FFF energies. Global maximum dose observed at higher depths for Acuros for both energies compared with AAA. Increase in dose was observed with Acuros algorithm in almost all densities and decrease at few densities ranging from 282 to 643 HU values. Field size, depth, beam energy, and material density influenced the dose difference between two algorithms.


PubMed | American Oncology Institute
Type: Journal Article | Journal: Journal of medical physics | Year: 2013

Four dimensional (4D) target localization system (Calypso System) was installed at our hospital, which is equipped with Beacon Transponders, Console, Electromagnetic Array, Optical System, Tracking Station, Treatment table overlay, and Calypso kVue Couch top. The objective of this presentation is to describe the results of commissioning measurements carried out on the Calypso System to verify the manufacturer specifications and also to evolve a quality assurance (QA) procedure which can be used to test its performance routinely. The QA program consists of a series of tests (QA for checking the calibration or system accuracy, Camera Calibration with L-frame fixture, Camera Calibration with T-frame fixture, System calibration Fixture targets test, Localization, and Tracking). These tests were found to be useful to assess the performance of the Calypso System.


1. online verification of patient position during treatment using calypso electromagnetic localization and tracking system. 2. Verification and comparison of positional accuracy between cone beam computed tomography and calypso system. 3. Presenting the advantage of continuation localization in Stereotactic radiosurgery treatments.Ten brain tumor cases were taken for this study. Patients with head mask were under gone Computed Tomography (CT). Before scanning, mask was cut on the fore head area to keep surface beacons on the skin. Slice thickness of 0.65 mm were taken for this study. x, y, z coordinates of these beacons in TPS were entered into tracking station. Varian True Beam accelerator, equipped with On Board Imager was used to take Cone beam Computed Tomography (CBCT) to localize the patient. Simultaneously Surface beacons were used to localize and track the patient throughout the treatment. The localization values were compared in both systems. For localization CBCT considered as reference. Tracking was done throughout the treatment using Calypso tracking system using electromagnetic array. This array was in tracking position during imaging and treatment. Flattening Filter free beams of 6MV photons along with Volumetric Modulated Arc Therapy was used for the treatment. The patient movement was observed throughout the treatment ranging from 2 min to 4 min.The average variation observed between calypso system and CBCT localization was less than 0.5 mm. These variations were due to manual errors while keeping beacon on the patient. Less than 0.05 cm intra-fraction motion was observed throughout the treatment with the help of continuous tracking.Calypso target localization system is one of the finest tools to perform radiosurgery in combination with CBCT. This non radiographic method of tracking is a real beneficial method to treat patients confidently while observing real-time motion information of the patient.


PubMed | American Oncology Institute and University of Pittsburgh
Type: Journal Article | Journal: Current oncology reports | Year: 2015

Immunologic approaches to cancer are over a century old. Over the years, the strategy has been fine-tuned from inciting infections in subjects to inhibiting negative regulatory signals from the innate immune system. Sarcomas are among the first tumors to be considered for immune interventions. From Coleys toxin to cytokine-based therapies to adoptive cell therapy, there have been numerous immunotherapeutic investigations in this patient population. A promising strategy includes adoptive T cell therapy which has been studied in small cohorts of synovial sarcoma, a subtype that is known to widely express the cancer testis antigen, NY-ESO-1. Additionally, recent data in metastatic melanoma and renal cell carcinoma demonstrate the utility and tremendous efficacy of immune checkpoint blockade with increased rates of durable responses compared to standard therapies. Responses in traditionally non-immunogenic tumors, such as lung and bladder cancers, provide ample rationale for the study of immune checkpoint inhibitors in sarcoma. While immunotherapy has induced some responses in sarcomas, further research will help clarify optimal patient selection for future clinical trials and new combinatorial immunotherapeutic strategies.


PubMed | American Oncology Institute and Oncology and Radiotherapy Institute
Type: Journal Article | Journal: Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India | Year: 2014

Hypertrophic pulmonary osteoarthropathy is manifested by clubbing and periostitis of bones. We present a very rare documentation of increased F18-sodium fluoride uptake in the distal phalanges of both hands correlating to clubbing of the fingers in a 55-year-old female patient with carcinoma of lung in whom bone positron emission tomography was performed for metastatic work-up.


PubMed | American Oncology Institute
Type: Journal Article | Journal: Journal of cancer research and therapeutics | Year: 2015

The purpose of this study was to report the dosimetric characteristics of the small fields in flattening filter free (FFF) beams (output measurements, profile analysis, surface dose and consistency) generated by medical linear accelerator and its variation with respect to flattened beams (FB).Surface doses were obtained for field sizes 1 1-40 40 cm(2). Field width and penumbra were analyzed for field sizes 1 1-40 40 cm(2). To take output factors for small fields, diode and micro chamber were used and data was taken at a source-to-surface distance (SSD) and extended SSD. Consistency checked for the dosimetric data for 1 year.Surface doses were higher in FFF compared with FB up to 20 20 cm(2) field size. Measured field sizes were slightly lesser in FFF and penumbra values were increased with respect to field size in both FB and FFF. For small fields, diode values have shown more promising results than micro chamber. Small field output measurements at nominal SSD and extended SSD were well in agreement with each other. FFF beams showed good data consistency in 1 year duration.Small field dosimetry, surface dose, profile analysis and consistency of FFF beams in FFF photon beams were derived and data shown good consistency during 1 year duration.

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