Ingham Institute for Applied Medical Research Liverpool

Sydney, Australia

Ingham Institute for Applied Medical Research Liverpool

Sydney, Australia
SEARCH FILTERS
Time filter
Source Type

Rai R.,University of New South Wales | Kumar S.,University of New South Wales | Batumalai V.,University of New South Wales | Elwadia D.,Liverpool and Macarthur Cancer Therapy Centres Liverpool | And 7 more authors.
Journal of Medical Radiation Sciences | Year: 2017

The increased utilisation of magnetic resonance imaging (MRI) in radiation therapy (RT) has led to the implementation of MRI simulators for RT treatment planning and influenced the development of MRI-guided treatment systems. There is extensive literature on the advantages of MRI for tumour volume and organ-at-risk delineation compared to computed tomography. MRI provides both anatomical and functional information for RT treatment planning (RTP) as well as quantitative information to assess tumour response for adaptive treatment. Despite many advantages of MRI in RT, introducing an MRI simulator into a RT department is a challenge. Collaboration between radiographers and radiation therapists is paramount in making the best use of this technology. The cross-disciplinary training of radiographers and radiation therapists alike is an area rarely discussed; however, it is becoming an important requirement due to detailed imaging needs for advanced RT treatment techniques and with the emergence of hybrid treatment systems. This article will discuss the initial experiences of a radiation oncology department in implementing a dedicated MRI simulator for RTP, with a focus on the training required for both radiographer and RT staff. It will also address the future of MRI in RT and the implementation of MRI-guided treatment systems, such as MRI-Linacs, and the role of both radiation therapists and radiographers in this technology. © 2017 Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.


Rajendra S.,University of New South Wales | Rajendra S.,Ingham Institute for Applied Medical Research Liverpool
Best Practice and Research: Clinical Gastroenterology | Year: 2015

Gastro-oesophageal reflux disease (GORD) and Barrett's oesophagus (BO) have been considered to be the most important known risk factors for oesophageal adenocarcinoma (OAC). It has been the fastest growing cancer in the Western World and has occurred against a backdrop of progressive reduction in the risk estimate of malignancy associated with BO and no reduction in mortality from OAC using the prevailing screening and surveillance guidelines. The recently published link between high risk HPV and Barrett's dysplasia/cancer may be the 'missing' strong risk factor responsible for the significant rise of OAC since the 1970's, as has been the case with head and neck tumours, another viral associated cancer. P53 immunohistochemistry has been proposed as a good molecular marker for predicting disease progression in BD. Nevertheless, significant negative staining for this mutation in BD remains a major hurdle to widespread routine clinical use as a sole molecular marker. Recent data raises the distinct possibility of at least 2 (probably more) carcinogenic pathways operating in OAC. One is HPV mediated devoid largely of p53 mutations and the other p53 dependent. The joint use of both these markers as part of a molecular panel may represent the best bet yet of detecting the high risk group of progressors to OAC. Patients who are positive for either or both biomarkers i.e p53 or/and transcriptional markers of HPV may warrant more intensive screening. In future, genome wide technology may provide molecular signatures to aid diagnosis and risk stratification in BO. © 2014 Published by Elsevier Ltd. All rights reserved.

Loading Ingham Institute for Applied Medical Research Liverpool collaborators
Loading Ingham Institute for Applied Medical Research Liverpool collaborators