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Personalised Procedures for Thoracic Radiotherapy

Chuang, Chi-Shuo; (2021) Personalised Procedures for Thoracic Radiotherapy. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

This thesis presents the investigation, development, and estimation of two personalised procedures for thoracic cancer therapy in Shenzhen, China and two projects were carried out: (1) respiratory motion management of a lung tumour, and (2) the application of a three-dimensional (3D) printing technique for postmastectomy irradiation. For the first project, all subjects attended sessions of free-breathing (FB) and personalised vocal coaching (VC) for respiratory regulation. Thoracic and abdominal breathing signals were extracted from the subjects’ surface area then estimated as kernel density estimation (KDE) for motion visualisation. The mutual information (MI) and correlation coefficient (CC) calculated from KDEs indicate the variation in the relationship between the two signals. From the 1D signal, through VC, the variation of cycle time and the signal value of end-of-exhale/inhale increased in the patient group but decreased in volunteers. Mixed results were presented on KDE and MI. Compared with FB, VC improves movement consistency between the two signals in eight of eleven subjects by increasing MI. The fixed instruction method showed no improvement for day-to-day variation, while the daily generated instruction enhanced the respiratory regularity in three of five volunteers. VC addresses the variation of the single signal, while the outcome of the two signals, thoracic and abdominal signals, requires further interpretation. The second project aims to address both the enhancement of the skin dose and avoidance of hotspots of critical organs, focusing on improving irradiative treatment for post-mastectomy patients. A 3D-printed bolus was presented as a solution for the air gap between the bolus and skin. The results showed no evidence of significant skin dose enhancement with the printed bolus. Additionally, an air gap larger than 5 mm was evident in all patients. Until a solution for complete bolus adhesion is found, this customised bolus is not suitable for clinical use.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Personalised Procedures for Thoracic Radiotherapy
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
URI: https://discovery.ucl.ac.uk/id/eprint/10125101
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