Anilkumar Talluri - Academia.edu (original) (raw)
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Papers by Anilkumar Talluri
Brachytherapy, 2020
PURPOSE The purpose of this study was to report our experience regarding the development of a low... more PURPOSE The purpose of this study was to report our experience regarding the development of a low-cost multichannel vaginal cylinder applicator for superficial and recurrent vaginal tumors. METHODS AND MATERIALS The applicator mold was created by applying heated wax sheets in layers around a plastic tube. Interstitial stainless-steel needles were placed at equal distance around the mold surface to create multiple channels for treatment. Two plans were created using CT images for a patient with a recurrent tumor over the posterior vaginal wall for comparing single-channel and multichannel cylinder dosimetry. The doses received by the target (high risk clinical target volume) and organs at risk (OARs) were computed using dose-volume histograms. RESULTS There was no significant difference in terms of the prescribed dose delivered to high risk clinical target volume between the two plans. The volume of the target receiving 150 and 200 percent (V150 and V200) dose was higher in the multichannel cylinder plan than the single-channel cylinder plan. In terms of doses to the OARs, there was no significant difference between the rectum doses (D2cc rectum). There was a significant reduction in the dose to the bladder (D2cc bladder), urethra (D0.1cc urethra), and uninvolved vagina (D2cc uninvolved vagina). CONCLUSIONS Multichannel vaginal cylinders reduce doses to the OARs as compared with the single-channel vaginal cylinder in superficial vaginal lesions limited to the wall of the vagina. Their use is limited by the cost of the applicator. Our low-cost multichannel vaginal cylinder can be used as a reliable alternative in such situations.
Introduction: Carcinoma cervix is a common gynecologic malignancy in India and is treated with ra... more Introduction: Carcinoma cervix is a common gynecologic malignancy in India and is treated with radical chemoradiation where intracavitary brachytherapy (ICR) is an integral part. In ICR of cervix, the two-dimensional (2D) point-based dosimetry cervix is the most common method used in high-volume centers with rectal dose calculation at modified ICRU rectal point with rectal wire placement. The rectal dose measurement using this method underestimates the dose to the rectum, and rectal dose also varies with the type of applicator used. The aim of our study is to compare the rectal dose calculated by ICRU 38 method versus rectal dose calculated by the rectal wire method using Henschke applicator. Materials and Methods: This is a single-institute, dosimetric comparison study done prospectively. Fifty patients were planned for ICR after 2D orthogonal radiograph-based, computer planning by iridium 192 high-dose rate remote afterloading technique after placing the appropriate Henschke appli...
Journal of Medical Physics, 2013
The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rect... more The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rectal Points when a patient is simulated in Supine (S Position) and Lithotomy M shaped positions (LM Position), respectively as part of Intracavitary Brachytherapy in Cervical Cancer patients. Patients (n = 19) were simulated and orthogonal images were taken in S Position and LM Positions on a physical simulator. Digital orthogonal X-ray images were transferred to Brachyvision Treatment Planning System via Dicom to generate treatment plans. Radio opaque dye of 7 ml was injected into the Foley bulb for identification and digitization of International Commission on Radiological Units and Measurements (ICRU) Bladder point. Pelvic side wall points were marked in accordance with ICRU 38 recommendations. A Rectal tube containing dummy source marker wire was used to identify Rectal Point. Students't-test was used to analyze the results. Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point. It was observed that movement of applicator could be the reason for the variations in doses between the two positions. Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position.
Brachytherapy, 2020
PURPOSE The purpose of this study was to report our experience regarding the development of a low... more PURPOSE The purpose of this study was to report our experience regarding the development of a low-cost multichannel vaginal cylinder applicator for superficial and recurrent vaginal tumors. METHODS AND MATERIALS The applicator mold was created by applying heated wax sheets in layers around a plastic tube. Interstitial stainless-steel needles were placed at equal distance around the mold surface to create multiple channels for treatment. Two plans were created using CT images for a patient with a recurrent tumor over the posterior vaginal wall for comparing single-channel and multichannel cylinder dosimetry. The doses received by the target (high risk clinical target volume) and organs at risk (OARs) were computed using dose-volume histograms. RESULTS There was no significant difference in terms of the prescribed dose delivered to high risk clinical target volume between the two plans. The volume of the target receiving 150 and 200 percent (V150 and V200) dose was higher in the multichannel cylinder plan than the single-channel cylinder plan. In terms of doses to the OARs, there was no significant difference between the rectum doses (D2cc rectum). There was a significant reduction in the dose to the bladder (D2cc bladder), urethra (D0.1cc urethra), and uninvolved vagina (D2cc uninvolved vagina). CONCLUSIONS Multichannel vaginal cylinders reduce doses to the OARs as compared with the single-channel vaginal cylinder in superficial vaginal lesions limited to the wall of the vagina. Their use is limited by the cost of the applicator. Our low-cost multichannel vaginal cylinder can be used as a reliable alternative in such situations.
Introduction: Carcinoma cervix is a common gynecologic malignancy in India and is treated with ra... more Introduction: Carcinoma cervix is a common gynecologic malignancy in India and is treated with radical chemoradiation where intracavitary brachytherapy (ICR) is an integral part. In ICR of cervix, the two-dimensional (2D) point-based dosimetry cervix is the most common method used in high-volume centers with rectal dose calculation at modified ICRU rectal point with rectal wire placement. The rectal dose measurement using this method underestimates the dose to the rectum, and rectal dose also varies with the type of applicator used. The aim of our study is to compare the rectal dose calculated by ICRU 38 method versus rectal dose calculated by the rectal wire method using Henschke applicator. Materials and Methods: This is a single-institute, dosimetric comparison study done prospectively. Fifty patients were planned for ICR after 2D orthogonal radiograph-based, computer planning by iridium 192 high-dose rate remote afterloading technique after placing the appropriate Henschke appli...
Journal of Medical Physics, 2013
The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rect... more The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rectal Points when a patient is simulated in Supine (S Position) and Lithotomy M shaped positions (LM Position), respectively as part of Intracavitary Brachytherapy in Cervical Cancer patients. Patients (n = 19) were simulated and orthogonal images were taken in S Position and LM Positions on a physical simulator. Digital orthogonal X-ray images were transferred to Brachyvision Treatment Planning System via Dicom to generate treatment plans. Radio opaque dye of 7 ml was injected into the Foley bulb for identification and digitization of International Commission on Radiological Units and Measurements (ICRU) Bladder point. Pelvic side wall points were marked in accordance with ICRU 38 recommendations. A Rectal tube containing dummy source marker wire was used to identify Rectal Point. Students't-test was used to analyze the results. Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point. It was observed that movement of applicator could be the reason for the variations in doses between the two positions. Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position.