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Papers by Milovan Savanovic

Research paper thumbnail of The assessment of consecutive 4D-CT scans during simulation for lung stereotactic body radiation therapy patients

Polish Journal of Medical Physics and Engineering, 2020

Purpose: To evaluate the breathing amplitude, tumor motion, patient positioning, and treatment vo... more Purpose: To evaluate the breathing amplitude, tumor motion, patient positioning, and treatment volumes among consecutive four-dimensional computed tomography (4D-CT) scans, during the simulation for lung stereotactic body radiation therapy (SBRT). Material and methods: The variation and shape of the breathing amplitude, patient positioning, and treatment volumes were evaluated for 55 lung cancer patients after consecutive 4D-CT acquisitions, scanned at one-week intervals. The impact of variation in the breathing amplitude on lung tumor motion was determined for 20 patients. The gross tumor volume (GTV) was contoured from a free-breathing CT scan and at ten phases of the respiratory cycle, for both 4D-CTs (440 phases in total). Results: Breathing amplitude decreased by 3.6 (3.4-4.9) mm, tumor motion by 3.2 (0.4-5.0) mm while breathing period increased by 4 (2-6) s, inter-scan for 20 patients. Intra-scan variation was 4 times greater for the breathing amplitude, 5 times for the breath...

Research paper thumbnail of Impact of lung tumor motion on dose delivered to organ at risk in lung stereotactic body radiation therapy

Journal of Radiation Oncology, 2020

To evaluate the amplitude of lung tumor motion and impact of tumor motion on dose delivered to th... more To evaluate the amplitude of lung tumor motion and impact of tumor motion on dose delivered to the organs at risk (OARs) during lung stereotactic body radiation therapy (SBRT). This study included 55 patients (30 males and 25 females) with lung cancer who had a small gross tumor volume (GTV). SBRT lung cancer patients were treated with a prescribed dose of 60 Gy in 4 to 8 fractions. Radiotherapy plans were planned in Pinnacle 9.10 with two partial dynamic conformal arcs (DCAs) for the peripheral region (PR) and three to four partial DCAs for the central region (CR). The amplitude of tumor motion and their impact on the maximum dose delivered (Dmax) to the OARs were evaluated in the upper lobe (UL) and lower lobe (LL) in cases of CR and PR tumor’s localizations. The median tumor motions between CR and PR were 4.5 vs 2.2 mm in the UL and 12.5 vs 7.0 mm in the LL. Max dose delivered to the OARs between CR and PR in the UL and LL were as follows: 6.7 vs 8.9 Gy and 9.1 vs 11.7 Gy for the spinal cord; 15.2 vs 0.6 Gy and 22.4 vs 7.6 Gy for the heart; and 11.7 vs 10.8 Gy and 14.8 vs 9.8 Gy for the esophagus, respectively. The dose received by the OARs depends on the amplitude of tumor motion and is relative to the OAR’s location and motion, due to patient respiration and heart contribution.

Research paper thumbnail of Radioactivity measurements in soil samples collected in the Republic of Srpska

Radiation Measurements, 2008

In the frame of the International Comparison Scheme for Radioactivity Environmental Monitoring (I... more In the frame of the International Comparison Scheme for Radioactivity Environmental Monitoring (ICS-REM), intercomparison soil samples will be distributed to European monitoring laboratories to be analysed for sixteen different radionuclides. The reference value of a comparison material is assumed to be valid for the whole batch at the level of a subsample with a minimum mass. Therefore, an inhomogeneity in the radionuclide concentration increases the uncertainty of the corresponding reference value. The homogeneity study of the soil samples was carried out at IRMM. For this purpose 10 bottles of the batch wi th intercom parison samples for REM laboratories, distributed over the entire range of filled bottles, were chosen for performing the homogeneity measurements. The homogeneity of the activity distribution of 137 Cs, 40 K, 212 Pb, 214 Pb, 212 Bi and 214 Bi in these samples was evaluated using gamma-ray spectrometry. How to obtain EU publications Our priced publications are available from EU Bookshop (http://bookshop.europa.eu), where you can place an order with the sales agent of your choice. The Publications Office has a worldwide network of sales agents. You can obtain their contact details by sending a fax to (352) 29 29-42758.

Research paper thumbnail of Deep inspiration breath hold radiotherapy for locally advanced lung cancer: Comparison of different treatment techniques on target coverage, lung dose and treatment delivery time

Acta Oncologica, 2013

Deep inspiration breath-hold radiotherapy for lung cancerimpact on image quality and registration... more Deep inspiration breath-hold radiotherapy for lung cancerimpact on image quality and registration uncertainty in cone beam CT image guidance

Research paper thumbnail of Assessment of Internal and External Surrogates for Lung Stereotactic Body Radiation Therapy

Purpose: To evaluate internal (lung, heart and diaphragm) and external (nine glass marbles) marke... more Purpose: To evaluate internal (lung, heart and diaphragm) and external (nine glass marbles) marker motion in correlation with lung tumor motion, to determine potential surrogate for respiratory gating radiation therapy (RGRT) depending on tumor localization, upper lobe (UL) vs lower lobe (LL).Methods: This study included 58 patients (34 male and 24 female) with small lung cancer (≤ 5cm), who underwent Stereotactic Body Radiation Therapy (SBRT). All patients were scanned and contoured in all ten phases (Varian Eclipse 13.7) after four-dimensional computed tomography simulation (4D-CT). The motion of internal markers and external markers were analyzed and correlated with tumor motion. The Pearson correlation coefficient (PCC) was used to evaluate the correlation between internal and external marker motion with tumor motion. Results: The median (range) values of tumor motion were 3.2 (0.6-11.0) vs 8.6 (4.0-24.0) mm in the UL vs LL. The median (range) values of organs motion and PCC com...

Research paper thumbnail of The assessment of consecutive 4D-CT scans during simulation for lung stereotactic body radiation therapy patients

Polish Journal of Medical Physics and Engineering, 2020

Purpose: To evaluate the breathing amplitude, tumor motion, patient positioning, and treatment vo... more Purpose: To evaluate the breathing amplitude, tumor motion, patient positioning, and treatment volumes among consecutive four-dimensional computed tomography (4D-CT) scans, during the simulation for lung stereotactic body radiation therapy (SBRT). Material and methods: The variation and shape of the breathing amplitude, patient positioning, and treatment volumes were evaluated for 55 lung cancer patients after consecutive 4D-CT acquisitions, scanned at one-week intervals. The impact of variation in the breathing amplitude on lung tumor motion was determined for 20 patients. The gross tumor volume (GTV) was contoured from a free-breathing CT scan and at ten phases of the respiratory cycle, for both 4D-CTs (440 phases in total). Results: Breathing amplitude decreased by 3.6 (3.4-4.9) mm, tumor motion by 3.2 (0.4-5.0) mm while breathing period increased by 4 (2-6) s, inter-scan for 20 patients. Intra-scan variation was 4 times greater for the breathing amplitude, 5 times for the breath...

Research paper thumbnail of Impact of lung tumor motion on dose delivered to organ at risk in lung stereotactic body radiation therapy

Journal of Radiation Oncology, 2020

To evaluate the amplitude of lung tumor motion and impact of tumor motion on dose delivered to th... more To evaluate the amplitude of lung tumor motion and impact of tumor motion on dose delivered to the organs at risk (OARs) during lung stereotactic body radiation therapy (SBRT). This study included 55 patients (30 males and 25 females) with lung cancer who had a small gross tumor volume (GTV). SBRT lung cancer patients were treated with a prescribed dose of 60 Gy in 4 to 8 fractions. Radiotherapy plans were planned in Pinnacle 9.10 with two partial dynamic conformal arcs (DCAs) for the peripheral region (PR) and three to four partial DCAs for the central region (CR). The amplitude of tumor motion and their impact on the maximum dose delivered (Dmax) to the OARs were evaluated in the upper lobe (UL) and lower lobe (LL) in cases of CR and PR tumor’s localizations. The median tumor motions between CR and PR were 4.5 vs 2.2 mm in the UL and 12.5 vs 7.0 mm in the LL. Max dose delivered to the OARs between CR and PR in the UL and LL were as follows: 6.7 vs 8.9 Gy and 9.1 vs 11.7 Gy for the spinal cord; 15.2 vs 0.6 Gy and 22.4 vs 7.6 Gy for the heart; and 11.7 vs 10.8 Gy and 14.8 vs 9.8 Gy for the esophagus, respectively. The dose received by the OARs depends on the amplitude of tumor motion and is relative to the OAR’s location and motion, due to patient respiration and heart contribution.

Research paper thumbnail of Radioactivity measurements in soil samples collected in the Republic of Srpska

Radiation Measurements, 2008

In the frame of the International Comparison Scheme for Radioactivity Environmental Monitoring (I... more In the frame of the International Comparison Scheme for Radioactivity Environmental Monitoring (ICS-REM), intercomparison soil samples will be distributed to European monitoring laboratories to be analysed for sixteen different radionuclides. The reference value of a comparison material is assumed to be valid for the whole batch at the level of a subsample with a minimum mass. Therefore, an inhomogeneity in the radionuclide concentration increases the uncertainty of the corresponding reference value. The homogeneity study of the soil samples was carried out at IRMM. For this purpose 10 bottles of the batch wi th intercom parison samples for REM laboratories, distributed over the entire range of filled bottles, were chosen for performing the homogeneity measurements. The homogeneity of the activity distribution of 137 Cs, 40 K, 212 Pb, 214 Pb, 212 Bi and 214 Bi in these samples was evaluated using gamma-ray spectrometry. How to obtain EU publications Our priced publications are available from EU Bookshop (http://bookshop.europa.eu), where you can place an order with the sales agent of your choice. The Publications Office has a worldwide network of sales agents. You can obtain their contact details by sending a fax to (352) 29 29-42758.

Research paper thumbnail of Deep inspiration breath hold radiotherapy for locally advanced lung cancer: Comparison of different treatment techniques on target coverage, lung dose and treatment delivery time

Acta Oncologica, 2013

Deep inspiration breath-hold radiotherapy for lung cancerimpact on image quality and registration... more Deep inspiration breath-hold radiotherapy for lung cancerimpact on image quality and registration uncertainty in cone beam CT image guidance

Research paper thumbnail of Assessment of Internal and External Surrogates for Lung Stereotactic Body Radiation Therapy

Purpose: To evaluate internal (lung, heart and diaphragm) and external (nine glass marbles) marke... more Purpose: To evaluate internal (lung, heart and diaphragm) and external (nine glass marbles) marker motion in correlation with lung tumor motion, to determine potential surrogate for respiratory gating radiation therapy (RGRT) depending on tumor localization, upper lobe (UL) vs lower lobe (LL).Methods: This study included 58 patients (34 male and 24 female) with small lung cancer (≤ 5cm), who underwent Stereotactic Body Radiation Therapy (SBRT). All patients were scanned and contoured in all ten phases (Varian Eclipse 13.7) after four-dimensional computed tomography simulation (4D-CT). The motion of internal markers and external markers were analyzed and correlated with tumor motion. The Pearson correlation coefficient (PCC) was used to evaluate the correlation between internal and external marker motion with tumor motion. Results: The median (range) values of tumor motion were 3.2 (0.6-11.0) vs 8.6 (4.0-24.0) mm in the UL vs LL. The median (range) values of organs motion and PCC com...