Julie Turcotte - Academia.edu (original) (raw)
Papers by Julie Turcotte
Technology in cancer research & treatment, 2003
Boron neutron capture therapy (BNCT) is based on the preferential targeting of tumor cells with (... more Boron neutron capture therapy (BNCT) is based on the preferential targeting of tumor cells with (10)B and subsequent activation with thermal neutrons to produce a highly localized radiation. In theory, it is possible to selectively irradiate a tumor and the associated infiltrating tumor cells with large single doses of high-LET radiation while sparing the adjacent normal tissues. The mixture of high- and low-LET dose components created in tissue during neutron irradiation complicates the radiobiology of BNCT. Much of the complexity has been unravelled through a combination of preclinical experimentation and clinical dose escalation experience. Over 350 patients have been treated in a number of different facilities worldwide. The accumulated clinical experience has demonstrated that BNCT can be delivered safely but is still defining the limits of normal brain tolerance. Several independent BNCT clinical protocols have demonstrated that BNCT can produce median survivals in patients wi...
Nous présentons ici le cas d’une patiente souffrant du trouble d’anxiété généralisée (TAG) à un d... more Nous présentons ici le cas d’une patiente souffrant du trouble d’anxiété généralisée (TAG) à un degré sévère et bénéficiant d’un traitement cognitivo-comportemental développé par notre équipe. Ce traitement validé empiriquement cible les 4 facteurs de notre modèle identifiés comme étant reliés au TAG: l’intolérance à l’incertitude, la surestimation de l’utilité de s’inquiéter, les difficultés de résolution de problèmes et l’évitement cognitif. Les stratégies thérapeutiques utilisées y sont décrites: modification de l’intolérance à l’incertitude, réévaluation de l’utilité de s’inquiéter, entraînement à la résolution de problèmes et exposition cognitive. Nous soulignons l’importance de l’application flexible du protocole de traitement.In this article, we describe the cognitive-behavioral treatment of a patient with severe generalized anxiety disorder (GAD). The treatment, which was developed by our group, targets the four components of our cognitive model of GAD: intolerance of uncertainty, positive beliefs about worry, ineffective problem solving, and cognitive avoidance. Examples of therapeutic strategies that are described include the modification of intolerance of uncertainty, the reevaluation of positive beliefs about worry, problem solving training, and cognitive exposure. Throughout the manuscript, we stress the importance of applying the treatment package in a flexible fashion.
Journal of Applied Clinical Medical Physics, 2010
International Journal of Radiation OncologyBiologyPhysics
Journal of applied clinical medical physics / American College of Medical Physics, 2011
The purpose of this study is to assess the temporal and reconstruction accuracy of a surface imag... more The purpose of this study is to assess the temporal and reconstruction accuracy of a surface imaging system, the GateCT under ideal conditions, and compare the device with a commonly used respiratory surrogate: the Varian RPM. A clinical CT scanner, run in cine mode, was used with two optical devices, GateCT and RPM, to detect respiratory motion. A radiation detector, GM-10, triggers the X-ray on/off to GateCT system, while the RPM is directly synchronized with the CT scanner through an electronic connection. Two phantoms were imaged: the first phantom translated on a rigid plate along the anterior-posterior (AP) direction, and was used to assess the temporal synchronization of each optical system with the CT scanner. The second phantom, consisting of five spheres translating 3 cm peak-to-peak in the superior-inferior direction, was used to assess the quality of rebinned images created by GateCT and RPM. Calibration assessment showed a nearly perfect synchronization with the scanner...
Practical radiation oncology
Proper positioning of patients with extremity sarcoma tumors can be challenging. A surface imagin... more Proper positioning of patients with extremity sarcoma tumors can be challenging. A surface imaging technique was utilized to quantify the setup uncertainties for sarcoma patients and to assess whether surface imaging could improve the accuracy of patient positioning. Pretreatment and posttreatment 3-dimensional (3D) surface images were obtained for 16 patients and 236 treatments. Offline surface registration was performed to quantify interfraction and intrafraction setup errors, and the required planning target volume (PTV) margins were calculated. Setup differences were also assessed using root mean square (RMS) error analysis. For intrafraction variation, the mean 3D vector shift was 2.1 mm, and the systematic and random errors were 1.3 mm or less. When using a reference surface from the first fraction, the mean interfraction setup variation (3D vector shift) was 7.6 mm. Systematic and random errors were 3-4 mm in each direction. When using a computed tomographic based reference s...
Santé mentale au Québec, 2003
Santé mentale au Québec, 2003
The efficacy of a new cognitive-behavioral group program to help discontinuation of benzodiazepin... more The efficacy of a new cognitive-behavioral group program to help discontinuation of benzodiazepines (PASSE) was evaluated by comparison to a group receiving only social support. Both programs lasted 20 weeks commencing with a preparatory period of one month and then tapering continually during 16 subsequent weeks until discontinuation. Forty-eight participants (24 in each condition) with a diagnosis of anxiety disorder took part in the study. These two active conditions were compared with a separate group of 41 people receiving standard tapering with physician counselling only. The results post-treatment supported the hypothesis that those receiving either of the two active treatments succeeded better in discontinuing benzodiazepines than those receiving the standard treatment. Among those completing the two active programs there was no difference in outcome between the social support and the cognitive behavioral (PASSE) group. However, when the rate of dropout was considered, the c...
Radiotherapy and Oncology, 2005
Journal of Radiation Research, 2007
Journal of Anxiety Disorders, 2012
International Journal of Radiation Oncology*Biology*Physics, 2008
International Journal of Radiation Oncology*Biology*Physics, 2012
Breath-hold (BH) treatments can be used to reduce cardiac dose for patients with left-sided breas... more Breath-hold (BH) treatments can be used to reduce cardiac dose for patients with left-sided breast cancer and unfavorable cardiac anatomy. A surface imaging technique was developed for accurate patient setup and reproducible real-time BH positioning. Three-dimensional surface images were obtained for 20 patients. Surface imaging was used to correct the daily setup for each patient. Initial setup data were recorded for 443 fractions and were analyzed to assess random and systematic errors. Real time monitoring was used to verify surface placement during BH. The radiation beam was not turned on if the BH position difference was greater than 5 mm. Real-time surface data were analyzed for 2398 BHs and 363 treatment fractions. The mean and maximum differences were calculated. The percentage of BHs greater than tolerance was calculated. The mean shifts for initial patient setup were 2.0 mm, 1.2 mm, and 0.3 mm in the vertical, longitudinal, and lateral directions, respectively. The mean 3-dimensional vector shift was 7.8 mm. Random and systematic errors were less than 4 mm. Real-time surface monitoring data indicated that 22% of the BHs were outside the 5-mm tolerance (range, 7%-41%), and there was a correlation with breast volume. The mean difference between the treated and reference BH positions was 2 mm in each direction. For out-of-tolerance BHs, the average difference in the BH position was 6.3 mm, and the average maximum difference was 8.8 mm. Daily real-time surface imaging ensures accurate and reproducible positioning for BH treatment of left-sided breast cancer patients with unfavorable cardiac anatomy.
International Journal of Radiation Oncology*Biology*Physics, 2005
European Neuropsychopharmacology, 2009
Cognitive Behaviour Therapy, 2005
The aim of this study was to examine the overall changes in healthcare services utilization after... more The aim of this study was to examine the overall changes in healthcare services utilization after providing an empirically supported cognitive-behavioral treatment for panic disorder with agoraphobia. Data on healthcare utilization were collected for a total of 84 adults meeting DSM-IV criteria. Participants were completers of a cognitive-behavioral treatment for panic disorder with agoraphobia. Data on utilization of healthcare services and medication were obtained from semi-structured interviews from baseline to 1-year after treatment. Results of the Friedman non-parametric analysis reveal a significant decrease in overall and mental health-related costs following treatment. This study shows a significant reduction in healthcare costs following cognitive behavior therapy for panic disorder with agoraphobia. More studies are needed to examine the potential long-term cost-offset effect of empirically supported treatments for panic disorder.
Canadian Psychology/Psychologie canadienne, 2004
Abstract 1. Concern over the costs of medical conditions has traditionally overshadowed interest ... more Abstract 1. Concern over the costs of medical conditions has traditionally overshadowed interest in assessing the costs of mental health problems. Recent research, however, indicates that mental disorders impose considerable costs on society and on the sufferer. ...
Technology in cancer research & treatment, 2003
Boron neutron capture therapy (BNCT) is based on the preferential targeting of tumor cells with (... more Boron neutron capture therapy (BNCT) is based on the preferential targeting of tumor cells with (10)B and subsequent activation with thermal neutrons to produce a highly localized radiation. In theory, it is possible to selectively irradiate a tumor and the associated infiltrating tumor cells with large single doses of high-LET radiation while sparing the adjacent normal tissues. The mixture of high- and low-LET dose components created in tissue during neutron irradiation complicates the radiobiology of BNCT. Much of the complexity has been unravelled through a combination of preclinical experimentation and clinical dose escalation experience. Over 350 patients have been treated in a number of different facilities worldwide. The accumulated clinical experience has demonstrated that BNCT can be delivered safely but is still defining the limits of normal brain tolerance. Several independent BNCT clinical protocols have demonstrated that BNCT can produce median survivals in patients wi...
Nous présentons ici le cas d’une patiente souffrant du trouble d’anxiété généralisée (TAG) à un d... more Nous présentons ici le cas d’une patiente souffrant du trouble d’anxiété généralisée (TAG) à un degré sévère et bénéficiant d’un traitement cognitivo-comportemental développé par notre équipe. Ce traitement validé empiriquement cible les 4 facteurs de notre modèle identifiés comme étant reliés au TAG: l’intolérance à l’incertitude, la surestimation de l’utilité de s’inquiéter, les difficultés de résolution de problèmes et l’évitement cognitif. Les stratégies thérapeutiques utilisées y sont décrites: modification de l’intolérance à l’incertitude, réévaluation de l’utilité de s’inquiéter, entraînement à la résolution de problèmes et exposition cognitive. Nous soulignons l’importance de l’application flexible du protocole de traitement.In this article, we describe the cognitive-behavioral treatment of a patient with severe generalized anxiety disorder (GAD). The treatment, which was developed by our group, targets the four components of our cognitive model of GAD: intolerance of uncertainty, positive beliefs about worry, ineffective problem solving, and cognitive avoidance. Examples of therapeutic strategies that are described include the modification of intolerance of uncertainty, the reevaluation of positive beliefs about worry, problem solving training, and cognitive exposure. Throughout the manuscript, we stress the importance of applying the treatment package in a flexible fashion.
Journal of Applied Clinical Medical Physics, 2010
International Journal of Radiation OncologyBiologyPhysics
Journal of applied clinical medical physics / American College of Medical Physics, 2011
The purpose of this study is to assess the temporal and reconstruction accuracy of a surface imag... more The purpose of this study is to assess the temporal and reconstruction accuracy of a surface imaging system, the GateCT under ideal conditions, and compare the device with a commonly used respiratory surrogate: the Varian RPM. A clinical CT scanner, run in cine mode, was used with two optical devices, GateCT and RPM, to detect respiratory motion. A radiation detector, GM-10, triggers the X-ray on/off to GateCT system, while the RPM is directly synchronized with the CT scanner through an electronic connection. Two phantoms were imaged: the first phantom translated on a rigid plate along the anterior-posterior (AP) direction, and was used to assess the temporal synchronization of each optical system with the CT scanner. The second phantom, consisting of five spheres translating 3 cm peak-to-peak in the superior-inferior direction, was used to assess the quality of rebinned images created by GateCT and RPM. Calibration assessment showed a nearly perfect synchronization with the scanner...
Practical radiation oncology
Proper positioning of patients with extremity sarcoma tumors can be challenging. A surface imagin... more Proper positioning of patients with extremity sarcoma tumors can be challenging. A surface imaging technique was utilized to quantify the setup uncertainties for sarcoma patients and to assess whether surface imaging could improve the accuracy of patient positioning. Pretreatment and posttreatment 3-dimensional (3D) surface images were obtained for 16 patients and 236 treatments. Offline surface registration was performed to quantify interfraction and intrafraction setup errors, and the required planning target volume (PTV) margins were calculated. Setup differences were also assessed using root mean square (RMS) error analysis. For intrafraction variation, the mean 3D vector shift was 2.1 mm, and the systematic and random errors were 1.3 mm or less. When using a reference surface from the first fraction, the mean interfraction setup variation (3D vector shift) was 7.6 mm. Systematic and random errors were 3-4 mm in each direction. When using a computed tomographic based reference s...
Santé mentale au Québec, 2003
Santé mentale au Québec, 2003
The efficacy of a new cognitive-behavioral group program to help discontinuation of benzodiazepin... more The efficacy of a new cognitive-behavioral group program to help discontinuation of benzodiazepines (PASSE) was evaluated by comparison to a group receiving only social support. Both programs lasted 20 weeks commencing with a preparatory period of one month and then tapering continually during 16 subsequent weeks until discontinuation. Forty-eight participants (24 in each condition) with a diagnosis of anxiety disorder took part in the study. These two active conditions were compared with a separate group of 41 people receiving standard tapering with physician counselling only. The results post-treatment supported the hypothesis that those receiving either of the two active treatments succeeded better in discontinuing benzodiazepines than those receiving the standard treatment. Among those completing the two active programs there was no difference in outcome between the social support and the cognitive behavioral (PASSE) group. However, when the rate of dropout was considered, the c...
Radiotherapy and Oncology, 2005
Journal of Radiation Research, 2007
Journal of Anxiety Disorders, 2012
International Journal of Radiation Oncology*Biology*Physics, 2008
International Journal of Radiation Oncology*Biology*Physics, 2012
Breath-hold (BH) treatments can be used to reduce cardiac dose for patients with left-sided breas... more Breath-hold (BH) treatments can be used to reduce cardiac dose for patients with left-sided breast cancer and unfavorable cardiac anatomy. A surface imaging technique was developed for accurate patient setup and reproducible real-time BH positioning. Three-dimensional surface images were obtained for 20 patients. Surface imaging was used to correct the daily setup for each patient. Initial setup data were recorded for 443 fractions and were analyzed to assess random and systematic errors. Real time monitoring was used to verify surface placement during BH. The radiation beam was not turned on if the BH position difference was greater than 5 mm. Real-time surface data were analyzed for 2398 BHs and 363 treatment fractions. The mean and maximum differences were calculated. The percentage of BHs greater than tolerance was calculated. The mean shifts for initial patient setup were 2.0 mm, 1.2 mm, and 0.3 mm in the vertical, longitudinal, and lateral directions, respectively. The mean 3-dimensional vector shift was 7.8 mm. Random and systematic errors were less than 4 mm. Real-time surface monitoring data indicated that 22% of the BHs were outside the 5-mm tolerance (range, 7%-41%), and there was a correlation with breast volume. The mean difference between the treated and reference BH positions was 2 mm in each direction. For out-of-tolerance BHs, the average difference in the BH position was 6.3 mm, and the average maximum difference was 8.8 mm. Daily real-time surface imaging ensures accurate and reproducible positioning for BH treatment of left-sided breast cancer patients with unfavorable cardiac anatomy.
International Journal of Radiation Oncology*Biology*Physics, 2005
European Neuropsychopharmacology, 2009
Cognitive Behaviour Therapy, 2005
The aim of this study was to examine the overall changes in healthcare services utilization after... more The aim of this study was to examine the overall changes in healthcare services utilization after providing an empirically supported cognitive-behavioral treatment for panic disorder with agoraphobia. Data on healthcare utilization were collected for a total of 84 adults meeting DSM-IV criteria. Participants were completers of a cognitive-behavioral treatment for panic disorder with agoraphobia. Data on utilization of healthcare services and medication were obtained from semi-structured interviews from baseline to 1-year after treatment. Results of the Friedman non-parametric analysis reveal a significant decrease in overall and mental health-related costs following treatment. This study shows a significant reduction in healthcare costs following cognitive behavior therapy for panic disorder with agoraphobia. More studies are needed to examine the potential long-term cost-offset effect of empirically supported treatments for panic disorder.
Canadian Psychology/Psychologie canadienne, 2004
Abstract 1. Concern over the costs of medical conditions has traditionally overshadowed interest ... more Abstract 1. Concern over the costs of medical conditions has traditionally overshadowed interest in assessing the costs of mental health problems. Recent research, however, indicates that mental disorders impose considerable costs on society and on the sufferer. ...