Russell J. Hamilton

The University of Arizona, Tucson, Arizona, United States

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Publications (23)64.99 Total impact

  • No preview · Article · Mar 2014 · Brachytherapy
  • Qianyi Xu · Zhijun He · Jiajin Fan · Russell J Hamilton · Yan Chen · C-M Ma · Lei Xing
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    ABSTRACT: Current gated radiation therapy starts with simulation 4DCT images of a patient with lung cancer. We propose a method to confirm the phase of 4DCT for planning and setup position at the time of treatment. An intensity-based rigid algorithm was developed in this work to register an orthogonal set of on-board projection X-ray images with each phase of the 4DCT. Multiple DRRs for one of ten 4DCT phases are first generated and the correlation coefficient (CC) between the projection X-ray image and each DRR is computed. The maximum value of CC for the phase is found via a simulated annealing optimization process. The whole process repeats for all ten phases. The 4DCT phase that has the highest CC is identified as the breathing phase of the X-ray. The phase verification process is validated by a moving phantom study. Thus, the method may be used to independently confirm the correspondence between the gating phase at the times of 4DCT simulation and radiotherapy delivery. When the intended X-ray phase and actual gating phase are consistent, the registration of the DRRs and the projection images may also yield the values of patient shifts for treatment setup. This method could serve as the 4D analog of the conventional setup film as it provides both verification of the specific phase at the time of treatment and isocenter positioning shifts for treatment delivery.
    No preview · Article · Oct 2009 · Physica Medica
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    ABSTRACT: Respiratory gating and tumor tracking for dynamic multileaf collimator delivery require accurate and real-time localization of the lung tumor position during treatment. Deriving tumor position from external surrogates such as abdominal surface motion may have large uncertainties due to the intra- and interfraction variations of the correlation between the external surrogates and internal tumor motion. Implanted fiducial markers can be used to track tumors fluoroscopically in real time with sufficient accuracy. However, it may not be a practical procedure when implanting fiducials bronchoscopically. In this work, a method is presented to track the lung tumor mass or relevant anatomic features projected in fluoroscopic images without implanted fiducial markers based on an optical flow algorithm. The algorithm generates the centroid position of the tracked target and ignores shape changes of the tumor mass shadow. The tracking starts with a segmented tumor projection in an initial image frame. Then, the optical flow between this and all incoming frames acquired during treatment delivery is computed as initial estimations of tumor centroid displacements. The tumor contour in the initial frame is transferred to the incoming frames based on the average of the motion vectors, and its positions in the incoming frames are determined by fine-tuning the contour positions using a template matching algorithm with a small search range. The tracking results were validated by comparing with clinician determined contours on each frame. The position difference in 95% of the frames was found to be less than 1.4 pixels (approximately 0.7 mm) in the best case and 2.8 pixels (approximately 1.4 mm) in the worst case for the five patients studied.
    Preview · Article · Jan 2009 · Medical Physics
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    ABSTRACT: To evaluate the effectiveness of implanted gold marker registration compared with bony fusion alignment for patient positioning using the Novalis Body system. Eighteen treatment fractions of stereotactic spinal radiotherapy were analyzed for three patients who each had three implanted gold seeds placed near their spinal lesions before radiotherapy. At each treatment session, the registration was first performed using bony fusion and then verified by another bony fusion, followed by registration with implanted markers. The software reported the calculated shifts for both methods. In addition, the actual three-dimensional coordinate positions of the markers were read using PTDReader software. Implanted marker positions were analyzed for variations in individual maker coordinate displacement, interseed distances, and area transcribed by them. Measured positional differences between the two fusion methods were applied to actual treatment plans to assess the resulting dosimetric differences in the treatment plans. Both fusion algorithms were shown to localize the patient well, within 1.5 mm, but the implanted marker fusion consistently related less deviation from the planned isocenter, by approximately 0.5 mm, than did the bony fusion. Exceptions to this localization occurred when the average interseed distances were less than 3.0 cm and resulted in the two registration methods being equivalent. Implanted spine markers were also shown to have less than 0.7 mm deviation from the planned marker coordinates, indicating no migration of the seeds. Dose distributions were found to be highly dependant on differences in fusion method, with spinal cord doses up to 350% greater with bony fusion than with implanted markers. Implanted markers used with the Novalis Body system have been shown to be more effective in patient positioning than the bony fusion method in the thoracic spine.
    No preview · Article · Jun 2008 · Neurosurgery
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    Qianyi Xu · Russell J Hamilton · Robert A Schowengerdt · Steve B Jiang
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    ABSTRACT: A dynamic multi-leaf collimator (DMLC) can be used to track a moving target during radiotherapy. One of the major benefits for DMLC tumor tracking is that, in addition to the compensation for tumor translational motion, DMLC can also change the aperture shape to conform to a deforming tumor projection in the beam's eye view. This paper presents a method that can track a deforming lung tumor in fluoroscopic video using active shape models (ASM) (Cootes et al 1995 Comput. Vis. Image Underst. 61 38-59). The method was evaluated by comparing tracking results against tumor projection contours manually edited by an expert observer. The evaluation shows the feasibility of using this method for precise tracking of lung tumors with deformation, which is important for DMLC-based real-time tumor tracking.
    Preview · Article · Oct 2007 · Physics in Medicine and Biology
  • Qianyi Xu · Russell J Hamilton
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    ABSTRACT: This paper proposes a novel respiratory detection method based on diaphragm motion measurements using a 2D ultrasound unit. The proposed method extracts a respiratory signal from an automated analysis of the internal diaphragm motion during breathing. The respiratory signal may be used for gating. Ultrasound studies of diaphragm breathing motion were performed on four volunteers. The ultrasound video stream was captured and transferred to a personal computer and decomposed into individual image frames. After straightforward image analysis, region of interest selection, and filtering, the mutual information (MI) and correlation coefficients (CCs) between a selected reference frame and all other frames were computed. The resulting MI and CC values were discovered to produce a signal corresponding to the respiratory cycle in both phase and magnitude. We also studied the diaphragm motion of two volunteers during repeated deep inspiration breath holds (DIBH) and found a slight relaxation motion of the diaphragm during the DIBH, suggesting that the residual motion may be important for treatments delivered at this breathing phase. Applying the proposed respiratory detection method to these ultrasound studies, we found that the MI and CC values demonstrate the relaxation behavior, indicatingthat our method may be used to determine the radiation triggering time for a DIBH technique.
    No preview · Article · May 2006 · Medical Physics
  • Andy Su · Michael J Blend · Danny Spelbring · Russell J Hamilton · Ashesh B Jani
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    ABSTRACT: The purpose of this study was to analyze regions of uptake in normal structures on postprostatectomy radioimmunoscintigraphy (RIS) images by evaluating differences in the overlap volumes of prostate fossa clinical target volume (CTV) and planning target volume (PTV) using correlative computed tomography (CT) images. The electronic records of 13 patients who received external beam radiotherapy postprostatectomy and who underwent a vessel-based RIS/CT registration were reviewed. For each patient, the RIS-defined CTV (CTV(RIS)) was compared (in terms of the overlap volume with the surrounding bladder, rectum, pubic symphysis, and penile bulb) with the CT-defined CTV(pre) before this registration and also with CTV(post) (the final target volume used for treatment). Similar analyses were done for PTV(RIS), PTV(pre), and PTV(post) defined in each case to be the corresponding CTV + 1-cm margin. CTV(RIS) overlapped significantly more with the bladder, rectum, and symphysis, but not with the penile bulb, than did either the CTV(pre) or CTV(post). However, the corresponding PTV analyses revealed no significant differences between any of the overlap volumes of any of the PTVs with the bladder, rectum, and penile bulb, but did reveal a significant difference between the PTV(RIS) and PTV(post) overlap volumes with the symphysis compared with PTV(pre) overlap volumes with the symphysis. On RIS images, there appear to be areas of uptake in the bladder, rectum, and pubic symphysis but not the penile bulb; however, the dosimetric consequences of this uptake for radiation treatment planning are minimal on the bladder, rectum, and penile bulb, but require segmentation for dose reduction to the pubic symphysis.
    No preview · Article · Apr 2006 · Clinical Nuclear Medicine
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    Benjamin Armbruster · Russell J Hamilton · Arthur K Kuehl
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    ABSTRACT: There are three ways to determine the spectrum of a clinical photon beam: direct measurement, modelling the source and reconstruction from ion-chamber measurements. We focus on reconstruction because the necessary equipment is readily available and it provides independent confirmation of source models for a given machine. Reconstruction methods involve measuring the dose in an ion chamber after the beam passes through an attenuator. We gain information about the spectrum from measurements using attenuators of differing compositions and thicknesses since materials have energy dependent attenuation. Unlike the procedures used in other papers, we do not discretize or parametrize the spectrum. With either of these two approximations, reconstruction is a least squares problem. The forward problem of going from a spectrum to a series of dose measurements is a linear operator, with the composition and thickness of the attenuators as parameters. Hence the singular value decomposition (SVD) characterizes this operator. The right singular vectors form a basis for the spectrum, and, at first approximation, only those corresponding to singular values above a threshold are measurable. A more rigorous error analysis shows with what confidence different components of the spectrum can be measured. We illustrate this theory with simulations and an example utilizing six sets of dose measurements with water and lead as attenuators.
    Full-text · Article · Dec 2004 · Physics in Medicine and Biology

  • No preview · Article · Nov 2003 · The Cancer Journal
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    ABSTRACT: The purpose of this study was to determine the treatment protocol, in terms of dose fractions and interfraction intervals, which minimizes normal tissue complication probability in the spinal cord for a given total treatment dose and treatment time. We generalize the concept of incomplete repair in the linear-quadratic model, allowing for arbitrary dose fractions and interfraction intervals. This is incorporated into a previously presented model of normal tissue complication probability for the spinal cord. Equations are derived for both mono-exponential and bi-exponential repair schemes, regarding each dose fraction and interfraction interval as an independent parameter, subject to the constraints of fixed total treatment dose and treatment time. When the interfraction intervals are fixed and equal, an exact analytical solution is found. The general problem is nonlinear and is solved numerically using simulated annealing. For constant interfraction intervals and varying dose fractions, we find that optimal normal tissue complication probability is obtained by two large and equal doses at the start and conclusion of the treatment, with the rest of the doses equal to one another and smaller than the two dose spikes. A similar result is obtained for bi-exponential repair. For the general case where the interfraction intervals are discrete and also vary, the pattern of two large dose spikes is maintained, while the interfraction intervals oscillate between the smallest two values. As the minimum interfraction interval is reduced, the normal tissue complication probability decreases, indicating that the global minimum is achieved in the continuum limit, where the dose delivered by the "middle" fractions is given continuously at a low dose rate. Furthermore, for bi-exponential repair, it is seen that as the slow component of repair becomes increasingly dominant as the magnitude of the dose spikes decreases. Continuous low-dose-rate irradiation with dose spikes at the start and end of treatment yields the lowest normal tissue complication probability in the spinal cord, given a fixed total dose and total treatment time, for both mono-exponential and bi-exponential repair. The magnitudes of the dose spikes can be calculated analytically, and are in close agreement with the numerical results.
    No preview · Article · May 2001 · Radiation Research
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    ABSTRACT: Volume rendering is a visualization technique that has important applications in diagnostic radiology and in radiotherapy but has not achieved widespread use due, in part, to the lack of volumetric analysis tools for comparison of volume rendering to conventional visualization techniques. The volume rendering quantification algorithm (VRQA), a technique for three-dimensional (3-D) reconstruction of a structure identified on six principal volume-rendered views, is introduced and described, VRQA involves three major steps: 1) preprocessing of the partial surfaces constructed from each of six volume-rendered images; 2) merging these processed partial surfaces to define the boundaries of a volume; and 3) computation of the volume of the structure from this boundary information. After testing on phantoms, VRQA was applied to CT data of patients with cerebral arteriovenous malformations (AVM's). Because volumetric visualization of the cerebral AVM is relatively insensitive to operator dependencies, such as the choice of opacity transfer function, and because precise volumetric definition of the AVM is necessary for radiosurgical treatment planning, it is representative of a class of structures that is ideal for testing and calibration of VRQA, AVM volumes obtained using VRQA are intermediate to those obtained using axial contouring and those obtained using CT-correlated biplanar angiography (two routinely used visualization techniques for treatment planning for AVM's). Applications and potential expansions of VRQA are discussed.
    No preview · Article · Feb 2000 · IEEE Transactions on Medical Imaging

  • No preview · Article · Jan 2000
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    ABSTRACT: A technique was developed to reduce the size and magnitude of the hot and cold spots in the abutting regions of photon and electron fields. The photon and electron fields were set up such that the photon field extended ∼2 cm into the electron field in the abutting region. The region of the photon beam that overlapped the electron field was modulated using a multileaf collimator, effectively broadening the photon penumbra to make it complimentary to the electron penumbra. The computer calculations were verified using film measurements for abutting a 6 MV photon beam with a 9 MeV electron beam. A uniform dose was achieved at a prespecified depth of 2 cm, and dose uniformity was improved at the specified depth and beyond compared with unmodulated photon beams. A slight increase in dose inhomogeneity was seen at shallower depths. The overall areas of the hot and cold spots were significantly reduced. The technique also reduced the sensitivity of dose homogeneity to setup errors such that the magnitudes of the hot and cold spots were about half of those produced with unmodulated photon beam when an overlap or gap of 4 mm was introduced. The technique was applied to the treatment of a head and neck cancer and a lymphoma involving the right pleura with markedly reduced dose inhomogeneity in the abutting regions. © 1999 American Association of Physicists in Medicine.
    No preview · Article · Oct 1999 · Medical Physics

  • No preview · Article · Dec 1998 · International Journal of Radiation OncologyBiologyPhysics
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    ABSTRACT: The optimal field shape achieved using a multileaf collimator (MLC) often requires collimator rotation to minimize the adverse effects of the scalloped dose distribution the leaf steps produce. However, treatment machines are designed to deliver wedged fields parallel or perpendicular to the direction of the leaves. An analysis of cases from our clinic showed that for 25% of the wedged fields used to treat brain and lung tumors, the wedge direction and optimal MLC orientation differed by 20 degrees or more. The recently published omni wedge technique provides the capability of producing a wedged field with orientation independent of the orientation of the collimator. This paper presents a comparison of the three-dimensional (3D) dose distributions of the omni wedged field with distributions of wedged fields produced using both the universal and dynamic wedge techniques. All measurements were performed using film dosimetry techniques. The omni wedge generated fields closely matched the conventional wedged fields. Throughout 95% of the irradiated volume (excluding the penubra), the dose distribution of the omni wedged field ranged from +5.5 to -3.5 +/- 1.5% of that of the conventionally wedged fields. Calculation of the omni wedged field is as accurate as conventional wedged field calculation when using a 3D treatment planning systems. For two-dimensional treatment planning systems, where one must assume that the omni wedged field is identical to a conventional field, the calculated field and the delivered field differs by a small amount.
    No preview · Article · Sep 1998 · Medical Physics
  • David J. Reisberg · Khaled T. Shaker · Russell J. Hamilton · Patrick Sweeney
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    ABSTRACT: Stereotactic radiotherapy provides the most accurate and effective therapy and protects the adjacent, normal tissues. The head must be positioned the same for all treatments. This article describes the fabrication and application of a noninvasive intraoral appliance that verifies the position of the head to deliver more accurate radiotherapy and protect the adjacent, normal tissues.
    No preview · Article · Feb 1998 · Journal of Prosthetic Dentistry
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    ABSTRACT: We have developed and tested an interactive video system that utilizes image subtraction techniques to enable high precision patient repositioning using surface features. We report quantitative measurements of system performance characteristics. Video images can provide a high precision, low cost measure of patient position. Image subtraction techniques enable one to incorporate detailed information contained in the image of a carefully verified reference position into real-time images. We have developed a system using video cameras providing orthogonal images of the treatment setup. The images are acquired, processed and viewed using an inexpensive frame grabber and a PC. The subtraction images provide the interactive guidance needed to quickly and accurately place a patient in the same position for each treatment session. We describe the design and implementation of our system, and its quantitative performance, using images both to measure changes in position, and to achieve accurate setup reproducibility. Under clinical conditions (60 cm field of view, 3.6 m object distance), the position of static, high contrast objects could be measured with a resolution of 0.04 mm (rms) in each of two dimensions. The two-dimensional position could be reproduced using the real-time image display with a resolution of 0.15 mm (rms). Two-dimensional measurement resolution of the head of a patient undergoing treatment for head and neck cancer was 0.1 mm (rms), using a lateral view, measuring the variation in position of the nose and the ear over the course of a single radiation treatment. Three-dimensional repositioning accuracy of the head of a healthy volunteer using orthogonal camera views was less than 0.7 mm (systematic error) with an rms variation of 1.2 mm. Setup adjustments based on the video images were typically performed within a few minutes. The higher precision achieved using the system to measure objects than to reposition them suggests that the variability in repositioning is dominated by the ability of the therapist to make small, controlled changes in the position of the patient. Using affordable, off-the-shelf technology, we have developed a patient positioning system that achieves repositioning accuracy normally associated with fractionated stereotactic systems. The technique provides real-time guidance and can be used to easily and quickly correct patient setup before every treatment, thus significantly reducing overall random positioning error. This improved positioning capability provides the precision required to realize the potential gains of conformal radiotherapy.
    No preview · Article · Aug 1997 · International Journal of Radiation OncologyBiologyPhysics
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    Barrett D. Milliken · Russell J. Hamilton · Steven J. Rubin
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    ABSTRACT: A method to produce wedged fields at any orientation relative to the collimator is described. The wedged field is generated by combining two appropriately weighted orthogonal wedged field segments at fixed collimator and gantry positions. The method requires only that wedged fields can be produced in orthogonal directions without rotating the collimator, such as is commonly provided on most radiation therapy accelerators by sets of standard and rotated wedges. Expressions are derived relating the effective wedge angle and orientation to the weighting and wedge angles of the orthogonal wedged field segments. This technique will be important when using multileaf collimator field shaping for which collimator rotation is dictated by target or critical structure shape and orientation. The term omni wedge is introduced to describe this technique.
    Preview · Article · Apr 1996 · Medical Physics
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    ABSTRACT: Preirradiation hormonal cytoreduction of prostate cancer has been proven to reduce exposure of normal structures by decreasing the size of the target volume. Dose-volume histogram (DVH) analysis, however, does not always appear to demonstrate a strong positive benefit with the use of neoadjuvant hormone therapy. This study analyzes various other factors influencing dose to normal organs, which may determine the success or failure of neoadjuvant hormonal therapy in achieving its goals. Patients with bulky clinical Stage C adenocarcinoma of the prostate were given 3 months of hormone treatment consisting of oral Flutamide and monthly Zoladex injections prior to irradiation. Computerized tomography (CT) scans of the pelvis were obtained both prior to and following hormonal treatment. Treatment plans were generated by three-dimensional (3D) conformal treatment planning. The change in the volume of the prostate was assessed along with the percentage of prescribed dose delivered to the rectum and bladder. Various factors such as prostate size, bladder/rectum size, and organ shape were studied. Both dose-volume histograms (DVH) and dose-surface area histograms (DSH) were used for analysis. Six of seven patients had reduction in the size of their prostates. The mean volumes of the prostate before and after hormonal manipulation were 129.1 +/- 32.9 standard deviation (SD) cm3 and 73.0 +/- 29.5 SD cm3, respectively (p = 0.0059). The volume of rectum receiving 80% of the prescribed dose was reduced in five of seven patients from a mean of 83.2 to 59.9 cm3 (p = 0.045). The volume of bladder receiving 80% of the prescribed dose was also reduced in five out of seven patients from a mean of 74.5 to 40.2 cm3 (p = 0.098). Correlation between the size of the prostate and volume of rectum and bladder treated was not always consistent: greater reduction in prostate size did not necessarily result in large decreases in dose to bladder or rectum. The total size of the bladder and rectum were found to be important factors in normal tissue radiation exposure; the benefits of hormone therapy may be lost if the bladder and rectum are allowed to decrease in size. Also, the bladder may be prone to sagging into the pelvis of some patients following hormone therapy, resulting in a less optimal therapeutic ratio. Reduction in prostate size by neoadjuvant hormonal manipulation does decrease the amount of normal tissue irradiated in most patients. However, the correlation between the reduction in prostate size and amount of rectum or bladder treated is not linear if other variables are not controlled. Factors such as the shape of the organs, as well as the distensible nature of the bladder and rectum, play major roles in dose to normal tissues. These facts may mask the benefits of cytoreduction and could be obstacles in realizing consistent benefits from preirradiation hormonal treatment in the clinical setting if they are ignored.
    No preview · Article · Jan 1996 · International Journal of Radiation OncologyBiologyPhysics

  • No preview · Article · Dec 1995 · International Journal of Radiation OncologyBiologyPhysics

Publication Stats

323 Citations
64.99 Total Impact Points


  • 2004-2009
    • The University of Arizona
      • Department of Radiation Oncology
      Tucson, Arizona, United States
  • 1996-2000
    • University of Chicago
      • Department of Radiation & Cellular Oncology
      Chicago, Illinois, United States
    • Cook County Hospital
      • Division of Urology
      Chicago, Illinois, United States
  • 1998-1999
    • University of Illinois at Chicago
      Chicago, Illinois, United States