Medical Physics Graduate Program Faculty

B. Gino Fallone, PhD, P Phys., FCCPM, DABMP, DABR, FAAPM

Professor and Director, Division of Medical Physics,
Department of Oncology
Director, Dept. of Medical Physics, Cross Cancer Institute

BSc (Physics Honors: McGill-1974)
MSc (Physics: Montréal-1976)
PhD (Physics: McGill-1983)

Fellow: Canadian College of Physicists in Medicine
Diplomat: American Board of Medical Physics
Diplomat: American Board of Radiology
Professional Physicist: Canadian Association of Physicists
Fellow: American Association of Physicists in Medicine

Research Interests

Image-Guided Adaptive Radiotherapy (IGAR)

The main goal of the research program entitled "Image-guided adaptive radiotherapy (IGAR)" in CBIAR, is to achieve the maximum curing potential by precisely delivering a radiation dose distribution that is "sculpted" to the anatomical and biological extent of the tumor while delivering minimal dose to healthy tissue to reduce side effects.

The IGAR program incorporates one of the world's first human Helical TomoTherapy System, a ultra-high human whole body (3 T) MR Imaging and Spectroscopy System, an animal 9.4T MR Imaging and Spectroscopy System, an image-fusion laboratory, and the computer laboratories for the Canadian Computational Cancer Center (C4). The MR systems provide the anatomical, functional, metabolic and biochemical information to identify diseases at an earlier stage, and monitor treatment response immediately after and at intervals after treatment. The resultant information is integrated with PET images within our image fusion laboratories to design advanced adaptive radiation therapy delivered by the experimental TomoTherapy system. The C4 facilities will evaluate the clinical outcome with respect to treatment by imaging follow-up and by correlating with gene profiling information provided of PolyomX. This evaluation will allow the quantification of fundamental cancer processes and its varying treatment, in an effort to develop novel treatment strategies.

We deliver the dose by a Helical TomoTherapy system, a revolutionary treatment device that was funded by the CFI, ASRA and the ACF (Total of about $5M. Conventional modern CT and MR (1.5 T) do not show the full extent of the tumor. To obtain the full biological extent of the tumor and the healthy tissues (functional, biochemical information in addition to the anatomical information), we have received funds from the CFI and ASRIP (about $10 M) to install a ultra-high field MR system. The system comprises a 3 T MRI and MRS system ($4 M) from Philips which is far superior in imaging capabilities to conventional 1.5 T systems. In addition, we were able to acquire a 9.4 T (super high field) animal MRI and MRS system to perform studies in MR molecular imaging. The latter system brings us to the limit of what futuristic MR imaging and spectroscopy can do for cancer detection, and cancer therapy from radiation and from other cancer treatment agents. The acquisition of the latter system has been made possible with the partial financial $660K commitment from the ACF.

The IGAR facilities are unique in the world, and allow the delivery of advanced adaptive radiation treatments, offer functional and metabolic information of cancer, and quantify cancer processes, and make the Cross Cancer Institute the most advanced center in the world for cancer molecular imaging and adaptive radiation therapy.

Digital Electroradiography

The investigation of a high resolution non-contact voltage sensor to obtain latent images from xeroradiographic plates composed of amorphous Selenium (a-Se), resulting in the development of a digital radiographic system for on-line portal imaging. We are presently investigating the performance of a novel portal imaging device composed of metal/a-Se coupled to amorphous Silicon active flat-panels (thin film transistors).

Digital Portal Imaging and Automatic Image Registration and Verification

Our studies in the digital contrast enhancement of portal localization radiographs have resulted in improved visualization of the treatment area and adjacent regions, thus facilitating the task of accurate localization. Automatic registration of portal to reference images have been performed with morphological processing and correlation techniques. We have also implemented techniques to create megavoltage digital reconstructed radiographs (DRRs) of 3-D CT data to produce CT simulation of patient treatment and subsequent automatic registration to portal images. We are presently investigating the automatic registration of portal to DRRs in three dimensions for on-line verification of radiation treatment.

Inverse Treatment Planning

State-of-the art conformal therapy is a technique that achieves increased survival rate by using intensity modulated beams to deliver dose distributions that tailor a high-dose region to the tumor volume while the dose to the healthy tissue as low as possible. Optimizing techniques have developed to design the modulated beams through a process of inverse treatment planning (ITP). We have develop a novel ITP technique and now plan to incorporate clinically relevant objectives and constraints, and to incorporate emerging radiobiological information to design plans that maximizes tumor control with minimum complications.

Conformal Therapy

We are pursuing Image-Guided Adaptive Radiotherapy (IGAR) techniques that use advanced imaging modalities, conventional and ultra-high field MR, PET, CT, megavoltage CT, to deliver highly conformal therapy beams using a unique Helical TomoTherapy system within the Center for Biological Imaging and Adaptive Radiotherapy (CBIAR). Research in this avenue involves megavoltage CT, detector design and analysis, inverse planning, Monte Carlo simulation and dosimetry, radiobiological modeling, etc. Within the newly-created Canadian Computational Cancer Center, we provide through a computational and theoretical approach, the systematic simplification, quantification and visualization of cancer processes and conventional treatments into practical models that can be developed to significantly increase cure rates.

Selected Peer Reviewed Publications (since 2002):

P Kirvan, T Monajemi, B G Fallone, S Rathee, "Performance Characterization of a MVCT Scanner using Multi-Slice Thick, Segmented Cadmium Tungstate-Photodiode Detectors."
in press (2010).

B Burke, M Lamey, S Rathee, B Murray and B G Fallone, "Radio Frequency noise from clinical linear accelerators."
Phys. Med. Biol. 54, 2483-2492(2009).

B G Fallone, B Murray, S Rathee, T Stanescu, S Steciw, S Vidakovic, E Blosser and D Tymofichuk, "First MR images obtained during megavoltage photon irradiation from a prototype linac-MR system."
Med. Phys. 36, 2084-2088(2009).

C Kirkby, T Stanescu, S Rathee, M Carlone, B Murray and B G Fallone, "Patient dosimetry for hybrid MRI-radiotherapy systems."
Med. Phys. 35, 1019-1027 (2008).

L N Baldwin , K Wachowicz , S D Thomas , R Rivest and B G Fallone, "Towards MR-based Treatment Planning: Characterisation of Geometric Distortion in 3 T MR Images."
Med Phys. 34(2), pp. 388-399 (2007).

K Breitman, S Rathee, C Newcomb, B Murray, D Robinson, C Field, H Warkentin, S Connors, M MacKenzie, P Dunscombe and B G Fallone, "Experimental Validation of the Eclipse AAA Algorithm."
J. App. Clin. Med. Phys, 8(2), pp.76-92, Spring (2007).

D M Drabik, M Mackenzie, and B G Fallone, "Quantifying appropriate PTV setup margins: analysis of patient setup fidelity and intrafraction motion using post treatment MVCT scans (TomoTherapy)."
Int J Radiat Oncol Bio Phys, 68(4), pp. 1222-1228 (2007).

C Kirkby, C Field, M MacKenzie, A Syme and B G Fallone , "A Monte Carlo study of the variation of electron fluence in water from a 6 MV photon beam outside of the field."
Phys. Med. Biol. 52, pp. 3563-3578 (2007).

P Stavrev, C Schinkel, N Stavreva, K Markov and B G Fallone, "Analytical investigation of properties of the iso-NTCP envelope."
Radiol. Oncol. 41(1), pp. 41-47 (2007).

A Yahya and B G Fallone, "Incorporating homonuclear polarization transfer into PRESS for proton spectral editing: Illustration with lactate and glutathione."
J.Magn. Reson., pp.111-121 (2007), doi:10.1016/j.jmr.2007.06.009.

C Schinkel, N Stavreva, P Stavrev, M Carlone and B G Fallone, "Functional form comparison between the population and the individual Poisson based TCP models."
Radiol. Oncol. 41(2), pp. 90-98 (2007).

C Schinkel, M Carlone, B Warkentin and B G Fallone , "An analytic investigation into the effect of population heterogeneity on parameter ratio estimates."
Int J Radiat Oncol Biol Phys. 2007 Nov;69(4):1323-30

S Kumar, M Parliament, N Jha, M Mackenzie, R Scrimger, C Field, B G Fallone, "Sparing the parotid glands and surgically transferred submandibular gland with helical tomotherapy in post-operative radiation of head and neck cancer: A planning study."
Radiotherapy and Oncology, 2007 Oct;85(1):98-104.

E P Saibishkumar, M Mackenzie, D Severin, A Mihai, J Hanson, H Daly, B G Fallone, M Parliament, B Abdulkarim, "Skin-Sparing Radiation using Intensity-Modulated Radiotherapy After Conservative Surgery in Early-Stage Breast Cancer: A Planning Study."
Int J Radiat Oncol Biol Phys, Sept. 17, 0360-3016 (Print), in press (2007).

T Monajemi , B G Fallone, S Rathee, "Thick segmented CdWO4 photodiode detector for Cone Beam CT."
Med. Phys. 33(12), pp. 4567-4577, 2006.

C Schinkel , P Stavrev, N Stavreva, B G Fallone, "A theoretical approach to the problem of dose-volume constraints estimation and their impact on the dose-volume histogram selection."
Med. Phys. 33(9), pp.3444-3459, 2006.

A T Kress , H R Hooper and B G Fallone, "Experimental Investigation of Two Techniques to Reduce Limited Field-Of-View Artifacts in CT Imaging."
Med. Phys. in press June 2006.

K Markov , C Schinkel , N Stavreva, P Stavrev, M Weldon, B G Fallone, "Reverse mapping of normal tissue complication probabilities onto dose volume histogram space: the problem of randomness of the dose volume histogram sampling."
Med. Phys., 33(9), pp. 3435-3443, 2006.

D Sambasivarao, D Murray, J Dufour, D Caranduga, S Myrehaug, B G Fallone, C Field, R Greiner, J Hanson, C Cass, M Parliament, "Association of DNA Repair and Steroid Metabolism Gene Polymorphisms with Clinical Late Toxicity in Patients Treated with Conformal Radiotherapy for Prostate Cancer."
Clinical Cancer Research, pp. 2545- 2554, 2006.

M Carlone, B Warkentin, P Stavrev and B G Fallone , "Fundamental form of the population TCP model in the limit of large heterogeneity."
Med. Phys. 33(6), pp. 1634-1642, 2006.

K Wachowicz, S Thomas, and B G Fallone, "Quantification of the susceptibility artifact around a prostate brachytherapy seed in MRI."
Med. Phys. 33(12), pp. 4459-4467, 2006

T Stanescu , J Hans-Sonke , P Stavrev, B G Fallone, "3T MR-based treatment planning for radiotherapy of brain lesions."
Radiol Oncol 40(2), pp. 125-132, 2006. [ISSN 1318-2099].

Hans-Sonke Jans, A Syme, S Rathee, B G Fallone, "3D inter-fractional patient position verification using 2D-3D registration of orthogonal images."
Med Phys, 33(5), pp. 1420-1439, 2006.

T Monajemi, D Tu, B G Fallone and S Rathee, "A bench-top megavoltage CT using CdWO 4-photodiode detectors: I. System description and detector characterization."
Med. Phys, 33(4), pp. 1078-1089, 2006.

T Monajemi, D Tu, B G Fallone and S Rathee, "A bench-top megavoltage CT using CdWO 4-photodiode detectors: II. Image performance evaulation."
Med. Phys, 33(4), pp. 1090-1100, 2006.

S D Thomas, M A Mackenzie, G C Field, A M Syme and B G Fallone, "Patient Specific Treatment Verifications For Helical Tomotherapy Treatment Plans."
Med. Phys. 32(12), pp.3793-3800, 2005.

S Steciw, B Warkentin, S Rathee and B G Fallone, "Three dimensional IMRT verification with a flat-panel EPID."
Medical Physics, Vol. 32, No. 2, pp. 600-612, 2005.

S D Thomas, M A Mackenzie, D W O Rogers and B G Fallone , "A Monte Carlo Derived TG-51 Equivalent Calibration for Helical Tomotherapy."
Med. Phys., 32 (5), pp. 1346-1353, 2005.

M Van Vulpen, C Field, C Raaijmakers, M Parliament, C Terhaard, M A MacKenzie, R Scrimger, J Lagendijk1 and B G Fallone , "Comparing Step-and-Shoot IMRT with Dynamic Helical Tomotherapy IMRT Plans for Head-and-Neck Cancer."
IJROBP, 62(5), pp. 1535-9, 2005.

B Warkentin, P Stavrev, N A Stavreva and B G Fallone , "Limitations of a TCP Model Incorporating Population Heterogeneity"
Physics in Medicine and Biology 50(15), pp. 3571-88, 2005.

E Barnett, M MacKenzie and B G Fallone, "IMRT point dose measurements using a diamond detector."
Oncol Radiol, 39(1), pp. 71-78, 2005.

N A Stavreva, B Warkentin, P V Stavrev and B G Fallone , "Investigating the Effect of Clonogen Resensitization on the Tumor Response to Fractionated External Radiotherapy."
Medical Physics 32(3), pp. 720-25, 2005.

K Nakonechny, B G Fallone and S Rathee, "Novel methods of measuring single scan dose profiles and cumulative dose in CT."
Medical Physics 32, pp. 98-109, 2005.

P Stavrev, M Weldon, B Warkentin, N A Stavreva and B G Fallone, "Radiation Damage, Repopulation and Cell Recovery Analysis of In Vitro Tumour Cell Megacolony Culture Data Using a Non-Poissonian Cell Repopulation TCP Model."
Physics in Medicine and Biology 50(13), pp. 3053-61, 2005.

P Stavrev, N Stavreva, J Sharplin, B G Fallone and A. Franko, "Critical Volume Model Analysis of Lung Complication Data from Different Strains of Mice."
Int J of Rad. Biol., in press (2004).

R Scrimger, P Stavrev, M Parliament, G C Field, H Thompson, N Stavreva and B.G. Fallone. "Phenomenologic Model Describing Flow Reduction for Parotid Gland Irradiation with Intensity-Modulated Radiotherapy: Evidence of Significant Recovery Effect."
Int J Rad Oncol Biol Phys., 60(1), pp. 178-185, 2004.

B Warkentin, P Stavrev, N Staverva, G C Field and B G Fallone, "A TCP-NTCP estimation module using DVHs and known radiobiological models and parameter sets."
J. App. Clin. Med. Phys, 5(1), pp. 50-63, 2004.

T Monajemi, S Steciw, B G Fallone and S Rathee, "Modeling Scintillator-Photodiodes as Detectors for Megavoltage CT."
Medical Physics 31(5), pp. 1225-1234, 2004.

C Schroeder, T Stanescu, S Rathee and B G Fallone , "Lag Measurement in an a-Se Active Matrix Flat Panel Imager."
Med. Phys. 31, pp. 1203-1209, 2004.

A M Syme, C Kirkby, T A Riauka, B G Fallone and S A McQuarrie, "Monte Carlo Investigation of Single Event Spectra for Radionuclides in Intraperitoneal Radionuclide Therapy."
Phys. Med. Biol., 49(10), pp. 1959-1972, 2004.

B Warkentin, S Steciw, S Rathee and B G Fallone , "Dosimetric IMRT verification with a flat-panel EPID."
Med. Phys. 30, pp. 3143-3155, 2003. [Farrington Daniels Award for Best Article on Radiation Dosimetry]

P Stavrev, D Hristov, B Warkentin, E Sham, N Stavreva and B G Fallone, "Inverse treatment planning by physically constrained minimization of a biological objective function."
Med. Phys. 30, pp. 2948-2958, 2003.

A M Syme, S McQuarrie, J Middleton and B G Fallone , "Dosimetric Model For Intraperitoneal Targeted Liposomal Radioimmunotherapy Of Ovarian Cancer Micrometastases."
Phys. Med. Biol., 48, pp. 1305-1320, 2003.

A M Syme, S McQuarrie and B G Fallone, "Beta dose-rate distributions in microscopic spherical tumours for intraperitioneal radioimmunotherapy."
Int. J. Rad. Oncol. Biol. Phys, 56(5), pp. 1495-1506, 2003.

N A Stavreva, P V Stavrev, B Warkentin and B G Fallone , "Investigating the Effect of Cell Repopulation on the Tumor Response to Fractionated External Radiotherapy."
Medical Physics 30(5), 2003.

D M Dimitriadis and B G Fallone, "Compensators for Intensity-Modulated Beams."
Medical Dosimetry 27(3), pp 215-220, 2002.

S Steciw , T Stanescu , S Rathee and B G Fallone , "Sensitivity reduction in biased amorphous selenium photoconductors."
J. Physics D: Appl. Phys., November 2002.

R Hooper and B G Fallone, "Sinogram merging to compensate for truncation of projection data in tomotherapy imaging."
Medical Physics, Vol 29, pp. 2548-2551, 2002.

N Stavreva , P Stavrev, B Warkentin and B G Fallone , "Derivation of the expressions for 50 and D50 for different individual TCP and NTCP models."
Phys Med. Biol. 47, pp. 3591-3605, 2002.

D Hristov, P Stavrev, E Sham and B G Fallone, "On the implementation of dose-volume objectives in gradient algorithms for inverse treatment planning."
Med. Phys., 29(5), pp. 848-856, 2002.

S Rathee, B G Fallone and D Robinson, "Modulation transfer function of digitally reconstructed radiographs for spiral computed tomography."
Med. Phys. 29(1), pp. 86-89, 2002.

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