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Learn more Contains ability to read monitor info T File and Directory Discovery Discovery Adversaries may enumerate files and directories or may search in specific locations of a host or network share for certain information within a file system. Learn more Contains ability to query volume size T Process Discovery Discovery Adversaries may attempt to get information about running processes on a system.
Learn more 1 confidential indicators T Security Software Discovery Discovery Adversaries may attempt to get a listing of security software, configurations, defensive tools, and sensors that are installed on the system. Download as CSV Close. Malicious Indicators 13 Environment Awareness Sets a global windows hook to intercept mouse events details “iexplore.
Suspicious Indicators 32 Anti-Reverse Engineering Creates guarded memory regions anti-debugging trick to avoid memory dumping details “iexplore. DLL” “iexplore. TMP” “regsvr EXE” “regsvr TMP” “iexplore. Hk” Heuristic match: “lrepacks. All Details:. Internet Download Manager 6. Filename Internet Download Manager 6. Resources Icon.
Visualization Input File PortEx. Tip: Click an analysed process below to view more details. This report was generated with enabled TOR analysis.
Domain Address Registrar Country yandex. COM EMail abuse key-systems. Associated Artifacts for yandex. Associated Artifacts for subca.
Associated Artifacts for ocsp. COM EMail domainabuse cscglobal. UK Name Server ns1. ORG EMail hostmaster letsencrypt. Associated Artifacts for crls. The RODC does not have the krbtgt secret. Thus, when removing a compromised RODC, the domain krbtgt account is not lost. So we asked, what changes have been made recently? In this case, the customer was unsure about what exactly happened, and these events seem to have started out of nowhere.
They reported no major changes done for AD in the past 2 months and suspected that this might be an underlying problem for a long time. So, we investigated the events and when we looked at it granularly we found that the event was coming from a RODC:. Computer: ContosoDC. Internal event: Active Directory Domain Services could not update the following object with changes received from the following source directory service.
This is because an error occurred during the application of the changes to Active Directory Domain Services on the directory service. To reproduce this error in lab we followed the below steps: —.
If you have a RODC in your environment, do keep this in mind. Thanks for reading, and hope this helps! Hi there! Windows Defender Antivirus is a built-in antimalware solution that provides security and antimalware management for desktops, portable computers, and servers.
This library of documentation is aimed for enterprise security administrators who are either considering deployment, or have already deployed and are wanting to manage and configure Windows Defender AV on PC endpoints in their network. Nathan Penn and Jason McClure here to cover some PKI basics, techniques to effectively manage certificate stores, and also provide a script we developed to deal with common certificate store issue we have encountered in several enterprise environments certificate truncation due to too many installed certificate authorities.
To get started we need to review some core concepts of how PKI works. Some of these certificates are local and installed on your computer, while some are installed on the remote site.
The lock lets us know that the communication between our computer and the remote site is encrypted. But why, and how do we establish that trust? Regardless of the process used by the site to get the certificate, the Certificate Chain, also called the Certification Path, is what establishes the trust relationship between the computer and the remote site and is shown below. As you can see, the certificate chain is a hierarchal collection of certificates that leads from the certificate the site is using support.
To establish the trust relationship between a computer and the remote site, the computer must have the entirety of the certificate chain installed within what is referred to as the local Certificate Store.
When this happens, a trust can be established and you get the lock icon shown above. But, if we are missing certs or they are in the incorrect location we start to see this error:. The primary difference being that certificates loaded into the Computer store become global to all users on the computer, while certificates loaded into the User store are only accessible to the logged on user.
To keep things simple, we will focus solely on the Computer store in this post. Leveraging the Certificates MMC certmgr. This tool also provides us the capability to efficiently review what certificates have been loaded, and if the certificates have been loaded into the correct location.
Trusted Root CAs are the certificate authority that establishes the top level of the hierarchy of trust. By definition this means that any certificate that belongs to a Trusted Root CA is generated, or issued, by itself. Simple stuff, right? We know about remote site certificates, the certificate chain they rely on, the local certificate store, and the difference between Root CAs and Intermediate CAs now. But what about managing it all?
On individual systems that are not domain joined, managing certificates can be easily accomplished through the same local Certificates MMC shown previously.
In addition to being able to view the certificates currently loaded, the console provides the capability to import new, and delete existing certificates that are located within. Using this approach, we can ensure that all systems in the domain have the same certificates loaded and in the appropriate store. It also provides the ability to add new certificates and remove unnecessary certificates as needed. On several occasions both of us have gone into enterprise environments experiencing authentication oddities, and after a little analysis trace the issue to an Schannel event This list has thus been truncated.
On a small scale, customers that experience certificate bloat issues can leverage the Certificate MMC to deal with the issue on individual systems. Unfortunately, the ability to clear the certificate store on clients and servers on a targeted and massive scale with minimal effort does not exist. This technique requires the scripter to identify and code in the thumbprint of every certificate that is to be purged on each system also very labor intensive.
Only certificates that are being deployed to the machine from Group Policy will remain. The ability to clear the certificate store on clients and servers on a targeted and massive scale with minimal effort. This is needed to handle certificate bloat issues that can ultimately result in authentication issues. On a small scale, customers that experience certificate bloat issues can leverage the built-in certificate MMC to deal with the issue on a system by system basis as a manual process.
CertPurge then leverages the array to delete every subkey. Prior to performing any operations i. In the event that required certificates are purged, an administrator can import the backup files and restore all purged certificates. NOTE: This is a manual process, so testing prior to implementation on a mass scale is highly recommended. KB details the certificates that are required for the operating system to operate correctly. Removal of the certificates identified in the article may limit functionality of the operating system or may cause the computer to fail.
If a required certificate either one from the KB, or one specific to the customer environment is purged, that is not being deployed via GPO, the recommended approach is as follows. Restore certificates to an individual machine using the backup registry file,. Leveraging the Certificate MMC, export the required certificates to file,. Update the GPO that is deploying certificates by importing the required certificates,. Rerun CertPurge on machine identified in step 1 to re-purge all certificates,.
Did we mention Test? Also, we now have a method for cleaning things up things in bulk should things get out of control and you need to rebaseline systems in mass. Let us know what you all think, and if there is another area you want us to expand on next.
The sample scripts are not supported under any Microsoft standard support program or service. Download CertPurge. Greetings and salutations fellow Internet travelers! It continues to be a very exciting time in IT and I look forward to chatting with you once more. Azure AD — Identity for the cloud era.
An Ambitious Plan. This is information based on my experiences; your mileage may vary. Save yourself some avoidable heartburn; go read them … ALL of them:. Service accounts. TIP — Make sure you secure, manage and audit this service account, as with any service account. You can see it in the configuration pages of the Synchronization Service Manager tool — screen snip below.
Planning on-prem sync filtering. Also, for a pilot or PoC, you can filter only the members of a single AD group. In prod, do it once; do it right. UPNs and email addresses — should they be the same? In a word, yes. This assumes there is an on-prem UPN suffix in AD that matches the publicly routable domain that your org owns i.
AAD Connect — Install and configuration. I basically break this phase up into three sections:. TIP — Recapping:. TIP — Subsequent delta synchronizations occur approx. Switch Editions? Mark channel Not-Safe-For-Work? Are you the publisher? Claim or contact us about this channel. Viewing all articles. First Page Page 19 Page 20 Page 21 Page 22 Page Last Page. Browse latest View live. Note: Device writeback should be enabled if using conditional access.
A Windows 10 version , Android or iOS client. To check that all required ports are open, please try our port check tool. The connector must have access to all on premises applications that you intend to publish. Install the Application Proxy Connector on an on-premises server.
Verify the Application Proxy Connector status. Configure constrained delegation for the App Proxy Connector server. Optional: Enable Token Broker for Windows 10 version clients. Work Folder Native —native apps running on devices, with no credentials, no strong identity of their own.
Work Folder Proxy — Web Application that can have their own credentials, usually run on servers. This is what allows us to expose the internal Work Folders in a secure way. If the user is validated, Azure AD creates a token and sends it to the user. The user passes the token to Application Proxy.
Application Proxy validates the token and retrieves the Username part of user principal name from it, and then sends the request, the Username from UPN, and the Service Principal Name SPN to the Connector through a dually authenticated secure channel.
Active Directory sends the Kerberos token for the application to the Connector. The Work Folders server sends the response to the Connector, which is then returned to the Application Proxy service and finally to the user.
Kerberos Survival Guide. I found this on the details page of the new test policy and it is marked as: I then open an administrative PowerShell to run my command in to see exactly what the settings look like in WMI. Topic 2: Purpose of the tool. Topic 3: Requirements of the tool. Topic 4: How to use the tool. Topic 5: Limitations of the tool. Topic 7: References and recommendations for additional reading.
The specific target gaps this tool is focused toward: A simple, easy to utilize tool which can be executed easily by junior staff up to principle staff. A means by which security staff can see and know the underlying code thereby establishing confidence in its intent.
A lite weight utility which can be moved in the form of a text file. An account with administrator rights on the target machine s. An established file share on the network which is accessible by both. Ok, now to the good stuff. If you have anything stored in that variable within the same run space as this script, buckle up.
Just FYI. The tool is going to validate that the path you provided is available on the network. However, if the local machine is unable to validate the path, it will give you the option to force the use of the path.
Now, once we hit enter here, the tool is going to setup a PowerShell session with the target machine. In the background, there are a few functions its doing:. Next, we must specify a drive letter to use for mounting the network share from Step 4. The tool, at present, can only target a single computer at a time. If you need to target multiple machines, you will need to run a separate instance for each.
Multiple PowerShell Sessions. I would recommend getting each instance to the point of executing the trace, and then do them all at the same time if you are attempting to coordinate a trace amongst several machines.
Again, the tool is not meant to replace any other well-established application. Instead, this tool is meant only to fill a niche. You will have to evaluate the best suitable option for your purposes. On November 27, , Azure Migrate, a free service, will be broadly available to all Azure customers.
Azure Migrate can discover your on-premises VMware-based applications without requiring any changes to your VMware environment. Integrate VMware workloads with Azure services. This valuable resource for IT and business leaders provides a comprehensive look at moving to the cloud, as well as specific guidance on topics like prioritizing app migration, working with stakeholders, and cloud architectural blueprints.
Download now. Azure Interactives Stay current with a constantly growing scope of Azure services and features. Windows Server Why use Storage Replica? Storage Replica offers new disaster recovery and preparedness capabilities in Windows Server Datacenter Edition. For the first time, Windows Server offers the peace of mind of zero data loss, with the ability to synchronously protect data on different racks, floors, buildings, campuses, counties, and cities.
After a disaster strikes, all data will exist elsewhere without any possibility of loss. The same applies before a disaster strikes; Storage Replica offers you the ability to switch workloads to safe locations prior to catastrophes when granted a few moments warning — again, with no data loss.
Move away from passwords, deploy Windows Hello. Security Stopping ransomware where it counts: Protecting your data with Controlled folder access Windows Defender Exploit Guard is a new set of host intrusion prevention capabilities included with Windows 10 Fall Creators Update.
Defending against ransomware using system design Many of the risks associated with ransomware and worm malware can be alleviated through systems design. Referring to our now codified list of vulnerabilities, we know that our solution must: Limit the number and value of potential targets that an infected machine can contact.
Limit exposure of reusable credentials that grant administrative authorization to potential victim machines. Prevent infected identities from damaging or destroying data. Limit unnecessary risk exposure to servers housing data. Securing Domain Controllers Against Attack Domain controllers provide the physical storage for the AD DS database, in addition to providing the services and data that allow enterprises to effectively manage their servers, workstations, users, and applications.
If privileged access to a domain controller is obtained by a malicious user, that user can modify, corrupt, or destroy the AD DS database and, by extension, all of the systems and accounts that are managed by Active Directory. Because domain controllers can read from and write to anything in the AD DS database, compromise of a domain controller means that your Active Directory forest can never be considered trustworthy again unless you are able to recover using a known good backup and to close the gaps that allowed the compromise in the process.
Cybersecurity Reference Strategies Video Explore recommended strategies from Microsoft, built based on lessons learned from protecting our customers, our hyper-scale cloud services, and our own IT environment.
Get the details on important trends, critical success criteria, best approaches, and technical capabilities to make these strategies real. How Microsoft protects against identity compromise Video Identity sits at the very center of the enterprise threat detection ecosystem. Proper identity and access management is critical to protecting an organization, especially in the midst of a digital transformation. This part three of the six-part Securing our Enterprise series where Chief Information Security Officer, Bret Arsenault shares how he and his team are managing identity compromise.
November security update release Microsoft on November 14, , released security updates to provide additional protections against malicious attackers. All Admin capabilities are available in the new Azure portal. Microsoft Premier Support News Application whitelisting is a powerful defense against malware, including ransomware, and has been widely advocated by security experts. Users are often tricked into running malicious content which allows adversaries to infiltrate their network.
The Onboarding Accelerator — Implementation of Application Whitelisting consists of 3 structured phases that will help customers identify locations which are susceptible to malware and implement AppLocker whitelisting policies customized to their environment, increasing their protection against such attacks.
The answer to the question? It depends. You can also use certificates with no Enhanced Key Usage extension. Referring to the methods mentioned in The following information is from this TechNet Article : “In Windows and Windows R2, you connect to the farm name , which as per DNS round robin, gets first directed to the redirector, then to the connection broker, and finally to the server that hosts your session. Click Remote Desktop Services in the left navigation pane.
In the Configure the deployment window, click Certificates. Click Select existing certificates, and then browse to the location where you have a saved certificate generally it’s a. Import the certificate. Cryptographic Protocols A cryptographic protocol is leveraged for security data transport and describes how the algorithms should be used. TLS has 3 specifications: 1.
This is accomplished leveraging the keys created during the handshake. The TLS Handshake Protocol is responsible for the Cipher Suite negotiation between peers, authentication of the server and optionally the client, and the key exchange.
SSL also came in 3 varieties: 1. SSL 1. SSL 2. In SSL 3. Well, that was exhausting! Key Exchanges Just like the name implies, this is the exchange of the keys used in our encrypted communication. Ciphers Ciphers have existed for thousands of years. The denotation of bit, bit, etc. Hashing Algorithms Hashing Algorithms, are fixed sized blocks representing data of arbitrary size.
Putting this all together Now that everything is explained; what does this mean? This eBook was written by developers for developers. It is specifically meant to give you the fundamental knowledge of what Azure is all about, what it offers you and your organization, and how to take advantage of it all.
Azure Backup now supports BEK encrypted Azure virtual machines Azure Backup stands firm on the promise of simplicity, security, and reliability by giving customers a smooth and dependable experience across scenarios. Continuing on the enterprise data-protection promise, we are excited to announce the support for backup and restore of Azure virtual machines encrypted using Bitlocker Encryption Key BEK for managed or unmanaged disks.
VMware virtualization on Azure is a bare metal solution that runs the full VMware stack on Azure co-located with other Azure services. It has something to do with. Net Framework 3.
Apparently the update required does not work to no prevail. When I looked up the error it told me to try disabling antivirus, and to Installation from to : My PC is 3 major updates behind.
Would like to seek advise if running Windows Update is preferable or jumping straight using ISO installation. I’ve called MS Technical Support and called back 3 times per their instructions which has been a bit challenging due to language issues. I believe they downloaded an ISO file and a “reset” icon on my desktop Updating from to : I’m on with a day deferral.
I want to try a manual update to so I can experiment with getting comfortable with it before the October 9 eol, but the only resources I can find is for How to stop bugged update from installing? This update is bugged and gives me an awful display experience. I installed windows several times to track it down, and I finally did.
Now I need a way to not install it. Toyoaki Nishida. Abstract The capacity of involvement and engagement plays an important role in making a robot social and robust. In order to reinforce the capacity of robot in human-robot interaction, we proposed a twolayered approach. In the upper layer, social interaction is flexibly controlled by Bayesian Net using social interaction patterns. In the lower layer, the robustness of the system can be improved by detecting repetitive and rhythmic gestures.
Abstract The purpose of this paper is to support a sustainable conversation. From a view point of sustainability, it is important to manage huge conversation content such as transcripts, handouts, and slides.
Our proposed system, called Sustainable Knowledge Globe SKG , supports people to manage conversation content by using geographical arrangement, topological connection, contextual relation, and a zooming interface. Abstract The progress of technology makes familiar artifacts more complicated than before. Tumour that is visible or palpable is drawn manually, usually on paper templates.
Treatment received to date, including any external beam radiotherapy EBRT delivered to date, should be noted. Dotted lines of the vagina represent a virtual division in thirds. Dotted lines in the parametria represent a border between the proximal and distal half of the parametria. A pink line in the coronal view represents uterine artery. Height, defined on the sagittal view, is measured along the long axis of the uterus.
Thickness, defined on the sagittal view, is measured perpendicular to the height. Width, measured on the axial view, represents the greatest lateral diameter. Vaginal extension of tumour is specified separately.
The drawing should be signed. A first option utilizes coloured marker pens and a colour legend. Four different, specific colours are used. In addition, tumour can be identified as exophytic in nature by changing the border as outlined in the legend. There are certain advantages to coloured marker approach, such as straightforward and quick implementation, and immediately recognizable distinctions of different anatomical areas of involvement.
However, the incorporation of up to four specifically coloured markers into routine clinical practice in clinics and operating rooms may be a challenge to do consistently.
Ensuring the consistent availability of the markers in multiple work environments, with multiple caregivers, may not be practical. Again, any exophytic tumour can be delineated with a special border. Unlike the colour approach, consistent availability of a pen at any location or with any caregiver should not be an issue. A drawback is that the drawings may appear less readily discernible. However, after a brief learning curve, practioners should be able to draw and read such drawings with ease.
This approach seems the most practical and reliable, and could be adopted widely. This method involves electronic versions of the colour or background lines templates, with electronically modifiable tumour cartoons.
Drawings for physical medical chart record-keeping would have to be printed. Advantages of an electronic approach include the consistency and clarity of the drawings produced.
In addition, the electronic format facilitates the storage, access, and distribution of the drawings. Electronic templates could be made available on the internet for clinical use.
Radiother Oncol. When introducing a 3D image based approach for GTV and CTV assessment, there is a need for a common language to describe the concepts and to define the terms which are to be used. The task was to describe basic concepts and terms and to work out a terminology enabling various groups working in this advanced field to use a common language. The recommendations described in this report were proposed based on clinical experience and dosimetric concepts of different institutions IGR, Leuven, Vienna and were stepwise validated against the background of different clinical experience.
Beside verbal descriptions detailed examples are given, partly in form of schematic drawings. Methods and parameters have been developed and validated from dosimetric, imaging and clinical experience from different institutions University of Vienna, IGR Paris, University of Leuven.
Cumulative dose volume histograms DVH are recommended for evaluation of the complex dose heterogeneity. V is recommended for quality assessment only within a given treatment schedule.
For Organs at Risk OAR the minimum dose in the most irradiated tissue volume is recommended for reporting: 0. Dose values are reported as absorbed dose and also taking into account different dose rates.
The linear-quadratic radiobiological model- equivalent dose EQD2 -is applied for brachytherapy and is also used for calculating dose from external beam therapy. This formalism allows systematic assessment within one patient, one centre and comparison between different centres with analysis of dose volume relations for GTV, CTV, and OAR.
Recommendations for the transition period from traditional to 3D image-based cervix cancer brachytherapy are formulated. Radiother Oncol ;]. It is expected that the therapeutic ratio including target coverage and sparing of organs at risk can be significantly improved, if radiation dose is prescribed to a 3D image-based CTV taking into account dose volume constraints for OAR. In image-guided brachytherapy the geometry of the applicator is extracted from the patient 3D images and introduced into the treatment planning system; a process referred to as applicator reconstruction.
Due to the steep brachytherapy dose gradients, reconstruction errors can lead to major dose deviations in target and organs at risk. Appropriate applicator commissioning and reconstruction methods must be implemented in order to minimise uncertainties and to avoid accidental errors.
Applicator commissioning verifies the location of source positions in relation to the applicator by using auto-radiography and imaging. Sectional imaging can be utilised in the process, with CT imaging being the optimal modality. The results from the commissioning process can be stored as library applicators. The importance of proper commissioning is underlined by the fact that errors in library files result in systematic errors for clinical treatment plans.
While the source channel is well visualised in CT images, applicator reconstruction is more challenging when using MR images. Availability of commercial dummy sources for MRI is limited, and image artifacts may occur with titanium applicators. The choice of MR sequence is essential for optimal visualisation of the applicator. Preferably, contouring and reconstruction should be performed in the same image series in order to avoid fusion uncertainties. Clear and correct strategies for the applicator reconstruction will ensure that reconstruction uncertainties have limited impact on the delivered dose.
Under well- controlled circumstances the reconstruction uncertainties are in general smaller than other brachytherapy uncertainties such as contouring and organ movement. The main advantage of MRI as an imaging modality is its superior soft tissue depiction quality.
To exploit the full potential of MRI for the better ability of the radiation oncologist to make the appropriate choice for the BT application technique and to accurately define the target volumes and the organs at risk, certain MR imaging criteria have to be fulfilled. Technical requirements, patient preparation, as well as image acquisition protocols have to be tailored to the needs of 3D image-based BT.
The present recommendation is focused on the general principles of MR imaging for 3D image-based BT. Methods and parameters have been developed and progressively validated from clinical experience from different institutions IGR, Universities of Vienna, Leuven, Aarhus and Ljubljana and successfully applied during expert meetings, contouring workshops, as well as within clinical and interobserver studies.
Both low and high-field imagers, as well as both open and close magnet configurations conform to the requirements of 3D image-based cervical cancer BT. Multiplanar transversal, sagittal, coronal and oblique image orientation T2-weighted images obtained with pelvic surface coils are considered as the golden standard for visualisation of the tumour and the critical organs.
The use of complementary MRI sequences e. Patient preparation has to be adapted to the needs of BT intervention and MR imaging. It is recommended to visualise and interpret the MR images on dedicated DICOM-viewer workstations, which should also assist the contouring procedure. Choice of imaging parameters and BT equipment is made after taking into account aspects of interaction between imaging and applicator reconstruction, as well as those between imaging, geometry and dose calculation.
MRI with applicator in place for at least the first Answer categories one answer possible : applicator insertion. Daily image guidance and bony registration Answer categories one answer possible : Daily Weekly First fractions Other free text Which kind of image guidance is used during external beam radiotherapy? However, a certain For each option: a free text box will be available for comments e.
Answer categories: Free text Treatment Which treatment planning system vendor and version are you using for EBRT planning systems Answer categories: Free text Which treatment planning system vendor and version are you using for brachytherapy Answer categories: Free text Substudies Are you interested in participating in translational research?
Answer categories several answers possible : Yes, by sending samples to other departments for analysis Yes, by performing analyses in your own laboratory No Are you interested in participating in an EBRT substudy involving daily CBCT guided EBRT with delivery of plan of the day library plans?
A precise target volume definition is crucial for radiotherapy planning and IMRT treatments. There are differences in views among radiation oncologists regarding their preferred volume of elective nodal irradiation, their PTV margins and organs at risk delineation. To ensure homogenous contours and to provide an efficient workflow when contouring, a step-by-step pictorial guide is provided for the delineation of tumor related target volume, nodal target volume and OARs. However, this appendix part is meant as practical guide to contouring which may contain some redundancies.
To facilitate the comprehension of this stepwise contouring atlas, you can use the following schematic workflow For these cases, we recommend an individualized approach in which the CTV-T LR initial margin is adapted according to the different image sets. As an example: in case of a completely empty rectum at time of treatment planning, it is more likely that the CTV-T LR initial will move in anterior direction and the ITV margin may be increased in anterior direction and reduced in posterior direction see figure A B Figure The planning CT should have been done according to the bladder filling protocol see section 9.
If it is impossible to appropriately register the bony structures on the planning CT with the ones on MRI due to positioning differences for example , try to match locally the cervix region on the soft tissue. Once fused, verify your MR-based contour on the planning CT. Subsequently, outline both parametria and paravaginal tissue figure If the whole vagina had to be outlined, the CTV-T LRinitial should include the vaginal introitus which is located below the level of the pelvic floor e.
Depending on degree of uterus flexion, this may also form the anterior boundary of parametrial tissue. Inferiorly Urogenital diaphragm Table Subsequently, outline both parametria figure 3A and 3B even if not involved with disease, the borders of the parametria are outlined in the figure If the whole vagina had to be outlined, the CTV-T LRinitial should include the level of the introitus located below the level of the pelvic floor.
The margins are independent in any direction and are chosen according to the information on the bladder, rectum, uterus, and primary target motion from the different image set available example figure They must be contoured and numbered, even if nodal boosting is not contemplated. Include extracapsular extension if visible.
For pragmatic purpose and because there is only minor movement in nodal region, there is no need to draw a real ITV-N. The most superior axial outline should be at the aortic bifurcation. The most inferior border should be at the level of ischial spine and upper edge of obturator foramen were internal iliac vessels leave or enter the true pelvis which represents the caudal margin of the external and internal iliac vessels. See the table 4 at the end of this annex for a more detail lymph nodes anatomical boundaries definition.
This ensures the obturators and infra-iliac nodes to be included. Internal iliac border should be extend to the pelvic sidewall. The most inferior axial slice to include should be at the level of the pelvic floor usually below the femoral heads. This outline should not include muscle or bone.
You do not need to extend into the sacral foramina figure Risk patients Cranial border of irradiation field Low risk One slice below the bifurcation of common iliac artery Intermediate One slice below the aortic bifurcation High risk Cranial border of L1 with a minimum of 3 cm superior to the upper border of the last positive lymph node s Table Subsequently, extend the contour posterior-laterally along the vertebral body figure The outline should have a minimum of mm margin around vessels.
The posterior border is the ventral fascia of the pectineus muscle. The lateral border is the ventral fascia of the ileopsoas and sartorius muscles figure Do not include abdominal cavity without bowel or sigmoid figure Registration Form 2. Status at Diagnosis Form 3. Baseline Morbidity Form 4. Status at Brachytherapy Form 5. Treatment and DVH Form 6. Follow-up Form 7. Off Study and Vital Status Form 8.
Minimum actions to be taken by the working groups are telephone conference meetings in 3 months intervals with the main mentor available with a pre-meeting agenda and summarizing minutes results. This is to be communicated in cc to the coordinators RP, KT. To facilitate this process and to maintain some uniformity, parts of the following paragraphs could be included in the written patient information but this information should be adjusted according to local institutional standard treatment policies and are subject to local ethical committee approval.
In addition, a study specific consent form will need to accompany the patient information form that needs to be adapted to fulfill the regulations of the local ethical committee. You will receive the same treatment if you do not participate in this study. The study is planned to include more than patients from approximately 25 different international radiotherapy departments. The radiotherapy departments who collaborate in this study all use advanced level technological methods to deliver radiation image guided, as precisely and optimally as possible, to the tumor while sparing the surrounding healthy organs.
In this document you can read more information about the treatment, the possible side effects of treatment and this study.
The treatment starts with external beam radiotherapy together with chemotherapy. Brachytherapy internal radiation will be started during the last part of external beam treatment or starts when external beam treatment has ended. This study focused on implementing a brachytherapy treatment method in which the radiation dose was shaped to the individual patients anatomy or position of the tumor and the healthy normal surrounding organs using MRI imaging at time of brachytherapy.
Results of this and other studies indicate that in patients with small tumors high doses of radiation can safely been given resulting in a very high chance that the cancer will be cured.
On the other hand, in patients with larger tumors a higher dose of brachytherapy could be safely given with advanced brachytherapy techniques and this higher dose resulted in an improved chance of tumor control. Furthermore, each day patients will be positioned as accurate as possible on the treatment machine using imaging on the machine. This will increase the precision of treatment. Together with MRI imaging at time of brachytherapy, this will increase the precision of treatment.
For smaller tumors this will result in less dose to healthy surrounding organs, while for larger tumors this will allow to increase the radiation dose necessary to effectively treat the tumor. In total 25 external beam radiotherapy treatments are given over a period of weeks. The side effects are most pronounced during the last 2 weeks of external beam radiotherapy and the first 2 weeks after completion.
During this period the tumor will decrease in size and sometimes patients will notice a change in discharge form the vagina. This results in having to go to the toilet more often for bowel movements.
The placement of the applicator is done using a form of anesthetic general or spinal. The applicator uses hollow tubes that are placed in the vagina and through the cervix into the cavity of the uterus womb. It may be necessary to place additional hollow tubes or needles directly in the tumor area. Using an MRI scan with the brachytherapy applicator in position the radiation dose can be optimally shaped. During the treatment a radioactive source will be placed in the hollow tubes in the area of the tumor for some time to deliver the radiotherapy dose.
How long the treatment takes and how much treatments are given depends on the equipment used and your radiation oncologist will provide more detailed information on this procedure.
In addition to these, there may be some bleeding from the vagina, which should stop within two days after treatment. There may be some additional soreness of the vagina or with passing urine after the procedure. Cisplatin is given intravenously, in the bloodstream.
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Windows 10 1703 download iso itarget – windows 10 1703 download iso itarget
Although these same treatment modalities will be used, EMBRACE II aims are to downloa an image guided risk adapted ссылка на продолжение and volume prescription protocol according to interventions specified in chapter 4. Learn more. Based on available evidence at the time of study closure, a more targeted approach will be undertaken, aiming to validate the most promising markers in the large cohort of patients.❿
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