Yvonne Mowery

Positions:

Butler Harris Assistant Professor in Radiation Oncology

Radiation Oncology
School of Medicine

Assistant Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2012

Duke University

Ph.D. 2012

Duke University

Intern, Medicine

Duke University School of Medicine

Resident, Radiation Oncology

Duke University School of Medicine

Grants:

The Duke Preclinical Research Resources for Quantitative Imaging Biomarkers

Administered By
Radiology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Patient Reported Outcomes and Financial Toxicity in Head and Neck Cancer

Administered By
Radiation Oncology
Awarded By
Radiation Oncology Institute
Role
Principal Investigator
Start Date
End Date

SARC Spore - Bridge Funding

Administered By
Radiation Oncology
Awarded By
Sarcoma Alliance for Research Through Collaboration
Role
Co Investigator
Start Date
End Date

Mechanisms that Regulate Sarcoma Response to Immune Checkpoint Inhibition of PD-1

Administered By
Radiation Oncology
Awarded By
Sarcoma Alliance for Research Through Collaboration
Role
Investigator
Start Date
End Date

Dissecting the Interplay between Tumor Mutational Load and the Immune System in Response of Primary Sarcomas to Radiation Therapy

Administered By
Radiation Oncology
Awarded By
Conquer Cancer Foundation
Role
Principal Investigator
Start Date
End Date

Publications:

Decreased Gram Negative Bloodstream and C. Difficile Infections with Early Ciprofloxacin/Metronidazole Prophylaxis in Myeloablative Allogeneic Hematopoietic Stem Cell Transplant

Authors
Kegerreis, KG; Mowery, YM; Shaw, JR; Grgic, T; Chang, J; Sito, E; Chao, NJ; Lassiter, M
MLA Citation
Kegerreis, Kristin G., et al. “Decreased Gram Negative Bloodstream and C. Difficile Infections with Early Ciprofloxacin/Metronidazole Prophylaxis in Myeloablative Allogeneic Hematopoietic Stem Cell Transplant.” Biology of Blood and Marrow Transplantation, vol. 23, no. 3, 2017, pp. S386–S386.
URI
https://scholars.duke.edu/individual/pub1452724
Source
wos-lite
Published In
Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Volume
23
Published Date
Start Page
S386
End Page
S386

Development and Implementation of an Educational Simulation Workshop in Fiberoptic Laryngoscopy for Radiation Oncology Residents.

PURPOSE: Fiberoptic laryngoscopy (FOL) is a critical tool for the diagnosis, staging, assessment of treatment response, and detection of recurrence for head and neck (H&N) malignancies. No standardized recommendations exist for procedural FOL education in radiation oncology. We therefore implemented a pilot simulation workshop to train radiation oncology residents in pertinent H&N anatomy and FOL technique. METHODS AND MATERIALS: A 2-phase workshop and simulation session was designed. Residents initially received a lecture on H&N anatomy and the logistics of the FOL examination. Subsequently, residents had a practical session in which they performed FOL in 2 simulated environments: a computerized FOL program and mannequin-based practice. Site-specific attending physicians were present to provide real-time guidance and education. Pre- and postworkshop surveys were administered to the participants to determine the impact of the workshop. Subsequently, postgraduate year (PGY)-2 residents were required to complete 6 supervised FOL examinations in clinic and were provided immediate feedback. RESULTS: Annual workshops were performed in 2017 to 2019. The survey completion rate was 14 of 18 (78%). Participants ranged from fourth-year medical students to PGY-2 to PGY-5 residents. All PGY-2 residents completed their 6 supervised FOL examinations. On a 5-point Likert scale, mean H&N anatomy knowledge increased from 2.4 to 3.7 (standard deviation = 0.6, P < .0001). Similarly, mean FOL procedural skill confidence increased from 2.2 to 3.3 (standard deviation = 0.7, P < .0001). These effects were limited to novice (fourth-year medical students to PGY-2) participants. All participants found the exercise clinically informative. CONCLUSIONS: A simulation-based workshop for teaching FOL procedural skills increased confidence and procedural expertise of new radiation oncology residents and translated directly to supervised clinical encounters. Adoption of this type of program may help to improve resident training in H&N cancer.
Authors
Price, JG; Spiegel, DY; Yoo, DS; Moravan, MJ; Mowery, YM; Niedzwiecki, D; Brizel, DM; Salama, JK
MLA Citation
Price, Jeremy G., et al. “Development and Implementation of an Educational Simulation Workshop in Fiberoptic Laryngoscopy for Radiation Oncology Residents.Int J Radiat Oncol Biol Phys, May 2020. Pubmed, doi:10.1016/j.ijrobp.2020.05.009.
URI
https://scholars.duke.edu/individual/pub1441495
PMID
32417408
Source
pubmed
Published In
Int J Radiat Oncol Biol Phys
Published Date
DOI
10.1016/j.ijrobp.2020.05.009

MRI-Based Deep Learning Segmentation and Radiomics of Sarcoma in Mice.

Small-animal imaging is an essential tool that provides noninvasive, longitudinal insight into novel cancer therapies. However, considerable variability in image analysis techniques can lead to inconsistent results. We have developed quantitative imaging for application in the preclinical arm of a coclinical trial by using a genetically engineered mouse model of soft tissue sarcoma. Magnetic resonance imaging (MRI) images were acquired 1 day before and 1 week after radiation therapy. After the second MRI, the primary tumor was surgically removed by amputating the tumor-bearing hind limb, and mice were followed for up to 6 months. An automatic analysis pipeline was used for multicontrast MRI data using a convolutional neural network for tumor segmentation followed by radiomics analysis. We then calculated radiomics features for the tumor, the peritumoral area, and the 2 combined. The first radiomics analysis focused on features most indicative of radiation therapy effects; the second radiomics analysis looked for features that might predict primary tumor recurrence. The segmentation results indicated that Dice scores were similar when using multicontrast versus single T2-weighted data (0.863 vs 0.861). One week post RT, larger tumor volumes were measured, and radiomics analysis showed greater heterogeneity. In the tumor and peritumoral area, radiomics features were predictive of primary tumor recurrence (AUC: 0.79). We have created an image processing pipeline for high-throughput, reduced-bias segmentation of multiparametric tumor MRI data and radiomics analysis, to better our understanding of preclinical imaging and the insights it provides when studying new cancer therapies.
Authors
Holbrook, MD; Blocker, SJ; Mowery, YM; Badea, A; Qi, Y; Xu, ES; Kirsch, DG; Johnson, GA; Badea, CT
MLA Citation
Holbrook, M. D., et al. “MRI-Based Deep Learning Segmentation and Radiomics of Sarcoma in Mice.Tomography, vol. 6, no. 1, Mar. 2020, pp. 23–33. Pubmed, doi:10.18383/j.tom.2019.00021.
URI
https://scholars.duke.edu/individual/pub1437329
PMID
32280747
Source
pubmed
Published In
Tomography
Volume
6
Published Date
Start Page
23
End Page
33
DOI
10.18383/j.tom.2019.00021

The impact of respiratory gating on improving volume measurement of murine lung tumors in micro-CT imaging.

Small animal imaging has become essential in evaluating new cancer therapies as they are translated from the preclinical to clinical domain. However, preclinical imaging faces unique challenges that emphasize the gap between mouse and man. One example is the difference in breathing patterns and breath-holding ability, which can dramatically affect tumor burden assessment in lung tissue. As part of a co-clinical trial studying immunotherapy and radiotherapy in sarcomas, we are using micro-CT of the lungs to detect and measure metastases as a metric of disease progression. To effectively utilize metastatic disease detection as a metric of progression, we have addressed the impact of respiratory gating during micro-CT acquisition on improving lung tumor detection and volume quantitation. Accuracy and precision of lung tumor measurements with and without respiratory gating were studied by performing experiments with in vivo images, simulations, and a pocket phantom. When performing test-retest studies in vivo, the variance in volume calculations was 5.9% in gated images and 15.8% in non-gated images, compared to 2.9% in post-mortem images. Sensitivity of detection was examined in images with simulated tumors, demonstrating that reliable sensitivity (true positive rate (TPR) ≥ 90%) was achievable down to 1.0 mm3 lesions with respiratory gating, but was limited to ≥ 8.0 mm3 in non-gated images. Finally, a clinically-inspired "pocket phantom" was used during in vivo mouse scanning to aid in refining and assessing the gating protocols. Application of respiratory gating techniques reduced variance of repeated volume measurements and significantly improved the accuracy of tumor volume quantitation in vivo.
Authors
Blocker, SJ; Holbrook, MD; Mowery, YM; Sullivan, DC; Badea, CT
MLA Citation
Blocker, S. J., et al. “The impact of respiratory gating on improving volume measurement of murine lung tumors in micro-CT imaging.Plos One, vol. 15, no. 2, 2020, p. e0225019. Pubmed, doi:10.1371/journal.pone.0225019.
URI
https://scholars.duke.edu/individual/pub1432965
PMID
32097413
Source
pubmed
Published In
Plos One
Volume
15
Published Date
Start Page
e0225019
DOI
10.1371/journal.pone.0225019

Oral cavity cancer: Diagnosis and treatment

© 2019 Elsevier Inc. All rights reserved. A comprehensive history, thorough head and neck physical examination, and adequate staging are critical to guide optimal locoregional treatment and evaluate for second primaries in patients with oral cavity cancer. A multidisciplinary approach-including head and neck surgery, radiation and medical oncology, pathology, radiology, nursing, dentistry, dietary, speech, and social work-is paramount for optimal management. Early-stage disease is typically treated with surgery alone, but in certain circumstances radiotherapy alone is preferred. Locally advanced disease is generally managed with upfront surgery and postoperative radiotherapy, with concomitant chemotherapy reserved for high-risk features such as positive surgical margins and extranodal extension.
Authors
Jacobs, CD; Moravan, MJ; Choe, J; Kahmke, R; Mowery, Y; Salama, JK
MLA Citation
Jacobs, C. D., et al. “Oral cavity cancer: Diagnosis and treatment.” Encyclopedia of Cancer, 2018, pp. 131–68. Scopus, doi:10.1016/B978-0-12-801238-3.65316-3.
URI
https://scholars.duke.edu/individual/pub1432327
Source
scopus
Published Date
Start Page
131
End Page
168
DOI
10.1016/B978-0-12-801238-3.65316-3

Research Areas:

Immunotherapy
Neck--Cancer--Radiotherapy
Radiation Oncology
Skin--Cancer--Radiotherapy