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Are We Off the Hook? An Update in Breast Localisation Trends 我们脱离困境了吗?乳房定位趋势的最新进展。
IF 1.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-05 DOI: 10.1111/1754-9485.13866
Sian Chin, Sally Burrows, Donna Taylor

Background

Hookwire localisation (HWL) is the most established method of localising impalpable breast lesions. Previous cross-sectional study of Australian and New Zealand surgeons in 2016 found HWL to be the most widely used breast lesion localisation technique (LLT). Many non-wire techniques have subsequently been developed to address the limitations of HWL. The aim of this study is to assess current trends in the use of breast LLTs in Australia and New Zealand and to compare results with previous findings of a prior study.

Methods

Attendees of a national Breast Conference were invited to participate in an online survey between 25 March and 21 April 2023.

Results

100 complete responses were received. The number of respondents using each LLT was: HWL 95, Magseed 30, Carbon-track 26, SCOUT 19, IOUS 13, ROLLIS 9, ROLL 4, MOLLI 2. Considering the LLTs they used the most, 73 respondents stated HWL, 14 Magseed, 6 carbon-track and 4 ROLLIS. Magseed and ROLLIS were more likely to be the most used LLT of respondents in public practice, and HWL was more likely to be the most used LLT in private practice (p = 0.010). Since 2016, the use of radioguided techniques has increased (4%–13%, p = 0.036).

Conclusion

HWL remains the most used LLT; however, non-wire LLTs are being used more frequently. Although non-wire LLTs have many advantages, familiarity and cost likely also influence the choice of technique.

背景:钩线定位(HWL)是最成熟的定位乳房不可触及病变的方法。2016年对澳大利亚和新西兰外科医生进行的横断面研究发现,HWL是使用最广泛的乳房病变定位技术(LLT)。为了解决HWL的局限性,随后开发了许多非丝技术。本研究的目的是评估目前在澳大利亚和新西兰使用乳腺llt的趋势,并将结果与先前研究的结果进行比较。方法:在2023年3月25日至4月21日期间,邀请全国乳腺会议的与会者参加在线调查。结果:共收到完整回复100份。使用每种LLT的受访者数量为:HWL 95, Magseed 30, Carbon-track 26, SCOUT 19, IOUS 13, ROLLIS 9, ROLL 4, MOLLI 2。考虑到他们使用最多的llt, 73名受访者选择HWL, 14名Magseed, 6名carbon-track和4名ROLLIS。Magseed和ROLLIS更有可能是公共实践中受访者最常用的LLT,而HWL更有可能是私人实践中最常用的LLT (p = 0.010)。自2016年以来,无线电制导技术的使用有所增加(4%-13%,p = 0.036)。结论:HWL仍是使用最多的LLT;然而,非有线llt的使用越来越频繁。尽管非电线llt有许多优点,但熟悉度和成本也可能影响技术的选择。
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引用次数: 0
Beyond the Image—Advancing Culturally Safe Radiology for Aboriginal and Torres Strait Islander Health 超越原住民和托雷斯海峡岛民健康的影像文化安全放射学。
IF 1.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-06-04 DOI: 10.1111/1754-9485.13871
Shabnam Mohamad Shafiq, Amlan Chowdhury, Ji Woo Kim

Despite the growing recognition of cultural safety in Australian healthcare, radiology remains an area where Aboriginal and Torres Strait Islander peoples continue to face substantial barriers. Although medical education has integrated broader Indigenous health training, clinical radiology has often been overlooked. The common misconception that radiology is a technical, patient-detached specialty has contributed to a lack of culturally competent training for radiologists and radiographers. Given the high burden of diseases requiring imaging, such as chronic respiratory illness, otitis media, cardiovascular disease and trauma-related injuries, culturally safe radiological services are vital for achieving health equity.

尽管越来越多的人认识到澳大利亚医疗保健中的文化安全,但放射学仍然是土著和托雷斯海峡岛民继续面临重大障碍的一个领域。虽然医学教育已纳入更广泛的土著卫生培训,但临床放射学常常被忽视。普遍的误解是,放射学是一门技术性的、与病人无关的专业,这导致放射科医生和放射技师缺乏文化上的培训。鉴于慢性呼吸系统疾病、中耳炎、心血管疾病和创伤性损伤等需要成像的疾病负担沉重,文化上安全的放射服务对于实现卫生公平至关重要。
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引用次数: 0
Natural History of True Renal Artery Aneurysms: A Multi-Centre Retrospective Cohort Study and Proposed Algorithm for Follow-Up 真肾动脉瘤的自然史:一项多中心回顾性队列研究和提出的随访算法。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-05-27 DOI: 10.1111/1754-9485.13869
Hayley Briody, Emma Tong, Alyssa Clark, Ronan J. Lee, Kevin P. Sheahan, Ronan Motyer, Emma Dunne, Conor Brosnan, Douglas P. Mulholland, Michael J. Lee

Aim

To identify the pattern of growth of true renal artery aneurysms (RAA) in a multicentre cohort and to propose an algorithm for the follow-up of asymptomatic RAA.

Methods

A retrospective review of all patients identified to have true RAA with subsequent follow-up cross-sectional imaging at three centres over a 15-year period was performed. Aneurysm maximal diameter was measured on initial and latest imaging and growth pattern assessed by two radiologists in consensus.

Results

In total, 155 patients with 171 aneurysms were identified with follow-up imaging. Mean initial aneurysm size was 1.27 cm (range 0.3–3.4 cm) with a mean follow-up time of 61.08 months (range 12–182.5 months). 159 (93%) aneurysms remained stable in size over time. Overall mean growth rate was 0.015 cm/y. RAA ≤ 1.5 cm at diagnosis were associated with significantly lower mean growth rates (0.01 cm/year; p = 0.0059). No RAA rupture occurred during the follow-up period.

Conclusion

The present study demonstrates an indolent course of RAA with no ruptures reported and stability over time demonstrated in 93% of a multicentre cohort. These findings are in agreement with multiple other published studies. A positive impact on cost, equity of resources, and cumulative radiation exposure with rationalisation of RAA surveillance warrants its consideration, particularly in low risk cohorts.

目的:确定多中心队列中真肾动脉瘤(RAA)的生长模式,并提出一种无症状肾动脉瘤的随访算法。方法:对所有确诊为真正RAA的患者进行回顾性研究,并在三个中心进行随访,随访时间超过15年。动脉瘤的最大直径测量的初始和最新的影像和生长模式评估由两名放射科医生一致。结果:155例患者171个动脉瘤经随访显像鉴定。平均初始动脉瘤大小为1.27 cm (0.3-3.4 cm),平均随访时间为61.08个月(12-182.5个月)。159个(93%)动脉瘤的大小随时间保持稳定。总体平均生长率为0.015 cm/y。诊断时RAA≤1.5 cm与较低的平均生长率相关(0.01 cm/年;p = 0.0059)。随访期间无RAA破裂。结论:目前的研究表明,在93%的多中心队列中,RAA的过程是无痛的,没有破裂的报道,并且随着时间的推移表现出稳定性。这些发现与其他多项已发表的研究结果一致。RAA监测合理化对成本、资源公平和累积辐射暴露的积极影响值得考虑,特别是在低风险人群中。
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引用次数: 0
A Greener Path for Interventional Radiology 介入放射学的绿色之路。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-05-19 DOI: 10.1111/1754-9485.13867
Sara Lojo-Lendoiro, Jose María Abadal Villayandre, Elena Lonjedo Vincent, Ángel Morales Santos, Àlex Rovira

The healthcare sector contributes substantially to global greenhouse gas (GHG) emissions, with hospital services being a major source. Interventional radiology (IR), as a resource-intensive subspecialty, has a disproportionately high environmental impact due to its reliance on advanced imaging equipment, sterile disposable materials and climate-controlled facilities. This narrative review aims to raise awareness of the environmental responsibilities of interventional radiologists and propose practical strategies to reduce the carbon, water and ecological footprints associated with IR procedures and operations. The manuscript describes best practices in energy and waste management, the use of environmentally friendly equipment and sustainable facility design, while addressing current barriers to their implementation. Through evidence-based recommendations and practical examples, this position paper advocates for a greener and more sustainable future in interventional radiology.

医疗保健部门对全球温室气体(GHG)排放的贡献很大,医院服务是一个主要来源。介入放射学(IR)作为一门资源密集型的亚专业,由于其对先进成像设备、无菌一次性材料和气候控制设施的依赖,对环境产生了不成比例的高影响。本文旨在提高介入放射科医生对环境责任的认识,并提出切实可行的策略,以减少与介入放射科手术和操作相关的碳、水和生态足迹。该手稿描述了能源和废物管理、环境友好型设备的使用和可持续设施设计方面的最佳做法,同时解决了目前实施这些做法的障碍。通过基于证据的建议和实际例子,本立场文件倡导介入放射学更绿色、更可持续的未来。
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引用次数: 0
Physiological Zonal Anatomical Variation and Distribution of PSMA Activity Within the Prostate on PSMA PET: A Study of 93 Prostatectomy Specimens Correlated to MRI and Histology PSMA PET显示前列腺内PSMA活性的生理分区解剖变异和分布:93例前列腺切除术标本的MRI和组织学相关研究
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-05-19 DOI: 10.1111/1754-9485.13855
Leon Vasquez, Dalveer Singh, Michael Kreltszheim, Hemamali Samaratunga, Zachary Drew, Chris Rothe

Introduction

This study aims to describe and quantify the normal physiologic zonal variation of PSMA expression within the prostate gland on 18F-DCFPyL-PSMA-PET imaging with histopathologic correlation, to aid in the accurate diagnosis of central zone (CZ) lesions. We also aim to quantify a normal range of CZ avidity and identify normal cut-off values below which CZ uptake can be safely considered physiologic.

Method

Prostate MR and 18F-DCFPyL-PSMA-PET imaging studies were assessed along with the review of histopathology for 93 consecutive patients who underwent radical prostatectomy for prostate cancer. Prostate MR and PSMA PET data sets were fused with standardised volumes of interest (VOI) placed on each zone (CZ, PZ & TZ) bilaterally based on MR T2 sequence prostate zonal anatomy. SUVmax and SUVmean values for each VOI were measured. Semi-quantitative histopathological correlation was performed for ten selected cases. The CZ, TZ and PZ in each sample were assessed for PSMA receptor density and graded by staining intensity and the percentage of cells staining with this level of intensity.

Results

A higher intensity of PSMA uptake was seen with respect to both SUVmax and SUVmean in the CZ compared to both the PZ and TZ. Histological analysis also provided concordant results, providing direct cellular surface correlation to the imaging findings.

Conclusion

Increased physiological PSMA expression (and thus molecular PSMA intensity) on PET/CT was seen in the CZ. This knowledge will improve confidence during interpretation of intra-prostatic findings on staging or restaging PSMA PET/CT studies.

本研究旨在描述和量化18F-DCFPyL-PSMA-PET在前列腺内PSMA表达的正常生理分区变化,并与组织病理相关,以帮助准确诊断中枢区(CZ)病变。我们还旨在量化CZ摄取的正常范围,并确定正常的临界值,低于该临界值CZ摄取可以被安全地认为是生理的。方法:对93例连续行根治性前列腺癌切除术的患者进行前列腺MR和18F-DCFPyL-PSMA-PET成像检查,并进行组织病理学复习。前列腺MR和PSMA PET数据集与标准化感兴趣体积(VOI)融合在每个区域(CZ, PZ和TZ)上,基于MR T2序列前列腺分区解剖。测量每个VOI的SUVmax和SUVmean值。对10例患者进行半定量组织病理学相关性分析。评估每个样品的CZ、TZ和PZ的PSMA受体密度,并通过染色强度和该强度染色的细胞百分比进行分级。结果:与PZ和TZ相比,CZ的SUVmax和SUVmean摄取强度更高。组织学分析也提供了一致的结果,提供了直接的细胞表面与影像学结果的相关性。结论:PET/CT显示CZ区PSMA生理性表达增加(因而PSMA分子强度增加)。这些知识将提高对PSMA PET/CT研究分期或再分期前列腺内发现的解释的信心。
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引用次数: 0
MRI Signatures of Parotid Tumours Impacting Management Decisions: A Retrospective Study With Radiology and Pathology Correlation 腮腺肿瘤的MRI特征影响治疗决策:一项具有放射学和病理学相关性的回顾性研究。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-05-19 DOI: 10.1111/1754-9485.13865
Nivedita Chakrabarty, Prathamesh Pai, Arpita Sahu, Oindrila Roy Chowdhury, Pashmina Kandalgaonkar, Tapish Dadlani, Munita Menon, Suman Kumar Ankathi

Introduction

Fine needle aspiration (FNA) from parotid tumour is inadequate and nondiagnostic in 8% and FNA/biopsy from deep lobe is technically challenging; hence, our first objective was to evaluate MRI findings which best predict the benign and malignant nature of parotid tumour. Our second objective was to develop MRI signatures for parotid tumour histopathologies including grades of carcinoma, to help in decision making regarding elective neck dissection.

Methods

Two head and neck radiologists retrospectively evaluated and developed signatures of common benign and malignant parotid tumours using morphology and signal intensity–related variables for 98 patients on MRI available in PACS from 01 January 2016 to 26 December 2022. T1 weighted image (WI), T2WI, short tau inversion recovery, diffusion WI/apparent diffusion coefficient and postcontrast T1WI sequences were evaluated. The developed MRI signatures were then validated by a blinded third radiologist.

Results

Sensitivity, specificity, accuracy, positive and negative predictive values using MRI signatures were 92.31%, 100%, 94.23%, 100% and 81.25%, respectively, for benign and malignant nature of parotid tumours with a highly significant p-value (< 1e-04). Developed MRI signatures also showed high statistical performance and significant p-value for parotid tumour histopathologies and grades of mucoepidermoid carcinoma (MEC). T2 signal intensity and enhancement patterns can help identify low-grade MEC, impacting management decisions regarding elective neck dissection.

Conclusions

MRI can predict the benign and malignant nature, parotid tumour histopathologies and grades of MEC when typical signatures are present, impacting management decisions.

导言:腮腺肿瘤的细针穿刺(FNA)不充分,8%无法诊断,深叶的FNA/活检在技术上具有挑战性;因此,我们的第一个目标是评估最能预测腮腺肿瘤良恶性性质的MRI结果。我们的第二个目标是开发腮腺肿瘤组织病理学的MRI特征,包括癌的等级,以帮助决定是否选择颈部清扫。方法:2016年1月1日至2022年12月26日,两名头颈部放射科医生回顾性评估并制定了98例PACS MRI患者常见良恶性腮腺肿瘤的形态学和信号强度相关变量。评估T1加权图像(WI)、T2WI、短tau反转恢复、弥散WI/表观弥散系数和对比后T1WI序列。开发的核磁共振成像特征然后由盲的第三放射科医生验证。结果:MRI特征对腮腺肿瘤良恶性的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为92.31%、100%、94.23%、100%和81.25%,p值高度显著(结论:当典型特征存在时,MRI可以预测腮腺肿瘤的良恶性、组织病理学和MEC的分级,影响管理决策)。
{"title":"MRI Signatures of Parotid Tumours Impacting Management Decisions: A Retrospective Study With Radiology and Pathology Correlation","authors":"Nivedita Chakrabarty,&nbsp;Prathamesh Pai,&nbsp;Arpita Sahu,&nbsp;Oindrila Roy Chowdhury,&nbsp;Pashmina Kandalgaonkar,&nbsp;Tapish Dadlani,&nbsp;Munita Menon,&nbsp;Suman Kumar Ankathi","doi":"10.1111/1754-9485.13865","DOIUrl":"10.1111/1754-9485.13865","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fine needle aspiration (FNA) from parotid tumour is inadequate and nondiagnostic in 8% and FNA/biopsy from deep lobe is technically challenging; hence, our first objective was to evaluate MRI findings which best predict the benign and malignant nature of parotid tumour. Our second objective was to develop MRI signatures for parotid tumour histopathologies including grades of carcinoma, to help in decision making regarding elective neck dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two head and neck radiologists retrospectively evaluated and developed signatures of common benign and malignant parotid tumours using morphology and signal intensity–related variables for 98 patients on MRI available in PACS from 01 January 2016 to 26 December 2022. T1 weighted image (WI), T2WI, short tau inversion recovery, diffusion WI/apparent diffusion coefficient and postcontrast T1WI sequences were evaluated. The developed MRI signatures were then validated by a blinded third radiologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sensitivity, specificity, accuracy, positive and negative predictive values using MRI signatures were 92.31%, 100%, 94.23%, 100% and 81.25%, respectively, for benign and malignant nature of parotid tumours with a highly significant <i>p</i>-value (&lt; 1e-04). Developed MRI signatures also showed high statistical performance and significant <i>p-</i>value for parotid tumour histopathologies and grades of mucoepidermoid carcinoma (MEC). T2 signal intensity and enhancement patterns can help identify low-grade MEC, impacting management decisions regarding elective neck dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MRI can predict the benign and malignant nature, parotid tumour histopathologies and grades of MEC when typical signatures are present, impacting management decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 4","pages":"452-461"},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13865","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Value of Routine Pelvic Examination in the Follow-Up of Patients Receiving Adjuvant Radiation Therapy for Endometrial Cancer: An Australian Tertiary-Centre Experience 常规盆腔检查在子宫内膜癌辅助放疗患者随访中的价值:澳大利亚三级中心经验。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-05-07 DOI: 10.1111/1754-9485.13864
M. C. Knox, A. Salkeld, A. Brand, U. Herbst, J. Chard, N. Thiruthaneeswaran

Introduction

Pelvic examination is a routine component of post-treatment surveillance for endometrial cancer, supported by global guidelines. However, there is no evidence of oncological or quality-of-life benefit, with data suggesting associated discomfort and potential psychological harm. We evaluate the value of routine pelvic examination in follow-up protocols after adjuvant radiation therapy.

Methods

We retrospectively reviewed all patients receiving adjuvant radiation therapy for endometrial carcinoma across two combined cancer services between January 2017 and December 2022. All stages and histological subtypes were eligible. At least 12 months of documented follow-up was required. Patients were stratified by FIGO stage (2009 and 2023) and ESGO/ESTRO risk group.

Results

Two hundred and sixty-four of 395 patients met inclusion criteria, with a median follow-up of 34 months. Whilst demographics were widely distributed, the most common features included endometrioid histology (76.5%), FIGO 2023 stage II (48.5%) and ESGO/ESTRO high-risk (36.7%).

Disease recurrence was identified in 41 patients (15.5%). Only four patients had isolated local recurrence, with most also having distant disease at detection. Only three patients had asymptomatic recurrence found on examination (1.1% of cohort), with only one proceeding to salvage therapy (0.4% of cohort). As expected, higher-risk groups were associated with worse overall survival (p < 0.001).

Conclusions

We found routine pelvic examination following adjuvant radiation therapy for endometrial cancer results in low recurrence detection rates, with salvageable local recurrences being rare. We advocate for the omission of routine pelvic examination from follow-up protocols for patients receiving adjuvant radiation therapy, with either clinic-based or telephone-based follow-up being offered on a risk-stratified basis.

盆腔检查是子宫内膜癌治疗后监测的常规组成部分,得到全球指南的支持。然而,没有证据表明对肿瘤或生活质量有好处,数据表明相关的不适和潜在的心理伤害。我们评估常规盆腔检查在辅助放射治疗后随访方案中的价值。方法:我们回顾性分析了2017年1月至2022年12月期间两家联合癌症服务机构接受子宫内膜癌辅助放射治疗的所有患者。所有分期和组织学亚型均符合条件。至少需要12个月的随访记录。根据FIGO分期(2009年和2023年)和ESGO/ESTRO风险组对患者进行分层。结果:395例患者中有264例符合纳入标准,中位随访时间为34个月。虽然人口统计学分布广泛,但最常见的特征包括子宫内膜样组织学(76.5%)、FIGO 2023期(48.5%)和ESGO/ESTRO高风险(36.7%)。41例(15.5%)患者出现疾病复发。只有4例患者有孤立的局部复发,大多数患者在检测时也有远处病变。只有3例患者在检查时发现无症状复发(占队列的1.1%),只有1例患者进行了挽救治疗(占队列的0.4%)。结论:我们发现子宫内膜癌辅助放射治疗后常规盆腔检查的复发率较低,可挽回的局部复发很少。我们提倡在接受辅助放疗的患者的随访方案中省略常规盆腔检查,在风险分层的基础上提供基于临床或电话的随访。
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引用次数: 0
A Comparative Study of Radical Radiotherapy in Very Elderly and Non-Very Elderly Patients With Malignant Tumour Using Pairwise Matching 两两配对根治性放疗治疗高龄与非高龄恶性肿瘤患者的比较研究。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-04-29 DOI: 10.1111/1754-9485.13863
Hidekazu Tanaka, Kazushi Ueda, Akane Hironaka, Chika Nakabe, Taiki Ono, Yuki Manabe, Miki Kajima, Koya Fujimoto, Takehiro Shiinoki

Introduction

This study aimed to compare the outcomes and complications following radical radiotherapy between very elderly patients aged ≥ 90 years and non-very elderly patients using pairwise matching analysis.

Methods

Data of patients who underwent radical radiotherapy at our hospital between January 2013 and March 2024 and those who were aged ≥ 90 years at the start of radical radiotherapy were extracted. Data of control patients were extracted by pairwise matching from patients aged < 90 years who underwent radical radiotherapy during the same period. Pairwise matching was performed using the following criteria: (i) cancer type, (ii) TNM classification, (iii) histological type, (iv) concurrent chemotherapy, (v) prescribed biological effective dose, (vi) performance status, (vii) sex and (viii) ability to walk. The local control (LC), cancer-specific survival (CSS) and overall survival (OS) rates were calculated from the date of completion of radiotherapy.

Results

Forty patients from each group were analysed. There were no significant differences in LC, CSS or OS rates between the two groups. The completion rate of radiotherapy and the incidence rate of adverse events were not significantly different between the two groups.

Conclusion

In this study, there was no difference in the outcomes of radiotherapy between very elderly and non-very elderly patients. Our findings may aid clinicians in the treatment of nonagenarian patients.

本研究旨在采用两两配对分析的方法,比较≥90岁高龄高龄患者和非高龄患者根治性放疗后的预后和并发症。方法:选取2013年1月至2024年3月在我院接受根治性放疗的患者及放疗开始时年龄≥90岁的患者资料。对照组从老年患者中两两配对提取数据。结果:每组各分析40例患者。两组间LC、CSS和OS率无显著差异。两组放疗完成率及不良事件发生率无显著差异。结论:本研究中,高龄和非高龄患者的放疗效果无差异。我们的发现可能有助于临床医生治疗老年患者。
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引用次数: 0
What Is the Safe Observation Period Following Image-Guided Percutaneous Renal Biopsies? 影像引导下经皮肾活检的安全观察期是多长?
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-04-28 DOI: 10.1111/1754-9485.13861
Fergus Taylor, Kunal Sehgal, Matthew Van Wees, Kenny Li, Diederick Willem De Boo, Lee-Anne Slater

Purpose

To investigate the timing, type, and severity of complications following percutaneous, image-guided renal biopsy and to determine if the current observation period of 4 h can be safely reduced.

Methods

Consecutive image-guided percutaneous renal biopsies performed between 2017 and 2022 in adult patients by radiology medical staff were included. The RIS-PACS imaging systems and electronic medical records (EMR) were accessed to obtain relevant patient information and procedural reports. A retrospective analysis of the type and timing of complications was performed against patient demographics and biopsy-related variables. Probabilities were calculated for a range of observation periods to assess the proportion of complications identified by shortening the observation period from 4 h.

Results

Three hundred and thirty-two percutaneous renal biopsies were included, and 44 (13%) complications were identified within the 4 h observation. Twenty-nine complications were post-operative bleeding, of which 2 developed macroscopic haematuria, 25 peri-nephric haematoma and 2 had haemodynamic instability with either haematuria or peri-nephric haematoma. 64% of all complications occurred within the first hour, and 86% occurred within 2 h. Of the six complications occurring after 2 h, two were post-operative bleeding in non-targeted renal biopsies requiring admission, and the other four did not require additional observation/procedures.

Conclusion

The vast majority of complications after targeted and non-targeted renal biopsies tend to occur within the first 2 h of observation. Complications that occurred after 2 h observation were often pain related, something that can be overcome with a standardised post-operative analgesic regime. It may be possible to safely reduce observation times following image-guided targeted renal biopsies.

目的:探讨经皮图像引导肾活检术后并发症的时间、类型和严重程度,并确定目前4小时的观察时间是否可以安全缩短。方法:纳入2017 - 2022年间影像学医务人员连续行经皮肾活检的成年患者。访问RIS-PACS成像系统和电子病历(EMR),获取相关患者信息和程序报告。对并发症的类型和时间进行回顾性分析,对照患者人口统计学和活检相关变量。计算观察时间范围内的概率,以评估缩短观察时间(4 h)后发现并发症的比例。结果:经皮肾活检32例,观察4 h内发现并发症44例(13%)。术后出血29例,其中2例出现肉眼血尿,25例出现肾周血肿,2例出现血尿或肾周血肿的血流动力学不稳定。64%的并发症发生在1小时内,86%发生在2小时内。在2小时后发生的6例并发症中,2例是非靶向肾活检的术后出血需要入院,另外4例不需要额外的观察/程序。结论:靶向和非靶向肾活检术后绝大多数并发症往往发生在观察后的前2h。观察2小时后发生的并发症通常与疼痛有关,可以通过标准化的术后镇痛方案来克服。有可能安全地减少图像引导下的靶向肾活检的观察时间。
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引用次数: 0
Mepitel Film Versus StrataXRT in Managing Radiation Dermatitis in an Intra-Patient Controlled Clinical Trial of 80 Postmastectomy Patients Mepitel膜与StrataXRT治疗放射性皮炎80例乳房切除术后患者的内部对照临床试验
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-04-14 DOI: 10.1111/1754-9485.13850
Patries Herst, Mary van Schalkwyk, Natasha Baker, Rebecca Thyne, Kelly Dunne, Kylie Moore, Freya Jackson, Kendal Beaven, Lucy Rutten, Gemma McKee, Robin Willink, Melissa James

Background

Mepitel film decreases the severity of radiation dermatitis in breast cancer patients, but its application is resource-intensive. Many departments therefore use StrataXRT, a gel that patients apply themselves. We compared the protective effects of Mepitel film and StrataXRT on radiation dermatitis during and immediately after radiation therapy.

Methods

This phase III multicentre randomised intra-patient-controlled clinical trial recruited breast cancer patients receiving radiation therapy following mastectomy in three New Zealand Hospitals. Lateral and medial aspects of the chest wall were randomised to either Mepitel film or StrataXRT. Overall skin reaction severity was measured using RISRAS and RTOG once a week during treatment and for 4 weeks after treatment completion. The primary outcome was moist desquamation (with a non-inferiority margin of 7.5%); secondary outcomes were overall skin reaction severity, patient tolerability, satisfaction and cost.

Results

Between June 2021 and May 2024, 93 patients were recruited, and 80 patients completed the trial. The absolute difference in moist desquamation rates was 6% lower under Mepitel film (p = 0.413, 95% CI -5%, 18%). Overall skin reaction severity was significantly lower for Mepitel film (Researcher RISRAS: p = 0.022; RTOG: p = 0.011). Mepitel film was cheaper to apply but was less well tolerated, with poor skin adherence being an issue for many patients.

Conclusion

The study did not show non-inferiority for StrataXRT; overall skin reaction severity and costs were significantly lower under Mepitel film; however, StrataXRT was better tolerated.

Trial Registration: ACTRN12621000124831

背景:Mepitel膜可降低乳腺癌患者放射性皮炎的严重程度,但其应用耗费大量资源。因此,许多部门使用患者自行涂抹的凝胶StrataXRT。我们比较了Mepitel膜和StrataXRT在放射治疗期间和放疗后对放射性皮炎的保护作用。方法:这项III期多中心随机对照临床试验招募了在新西兰三家医院接受乳房切除术后放射治疗的乳腺癌患者。胸壁外侧和内侧随机分为Mepitel片或StrataXRT。在治疗期间和治疗结束后4周,使用RISRAS和RTOG每周一次测量总体皮肤反应严重程度。主要结局是湿性脱屑(非劣效裕度为7.5%);次要结果是总体皮肤反应严重程度、患者耐受性、满意度和成本。结果:在2021年6月至2024年5月期间,招募了93名患者,80名患者完成了试验。Mepitel膜下湿脱屑率的绝对差异降低了6% (p = 0.413, 95% CI -5%, 18%)。Mepitel薄膜的总体皮肤反应严重程度显著降低(RISRAS研究员:p = 0.022;RTOG: p = 0.011)。Mepitel薄膜的使用成本较低,但耐受性较差,许多患者的皮肤粘附性差。结论:该研究并未显示StrataXRT的非劣效性;Mepitel涂膜后皮肤反应严重程度和成本显著降低;然而,StrataXRT的耐受性更好。试验注册:ACTRN12621000124831。
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Journal of Medical Imaging and Radiation Oncology
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