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Optimising PTV margins in oesophageal cancer radiotherapy: A modern radiotherapy planning, treatment delivery and verification approach – A single institutional analysis 优化食道癌放疗的 PTV 边界:现代放射治疗计划、治疗实施和验证方法--单一机构分析。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-18 DOI: 10.1111/1754-9485.13738
Jack Mitchell, Amelia Campbell, Ming Zhao, Jennifer Harvey, Gang Tao Mai, Yoo Young Lee

Introduction

Radiotherapy plays a key role in the multidisciplinary management of oesophageal cancers across neoadjuvant, definitive and palliative settings. Improved precision in radiotherapy planning and delivery techniques have allowed treating disease with tighter margins reducing toxicity. In this study, we examine the appropriateness of current practice in defining the planning target volume (PTV).

Methods

This is a single institutional retrospective study of patients who received radiotherapy for oesophageal cancers using volumetric modulated arc therapy (VMAT) during 2020. All cone-beam computerised tomography (CBCT) scans were reviewed to assess whether PTV expansions appropriately accounted for tumour motion and interfractional variation.

Results

Of the 27 patients, 2 (7%), 5 (19%) and 20 (74%) had cervical, thoracic and distal/gastro-oesophageal junction (GOJ) disease, respectively. 16 (59%) had adenocarcinoma and 9 (33%) had squamous cell carcinoma. 9 of 20 distal/GOJ patients were planned and treated according to the institutional stomach filling protocol. 521/528 (98.7%) CBCTs demonstrated adequate target coverage. Cervical, thoracic and GOJ regions demonstrated adequate target coverage in 57/58, 96/97 and 368/373 CBCTs with median PTV expansions of 5, 7 and 7 mm, respectively. In four patients with GOJ disease, CBCT review identified five episodes where the target volume was insufficiently covered during the treatment course.

Conclusion

In this single institutional retrospective study, for the vast majority of patients, our institutional practice of defining PTV margins achieved satisfactory target treatment. The interfractional variations observed in patients with GOJ tumours due to target motion and variable gastric volume, highlights the role of further refinements to motion management techniques in this cohort.

简介放疗在食道癌的多学科治疗中发挥着关键作用,包括新辅助治疗、根治性治疗和姑息治疗。放疗计划和放疗技术精度的提高使得治疗疾病的边缘更紧密,从而降低了毒性。在本研究中,我们探讨了目前确定计划靶区(PTV)的做法是否恰当:这是一项单一机构的回顾性研究,研究对象是 2020 年期间接受容积调制弧线疗法(VMAT)放疗的食道癌患者。研究人员对所有锥形束计算机断层扫描(CBCT)扫描进行了审查,以评估PTV扩展是否适当考虑了肿瘤运动和点间变化:27名患者中,分别有2人(7%)、5人(19%)和20人(74%)患有颈部、胸部和远端/胃食管交界处(GOJ)疾病。16人(59%)患有腺癌,9人(33%)患有鳞状细胞癌。在20名远端/GOJ患者中,有9名患者是按照医院的胃填充方案进行计划和治疗的。521/528(98.7%)例 CBCT 显示目标覆盖充分。在57/58、96/97和368/373例CBCT中,颈部、胸部和GOJ区域显示出充分的靶点覆盖,PTV扩展中位数分别为5、7和7毫米。在4名患有GOJ疾病的患者中,CBCT检查发现了5次在治疗过程中靶区覆盖不足的情况:在这项单一机构的回顾性研究中,对于绝大多数患者来说,我们机构的PTV边缘界定方法都达到了令人满意的目标治疗效果。在GOJ肿瘤患者中观察到的因靶点移动和胃容积变化而导致的切缘间变化,强调了进一步完善移动管理技术在这类患者中的作用。
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引用次数: 0
Reflections on Australian radiology education: How can we innovate and improve? 对澳大利亚放射学教育的思考:如何创新和改进?
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-18 DOI: 10.1111/1754-9485.13786
Sally L Ayesa
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引用次数: 0
Thoracic hernias: What the radiologist should know. 胸椎疝气:放射科医生须知。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-18 DOI: 10.1111/1754-9485.13792
Felipe Aluja-Jaramillo, Omar Andrés Pantoja Burbano, Fernando R Gutiérrez, Carlos Previgliano, Sanjeev Bhalla

Thoracic hernias encompass the protrusion of thoracic contents through the thorax or intra-abdominal tissue into the thorax. They can be classified as diaphragmatic hernias - either congenital or acquired; pulmonary hernias - involving tissue protrusion through cervical fascia or intercostal spaces; and mediastinal hernias - including cardiac, intrapericardial and hiatal hernias. Prompt identification and classification of thoracic hernias rely on diagnostic imaging, primarily through computed tomography and magnetic resonance, to identify associated complications. This article comprehensively reviews thoracic hernias and their key imaging features.

胸廓疝包括胸腔内容物通过胸腔或腹腔内组织向胸腔的突出。它们可分为膈疝--先天性或后天性;肺疝--涉及组织通过颈筋膜或肋间隙突出;纵隔疝--包括心脏疝、心包内疝和食道裂孔疝。胸廓疝的及时识别和分类依赖于诊断成像,主要是通过计算机断层扫描和磁共振来识别相关并发症。本文全面回顾了胸廓疝及其主要成像特征。
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引用次数: 0
Prognostic value of PSMA PET in predicting long-term biochemical control following curative intent treatment for prostate cancer. PSMA PET 在预测前列腺癌根治性治疗后长期生化控制方面的预后价值。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-11 DOI: 10.1111/1754-9485.13787
Angus Ades, Tanya Holt, Handoo Rhee, Myles Webb, Ahmed M Mehdi, Gishan Ratnayake

Introduction: The aim of this study is to investigate the prognostic value of 68Ga-labelled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) metrics in predicting long-term biochemical failure-free survival (BFFS) following curative intent treatment for prostate cancer.

Methods: We completed a prospective study that followed men who had PSMA PET for staging of newly diagnosed prostate cancer between 2015 and 2017 who went on to have curative intent treatment with radiotherapy (RT) or radical prostatectomy (RP). PSMA PET CT imaging was reported and the intraprostatic maximum standardised uptake value (SUVmax) was recorded. The primary outcome was BFFS. Statistical analysis included descriptive statistics, Cox proportional hazards (PH) models, Kaplan-Meier survival analysis and a regression tree structured method.

Results: A total of 183 men were included in the analysis with a median age of 66 years and the majority of patients (55.2%) had ISUP grade 1-3 disease. All patients had PSMA PET staging prior to curative intent treatment with RP (66.1%) or external beam radiotherapy (33.9%). PSMA-avid pelvic nodes were present in 26 patients but were not associated with worse biochemical control. A PSMA SUVmax of the prostate primary greater than the median (>5.6) was associated with a lower BFFS (HR: 4.4, 95% CI 1.42-3.72, P = 0.01). A multivariate Cox model incorporating initial biopsy grade, age and PSMA SUVmax showed that PSMA SUVmax was an independent predictor of BFFS. The RT-structured method identified an optimal threshold of 6.8 for PSMA SUVmax, above which patients with ISUP 1-3 disease had a significantly worse BFFS.

Conclusion: PSMA SUVmax is a strong predictor of BFFS in patients with non-metastatic prostate cancer who underwent curative intent treatment. Patients with low-risk disease on biopsy (ISUP 1-3) but high PSMA SUVmax may have biochemical failure risk analogous to higher-risk disease (ISUP 4-5). These findings allow for further risk stratification and prognosis of patients with newly diagnosed prostate cancer planned for definitive treatment.

简介本研究旨在探讨68Ga标记的前列腺特异性膜抗原(PSMA)正电子发射断层扫描(PET)指标在预测前列腺癌根治性治疗后长期无生化失败生存期(BFFS)方面的预后价值:我们完成了一项前瞻性研究,对2015年至2017年期间接受PSMA PET分期的新诊断前列腺癌男性患者进行了随访,这些患者随后接受了放射治疗(RT)或根治性前列腺切除术(RP)的治愈性治疗。报告了 PSMA PET CT 成像,并记录了前列腺内最大标准化摄取值 (SUVmax)。主要结果为 BFFS。统计分析包括描述性统计、考克斯比例危险(PH)模型、卡普兰-梅耶生存分析和回归树结构法:共有 183 名男性患者参与分析,中位年龄为 66 岁,大多数患者(55.2%)患有 ISUP 1-3 级疾病。所有患者在接受RP(66.1%)或体外放射治疗(33.9%)的根治性治疗前都进行了PSMA PET分期。26例患者的盆腔结节存在PSMAavid,但与生化控制恶化无关。前列腺原发癌的 PSMA SUVmax 高于中位数(>5.6)与较低的 BFFS 相关(HR:4.4,95% CI 1.42-3.72,P = 0.01)。包含初始活检分级、年龄和 PSMA SUVmax 的多变量 Cox 模型显示,PSMA SUVmax 是 BFFS 的独立预测因子。RT结构化方法确定了PSMA SUVmax的最佳阈值为6.8,超过这一阈值,ISUP 1-3患者的BFFS明显降低:结论:PSMA SUVmax是预测接受根治性治疗的非转移性前列腺癌患者BFFS的有力指标。活检结果为低风险疾病(ISUP 1-3)但 PSMA SUVmax 较高的患者,其生化治疗失败的风险可能与高风险疾病(ISUP 4-5)类似。这些发现有助于对计划接受明确治疗的新诊断前列腺癌患者进行进一步的风险分层和预后评估。
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引用次数: 0
A cost-effectiveness analysis of stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the management of stage 1 non-small-cell lung cancer: Results from the TROG 09.02 CHISEL study 立体定向消融放疗与传统分次放疗在非小细胞肺癌一期治疗中的成本效益分析:TROG 09.02 CHISEL研究结果。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-09 DOI: 10.1111/1754-9485.13755
Adam Byrne, Richard De Abreu Lourenco, Ramkumar Govindaraj, David Ball, Hien Le

Introduction

Stereotactic ablative radiotherapy (SABR) is a standard of care treatment for medically inoperable early-stage non-small-cell lung cancer (NSCLC). The CHISEL trial was a phase 3 randomised controlled trial that compared SABR to conventional radiation therapy (CRT). Using patient-level data, we compared the cost-effectiveness of SABR and CRT for early-stage NSCLC.

Methods

Data on treatment exposure, outcomes (recurrence, survival) and quality of life (QoL; EORTC QLQ-C30) were sourced from the trial. Quality-adjusted life years (QALYs) were estimated for the trial period using Australian utility weights for the EORTC QLQ-C30-derived QLU-C10D. Costs related to simulation, planning, delivery, verification and post-treatment monitoring were estimated by applying Australian Medicare Benefits Schedule fees. The costs of post-progression therapy and grade ≥3 toxicity were estimated using trial data and relevant literature sources. Cost-effectiveness was investigated as the incremental cost per QALY gained for SABR compared to CRT.

Results

Complete QoL data were available for 21 patients: 14 in the SABR arm and 7 in the CRT arm. Mean QALYs discounted at 5% per annum were similar between arms: 12.68 months for SABR and 12.12 months for CRT. The mean costs of delivering SABR and CRT were $4763 and $6817, respectively. The costs of monitoring were similar in both arms, $4856 and $4853 for SABR and CRT. The mean costs of post-progression therapy were $24,572 for SABR and $42,801 for CRT. The mean costs of grade ≥3 toxicity were $809 in the SABR arm and $132 in the CRT arm. Therefore, the total mean cost for SABR over the period of interest was lower for SABR than CRT. Given lower mean costs and numerically higher QALYs for SABR compared with CRT, an incremental cost-effectiveness ratio was not calculated.

Conclusion

Compared to CRT, SABR is a cost-effective treatment for early-stage NSCLC as the estimated upfront treatment cost and the cost of subsequent care are lower for SABR for comparable mean QALYs. Assessment of the lifetime QALYs and projections of cost estimation will provide a better indication of the long-term cost-effectiveness of SABR.

简介立体定向消融放射治疗(SABR)是治疗无法手术的早期非小细胞肺癌(NSCLC)的标准疗法。CHISEL试验是一项3期随机对照试验,比较了SABR和传统放疗(CRT)。利用患者层面的数据,我们比较了 SABR 和 CRT 治疗早期 NSCLC 的成本效益:方法:有关治疗暴露、结果(复发、生存)和生活质量(QoL;EORTC QLQ-C30)的数据均来自试验。使用澳大利亚效用权重对 EORTC QLQ-C30 衍生的 QLU-C10D 对试验期间的质量调整生命年(QALYs)进行了估算。与模拟、计划、实施、验证和治疗后监测相关的成本是通过应用澳大利亚医疗保险福利表费用进行估算的。进展后治疗和≥3级毒性的成本是根据试验数据和相关文献资料估算的。与 CRT 相比,SABR 的成本效益是每 QALY 增益的增量成本:有 21 名患者获得了完整的 QoL 数据:结果:21 位患者获得了完整的 QoL 数据:14 位在 SABR 治疗组,7 位在 CRT 治疗组。两组的平均 QALYs(QALYs)按每年 5%折算,结果相似:SABR 为 12.68 个月,CRT 为 12.12 个月。实施 SABR 和 CRT 的平均成本分别为 4763 美元和 6817 美元。两组的监测成本相似,SABR 和 CRT 分别为 4856 美元和 4853 美元。SABR 和 CRT 进展后治疗的平均费用分别为 24,572 美元和 42,801 美元。SABR 治疗组≥3 级毒性的平均费用为 809 美元,CRT 治疗组为 132 美元。因此,在关注期内,SABR 的总平均成本低于 CRT。鉴于与 CRT 相比,SABR 的平均成本更低,QALYs 数值更高,因此没有计算增量成本效益比:结论:与 CRT 相比,SABR 是一种治疗早期 NSCLC 的经济有效的方法,因为在平均 QALY 值相当的情况下,SABR 的预估治疗成本和后续护理成本更低。对终生质量调整生命年的评估和成本估算的预测将更好地说明 SABR 的长期成本效益。
{"title":"A cost-effectiveness analysis of stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the management of stage 1 non-small-cell lung cancer: Results from the TROG 09.02 CHISEL study","authors":"Adam Byrne,&nbsp;Richard De Abreu Lourenco,&nbsp;Ramkumar Govindaraj,&nbsp;David Ball,&nbsp;Hien Le","doi":"10.1111/1754-9485.13755","DOIUrl":"10.1111/1754-9485.13755","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Stereotactic ablative radiotherapy (SABR) is a standard of care treatment for medically inoperable early-stage non-small-cell lung cancer (NSCLC). The CHISEL trial was a phase 3 randomised controlled trial that compared SABR to conventional radiation therapy (CRT). Using patient-level data, we compared the cost-effectiveness of SABR and CRT for early-stage NSCLC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on treatment exposure, outcomes (recurrence, survival) and quality of life (QoL; EORTC QLQ-C30) were sourced from the trial. Quality-adjusted life years (QALYs) were estimated for the trial period using Australian utility weights for the EORTC QLQ-C30-derived QLU-C10D. Costs related to simulation, planning, delivery, verification and post-treatment monitoring were estimated by applying Australian Medicare Benefits Schedule fees. The costs of post-progression therapy and grade ≥3 toxicity were estimated using trial data and relevant literature sources. Cost-effectiveness was investigated as the incremental cost per QALY gained for SABR compared to CRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Complete QoL data were available for 21 patients: 14 in the SABR arm and 7 in the CRT arm. Mean QALYs discounted at 5% per annum were similar between arms: 12.68 months for SABR and 12.12 months for CRT. The mean costs of delivering SABR and CRT were $4763 and $6817, respectively. The costs of monitoring were similar in both arms, $4856 and $4853 for SABR and CRT. The mean costs of post-progression therapy were $24,572 for SABR and $42,801 for CRT. The mean costs of grade ≥3 toxicity were $809 in the SABR arm and $132 in the CRT arm. Therefore, the total mean cost for SABR over the period of interest was lower for SABR than CRT. Given lower mean costs and numerically higher QALYs for SABR compared with CRT, an incremental cost-effectiveness ratio was not calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to CRT, SABR is a cost-effective treatment for early-stage NSCLC as the estimated upfront treatment cost and the cost of subsequent care are lower for SABR for comparable mean QALYs. Assessment of the lifetime QALYs and projections of cost estimation will provide a better indication of the long-term cost-effectiveness of SABR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 7","pages":"843-850"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A comparative study of hysterosalpingograms from 40 years ago 40 年前子宫输卵管造影对比研究
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-08 DOI: 10.1111/1754-9485.13743
Christine M Acton
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引用次数: 0
Head, face and neck injury patterns for electric scooter accidents identified on computed tomography scanning: Does legislative change enforcing safer riding practices have an impact on morbidity for significant head, face and neck trauma? 通过计算机断层扫描确定电动滑板车事故的头部、面部和颈部损伤模式:加强骑行安全的立法变革是否会对重大头面部和颈部创伤的发病率产生影响?
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-07 DOI: 10.1111/1754-9485.13788
Nicholas Watson, Brett Droder, Gary Mitchell, Craig Hacking

Introduction

The purpose of this study is to review whether legislative change enforcing safer riding conditions for Electric Scooters (E-Scooter), regardless of other factors, had an impact on reducing significant head, facial and neck trauma. Additionally, to identify the radiological injury patterns for head, face and neck injuries identified on CT imaging for a patient's initial presentation to the emergency department (ED) resulting from an E-Scooter accident.

Methods

A retrospective single-centre observational study at a metropolitan tertiary ED of patients presenting after an E-Scooter accident comparing 6 months before and after legislative change.

Results

Four hundred and forty-three patients presented following an E-Scooter accident: 191 patients 6 months before and 252 patients 6 months after legislative change. One hundred and sixty-two patients pre- and 217 patients post-legislative change had negative CT studies. Twenty-nine patients pre- and 35 patients post-legislative change had CT studies demonstrating significant head, face or neck trauma. The most common type of intracranial bleeding was subarachnoid haemorrhage followed by subdural haemorrhage with a significant proportion (41%) presenting with multi-factorial intracranial bleeding. There was no specific injury pattern involving the cranial vault or cervical spine. Of the patients presenting with a significant injury, facial bones were the most common injury site (84% (n = 54)). The most common site of facial fractures was the nasal bones followed by dental trauma and maxillary fractures.

Conclusion

This single-centre, retrospective observational study has shown no reduction in serious head, neck and facial injuries. Large-scale, multicentre studies will need to be undertaken to understand the true impact of legislative change.

导言本研究的目的是探讨在不考虑其他因素的情况下,为电动滑板车(E-Scooter)提供更安全骑行条件的立法改革是否会对减少重大头部、面部和颈部创伤产生影响。此外,还要确定因电动滑板车事故初次到急诊科(ED)就诊的患者的头部、面部和颈部放射损伤模式:在一个大都市的三级急诊室对电动滑板车事故后的患者进行回顾性单中心观察研究,比较立法修改前后 6 个月的情况:结果:443名患者在电动摩托车事故后就诊:191名患者在立法修改前6个月就诊,252名患者在立法修改后6个月就诊。立法修改前和立法修改后分别有 162 名和 217 名患者进行了阴性 CT 检查。立法修改前和立法修改后分别有 29 名和 35 名患者的 CT 检查显示头部、面部或颈部有明显创伤。最常见的颅内出血类型是蛛网膜下腔出血,其次是硬膜下腔出血,有相当一部分患者(41%)表现为多因素颅内出血。颅顶或颈椎没有特殊的损伤模式。在出现明显损伤的患者中,面部骨骼是最常见的损伤部位(84%(n = 54))。面部骨折最常见的部位是鼻骨,其次是牙齿外伤和上颌骨骨折:这项单中心回顾性观察研究表明,严重的头颈部和面部损伤并没有减少。要了解立法改革的真正影响,还需要进行大规模的多中心研究。
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引用次数: 0
Are histomorphological patterns a predictor for survival in uveal melanoma patients with hepatic metastases undergoing hepatic artery infusion chemotherapy? 组织形态学模式能否预测接受肝动脉输注化疗的肝转移葡萄膜黑色素瘤患者的生存率?
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-24 DOI: 10.1111/1754-9485.13783
Hannah L Steinberg-Vorhoff, Saskia C Ting, Sebastian Zensen, Johannes M Ludwig, Yan Li, Heike Richly, Johannes Grüneisen, Jens T Siveke, Jens M Theysohn, Benedikt M Schaarschmidt

Introduction

In uveal melanoma (UM) patients with hepatic metastases, hepatic artery infusion chemotherapy (HAIC) is a viable, palliative treatment option. To evaluate the impact of two histomorphological patterns (spindle cell vs. epithelioid) of liver metastases on median overall survival (mOS) in UM patients undergoing HAIC.

Methods

A retrospective analysis with 60 UM patients (29 females, mean age: 61.6 ± 12.1 years) with hepatic metastases was performed. Histomorphological patterns in metastases were analysed and classified as either predominant spindle cell or epithelioid pattern. mOS between both patient groups was analysed using Kaplan–Meier curves and the log-rank test.

Results

In 73.3% (44/60) of the metastases, a predominant epithelioid pattern, in 21.7% (13/60) a predominant spindle cell pattern, and in 5% (3/60) other patterns were found. No significant differences between patients with an epithelioid (mOS: 14.2 months, 95% CI: 8.8–19.6) and a spindle cell pattern (mOS: 14.4 months, 95% CI: 4.3–24.5) were detected by the log-rank test, χ2(2) = 0.22, P = 0.881.

Conclusion

Histomorphological patterns of UM metastases do not seem to be a predictor for mOS in UM patients undergoing HAIC.

简介:对于有肝转移的葡萄膜黑色素瘤(UM)患者,肝动脉灌注化疗(HAIC)是一种可行的姑息治疗方案。目的是评估两种组织形态学模式(纺锤形细胞与上皮样)的肝转移对接受HAIC治疗的UM患者中位总生存期(mOS)的影响:方法:对60例有肝转移的子宫内膜癌患者(29例女性,平均年龄:61.6 ± 12.1岁)进行回顾性分析。采用卡普兰-梅耶曲线和对数秩检验对两组患者的 mOS 进行分析:73.3%(44/60)的转移灶以上皮样形态为主,21.7%(13/60)的转移灶以纺锤形细胞形态为主,5%(3/60)的转移灶以其他形态为主。上皮样(mOS:14.2 个月,95% CI:8.8-19.6)和纺锤形细胞样(mOS:14.4 个月,95% CI:4.3-24.5)患者之间无明显差异,经对数秩检验,χ2(2) = 0.22,P = 0.881:UM转移灶的组织形态学模式似乎并不能预测接受HAIC治疗的UM患者的mOS。
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引用次数: 0
Demystifying the challenging diagnosis of post-radiation nasopharyngeal necrosis on multimodality imaging 揭开多模态成像对放疗后鼻咽坏死诊断的神秘面纱。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-24 DOI: 10.1111/1754-9485.13784
Kwok Yan Li, Hoi Ming Kwok, Wah Cheuk, Ka Fai Johnny Ma

Post-radiation nasopharyngeal necrosis (PRNN) is a rare but life-threatening condition that often poses a diagnostic challenge in imaging studies owing to its overlapping features with recurrent nasopharyngeal tumours. We herein describe the characteristic imaging appearance of PRNN on post-contrast T1-weighted magnetic resonance imaging, diffusion-weighted imaging (DWI) and fluorodeoxyglucose (FDG)-PET/CT which may provide insights into its pathological findings.

放疗后鼻咽坏死(PRNN)是一种罕见但危及生命的疾病,由于其特征与复发性鼻咽肿瘤重叠,往往给影像学诊断带来挑战。我们在此描述了 PRNN 在对比后 T1 加权磁共振成像、弥散加权成像(DWI)和氟脱氧葡萄糖(FDG)-PET/CT 上的特征性成像表现,这可能有助于了解其病理结果。
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引用次数: 0
A cross-sectional study assessing the role of interventional radiology services in regional and remote Australia 一项横断面研究,评估介入放射学服务在澳大利亚地区和偏远地区的作用。
IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-23 DOI: 10.1111/1754-9485.13782
Warren Clements, Adil Zia, Kelvin Chang, Nicholas Brown, Jim Koukounaras, Tim Joseph, Matthew W Lukies, Tuan Phan, Gerard S Goh, Dinesh Varma, Heath Tomlinson, Mark Bolger, Helen Kavnoudias

Introduction

It is estimated that 8% of hospitalised patients require treatment from Interventional Radiology (IR). However, little is known about the potential impact of IR on regional and remote Australians, including Indigenous patients. This study aimed to assess treatments performed by IRs on regional/remote patients to predict future IR workforce and governance needs.

Methods

Single-centre cross-sectional study at a tertiary Victorian hospital. Patients were identified when they had an advanced IR treatment between 1 January 2022 and 2024. Basic procedures such as biopsy and drain insertion were not included. The primary outcome was the type and volume of IR treatments performed on patients who were transferred from a regional or remote home location for treatment.

Results

Of 3485 advanced IR interventions, 908 procedures (26.0%) from patients who lived in a regional or remote location were included with 36.5% female, of mean age 55.6 years (SD 17.9). 1.4% identified as Indigenous which is similar to the Indigenous population incidence in Victoria of 1.0%. Of this group, 350 (38.5%) were either a day procedure, overnight elective admission, or simple inpatient procedure which could have been performed in a regional centre, which included 1.1% Indigenous patients.

Conclusion

There is an unmet need for IR services in regional and remote Australia, with many patients being transferred to our metropolitan centre for treatment that could be performed in regional IR hubs. This data will be important to drive government and hospital planning including capital infrastructure, workforce modelling and future recognition of IR as a new specialty in Australia.

导言:据估计,8% 的住院病人需要接受介入放射学(IR)治疗。然而,人们对介入放射学对地区和偏远地区澳大利亚人(包括土著患者)的潜在影响知之甚少。本研究旨在评估介入放射科对地区/偏远地区患者进行的治疗,以预测未来介入放射科的劳动力和管理需求:方法:在维多利亚州一家三级医院进行单中心横断面研究。2022年1月1日至2024年1月1日期间,对接受过先进IR治疗的患者进行识别。不包括活检和插入引流管等基本程序。主要结果是对从地区或偏远家庭所在地转院接受治疗的患者进行红外治疗的类型和数量:在 3485 例先进红外介入治疗中,有 908 例(26.0%)来自地区或偏远地区的患者,其中女性占 36.5%,平均年龄 55.6 岁(SD 17.9)。1.4%的患者被认定为土著居民,这与维多利亚州土著居民的发病率1.0%相似。在这组患者中,有350人(38.5%)是日间手术、过夜择期入院或简单的住院手术,这些手术本可以在地区中心进行,其中包括1.1%的土著患者:结论:澳大利亚地区和偏远地区对红外服务的需求尚未得到满足,许多病人被转到我们的都市中心接受治疗,而这些治疗本可以在地区红外中心进行。这些数据对于推动政府和医院的规划(包括资本基础设施、劳动力建模以及未来将红外成像作为澳大利亚的一个新专科)非常重要。
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Journal of Medical Imaging and Radiation Oncology
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