Interventional Radiology (IR) is a relatively young specialty that has experienced rapid development since Charles Dotter performed the first percutaneous transluminal angioplasty in 1964. Since then, IR has expanded to include a diverse array of minimally invasive image-guided procedures. It was the same Charles Dotter who early on recognized that the Interventional Radiologist must be involved in patient care as a true clinician, not just a skilled mechanic. However, outpatient and periprocedural clinical patient management by IR has remained underdeveloped when compared to the significant procedural advancements seen over the past four decades. We present local Australian health service data reinforcing the value of formal outpatient clinics in delivering adequate patient counselling, improving consent rates prior to the procedure day, and decreasing costly day-of-procedure cancellations and reschedulling.
While gender disparities in the radiology workforce are well-documented, there has been no analysis of outcomes for competitive awards in Australia and New Zealand. As formal recognition is critical for career progression, this study aimed to investigate gender-based differences in application and success rates for grants, prizes and educational fellowships within the Australasian context.
We retrospectively reviewed applications for Royal Australian and New Zealand College of Radiologists' (RANZCR) Faculty of Clinical Radiology grants, prizes and educational fellowships from 2011 to 2024. Application and success rates were stratified by gender and compared to College membership demographics. Significance was assessed using Fisher's exact test.
Across 333 total applications, 227 (68.2%) were from males and 106 (31.8%) from females, closely reflecting College membership gender ratios (69.2% male vs. 30.8% female). No significant gender disparity was found in the success rates for grants (40.3% for males vs. 35.0% for females, p = 0.58), prizes (8.8% vs. 11.1%, p = 0.08) or educational fellowships (36.7% vs. 32.1%, p = 0.32). Application rates for each award type also broadly reflected the gender composition of the College membership.
This study is the first to examine gender differences in clinical radiology grant, prize and educational fellowship outcomes in Australia and New Zealand. We found no significant disparities in success rates, and application rates generally mirrored College membership, suggesting the award process itself is equitable. However, the continued underrepresentation of women in radiology underscores the need to examine broader structural and sociocultural factors that may impact engagement with competitive academic opportunities.
Decision-making for adjuvant therapy regimen of elderly patients with glioblastoma may be based on age alone rather than prognostic factors. This study assesses treatment outcomes for elderly patients with good prognostic factors managed with the EORTC-NCIC Protocol.
Patients treated for glioblastoma with adjuvant chemoradiotherapy in accordance with the EORTC-NCIC (Stupp) Protocol between 2008 and 2021 were entered into a prospective database. Outcomes for patients aged < 65 were compared to those ≥ 65 years, divided into subgroups 65–70, 70–74 and > 75 years. Overall survival (OS) and progression-free survival (PFS) were the primary and secondary endpoints, respectively.
The study included 437 patients, of whom 319 were aged < 65 and 118 were aged ≥ 65 years. Median OS was 19.2 months for patients aged < 65 years and 15.0 months for those aged ≥ 65 years (p = 0.006). Median PFS were 12.0 and 11.3 months, respectively (p = 0.119). For both age groups, performance status, extent of resection and MGMT methylation were significant predictors of overall survival. Age group was not a significant predictor of OS when these factors were accounted for (p = 0.237).
When stratified for performance status and MGMT methylation, elderly patients had similar outcomes compared with the younger cohort. This suggests that elderly patients who managed well following diagnosis and subsequent surgical procedure may be optimally treated with long-course standard rather than elderly protocols.
Breast conserving surgery for non-palpable tumours requires imaging-guided localisation, historically achieved with hookwire localisation (HWL). HWL, however, has recognised shortcomings including the need for same-day surgery with associated radiology resource/logistical constraints, psychological impact of wire protrusion, and complications such as wire displacement or fracture. The introduction of novel non-wire surgical marker navigation (SMN) techniques offers promising benefits. This study evaluates the early implementation of SMN (Sirius Pintuition and Merit SAVISCOUT systems) in one radiology department in Auckland, New Zealand.
This is a retrospective cohort study evaluating surgical outcomes in patients with non-palpable tumours who underwent preoperative localisation between May 2023 and June 2024. Three groups were compared: two cohorts who underwent SMN in the form of Pintution (n = 36) and SAVISCOUT (n = 42) and one who underwent HWL (n = 35). Surgical outcomes assessed included histological margin status and rates of re-excision. Technical challenges and complications were recorded.
There was no significant difference in surgical outcomes between HWL and SMN groups. The ‘surgery complete’ rate was 89% in the HWL group, 82% in the Pintuition group, and 97% in the SAVISCOUT group (p = 0.10). Technique failure occurred in five cases of SMN (6%) due to inadequate seed position and one case of HWL (3%) due to wire displacement.
SMN in the form of Pintuition and SAVISCOUT demonstrate comparable surgical outcomes to HWL, whilst also offering advantages in scheduling flexibility and resource utilisation. A small rate of technical failure highlights the operator learning curve and need for appropriate training.
This study aimed to assess pelvic organ motion and volume changes during long-course radiation therapy (LCRT) for anorectal cancer and propose an optimal planning target volume (PTV) margin.
This retrospective study analysed 526 daily cone-beam computed tomography (CBCT) from 22 patients with anorectal cancer undergoing LCRT. Patients followed a bladder-filling protocol by drinking water before treatment. The bladder, rectum and mesorectum were delineated on planning CT and CBCTs. PTV margins were calculated using the van Herk formula, and margins to cover 95% interfractional motion were also evaluated.
Bladder volume exhibited the higher variability (mean ± standard deviations, 271.3 ± 130.5 mL), compared to the mesorectum (111.3 ± 26.2 mL) and rectum (50.6 ± 15.6 mL). Mesorectum motion showed no significant correlation with bladder volume changes but was significantly associated with rectal volume (r = 0.566; p < 0.001 in the superior mesorectum). Anterior mesorectum motion was larger compared to other directions, particularly in the superior region, with systematic and random variations of 4.4 and 3.5 mm. Using the van Herk formula, PTV margins for the anterior mesorectum were 5.8, 4.9, and 3.3 mm for the superior, middle and inferior regions, respectively. Similarly, margins to cover 95% interfractional movement extended up to 6.7 mm in the superior–anterior region.
Bladder volume varied significantly during LCRT, while mesorectum motion was influenced by rectal volume changes. A 5-mm PTV margin was sufficient for the mid to lower mesorectum, with a larger 7-mm margin needed for the superior–anterior mesorectum. Incorporating 95% interfractional motion coverage further refined these margin recommendations.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：