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Mri rectum

Borut Kragelj, Jernej Zlatic, Lijana Zaletel-Kragelj
PURPOSE: To elucidate potential risk factors important for the appearance of late rectal toxicity (LRT) after high-dose-rate boost treatment (HDRBT) of prostate cancer and to validate the predictive value of the minimal dose to the most exposed 2 cc of rectum received with HDRBT (D2ccrect). METHODS AND MATERIALS: The study of LRT, defined as relative deterioration of defecation problems (RDDP) (stool frequency, pain, rectal bleeding, fecal urgency, and incontinence) during follow-up period, was carried out on 88 patients, consecutively treated from October 2006 through April 2011 with HDRBT of 3 × 6-7 Gy to 50-50...
November 28, 2016: Brachytherapy
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone...
November 28, 2016: Female Pelvic Medicine & Reconstructive Surgery
Silvia Rodríguez Villalba, Jose Richart Sancho, Antonio Otal Palacín, Jose Perez-Calatayud, Manuel Santos Ortega
PURPOSE: To study outcome and toxicity in 59 patients with locally advanced cervix carcinoma treated with computed tomography (CT)-based Martinez universal perineal interstitial template (MUPIT) and the new magnetic resonance imaging (MRI)-compatible template Benidorm (TB). MATERIAL AND METHODS: From December 2005 to October 2015, we retrospectively analyzed 34 patients treated with MUPIT and 25 treated with the TB. Six 4 Gy fractions were prescribed to the clinical target volume (CTV) combined with external beam radiotherapy (EBRT)...
October 2016: Journal of Contemporary Brachytherapy
Youngkyong Kim, Yeon-Joo Kim, Joo-Young Kim, Young Kyung Lim, Chiyoung Jeong, Jonghwi Jeong, Meyoung Kim, Myong Cheol Lim, Sang-Soo Seo, Sang-Yoon Park
PURPOSE: To analyze the toxicities and dose-volume histogram parameters of external-beam and magnetic resonance imaging-based intracavitary brachytherapy in cervical cancer patients. METHODS AND MATERIALS: Acute and late toxicities were assessed in 135 patients divided into four groups: group 1, grade 0; group 2, grades 1-4; group 3, grades 0-1; and group 4, grades 2-4. The doses at the International Commission on Radiation Units and Measurements (DICRU) and minimum doses to the most exposed 0...
November 18, 2016: Brachytherapy
Dean A Harris, Kymberley Thorne, Hayley Hutchings, Saiful Islam, Gail Holland, Olivia Hatcher, Sarah Gwynne, Ian Jenkins, Peter Coyne, Michael Duff, Melanie Feldman, Des C Winter, Simon Gollins, Phil Quirke, Nick West, Gina Brown, Deborah Fitzsimmons, Alan Brown, John Beynon
INTRODUCTION: There are 11 500 rectal cancers diagnosed annually in the UK. Although surgery remains the primary treatment, there is evidence that preoperative radiotherapy (RT) improves local recurrence rates. High-quality surgery in rectal cancer is equally important in minimising local recurrence. Advances in MRI-guided prediction of resection margin status and improvements in abdominoperineal excision of the rectum (APER) technique supports a reassessment of the contribution of preoperative RT...
November 21, 2016: BMJ Open
Jacob Carlson, Wilson Alobuia, Jason Mizell
We report the case of a 51-year-old gentleman with previously diagnosed gastrointestinal stromal tumor (GIST) of the rectum with metastasis to the penis. The patient underwent abdominoperineal resection of the primary tumor with negative margins and completed a three-year course of imatinib mesylate (Gleevec). Forty months after resection of his rectal tumor, the patient presented to his urologist with worsening testicular pain, mild lower urinary tract obstructive symptoms, and nocturia. A pelvic MRI revealed the presence of an ill-defined mass in the right perineum extending from the base of the penis to the penoscrotal junction...
November 9, 2016: International Journal of Surgery Case Reports
Toshisada Aiba, Keisuke Uehara, Satoshi Tsukushi, Yasushi Yoshino, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Masato Nagino
A 20-year-old woman with a perineal alveolar soft part sarcoma was referred to our hospital. MRI showed that an irregular oval tumor occupied the perineum. The tumor was contiguous to the vagina, rectum, levator muscle, and pubis and was diagnosed as alveolar soft part sarcoma by transvaginal biopsy. Laparoscopy-assisted total pelvic exenteration combined with a pubic resection was performed, and an R0 resection with a wide margin was achieved. It is well known that only R0 resection improves the outcome of patients with localized alveolar soft part sarcoma...
November 10, 2016: Asian Journal of Endoscopic Surgery
Vicky Koh, Bok Ai Choo, Khai Mun Lee, Teng Hwee Tan, Jen Hui Jeffrey Low, Soon Yau Joseph Ng, Arunachalam Ilancheran, Liang Shen, Johann Tang
PURPOSE: To report late rectal and bladder toxicity outcomes of a CT-based image-guided brachytherapy (IGBT) technique for treatment of cervical cancer. METHODS AND MATERIALS: Between 2008 and 2014, 95 women with International Federation of Gynecology and Obstetrics stage IB to IVA cervical carcinoma treated with definitive concurrent cisplatin-based chemotherapy and external beam radiation therapy 50.4 Gy in 28 fractions followed by planned prescription dose of 7 Gy × 4 fractions of high-dose-rate IGBT was retrospectively reviewed...
November 2, 2016: Brachytherapy
Robert Laing, Adrian Franklin, Jennifer Uribe, Alex Horton, Santiago Uribe-Lewis, Stephen Langley
BACKGROUND AND PURPOSE: Advances in magnetic resonance imaging (MRI) and prostate sampling enable early identification of men with low to intermediate risk prostate cancer who are candidates for focal therapies that minimise side effects. We report dosimetry data from a pilot study evaluating the effectiveness of hemi-gland low dose rate (HG-LDR) brachytherapy as a focal therapy approach to control unilateral localised disease. MATERIAL AND METHODS: Twenty-two men underwent HG-LDR brachytherapy...
November 1, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
R J Cassidy, X Yang, T Liu, M Thomas, S G Nour, A B Jani
PURPOSE: Sexual dysfunction after radiotherapy for prostate cancer remains an important late adverse toxicity. The neurovascular bundles (NVB) that lie posterolaterally to the prostate are typically spared during prostatectomy, but in traditional radiotherapy planning they are not contoured as an organ-at-risk with dose constraints. Our goal was to determine the dosimetric feasibility of "NVB-sparing" prostate radiotherapy while still delivering adequate dose to the prostate. METHODS: Twenty-five consecutive patients with prostate cancer (with no extraprostatic disease on pelvic magnetic resonance imaging [MRI]) who that were treated with external beam radiotherapy, with the same primary planning target volume margins, to a dose of 79...
October 13, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Finn Ole Larsen, Alice Markussen, Benny V Jensen, Anne L Fromm, Kirsten K Vistisen, Vibeke K Parner, Dorte Linnemann, Rasmus H Hansen, Helle H Johannesen, Jakob V Schou
PURPOSE: To evaluate the effect of capecitabine and oxaliplatin before, during, and after radiotherapy for high-risk rectal cancer. PATIENTS AND METHODS: Patients with rectum cancer T4 or T3 involving the mesorectal fascia was included in a prospective phase 2 trial. Liver or lung metastases were accepted if the surgeons found them resectable. The patients received 6 weeks of capecitabine and oxaliplatin before chemoradiotherapy (CRT), continued capecitabine and oxaliplatin during radiotherapy, and received 4 weeks of capecitabine and oxaliplatin after CRT...
September 14, 2016: Clinical Colorectal Cancer
R Boissier, C Udrescu, X Rebillard, J E Terrier, A Faix, O Chapet, D Azria, M Devonec, P Paparel, A Ruffion
OBJECTIVE: To describe a technique combining the implantation of fiducials and a prostatic spacer (hyaluronic acid (HA)) to decrease the rectal toxicity after an image-guided EBRT with hypofractionation for prostate cancer and to assess the tolerance and the learning curve of the procedure. MATERIAL & METHOD: Thirty patients with prostate cancer at low or intermediate risk were included in a phase II trial: image-guided EBRT of 62Gy in 20 fractions of 3.1Gy with intensity-modulated radiotherapy (IMRT)...
October 7, 2016: Urology
Peter Bondeven
Rectal cancer constitutes one-third of all colorectal cancers, and the incidence in Denmark increasing. In 2012, 1.400 cases were registered, and of these 38% were located in the upper rectum. There have been several key advances in the optimal management of rectal cancer during the past decades, primarily by standardisation and improvement of the surgical procedure. There is now general agreement that the optimal surgical treatment involves the concept of total mesorectal excision and that a resection with tumour-free margins is crucial...
October 2016: Danish Medical Journal
Grant Harmon, Abbie Diak, Steven M Shea, Joseph H Yacoub, William Small, Matthew M Harkenrider
PURPOSE: To evaluate the dosimetric benefits of MRI-based brachytherapy in small and large high-risk clinical target volume (HR-CTV) in cervical cancer. METHODS AND MATERIALS: Twenty-eight fractions obtained from sixteen cervical cancer patients treated with MRI-based high-dose-rate brachytherapy with standard tandem and ovoid applicators were used; original fractions were optimized to HR-CTV D90. Fractions were separated based on the median volume into small and large (HR-CTV <25 cm(3) or >25 cm(3)) lesion groups...
September 29, 2016: Brachytherapy
Juan Ren, Wei Yuan, Ruihua Wang, Qiuping Wang, Yi Li, Chaofan Xue, Yanli Yan, Xiaowei Ma, Li Tan, Zi Liu
OBJECTIVE: The purpose of this study was to comprehensively compare the 3-dimensional (3D) magnetic resonance imaging (MRI)-guided and conventional 2-dimensional (2D) point A-based intracavitary brachytherapy (BT) planning for cervical cancer with regard to target dose coverage and dosages to adjacent organs-at risk (OARs). METHODS: A total of 79 patients with cervical cancer were enrolled to receive 2D point A-based BT planning and then immediately to receive 3D planning between October 2011 and April 2013 at the First Hospital Affiliated to Xi'an Jiao Tong University (Xi'an, China)...
2016: PloS One
Ashesh Jani, Eduard Schreibmann, Peter J Rossi, Joseph W Shelton, Karen Godette, Peter Nieh, Viraj A Master, Omer Kucuk, Mark Goodman, Raghuveer Halkar, Sherrie Cooper, Zhengjia Chen, David M Schuster
: The purpose was to evaluate the role of the synthetic amino acid positron emission tomography (PET) radiotracer fluciclovine ((18)F) in modifying the clinical and planning target volume (CTV and PTV) definition in post-prostatectomy patients undergoing salvage radiotherapy and to evaluate the resulting dosimetric consequences to surrounding organs at risk. METHODS: 96 patients were enrolled in a randomized prospective intention to treat clinical trial for potential salvage radiotherapy for recurrent prostate cancer after prostatectomy...
September 8, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Dae Yup Han, Habib Safigholi, Abraam Soliman, Ananth Ravi, Eric Leung, Daniel J Scanderbeg, Zhaowei Liu, Amir Owrangi, William Y Song
PURPOSE: To perform a comprehensive comparative planning study evaluating the utility of the proposed direction modulated brachytherapy (DMBT) tandem applicator against standard applicators, in the setting of image guided adaptive brachytherapy of cervical cancer. METHODS AND MATERIALS: A detailed conceptual article was published in 2014. The proposed DMBT tandem applicator has 6 peripheral grooves of 1.3-mm width, along a 5.4-mm-thick nonmagnetic tungsten alloy rod of density 18...
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Shimpei Ogawa, Jin-Ichi Hida, Hideyuki Ike, Tetsushi Kinugasa, Mitsuyoshi Ota, Eiji Shinto, Michio Itabashi, Takahiro Okamoto, Kenichi Sugihara
PURPOSE: This study seeks to evaluate lateral pelvic lymph node (LPLN) and perirectal lymph node (PRLN) status on magnetic resonance imaging (MRI) as potential risk factors for lymph node metastasis. METHODS: The subjects were 394 patients with lower rectal cancer who underwent MRI prior to mesorectal excision (combined with lateral pelvic lymph node dissection in 272 patients) at 6 institutes. No patients received neoadjuvant therapy. Cases were classified as cN(+) and cN(-) based on the short axis of the largest lymph node ≥5 and <5 mm, respectively...
October 2016: International Journal of Colorectal Disease
Gang Yin, Pei Wang, Jinyi Lang, Yin Tian, Yangkun Luo, Zixuan Fan, Kin Yip Tam
PURPOSE: Intensity modulated radiation therapy (IMRT) compensation based on 3D high-dose-rate (HDR) intracavitary brachytherapy (ICBT) boost technique (ICBT + IMRT) has been used in our hospital for advanced cervix carcinoma patients. The purpose of this study was to compare the dosimetric results of the four different boost techniques (the conventional 2D HDR intracavitary brachytherapy [CICBT], 3D optimized HDR intracavitary brachytherapy [OICBT], and IMRT-alone with the applicator in situ)...
June 2016: Journal of Contemporary Brachytherapy
Chun-Han Nigel Tan, Choon-Seng Chong, Yoke-Fai Fong, Shakina Rauff, Ker-Kan Tan
BACKGROUND: Natural orifice specimen extraction (NOSE) has evolved to circumvent the need for a specimen extraction site. Transvaginal specimen extraction (TVSE) for colorectal disease has been shown to be safe and feasible in selected cases.1 (,) 2 We describe our technique of TVSE in a case of laparoscopic ultra-low anterior resection (ULAR) with defunctioning ileostomy (DI) with a concomitant total hysterectomy and bilateral salpingo-oophrectomy (THBSO). METHODS AND RESULTS: A 74-year-old Chinese female was diagnosed with a mid-rectal cancer following colonoscopic evaluation for a change in bowel habits...
August 5, 2016: Annals of Surgical Oncology
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