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https://www.readbyqxmd.com/read/28105886/interobserver-delineation-uncertainty-in-involved-node-radiation-therapy-inrt-for-early-stage-hodgkin-lymphoma-on-behalf-of-the-radiotherapy-committee-of-the-eortc-lymphoma-group
#1
Marianne C Aznar, Theodore Girinsky, Anne Kiil Berthelsen, Berthe Aleman, Max Beijert, Martin Hutchings, Yolande Lievens, Paul Meijnders, Peter Meidahl Petersen, Deborah Schut, Maja V Maraldo, Richard van der Maazen, Lena Specht
BACKGROUND AND PURPOSE: In early-stage classical Hodgkin lymphoma (HL) the target volume nowadays consists of the volume of the originally involved nodes. Delineation of this volume on a post-chemotherapy CT-scan is challenging. We report on the interobserver variability in target volume definition and its impact on resulting treatment plans. MATERIALS AND METHODS: Two representative cases were selected (1: male, stage IB, localization: left axilla; 2: female, stage IIB, localizations: mediastinum and bilateral neck)...
January 20, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28104385/an-evidence-based-approach-to-surgical-teaching-in-ophthalmology
#2
Alice C Lorch, Carolyn E Kloek
An apprenticeship model has traditionally been used in procedural and surgical teaching. As the pressures of work hours and patient outcome monitoring increase, surgical teachers need a more flexible plan for teaching procedural skills. We attempt to delineate a program of pre-, intra-, and post- procedural teaching that can be used in the field of ophthalmology to maximize a resident's skill acquisition in a constructive learning environment.We review the literature on surgical teaching from within ophthalmology as well as other surgical fields and combine this with teaching experience in an ophthalmic surgical training program to produce a collection of procedural teaching guidelines...
January 16, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28093835/the-assessment-and-treatment-of-unhealthy-exercise-in-adolescents-with-anorexia-nervosa-a-delphi-study-to-synthesize-clinical-knowledge
#3
Melissa Noetel, Lisa Dawson, Phillipa Hay, Stephen Touyz
This study aimed to explore and synthesize expert clinical knowledge on defining and managing unhealthy exercise in adolescents with AN. The Delphi methodology was used. Clinicians (n = 25) considered experts in the treatment of AN in adolescents were recruited internationally to form the panel. The first round of the questionnaires was comprised of five open-ended questions regarding defining, assessing, and treating unhealthy exercise in adolescents with AN. Statements were derived from this data using content analysis, and included as Likert-based items in two subsequent rounds, in which panellists were required to rate their level of agreement for each item...
January 17, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28089481/recommendations-for-mri-based-contouring-of-gross-tumor-volume-and-organs-at-risk-for-radiation-therapy-of-pancreatic-cancer
#4
H D Heerkens, W A Hall, X A Li, P Knechtges, E Dalah, E S Paulson, C A T van den Berg, G J Meijer, E J Koay, C H Crane, K Aitken, M van Vulpen, B A Erickson
PURPOSE: Local recurrence is a common and morbid event in patients with unresectable pancreatic adenocarcinoma. A more conformal and targeted radiation dose to the macroscopic tumor in nonmetastatic pancreatic cancer is likely to reduce acute toxicity and improve local control. Optimal soft tissue contrast is required to facilitate delineation of a target and creation of a planning target volume with margin reduction and motion management. Magnetic resonance imaging (MRI) offers considerable advantages in optimizing soft tissue delineation and is an ideal modality for imaging and delineating a gross tumor volume (GTV) within the pancreas, particularly as it relates to conformal radiation planning...
October 17, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28070804/toward-mindfulness-in-quality-of-life-research-perspectives-on-how-to-avoid-rigor-becoming-rigidity
#5
Mirjam A G Sprangers, Carolyn E Schwartz
BACKGROUND: The field of quality-of-life (QOL) research has matured into a discipline with scientific rigor, sophisticated methods, and guidelines. While this maturation is laudable and needed, it can result in a limiting rigidity. We aim to highlight examples of practices that are based on shared research values and principles that, when dogmatically applied, may limit the potential impact of QOL research. METHODS: By juxtaposing rigorous standards with their rigid application for different stages of the research cycle, we suggest more balanced approaches...
January 9, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28066522/predicting-walking-ability-following-lower-limb-amputation-an-updated-systematic-literature-review
#6
Jason T Kahle, M Jason Highsmith, Hans Schaepper, Anton Johannesson, Michael S Orendurff, Kenton Kaufman
There is not a clear clinical recommendation for the determination of prosthetic candidacy. Guidelines do not delineate which member(s) of the multidisciplinary team are responsible for prosthetic candidacy decisions and which factors will best predict a positive outcome. Also not clearly addressed is a patient-centered decision-making role. In a previous systematic review (SR), Sansam et al. reported on the prediction of walking ability following lower limb amputation using literature up to 2007. The search strategy was designed from the previous Sansam SR as an update of previously valuable predictive factors of prosthetic candidacy...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28060176/bone-morphogenetic-proteins-in-pediatric-spinal-arthrodesis-a-statewide-analysis-of-trends-and-outcome-of-utilization
#7
Benedict U Nwachukwu, William W Schairer, Ting Pan, Roger F Widmann, John S Blanco, Daniel W Green, Stephen Lyman, Emily R Dodwell
INTRODUCTION: Bone morphogenetic protein (BMP) is considered off-label when used to augment spinal arthrodesis in children and adolescents. There is a paucity of longer-term information on BMP use in this population. The purpose of this study was to determine the rate of BMP utilization in pediatric spinal arthrodesis, assess factors associated with BMP use in this population, and evaluate long-term outcome. METHODS: Spinal arthrodeses in patients 18 years and younger performed in New York State between 2004 and 2014 were identified through the Statewide Planning and Research Cooperative System database...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28049593/quantitative-and-computed-tomography-anatomic-analysis-of-glenoid-fixation-for-superior-capsule-reconstruction-a-cadaveric-study
#8
Jason M Schon, J Christoph Katthagen, Cameron N Dupre, Justin J Mitchell, Travis Lee Turnbull, Christopher R Adams, Patrick J Denard, Peter J Millett
PURPOSE: To investigate glenoid fixation for superior capsule reconstruction (SCR) and evaluate anchor positions, intraosseous trajectories, and proximity to the suprascapular nerve (SSN) and glenoid fossa. The secondary purpose was to provide technical pearls and pitfalls for anchor insertion on the superior glenoid during SCR. METHODS: Three beath pins were arthroscopically inserted into 12 (n = 12) nonpaired human cadaveric shoulders through Neviaser, anterior, and posterior portals to simulate anchor placement on the superior glenoid during SCR...
December 31, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28048700/tu-d-bra-00-treatment-planning-system-commissioning-and-qa
#9
Greg Salomons
INTRODUCTION: Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048140/mo-fg-campus-jep2-05-mri-guided-single-fraction-boost-delivery-on-individual-axillary-lymph-nodes
#10
T C F van Heijst, N Hoekstra, M E P Philippens, D Eschbach, J J W Lagendijk, H J G D van den Bongard, B van Asselen
PURPOSE: The Utrecht MRI-linac (MRL) design enables new MR-guided radiotherapy (RT) approaches. This is a feasibility study for a single-fraction high dose (boost) to individual lymph nodes (LNs) in breast-cancer patients, after breast-conserving surgery (BCS) and hypofractionated whole-breast irradiation (WBI) with conventional axillary RT (AxRT). METHODS: After written informed consent, 5 breast-cancer patients (cT1-3N0) were enrolled (NL500460.041.14 trial) and underwent 1...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048038/tu-d-bra-01-tps-commissioning-and-qa-planning-and-monitoring
#11
G Salomons
INTRODUCTION: Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047917/tu-h-campus-jep2-01-inter-observer-delineation-comparison-of-visible-glandular-breast-tissue-on-magnetic-resonance-imaging-and-computed-tomography-prone-and-supine
#12
E M Pogson, G Delaney, V Ahern, M Boxer, S David, M Dimigen, J Harvey, E Koh, K Lim, G Papadatos, M Yap, V Batumalai, P Metcalfe, L Holloway
PURPOSE: Breast cancers predominantly arise from Glandular Breast Tissue (GBT). If the GBT can be treated effectively post-operatively utilising radiotherapy this may be adequate volumetric coverage for adjuvant breast radiotherapy. Adequate imaging of the GBT is necessary and will be assessed between MRI and CT modalities. GBT visualisation is acknowledged to be qualitatively superior on Magnetic Resonance Image (MRI) compared to Computed Tomography (CT), the current radiotherapy imaging standard, however this has not been quantitatively assessed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047707/su-g-201-14-is-maximum-skin-dose-a-reliable-metric-for-accelerated-partial-breast-irradiation-with-brachytherapy
#13
S Park, O Ragab, S Patel, Y Kim, J Demanes, M Kamrava
PURPOSE: To evaluate the reliability of the maximum point dose (Dmax) to the skin surface as a dosimetric constraint, we investigated the correlation between Dmax at the skin surface and dose metrics at various definitions of skin thickness. METHODS: 42 patients treated with APBI using a Strut Adjusted Volume Implant (SAVI) applicator between 2010 and 2014 were retrospectively reviewed. Target (PTV_EVAL) and organs at risk (OARs: skin, lung, and ribs) were delineated on a CT following NSABP B-39 guidelines...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047373/tu-d-bra-02-recommendations-of-mppg-5-and-practical-implementation-strategies
#14
J Smilowitz
INTRODUCTION: Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047106/su-g-iep2-03-comparison-of-dose-calculation-on-mar-metal-artifact-reduction-and-non-mar-datasets-for-pelvic-patients-with-hip-prosthesis-and-head-and-neck-patients-with-dental-filling
#15
V Huang, K Kohli
PURPOSE: Metal artifact reduction (MAR) software in computed tomography (CT) was previously evaluated with phantoms demonstrating the algorithm is capable of reducing metal artifacts without affecting the overall image quality. The goal of this study is to determine the dosimetric impact when calculating with CT datasets reconstructed with and without MAR software. METHODS: Twelve head and neck cancer patients with dental fillings and four pelvic cancer patients with hip prosthesis were scanned with a GE Optima RT 580 CT scanner...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046948/su-f-j-159-influence-of-the-elevated-posterior-position-by-using-the-customized-vacuum-bag-on-the-abdominal-mr-image-quality-a-quantitative-phantom-study
#16
O Wong, J Yuan, M Law, A Ding, S Yu, K Cheung
PURPOSE: Signal-to-noise ratio(SNR) of MR abdominal imaging in diagnostic radiology is maximized by minimizing the coil-to-patient distance. However, for radiotherapy applications, customized vacuum-bag is needed for abdominal immobilization at the cost of the increasing distance to the posterior spine coil. This sub-optimized coil setting for RT applications may compromise image quality, such as SNR and homogeneity, thus potentially affect tissue delineation. In this study, we quantitatively evaluate the effect of the vertical position change on SNR and image quality change using an ACR MR phantom...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046707/tu-d-bra-03-tps-commissioning-and-qa-incorporating-the-entire-planning-process
#17
S Mutic
INTRODUCTION: Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28041858/combining-clinical-and-angiographic-variables-for-estimating-risk-of-target-lesion-revascularization-after-drug-eluting-stent-placement
#18
Joshua M Stolker, David J Cohen, Kevin F Kennedy, Michael J Pencina, Suzanne V Arnold, Neal S Kleiman, John A Spertus
BACKGROUND: Drug-eluting stents (DES) reduce restenosis but require prolonged antiplatelet therapy, when compared with bare metal stents. Ideally, the patient should be involved in this risk:benefit assessment prior to selecting DES, to maximize the benefits and cost-effectiveness of care, and to improve medication adherence. However, accurate estimation of restenosis risk may require angiographic factors identified at cardiac catheterization. METHODS: In a large PCI registry, we used logistic regression to identify clinical and angiographic predictors of clinically-driven target lesion revascularization (TLR) over the first year after stent placement...
December 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28041315/anatomic-and-functional-imaging-in-the-diagnosis-of-spine-metastases-and-response-assessment-after-spine-radiosurgery
#19
Moaaz Soliman, Neil K Taunk, Robert E Simons, Joseph R Osborne, Michelle M Kim, Nicholas J Szerlip, Daniel E Spratt
Spine stereotactic radiosurgery (SSRS) has recently emerged as an increasingly effective treatment for spinal metastases. Studies performed over the past decade have examined the role of imaging in the diagnosis of metastases, as well as treatment response following SSRS. In this paper, the authors describe and review the utility of several imaging modalities in the diagnosis of spinal metastases and monitoring of their response to SSRS. Specifically, we review the role of CT, MRI, and positron emission tomography (PET) in their ability to differentiate between osteoblastic and osteolytic lesions, delineation of initial bony pathology, detection of treatment-related changes in bone density and vertebral compression fracture after SSRS, and tumor response to therapy...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28038321/barriers-beliefs-and-practice-patterns-for-breast-cancer-reconstruction-a-provincial-survey
#20
Christopher J Coroneos, Karina Roth-Albin, Ajit S Rai, Amrit S Rai, Sophocles H Voineskos, Melissa C Brouwers, Ronen Avram, Barbara Heller
BACKGROUND: The purpose of this study was to characterize beliefs and practice patterns for breast cancer reconstruction among physicians who treat patients with breast cancer, in order to delineate current clinical practice. This survey was administered prior to Cancer Care Ontario guideline publication. METHOD: Survey questions addressed four domains: survival, delayed or obscured recurrence detection, delayed adjuvant therapy, and aesthetics. The survey was administered to 1160 Ontario plastic and general surgeons and radiation and medical oncologists...
December 27, 2016: Breast: Official Journal of the European Society of Mastology
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