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delineation guidelines

Tejinder Kataria, Deepak Gupta, Shikha Goyal, Shyam Singh Bisht, Ravi Chaudhary, Kushal Narang, Susovan Banerjee, Trinanjan Basu, Ashu Abhishek, Sasikumar Sambasivam, Nisha T Vishnu
Stereotactic body radiotherapy (SBRT) is being increasingly utilized in the treatment of prostate cancer. With the advent of high precision radiosurgery systems, it is possible to obtain dose distributions akin to High Dose Rate (HDR) brachytherapy with SBRT. However, urethral toxicity has a significant impact on the quality of life in prostate cancer patients. Contouring the male urethra on a computed tomography scan is difficult in the absence of an indwelling catheter. In this pictorial essay, we have used the magnetic resonance imaging obtained for radiotherapy planning to aid in delineation of the male urethra and have attempted to define guidelines for the same...
October 17, 2016: British Journal of Radiology
Thomas Ebenhan, Isabel Schoeman, Daniel D Rossouw, Anne Grobler, Biljana Marjanovic-Painter, Judith Wagener, Hendrik G Kruger, Mike M Sathekge, Jan Rijn Zeevaart
PURPOSE: Radiopharmaceuticals containing the motive tripeptide arginyl-glycyl-asparatic acid (RGD) are known to target ανβ3 integrins during tumor angiogenesis. A more generic kit radiolabeling procedure accommodating Ga-68 from different generators was developed for NOTA-RGD and evaluated for its versatile use and safety in subsequent in vivo applications. The [(68)Ga]NOTA-RGD kit was further verified for its expected biodistribution and pharmacokinetics in nonhuman primates and its clinical sensitivity to detect solitary pulmonary nodules (SPN) in cancer patients...
October 14, 2016: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Onanong Jitkritsadakul, Roongroj Bhidayasiri
BACKGROUND: Physicians are usually at the forefront when the issue of driving ability is raised by Parkinson's disease (PD) patients or their family members, even though few have been formally trained in this area. OBJECTIVES AND METHODS: To identify relevant literature on driving assessment tools in patients with PD by performing a systematic review on this subject in order to provide background information for physicians on what types of driving assessment are available, and to delineate the role of physicians in providing fitness to drive recommendations...
2016: Journal of Clinical Movement Disorders
Alberto M Marra, Nicola Benjamin, Francesco Ferrara, Olga Vriz, Michele D'Alto, Antonello D'Andrea, Anna Agnese Stanziola, Luna Gargani, Antonio Cittadini, Ekkehard Grünig, Eduardo Bossone
The right ventricular outflow tract acceleration time (RVOT-AT) has shown to progressively shorten with increasing degrees of pulmonary pressure. However, the physiologic ranges of RVOT AT are based on small sample sizes and have not been investigated regarding their determining factors. The aim of this study was to investigate reference values and determining factors of RVOT-AT in a large population of healthy subjects and by values described in the literature. In the first part of the study, 1029 healthy subjects (mean age 45...
October 6, 2016: International Journal of Cardiovascular Imaging
Heather B Neuman, Jessica R Schumacher, David F Schneider, Emily R Winslow, Rebecca A Busch, Jennifer L Tucholka, Maureen A Smith, Caprice C Greenberg
BACKGROUND: The current guidelines do not delineate the types of providers that should participate in early breast cancer follow-up care (within 3 years after completion of treatment). This study aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors and to identify factors associated with receipt of follow-up care from different types of providers. METHODS: Stages 1-3 breast cancer survivors treated from 2000 to 2007 were identified in the Surveillance, Epidemiology and End results Medicare database (n = 44,306)...
October 5, 2016: Annals of Surgical Oncology
Caleb V Grieme, Dena R Voss, Karin E Olson, Scott R Davis, Jeff Kulhavy, Matthew D Krasowski
OBJECTIVE: Panels of clinical laboratory testing may generate "incidental" critical values from unordered parameters. Existing regulations do not clearly delineate guidelines for handling incidental critical values. The objective of this study was to examine the patterns and clinical utility of incidental critical values at 2 critical care laboratories within an academic medical center. METHODS: In this retrospective study, the electronic health record and laboratory information system were reviewed for incidental critical results obtained from blood gas analyzer analysis of whole blood specimens between November 2010 and August 2014...
November 2016: Laboratory Medicine
Lin Xiao, Andrew C Dudley
In the heart and other organs, endothelial-mesenchymal transition (EndMT) has emerged as an important developmental process that involves coordinated migration, differentiation, and proliferation of the endothelium. In multiple disease states including cancer angiogenesis and cardiovascular disease, the processes that regulate EndMT are recapitulated, albeit in an uncoordinated and dysregulated manner. Members of the transforming growth factor beta (TGFβ) super-family are well known to impart cellular plasticity during EndMT by the timely activation (or repression) of transcription factors and miRNAs in addition to epigenetic regulation of gene expression...
October 4, 2016: Journal of Pathology
Ahmed R Eldesoky, Esben S Yates, Tine B Nyeng, Mette S Thomsen, Hanne M Nielsen, Philip Poortmans, Carine Kirkove, Mechthild Krause, Claus Kamby, Ingvil Mjaaland, Egil S Blix, Ingelise Jensen, Martin Berg, Ebbe L Lorenzen, Zahra Taheri-Kadkhoda, Birgitte V Offersen
BACKGROUND AND PURPOSE: To internally and externally validate an atlas based automated segmentation (ABAS) in loco-regional radiation therapy of breast cancer. MATERIALS AND METHODS: Structures of 60 patients delineated according to the ESTRO consensus guideline were included in four categorized multi-atlas libraries using MIM Maestro™ software. These libraries were used for auto-segmentation in two different patient groups (50 patients from the local institution and 40 patients from other institutions)...
September 30, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Christine H Feng, Yasmin Hasan, Malgorzata Kopec, Hania A Al-Hallaq
We performed a dosimetric comparison of sequential IMRT (sIMRT) and simul-taneously integrated boost (SIB) IMRT to boost PET-avid lymph nodes while concurrently treating pelvic targets to determine the potential of SIB IMRT to reduce overall treatment duration in locally advanced cervical cancer. Ten patients receiving definitive radiation therapy were identified retrospectively. RTOG consensus guidelines were followed to delineate the clinical target volume and organs at risk (OAR), which were then expanded per IMRT consortium guidelines to yield the planning target volume (PTV)...
2016: Journal of Applied Clinical Medical Physics
Lotte Kaasenbrood, S Matthijs Boekholdt, Yolanda van der Graaf, Kausik K Ray, Ron J G Peters, John J P Kastelein, Pierre Amarenco, John C LaRosa, Maarten J M Cramer, Jan Westerink, L Jaap Kappelle, Gert Jan de Borst, Frank L J Visseren
BACKGROUND: -Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction, as well as the residual risk, that can be achieved if patients reach guideline-recommended risk factor targets. METHODS: -The SMART (Second Manifestations of ARTerial disease) score for 10-year risk of myocardial infarction, stroke or vascular death was applied to 6,904 patients with vascular disease...
September 28, 2016: Circulation
Barbara Segedin, Primoz Petric
BACKGROUND: Modern radiotherapy techniques enable delivery of high doses to the target volume without escalating dose to organs at risk, offering the possibility of better local control while preserving good quality of life. Uncertainties in target volume delineation have been demonstrated for most tumour sites, and various studies indicate that inconsistencies in target volume delineation may be larger than errors in all other steps of the treatment planning and delivery process. The aim of this paper is to summarize the degree of delineation uncertainties for different tumour sites reported in the literature and review the effect of strategies to minimize them...
September 1, 2016: Radiology and Oncology
Aaron Brody, Michael Twiner, Arun Kumar, Elizabeth Goldberg, Candace McNaughton, Kimberly Souffront, Scott Millis, Phillip D Levy
Uncontrolled hypertension (HTN) is commonly encountered in emergency medicine practice, but the optimal approach to management has not been delineated. The objective of this study was to define emergency physician (EP) approaches to management of asymptomatic HTN in various clinical scenarios and assess adherence to the American College of Emergency Physician clinical policies, utilizing an online survey of EPs. A total of 1200 surveys were distributed by e-mail with completion by 199 participants. The variables associated with a decision to prescribe oral antihypertensive medications were a history of HTN and referral from primary care...
September 28, 2016: Journal of Clinical Hypertension
Amie Steel, Jayne Lucke, Rebecca Reid, Jon Adams
BACKGROUND: The value and importance of preconception care (PCC) have been acknowledged by leading health organizations as a vital element within preventive medicine and health promotion for the wider population. The translation of PCC from position statement to relevant service and programme delivery is essential for the benefits of PCC to be realized and relies on insights from health services research. This article aims to review contemporary health services research literature examining women's and health professionals' perceptions and experiences of PCC services...
September 20, 2016: Family Practice
Tristen S Park, E Shelley Hwang
Ductal carcinoma in situ (DCIS), once a rare entity, now comprises up to 30% of newly diagnosed breast cancers detected on mammography. It is now appreciated as a widely heterogeneous disease, with indolent lesions of minimal clinical significance on one end of the spectrum, and aggressive lesions with malignant invasive potential on the other. Therefore, the traditional guideline-concordant approach to treatment with surgery, radiation, and endocrine therapy may lead to overtreatment of certain patients, and insufficient treatment of others...
September 15, 2016: Oncology (Williston Park, NY)
Sarah Reece-Stremtan, Larry Gray
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. These guidelines are not intended to be all-inclusive, but to provide a basic framework for physician education regarding breastfeeding...
September 13, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Han Zhang, Nami McCarty
The recent advent of the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-CRISPR associated protein 9 (Cas9) system for precise genome editing has revolutionized methodologies in haematology and oncology studies. CRISPR-Cas9 technology can be used to remove and correct genes or mutations, and to introduce site-specific therapeutic genes in human cells. Inherited haematological disorders represent ideal targets for CRISPR-Cas9-mediated gene therapy. Correcting disease-causing mutations could alleviate disease-related symptoms in the near future...
October 2016: British Journal of Haematology
J R Ten Hove, E Mooiweer, E Dekker, A E van der Meulen-de Jong, G J A Offerhaus, C Y Ponsioen, P D Siersema, B Oldenburg
BACKGROUND & AIMS: When dysplastic lesions are encountered during surveillance colonoscopy of patients with inflammatory bowel diseases (IBD), guidelines recommend collection of additional biopsies from the surrounding mucosa, to ensure the lesion has been adequately circumscribed. We aimed to determine the rate of dysplasia in mucosa biopsies collected from tissues surrounding dysplastic lesions during IBD surveillance. METHODS: In a retrospective study, we collected endoscopy and pathology reports from 1065 patients undergoing colonoscopic surveillance for IBD, from 2000 through 2015, at 3 centers in the Netherlands...
September 6, 2016: Clinical Gastroenterology and Hepatology
Elise Anne Jager, Hans Ligtenberg, Joana Caldas-Magalhaes, Tim Schakel, Marielle E Philippens, Frank A Pameijer, Nicolien Kasperts, Stefan M Willems, Christiaan H Terhaard, Cornelis P Raaijmakers
BACKGROUND: Validation of magnetic resonance imaging (MRI) and development of guidelines for the delineation of the gross tumor volume (GTV) is of utmost importance to benefit from the visibility of anatomical details on MR images and to achieve an accurate GTV delineation. In the ideal situation, the GTV delineation corresponds to the histopathologically determined 'true tumor volume'. Consequently, we developed guidelines for GTV delineation of laryngeal and hypopharyngeal tumors on MRI and determined the accuracy of the resulting delineation of the tumor outline on histopathology as gold standard...
November 2016: Acta Oncologica
Samuel A Kantonen, Niel M Henriksen, Michael K Gilson
BACKGROUND: Isothermal titration calorimetry (ITC) is uniquely useful for characterizing binding thermodynamics, because it straightforwardly provides both the binding enthalpy and free energy. However, the precision of the results depends on the experimental setup and how thermodynamic results are obtained from the raw data. METHODS: Experiments and Monte Carlo analysis are used to study how uncertainties in injection heat and concentration propagate to binding enthalpies in various scenarios...
September 3, 2016: Biochimica et Biophysica Acta
Cheng B Saw, Frank Battin, Janice McKeague, Meghan Haggerty, Madhava Baikadi, Christopher Peters
Dose or treatment planning management is necessary for the re-irradiation of intracranial relapses after focal irradiation, radiosurgery, or stereotactic radiotherapy. The current clinical guidelines for metastatic brain tumors are the use of focal irradiation if the patient presents with 4 lesions or less. Salvage treatments with the use of whole brain radiation therapy (WBRT) can then be used to limit disease progression if there is an intracranial relapse. However, salvage WBRT poses a number of challenges in dose planning to limit disease progression and preserve neurocognitive function...
September 1, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
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