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Sample records for intravascular brachytherapy calculos

  1. Dosimetric calculus in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho; Stabin, Michael Gregory [Pernambuco Univ., Recife, PE (Brazil). Dept. de Energia Nuclear

    2000-07-01

    Among the cardiovascular diseases, the most common is acute myocardial infarction, which occurs because of the occlusion of one or more coronary arteries. Balloon angioplasty has been a popular treatment which is less invasive than surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment). Known as Intravascular Brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis. In order to study the radiation dosimetry in the patient and radiological protection for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, 0.30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several radionuclides. Two stent sources employing {sup 32}P are also simulated. Advantages and disadvantages of the radionuclides and source geometries are discussed and the dosimetry developed here will aid in the realization of the benefits obtained in patients. (author)

  2. Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  3. Dosimetry in intravascular brachytherapy

    International Nuclear Information System (INIS)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing 32 P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  4. Dosimetric model for intravascular brachytherapy

    International Nuclear Information System (INIS)

    Flower, E.E.; Stroud, D.B.

    2000-01-01

    Full text: Intravascular brachytherapy has been shown to be a prophylaxis for restenosis. Adventitial macrophages, which are extremely radiosensitive, initiate neointima formation. A model of the dose levels of the treatment range is developed, assuming that the adventitia is the target tissue. If the adventitia receives a dose of less than 10 Gy, it is assumed the treatment will be ineffective. If the dose to any part of the wall is above 30 Gy, it is assumed that the treatment could be detrimental. Hence the treatment range is between 10 and 30 Gy, with 20 Gy being the optimum dosage to the adventitia. An algorithm using numerical integration of published dose kernels calculates the dose at any point surrounding a beta ( 32 P) line source of finite length. Dose profiles were obtained to demonstrate edge effects. For long lesions, the source is often stepped along the artery. Dose changes due to separation or overlapping of sources during source stepping procedures were also determined. Isodose curves were superimposed on intravascular ultrasound images to demonstrate dose levels. For an exposure time of 60 seconds with a 200mCi source, the optimum dose of 20 Gy occurs at a distance 1.94mm from the centre of the source. The upper limit of the treatment dose range (30 Gy) occurs at 1.59mm. The lower limit of the treatment dose range (10 Gy) occurs at 2.7mm. Significant perturbations to the treatment dose range can be caused by non-centering of the source, edge effects and separation or overlapping of sources in stepping procedures. Despite these concerns, many successful procedures have been reported and this implies that the model is over simplified and requires modifications. Copyright (2000) Australasian College of Physical Scientists and Engineers in Medicine

  5. Brachytherapy optimal planning with application to intravascular radiation therapy

    DEFF Research Database (Denmark)

    Sadegh, Payman; Mourtada, Firas A.; Taylor, Russell H.

    1999-01-01

    . Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes...... determination of an optimal dwell-time sequence for a train of seeds that deliver ratiation while stepping through the vessel lesion. The results illustrate the advantage of this strategy over the common approach of delivering radiation by positioning a single train of seeds along the whole lesion....

  6. Model of distribution of dose for intravascular brachytherapy; Modelo de distribucion de dosis para braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Pirchio, Rosana; Signoretta, Catalina [Comision Nacional de Energia Atomica (CNEA), Buenos Aires (Argentina). Dosimetria de Radioaciones Ionizantes; Martin, Gabriela; Rivera, Elena; Bergoc, Rosa [Univeridad de Buenos Aires (Argentina). Facultad de Farmacia y Bioquimica. Lab. de Radioisotopos; Guzman, Luis [Instituto Cardiovascular de Buenos Aires (Argentina)

    2001-07-01

    In this work we present the radiation dose distributions for a theoretical model with Monte Carlo simulation, which was based on an experimental model developed for the study of the prevention of restenosis post-angioplasty employing intravascular brachytherapy. In the experimental model, the atherosclerotic plaques were induced in femoral arteries of male New Zealand rabbits through surgical intervention and later administration of cholesterol enriched diet. For the intravascular irradiation we employed a {sup 32} P source contained within the balloon used for the angioplasty. The radiation dose distributions were calculated using the Monte Carlo code MCNP4B according to a segment of a simulated artery. We studied the radiation dose distribution in the axial and radial directions for different thickness of the atherosclerotic plaques. The results will be correlated with the biologic effects observed by means of histological analysis of the irradiated arteries. (author)

  7. Design and implementation of an intravascular brachytherapy installation in cardiology

    International Nuclear Information System (INIS)

    Prieto, C.; Vano, E.; Fernandez, J.M.; Sabate, M.; Galvan, Y.C.

    2001-01-01

    Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

  8. Application of Gafchromic registered film in the dosimetry of an intravascular brachytherapy source

    International Nuclear Information System (INIS)

    Song Haijun; Roa, D. Eduardo; Yue Ning; D'Errico, Francesco; Chen Zhe; Nath, Ravinder

    2006-01-01

    The methodology of brachytherapy source dosimetry with Gafchromic registered MD 55-2 film (ISP Technologies, Inc.) is examined with an emphasis on the nonlinearity of the optical density-dose relation within the dynamic dose range, the radial distance-dependent measurement uncertainty, and the format of data presentation. The specific source chosen for this study was a Checkmate trade mark sign (Cordis Corporation) intravascular brachytherapy system. The two-dimensional dose distribution around the source was characterized by a comprehensive analysis of measurement uncertainties. A comparative analysis of the dosimetric data from the vendor and from the scientific literature showed a substantial consistency of the information available for the Checkmate trade mark sign source. Our two-dimensional dosimetric data for the Checkmate trade mark sign source trains is presented in the form of measured along and away dose tables

  9. Monte Carol-Based Dosimetry of Beta-Emitters for Intravascular Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, C.K.

    2002-06-25

    Monte Carlo simulations for radiation dosimetry and the experimental verifications of the simulations have been developed for the treatment geometry of intravascular brachytherapy, a form of radionuclide therapy for occluded coronary disease (restenosis). Monte Carlo code, MCNP4C, has been used to calculate the radiation dose from the encapsulated array of B-emitting seeds (Sr/Y-source train). Solid water phantoms have been fabricated to measure the dose on the radiochromic films that were exposed to the beta source train for both linear and curved coronary vessel geometries. While the dose difference for the 5-degree curved vessel at the prescription point of f+2.0 mm is within the 10% guideline set by the AAPM, however, the difference increased dramatically to 16.85% for the 10-degree case which requires additional adjustment for the acceptable dosimetry planning. The experimental dose measurements agree well with the simulation results

  10. Effectiveness Evaluation of Skin Covers against Intravascular Brachytherapy Sources Using VARSKIN3 Code

    Directory of Open Access Journals (Sweden)

    Baghani HR

    2013-12-01

    Full Text Available Background and Objective: The most common intravascular brachytherapy sources include 32P, 188Re, 106Rh and 90Sr/90Y. In this research, skin absorbed dose for different covering materials in dealing with these sources were evaluated and the best covering material for skin protection and reduction of absorbed dose by radiation staff was recognized and recommended. Method: Four materials including polyethylene, cotton and two different kinds of plastic were proposed as skin covers and skin absorbed dose at different depths for each kind of the materials was calculated separately using the VARSKIN3 code. Results: The results suggested that for all sources, skin absorbed dose was minimized when using polyethylene. Considering this material as skin cover, maximum and minimum doses at skin surface were related to 90Sr/90Y and 106Rh, respectively. Conclusion: polyethylene was found the most effective cover in reducing skin dose and protecting the skin. Furthermore, proper agreement between the results of VARSKIN3 and other experimental measurements indicated that VRASKIN3 is a powerful tool for skin dose calculations when working with beta emitter sources. Therefore, it can be utilized in dealing with the issue of radiation protection.

  11. Manual method for dose calculation in gynecologic brachytherapy; Metodo manual para o calculo de doses em braquiterapia ginecologica

    Energy Technology Data Exchange (ETDEWEB)

    Vianello, Elizabeth A.; Almeida, Carlos E. de [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil); Biaggio, Maria F. de [Universidade do Estado, Rio de Janeiro, RJ (Brazil)

    1998-09-01

    This paper describes a manual method for dose calculation in brachytherapy of gynecological tumors, which allows the calculation of the doses at any plane or point of clinical interest. This method uses basic principles of vectorial algebra and the simulating orthogonal films taken from the patient with the applicators and dummy sources in place. The results obtained with method were compared with the values calculated with the values calculated with the treatment planning system model Theraplan and the agreement was better than 5% in most cases. The critical points associated with the final accuracy of the proposed method is related to the quality of the image and the appropriate selection of the magnification factors. This method is strongly recommended to the radiation oncology centers where are no treatment planning systems available and the dose calculations are manually done. (author) 10 refs., 5 figs.

  12. Monte Carlo dose characterization of a new 90Sr/90Y source with balloon for intravascular brachytherapy

    International Nuclear Information System (INIS)

    Wang Ruqing; Li, X. Allen; Lobdell, John

    2003-01-01

    Beta emitting source wires or seeds have been adopted in clinical practice of intravascular brachytherapy for coronary vessels. Due to the limitation of penetration depth, this type of source is normally not applicable to treat vessels with large diameter, e.g., peripheral vessel. In the effort to extend application of its beta source for peripheral vessels, Novoste has recently developed a new catheter-based system, the Corona trade mark sign 90 Sr/ 90 Y system. It is a source train of 6 cm length and is jacketed by a balloon. The existence of the balloon increases the penetration of the beta particles and maintains the source within a location away from the vessel wall. Using the EGSnrc Monte Carlo system, we have calculated the two-dimensional (2-D) dose rate distribution of the Corona trade mark sign system in water for a balloon diameter of 5 mm. The dose rates on the transverse axis obtained in this study are in good agreement with calibration results of the National Institute of Standards and Technology for the same system for balloon diameters of 5 and 8 mm. Features of the 2-D dose field were studied in detail. The dose parameters based on AAPM TG-60 protocol were derived. For a balloon diameter of 5 mm, the dose rate at the reference point (defined as r 0 =4.5 mm, 2 mm from the balloon surface) is found to be 0.010 28 Gy min -1 mCi -1 . A new formalism for a better characterization of this long source is presented. Calculations were also performed for other balloon diameters. The dosimetry for this source is compared with a 192 Ir source, commonly used for peripheral arteries. In conclusion, we have performed a detailed dosimetric characterization for a new beta source for peripheral vessels. Our study shows that, from dosimetric point of view, the Corona trade mark sign system can be used for the treatment of an artery with a large diameter, e.g., peripheral vessel

  13. A simple method for verifying brachytherapy dose calculation high rate; Un metodo simple para la verificacion del calculo de dosis en braquiterapia de alta tasa

    Energy Technology Data Exchange (ETDEWEB)

    Almansa Lopez, J.; Jover Perez, C. I.; Alaman Sanchez, C.; Osorio Ceballos, J. L.

    2013-07-01

    Variations in the time of treatment can cause adverse side effects in the patient or a failure of the effectiveness of the treatment. In addition RD 1566 / 1998 on quality criteria in radiotherapy establishes the need for a control monitor units or the treatment times in the schedules of teletherapy and brachytherapy. (Author)

  14. Verification of the calculation program for brachytherapy planning system of high dose rate (PLATO); Programa de verificacion del calculo para un sistema de planificacion de braquiterapia de alta tasa de dosis (PLATO)

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    Almansa, J.; Alaman, C.; Perez-Alija, J.; Herrero, C.; Real, R. del; Ososrio, J. L.

    2011-07-01

    In our treatments are performed brachytherapy high dose rate since 2007. The procedures performed include gynecological intracavitary treatment and interstitial. The treatments are performed with a source of Ir-192 activity between 5 and 10 Ci such that small variations in treatment times can cause damage to the patient. In addition the Royal Decree 1566/1998 on Quality Criteria in radiotherapy establishes the need to verify the monitor units or treatment time in radiotherapy and brachytherapy. All this justifies the existence of a redundant system for brachytherapy dose calculation that can reveal any abnormality is present.

  15. Preparation of a program for the independent verification of the brachytherapy planning systems calculations; Confeccion de un programa para la verificacion independiente de los calculos de los sistemas de planificacion en braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    V Carmona, V.; Perez-Calatayud, J.; Lliso, F.; Richart Sancho, J.; Ballester, F.; Pujades-Claumarchirant, M.C.; Munoz, M.

    2010-07-01

    In this work a program is presented that independently checks for each patient the treatment planning system calculations in low dose rate, high dose rate and pulsed dose rate brachytherapy. The treatment planning system output text files are automatically loaded in this program in order to get the source coordinates, the desired calculation point coordinates and the dwell times when it is the case. The source strength and the reference dates are introduced by the user. The program allows implementing the recommendations about independent verification of the clinical brachytherapy dosimetry in a simple and accurate way, in few minutes. (Author).

  16. Verification of dosimetry planning in brachytherapy in format Dicom and EUD calculation of Risk in bodies; Verificacion de la planificacion dosimetria en braquiterapia en formato Dicom y calculo del EUD en organos de riesgo

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Hernandez, M. J.; Sendon del Rio, J. R.; Ayala Lazaro, R.; Jimenez Rojas, M. R.; Gomez Cores, S.; Polo Cezon, R.; Lopez Bote, M. A.

    2013-07-01

    This work Describes a program that automates the verification of the schedules in brachytherapy (configuration and dosimetric treatment parameters) for sources of Ir-192 (mHDR v2) and Co-60 (Co0.A86) from the plan exported in DICOM format data. (Author)

  17. Calculation Monte Carlo equivalent dose to organs in a treatment of prostate with Brachytherapy of high rate; Calculo Monte Carlo de dosis equivalente a organos en un tratamiento de prostata con braquiterapia de alta tasa

    Energy Technology Data Exchange (ETDEWEB)

    Candela-Juan, C.; Vijande, J.; Granero, D.; Ballester, F.; Perez-Calatayud, J.; Rivard, M. J.

    2013-07-01

    The objective of this study was to obtain equivalent dose to radiosensitive organs when applies brachytherapy high dose (HDR) with sources of 60 Co or 192 Go to a localized carcinoma of the prostate. The results are compared with those reported in the literature on treatment with protons and intensity modulated (IMRT) radiation therapy. (Author)

  18. Study of the workload to be applied in the shielding calculation in HDR brachytherapy facilities with IR-192; Estudio de la carga de trabajo a aplicar en el calculo de blindajes en instalaciones de braquiterapia HDR con IR-192

    Energy Technology Data Exchange (ETDEWEB)

    Pujades-Clamarchirant, M. C.; Perez-Calatayud, J.; Ballester, F.; Gimeno, J.; Granero, D.; Camacho, C.; Carmona, V.; Lliso, F.; Vijande, J.

    2011-07-01

    The design of shielding facilities high rate brachytherapy (HDR) requires an estimate of the workload (w) . The aim of this study was to evaluate the W typical service HDR BT with a high number of applications and their impact on the final thickness the shielding of the room. To do this, a review of patients treated in our center HDR W has been evaluated and studied their impact on the shielding design of the facility.

  19. Intravascular pulmonary metastases

    International Nuclear Information System (INIS)

    Shepard, J.A.O.; Moore, E.H.; Templeton, P.A.; McLoud, T.C.

    1988-01-01

    The diagnosis of intravascular metastatic tumor emboli to the lungs is rarely made. The authors present a characteristic radiographic finding of intravascular lung metastases that they observed in four patients with diagnoses or right atrial myoxoma, invasive renal cell carcinoma, invasive pelvic osteosarcoma, and recurrent pelvic chondrosarcoma. Substantiation of intravascular pulmonary metastases was achieved by means of autopsy, pulmonary artery biopsy, and surgical documentation of tumor invasion of the inferior vena cava or pelvic veins. In all four cases, chest computed tomography (CT) demonstrated branching, beaded opacities extending from the hila into the periphery of the lung in the distribution of pulmonary arteries. In one case, similar findings were observed in magnetic resonance (MR) images of the chest. Follow-up studies in three cases showed progressive enlargement and varicosity of the abnormal pulmonary artery consistent with proliferation of intravascular tumor. In the case of metastatic osteosarcoma, intraluminal ossification was also observed at CT. In three of four cases, pulmonary infarction was demonstrated in the distribution of the abnormal pulmonary arteries seen at CT as small, peripheral, wedge-shaped opacities. The demonstration of progressively dilated and beaded pulmonary arteries in patients with extrathoracic malignancies is suggestive of intravascular lung metastases, particularly when accompanied by peripheral infarction

  20. [Intravascular endothelioma (author's transl)].

    Science.gov (United States)

    Vanĕk, J

    1978-01-01

    A 76-year-old woman developed a slowly growing lesion over the right index and the adjacent part of the metacarpus. A cell proliferation filling up the skin veins was classified as intravascular endothelioma. This rather rare oncological entity with a good prognosis should be differentiated from peculiar pattern occasionally seen in organisation of thrombi as well as malignant endothelial tumours.

  1. Harmonic Intravascular Ultrasound

    NARCIS (Netherlands)

    M.E. Frijlink (Martijn)

    2006-01-01

    textabstractMedical ultrasound is a popular imaging modality in cardiology. Harmonic Imaging is a technique that has been shown to increase the image quality of diagnostic ultrasound at frequencies below 10 MHz. However, Intravascular Ultrasound, which is a technique to acoustically investigate

  2. Dose calculation in eye brachytherapy with Ir-192 threads using the Sievert integral and corrected by attenuation and scattering with the Meisberg polynomials; Calculo de dosis en braquiterapia ocular con hilos de Ir-192 utilizando la integral de Sievert y cooregida por atenuacion y dispersion con los polinomios de Meisberg

    Energy Technology Data Exchange (ETDEWEB)

    Vivanco, M.G. Bernui de; Cardenas R, A. [Instituto Nacional de Enfermedades Neoplasicas, Universidad Nacional de Ingenieria, Av. Angamos No. 2520, Surquillo, Lima (Peru)]. e-mail: gisellebdv@hotmail.com

    2006-07-01

    The ocular brachytherapy many times unique alternative to conserve the visual organ in patients of ocular cancer, one comes carrying out in the National Institute of Neoplastic Illnesses (INEN) using threads of Iridium 192; those which, they are placed in radial form on the interior surface of a spherical cap of gold of 18 K; the cap remains in the eye until reaching the prescribed dose by the doctor. The main objective of this work is to be able to calculate in a correct and practical way the one time that the treatment of ocular brachytherapy should last to reach the dose prescribed by the doctor. To reach this objective I use the Sievert integral corrected by attenuation effects and scattering (Meisberg polynomials); calculating it by the Simpson method. In the calculations by means of the Sievert integral doesn't take into account the scattering produced by the gold cap neither the variation of the constant of frequency of exposure with the distance. The calculations by means of Sievert integral are compared with those obtained using the Monte Carlo Penelope simulation code, where it is observed that they agree at distances of the surface of the cap greater or equal to 2mm. (Author)

  3. Intravascular (catheter) MR imaging

    International Nuclear Information System (INIS)

    Cohen, A.M.; Hurst, G.C.; Katz, D.E.; Dverk, J.L.; Wiesen, E.J.; Czerski, L.W.; Malaya, R.; Bellon, E.M.

    1989-01-01

    Intravascular MR probes allow excellent spatial resolution and have the potential to detect arterial wall microstructure. Ultrasonic intravascular probes suggest that detailed morphologic information can assist clinical decision making. Catheter MR probes of 2--7 mm outside diameter (OD) were built of copper wire, Teflon, and parts from standard commercial catheters. The probes were connected to the surface coil receiver input of our Picker VISTA 2055HP 1.5-T imaging system. The extant (linear) body coil was used for transmit. Phantoms were constructed of coaxial glass MR tubes, filled with doped water. Watanabe rabbit aorta and human autopsy iliac artery specimens were examined within 4 hours of excision or stored by freezing. In vivo iliac arteries in dogs under general anesthesia were imaged, with percutaneous placement of the probe. Results are presented

  4. Intravascular "mulberry-like" bodies

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Klebe, J G; Henriques, U V

    1988-01-01

    Intravascular "mulberry-like" bodies in a stillborn female infant with moderate maceration are reported. The histogenesis of these structures is discussed based on light-microscopic, immunohistochemical and ultrastructural findings. No demonstrable causal relation between the intravascular lesion...... and fetal death was found, the cause of death being attributed to intrauterine asphyxia. It is concluded, that intravascular "mulberry-bodies" most likely represent artifacts due to red blood cell autolysis....

  5. Brachytherapy optimal planning with application to intravascular radiation therapy

    DEFF Research Database (Denmark)

    Sadegh, Payman; Mourtada, Firas A.; Taylor, Russell H.

    1999-01-01

    determination of an optimal dwell-time sequence for a train of seeds that deliver ratiation while stepping through the vessel lesion. The results illustrate the advantage of this strategy over the common approach of delivering radiation by positioning a single train of seeds along the whole lesion....

  6. Disseminated intravascular coagulation in sepsis

    NARCIS (Netherlands)

    Zeerleder, Sacha; Hack, C. Erik; Wuillemin, Walter A.

    2005-01-01

    Disseminated intravascular coagulation is a frequent complication of sepsis. Coagulation activation, inhibition of fibrinolysis, and consumption of coagulation inhibitors lead to a procoagulant state resulting in inadequate fibrin removal and fibrin deposition in the microvasculature. As a

  7. The need for international standardization in clinical beta dosimetry for brachytherapy

    International Nuclear Information System (INIS)

    Quast, U.; Boehm, J.; Kaulich, T.W.

    2002-01-01

    Beta radiation has found increasing interest in radiotherapy. Besides the curative treatment of small and medium-sized intraocular tumors by means of ophthalmic beta radiation plaques, intravascular brachytherapy has proven to successfully overcome the severe problem of restenosis after interventional treatment of arterial stenosis in coronaries and peripheral vessels in many clinical trials with a large number of patients. Prior to initiating procedures applying beta radiation in radiotherapy, however, there is a common need to specify methods for the determination and specification of the absorbed dose to water or tissue and their spatial distributions. The IAEA-TECDOC-1274 Calibration of photon and beta ray sources used in brachytherapy (2002) is a help for photon brachytherapy calibration. But, for beta seed and line sources, IAEA recommends well type ionization chambers as working standards which are far from measuring absorbed dose to water of the radiation clinically used. Although the application of such working standards seems to be more precise, large errors can occur when the medical physicist has to convert the calibration data to absorbed dose to water of the beta radiation emitted. The user must believe that the source is equally activated and that the manufacturer did not change the design and construction of the source encapsulation. With the DGMP Report 16 (2001) Guidelines for medical physical aspects of intravascular brachytherapy a very detailed code of practice is given, especially for the calibration and clinical dosimetry of intravascular beta radiation sources. As there is a global need for standardization in clinical dosimetry for intravascular brachytherapy utilizing beta radiation, the DIN-NAR, the German committee on standardization in radiology, task group dosimetry, has initiated an international adhoc working group for a new ISO work item proposal on the standardization of procedures in clinical dosimetry to guarantee reliable

  8. Intravascular blood coagulation after irradiation

    International Nuclear Information System (INIS)

    Sushkevich, G.N.

    1981-01-01

    The problems of activation of intravascular blood coagulation (JVBC) at different stages after irradiation, are considered. JVBC peculiarities (disseminated intravascular syndrome (DIV) or thrombo hemorrhagic syndrome) are investigated. Literature on alterations which take place in the organism under effect of ionizing irradiation is analyzed. This analysis proves the characteristic features of thrombinogenesis activation and development of DIV syndrome not only in the early post-radiation period, but in the middle of radiation disease, as well. It is also shown that ionizing radiation activizes the hemocoagulation process and causes IVBC in the case of both local and general irradiation [ru

  9. Prostate cancer brachytherapy

    International Nuclear Information System (INIS)

    Abreu, Carlos Eduardo Vita; Silva, Joao L. F.; Srougi, Miguel; Nesrallah, Adriano

    1999-01-01

    The transperineal brachytherapy with 125 I/Pd 103 seed implantation guided by transurethral ultrasound must be presented as therapeutical option of low urinary morbidity in patients with localized prostate cancer. The combined clinical staging - including Gleason and initial PSA - must be encouraged, for definition of a group of low risk and indication of exclusive brachytherapy. Random prospective studies are necessary in order to define the best role of brachytherapy, surgery and external beam radiation therapy

  10. Intravascular Stenting in Microvascular Anastomoses

    DEFF Research Database (Denmark)

    Assersen, Kristine; Sørensen, Jens

    2015-01-01

    Background The effect of intravascular stenting (IVaS) on microvascular anastomoses has given adverse results. For experienced microsurgeons the benefit of IVaS is doubtful. We have investigated the potential benefit of the IVaS technique for two groups of inexperienced microsurgeons with differe...

  11. Intravascular bronchio-alveolar tumor

    International Nuclear Information System (INIS)

    Mata, J.M.; Caceres, J.; Prat, J.; Lopez, J.I.; Velilla, O.

    1991-01-01

    In 1975 Dail and Liebow described the clinical and pathological characteristics of a pulmonary tumor which they dominated intravascular bronchio-alveolar tumor (IVBAT). Our aim is to acquaint radiologists with the existence of this tumor by describing the radiologic findings in 2 patients with IVBAT, 1 with hepatic involvement ant the other with pulmonary osteoarthropathy. (author). 7 refs.; 2 figs

  12. Advancements in brachytherapy

    DEFF Research Database (Denmark)

    Tanderup, Kari; Ménard, Cynthia; Polgar, Csaba

    2017-01-01

    Brachytherapy is a radiotherapy modality associated with a highly focal dose distribution. Brachytherapy treats the cancer tissue from the inside, and the radiation does not travel through healthy tissue to reach the target as with external beam radiotherapy techniques. The nature of brachytherap...

  13. Brachytherapy in lip cancer.

    Science.gov (United States)

    Rovirosa-Casino, Angeles; Planas-Toledano, Isabel; Ferre-Jorge, Jorge; Oliva-Díez, José María; Conill-Llobet, Carlos; Arenas-Prat, Meritxell

    2006-05-01

    Lip cancer is one of the most prevalent skin tumours of the head and neck. The characteristics of the tumour relate to their exophyitic growth in an area of easy visual acces which allows their diagnosis in early stages. As a result, there is a better prognosis with the present treatments. In early stages the treatment can be performed by surgery or by brachytherapy, and the results are similar on local control; nevertheless brachytherapy offers the best functional and esthetic results. We are reporting on a review of the literature in relation to indications, techniques and results of brachytherapy for lip cancer.

  14. Radiation protection in brachytherapy

    International Nuclear Information System (INIS)

    Benitez, Manuel

    1996-02-01

    It covers technical procedures in medical applications for cancer treatment. Radiation protection principles in brachytherapy. Medical uses in therapy for Sr-90, Cs-137, Co-60, Ra-226, Ir-192, Au-198, Bi-214, Pb-214. (The author)

  15. Development of sup 1 sup 9 sup 2 Ir radiation sources for intravascular irradiation

    CERN Document Server

    Kogure, H; Iwamoto, S; Iwata, K; Kawauchi, Y; Nagata, Y; Sorita, T; Suzuki, K

    2003-01-01

    Intravascular brachytherapy is a novel therapy for preventing the restenosis of coronary artery by use of low-dose irradiation. JAERI and Kyoto University have been developing sup 1 sup 9 sup 2 Ir radiation sources by the cooperative research project entitled as 'The research on safety and effectiveness of the intravascular brachytherapy for preventing restenosis of the coronary artery disease' since 1998. The radiation source was introduced into the stenosis through a catheter (a guide-tube to insert directly into vascular) to irradiate the diseased part. Ten sup 1 sup 9 sup 2 Ir seed sources (phi 0.4 mm x 2.5 mm) were positioned between nylon spacers (phi 0.3 mm x 1.0 mm) in a flexible covering tube and the tube was plugged with a core-wire; the tube was shrunk to fix the inside materials and the size is 0.46 mm in diameter and 3 m in length. The physically optimal design was determined to insert the radiation source easily into vascular and to get the dose uniformity in the diseased part. The production me...

  16. CNS Intravascular Lymphoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Amer Awad

    2011-01-01

    Full Text Available Intravascular lymphoma is a rare but well-described entity. The clinical manifestations are heterogeneous. We report a case of a 59-year-old woman who presented initially with syncope followed by subacute cognitive decline that progressed to minimally conscious state. Shortly after the transfer to our tertiary center the patient died. Brain autopsy disclosed the diagnosis of B-cell intravascular lymphoma. We speculate that syncope could be the first manifestation of central nervous system intravascular lymphoma and should be considered in the differential diagnosis of unexplained syncope. In addition, we stress the importance of early brain biopsy in unexplained white matter disease.

  17. Intravascular lipoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Z Doyle

    2015-06-01

    Full Text Available Lipomas are benign neoplasms composed of adipocytes encased in a fibrous capsule. Intravascular lipomas are rare and almost always incidental findings. In the published literature, the majority are described within the inferior vena cava (IVC and less frequently reported in the superior vena cava, brachiocephalic vein, subclavian vein, internal jugular vein, external iliac vein and common femoral vein. We present the case of a 59-year-old male who presented with a symptomatic ureteral calculus and was found to have an intravascular lipoma of the right renal vein with extension into the IVC. To our knowledge, this is the first ever report of an intravascular lipoma in the renal vein. We discuss the imaging characteristics of intravascular lipomas and the differential diagnosis that should be considered.

  18. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    OpenAIRE

    Kensuke Tashiro, MD; Shuji Yamashita, MD; Mitsunaga Narushima, MD; Isao Koshima, MD; Shimpei Miyamoto, MD

    2017-01-01

    Background:. Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined...

  19. Coagulación intravascular diseminada = Disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Arango Barrientos, Marcos

    2010-12-01

    Full Text Available La coagulación intravascular diseminada (CID es una entidad clínica frecuente que se presenta como fenómeno secundario a diversas enfermedades entre las cuales se destacan las infecciones graves, las neoplasias y las catástrofes obstétricas. Se caracteriza por una activación difusa y simultánea de los sistemas endógenos de la coagulación y la fibrinólisis. El depósito de pequeños trombos en la circulación conduce finalmente a disfunción orgánica múltiple y en algunos casos a la muerte. Las manifestaciones clínicas pueden incluir fenómenos trombóticos y hemorrágicos. Se ha propuesto un puntaje de fácil aplicación para simplificar el diagnóstico de la entidad. El tratamiento incluye el control específico de la causa subyacente que favorece la aparición de la CID, el soporte con hemoderivados en pacientes con manifestaciones de sangrado y la anticoagulación terapéutica en pacientes con trombosis mayores. El desarrollo de CID es un factor pronóstico adverso que aumenta significativamente la tasa de mortalidad. En este artículo de revisión se incluyen los siguientes aspectos de la CID: historia, epidemiología, clasificación, entidades asociadas, fisiopatología, clínica, diagnóstico, tratamiento y pronóstico.

  20. Glass microspheres for brachytherapy

    International Nuclear Information System (INIS)

    Prado, Miguel O.; Prastalo, Simon; Blaumann, Herman; Longhino, Juan M.; Repetto Llamazares, A.H.V.

    2007-01-01

    We developed the capacity to produce glass microspheres containing in their structure one or more radioactive isotopes useful for brachytherapy. We studied the various facts related with their production: (Rare earth) alumino silicate glass making, glass characterization, microspheres production, nuclear activation through (n,γ) nuclear reactions, mechanical characterization before and after irradiation. Corrosion tests in simulated human plasma and mechanical properties characterization were done before and after irradiation. (author) [es

  1. Brachytherapy for cancer

    International Nuclear Information System (INIS)

    Nishio, Masamichi; Sakurai, Tomoyasu; Kagami, Yoshikazu; Narimatsu, Naoto

    1987-01-01

    Brachytherapy is one of most effective methods of radiotherapy for cancer, and therefore, low-dose-rate brachytherapy is widely used for carcinoma of the uterus and carcinoma of the tongue. Between 1974 and 1983, 76 primary thoracic esophageal squamous cell carcinomas were treated with external irradiation combined with additional intracavitary radium therapy at the National Sapporo Hospital. The esophageal primary control rate was 34 % and the 5-year survival rate was 24.1 %. We believe that external irradiation therapy followed by additional intracavitary radium irradiation produces good results. Also, from 1982, 30 patients with small residual or unresectable tumors received interstitial irradiation using an after-loading technique and iridium-192 seeds. Eighteen of these 30 patients treated with iridium-192 were recurrent cases, and 20 had outer tubes intra-operatively inserted into the tumor following iridium-192 irradiation. Ten of these patients had brain tumor, nine had cancer of the head and neck, and each of the remaining fifteen had the following malignancies : lung cancer, breast cancer, pancreatic cancer, bile duct cancer, uterus cancer, skin cancer and soft tissue sarcoma. Overall 4-year survival was 17.1 % in among the patients treated with Ir-192. Favorable preliminary results from these patients and those of various clinical trials on the extension of indications for brachytherapy were also reported. (author)

  2. Fluorescent Method for Observing Intravascular Bonghan Duct

    Directory of Open Access Journals (Sweden)

    Byung-Cheon Lee

    2005-12-01

    Full Text Available Observation of intra-vascular threadlike structures in the blood vessels of rats is reported with the images by differential interference contrast microscope, and fluorescence inverted microscope of the acridine-orange stained samples. The confocal microscope image and the hematoxylin-eosin staining revealed the distinctive pattern of nuclei distribution that clearly discerned the threadlike structure from fibrin, capillary, small venule, arteriole, or lymph vessel. Physiological function of the intra-vascular thread in connection with acupuncture is discussed. Especially, this threadlike duct can be a circulation path for herb-liquid flow, which may provide the scientific mechanism for therapeutic effect of herbal acupuncture.

  3. A 3D computer graphics approach to brachytherapy planning.

    Science.gov (United States)

    Weichert, Frank; Wawro, Martin; Wilke, Carsten

    2004-06-01

    Intravascular brachytherapy (IVB) can significantly reduce the risk of restenosis after interventional treatment of stenotic arteries, if planned and applied correctly. In order to facilitate computer-based IVB planning, a three-dimensional reconstruction of the stenotic artery based on intravascular ultrasound (IVUS) sequences is desirable. For this purpose, the frames of the IVUS sequence are properly aligned in space, possible gaps inbetween the IVUS frames are filled by interpolation with radial basis functions known from scattered data interpolation. The alignment procedure uses additional information which is obtained from biplane X-ray angiography performed simultaneously during the capturing of the IVUS sequence. After IVUS images and biplane angiography data are acquired from the patient, the vessel-wall borders and the IVUS catheter are detected by an active contour algorithm. Next, the twist (relative orientation) between adjacent IVUS frames is determined by a sequential triangulation method. The absolute orientation of each frame is established by a stochastic analysis based on anatomical landmarks. Finally, the reconstructed 3D vessel model is visualized by methods of combined volume and polygon rendering. The reconstruction is then used for the computation of the radiation-distribution within the tissue, emitted from a beta-radiation source. All these steps are performed during the percutaneous intervention.

  4. Neutrophils Cause an Intravascular Traffic Jam.

    Science.gov (United States)

    Minns, Martin S; Pearlman, Eric

    2018-01-10

    Neutrophil swarming is defined by large numbers of cells simultaneously and rapidly migrating to a site of injury or infection. In this issue of Cell Host & Microbe, Lee et al. (2018) demonstrate that intravascular swarming of neutrophils occurs in response to Candida albicans infection and causes vascular occlusion and pathological sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    Directory of Open Access Journals (Sweden)

    Kensuke Tashiro, MD

    2017-11-01

    Conclusions:. Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery.

  6. Intravascular volume after aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Hoff, R.G.

    2009-01-01

    Intravascular volume after aneurysmal subarachnoid hemorrhage A subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disorder with an often poor prognosis. The occurrence of delayed cerebral ischemia (DCI) is one of the most important factors determining outcome in

  7. Disseminated Intravascular Coagulation Following Induction of ...

    African Journals Online (AJOL)

    Background: Disseminated Intravascular coagulopathy (DIC) has been reported following use of Misoprostol which is an old drug with new indications in Obstetrics and. Gynecology. Its effectiveness, low cost, stability in tropical conditions and ease of administration as well as side effects like gastrointestinal effect, uterine ...

  8. Development of brachytherapy medium doserate

    International Nuclear Information System (INIS)

    Atang Susila; Ari Satmoko; Ahmad Rifai; Kristiyanti

    2010-01-01

    Brachytherapy has proven to be an effective treatment for different types of cancers and it become a common treatment modality in most radiotherapy clinics. PRPN has had experience in development of Low Dose Rate Brachytherapy for cervix cancer treatment. However the treatment process using LDR device needs 5 hours in time that the patient feel uncomfort. Therefore PRPN develops Medium Dose Rate Brachytherapy with radiation activity not more than 5 Currie. The project is divided into two stages. Purchasing of TPS software and TDS design are held in 2010, and the construction will be in 2011. (author)

  9. Mapping intravascular ultrasound controversies in interventional cardiology practice.

    Directory of Open Access Journals (Sweden)

    David Maresca

    Full Text Available Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with

  10. Brachytherapy in childhood rhabdomyosarcoma treatment

    International Nuclear Information System (INIS)

    Novaes, Paulo Eduardo Ribeiro dos Santos

    1995-01-01

    A retrospective study of 21 children with rhabdomyosarcoma treated by brachytherapy to the primary site of the tumor at the Radiotherapy Department of the A.C.Camargo Hospital between january/1980 to june/1993 was undertaken. The main objectives were to comprove the utility of brachytherapy in childhood rhabdomyosarcoma, to evaluate the local control and survival, in association with chemotherapy, to analyze the late effects of the treatment and to determinate the preferential technique to each clinical situation. All patients received brachytherapy to the tumor site. The radioactive isotopes employed were Gold 198 , Cesium 137 and Iridium 192 . The brachytherapy techniques depended on the tumor site, period of treatment, availability of the radioactive material and stage of the disease. Patients treated exclusively by brachytherapy received 40 Gy to 60 Gy. When brachytherapy was associated with external radiotherapy the dose ranged from 20 Gy to 40 Gy. Local control was achieved in 18 of 20 patients (90%). The global survival and local control survival rates were 61.9% (13/21 patients) and 72,2% (13/18 patients) respectively. (author)

  11. Intravascular photoacoustic imaging of human coronary atherosclerosis

    Science.gov (United States)

    Jansen, Krista; van der Steen, Antonius F. W.; Springeling, Geert; van Beusekom, Heleen M. M.; Oosterhuis, J. Wolter; van Soest, Gijs

    2011-03-01

    We demonstrate intravascular photoacoustic imaging of human coronary atherosclerotic plaque. We specifically imaged lipid content, a key factor in vulnerable plaques that may lead to myocardial infarction. An integrated intravascular photoacoustics (IVPA) and ultrasound (IVUS) catheter with an outer diameter of 1.25 mm was developed. The catheter comprises an angle-polished optical fiber adjacent to a 30 MHz single-element transducer. The ultrasonic transducer was optically isolated to eliminate artifacts in the PA image. We performed measurements on a cylindrical vessel phantom and isolated point targets to demonstrate its imaging performance. Axial and lateral point spread function widths were 110 μm and 550 μm, respectively, for PA and 89 μm and 420 μm for US. We imaged two fresh human coronary arteries, showing different stages of disease, ex vivo. Specific photoacoustic imaging of lipid content, is achieved by spectroscopic imaging at different wavelengths between 1180 and 1230 nm.

  12. INTRAVASCULAR ENDOTHELIOMA (ENDOTHELIOMA IN SITU, SYSTEMIC ENDOTHELIOMATOSIS).

    Science.gov (United States)

    HABER, H; HARRIS-JONES, J N; WELLS, A L

    1964-11-01

    A woman aged 48 years was found to be suffering from intravascular endothelioma. The initial clinical presentation was the presence of red, painless swellings in the skin of the lower limbs. The other clinical features, and the histological changes in skin biopsies, are described and compared with those in the two previously reported patients. It is suggested that the condition is analogous to the pre-invasive carcinomatous states.

  13. Radiotherapy and brachytherapy

    International Nuclear Information System (INIS)

    2007-02-01

    This presentation first defines the radiotherapy and brachytherapy techniques, indicates the used ionizing radiations (electromagnetic and particles), describes the mechanisms and processes of action of ionizing radiations: they can be physical by photon-matter interactions (Compton effect and photoelectric effect) or due to electron-matter interactions (excitation, ionization), physical-chemical by direct or indirect action (DNA damage), cellular (mitotic or apoptotic death), tissue (sane and tumorous tissues and differential effect). It discusses the biological efficiency of these treatments which depends on different parameters: intrinsic radio-sensitivity, time (session fractioning and organisation in time), oxygen, radiation quality, cellular cycle, dose rate, temperature. It presents the different types of radiotherapy: external radiotherapy (general sequence, delineation, dosimetry, protection of critical organs, treatment session, quality control, monitoring consultation) and briefly presents some specific techniques (total body irradiation, total cutaneous electron therapy, pre-operation radiotherapy, radio-surgery, hadron-therapy). It proposes an overview of the main indications for this treatment: brain tumours, upper aero digestive tract tumours, bronchial tumours, oesophagus, stomach and pancreas tumours, breast tumours, cervix cancer, rectum tumour, and so on, and indicates the possible associated treatments. The next part addresses brachytherapy. It presents the principles and comments the differences with radiotherapy. It indicates the used radio-elements (Caesium 137, Iridium 192, Iodine 125), describes the implementation techniques (plastic tubes, use of iodine 125, intracavitary and endo-luminal radiation therapy). It proposes an overview of the different treated tumours (skin, breast, prostates, bronchial, oesophagus, ENT) and indicates possible early and late secondary effects for different organs

  14. Preparation and evaluation of various 32P sources for intravascular brachytherapy

    International Nuclear Information System (INIS)

    Petelenz, B.U.; Bilski, P.; Ochab, E.; Rajchel, B.; Styczen, J.; Walichiewicz, P.; Wodniecki, J.; Wilczek, K.

    2001-01-01

    A relatively high per cent of restenoses, being a long-term complication of percutaneous transluminal coronary angioplasty (PTCA), can be significantly reduced by short-range ionizing radiation applied locally, immediately after PTCA. In search for dosimetrically favourable and easy to handle radiation sources for this purpose, we tried a pure β - emitter 32 P (t 1/2 =14.3 days). Ways of preparation of 32 P sources were the following: (1) Neutron activation of 31 P layers implanted into metallic surfaces by ionic methods; (2) Conversion coating of metallic surfaces in aqueous solutions containing 32 PO 4 3- ions; (3) Direct application of Na 2 H 32 PO 4 solutions in the angioplasty balloon. It was shown that: (1) 32 P sources obtained by 31 P ion implantation followed by neutron activation can be useful, but only if activation of the support material by thermal neutrons is negligible; (2) Phosphate layers on stainless steel surface exhibit rather poor adhesion. Similar layers on titanium require further studies; (3) Liquid 32 P sources ensure very good radial dose distribution but only utmost care in filling the balloon can give a reliable activity-dose dependence. Dosimetry of liquid sources, performed in a PMMA phantom by thermoluminescence method showed that 32 P sources of radioactive concentration of 200 MBq/cm 3 can deposit therapeutic dose during about 12 min of exposition. TL detectors manufactured for this purpose in our laboratory show very good spatial resolution and can be recommended for similar studies. (author)

  15. Erectile function after prostate brachytherapy

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Wallner, Kent E.; Galbreath, Robert W.; Anderson, Richard L.; Kurko, Brian S.; Lief, Jonathan H.; Allen, Zachariah A.

    2005-01-01

    Purpose: To evaluate erectile function after permanent prostate brachytherapy using a validated patient-administered questionnaire and to determine the effect of multiple clinical, treatment, and dosimetric parameters on penile erectile function. Methods and materials: A total of 226 patients with preimplant erectile function determined by the International Index of Erectile Function (IIEF) questionnaire underwent permanent prostate brachytherapy in two prospective randomized trials between February 2001 and January 2003 for clinical Stage T1c-T2c (2002 American Joint Committee on Cancer) prostate cancer. Of the 226 patients, 132 were potent before treatment and, of those, 128 (97%) completed and returned the IIEF questionnaire after brachytherapy. The median follow-up was 29.1 months. Potency was defined as an IIEF score of ≥13. The clinical, treatment, and dosimetric parameters evaluated included patient age; preimplant IIEF score; clinical T stage; pretreatment prostate-specific antigen level; Gleason score; elapsed time after implantation; preimplant nocturnal erections; body mass index; presence of hypertension or diabetes mellitus; tobacco consumption; the volume of the prostate gland receiving 100%, 150%, and 200% of the prescribed dose (V 100/150/200 ); the dose delivered to 90% of the prostate gland (D 90 ); androgen deprivation therapy; supplemental external beam radiotherapy (EBRT); isotope; prostate volume; planning volume; and radiation dose to the proximal penis. Results: The 3-year actuarial rate of potency preservation was 50.5%. For patients who maintained adequate posttreatment erectile function, the preimplant IIEF score was 29, and in patients with brachytherapy-related ED, the preimplant IIEF score was 25. The median time to the onset of ED was 5.4 months. After brachytherapy, the median IIEF score was 20 in potent patients and 3 in impotent patients. On univariate analysis, the preimplant IIEF score, patient age, presence of nocturnal

  16. Hypothesis: Disseminated Intravascular Inflammation as the Inflammatory Counterpart to Disseminated Intravascular Coagulation

    Science.gov (United States)

    Bull, Brian S.; Bull, Maureen H.

    1994-08-01

    We have identified a leukocyte activation syndrome that is occasionally associated with the transfusion of intraoperatively recovered erythrocytes. This syndrome appears to result from intravascular damage caused by leukocytes activated during the erythrocyte salvage process. We hypothesize that this syndrome is part of a larger disease grouping: disseminated intravascular inflammation (DII). DII is the analog of the coagulation disorder disseminated intravascular coagulation. In disseminated intravascular coagulation, the organ damage results from uncontrolled activation of the clotting pathway; in DII the damage is caused by leukocytes that have become activated by direct contact with bacteria or in rare instances-such as erythrocyte salvage-in the absence of bacteria and bacterial products. Recent studies of the hazards associated with intraoperative blood salvage indicate that activation of leukocytes can be achieved by exposure to activated platelets alone. If such activated leukocytes are reinfused along with the washed erythrocytes, widespread organ damage may result. The lung is the organ most severely affected by activated leukocytes. Adult respiratory distress syndrome is one outcome. It is likely that DII is a presently unrecognized pathophysiological process that complicates a variety of primary disease states and increases their lethality.

  17. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    Science.gov (United States)

    Yamashita, Shuji; Narushima, Mitsunaga; Koshima, Isao; Miyamoto, Shimpei

    2017-01-01

    Background: Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined its usefulness. Methods: Between January 2013 and February 2015, 11 anastomoses in 11 cases of lymphaticovenular anastomosis for lymphedema patients, 14 anastomoses in 7 cases of free perforator flap transfer with supermicrosurgical perforator-to-perforator anastomosis, and 9 anastomoses in 5 cases of fingertip replantation were performed using hemi-IVaS. Time required for anastomosis and complications were examined. Flap survival rate was also examined in free perforator flap transfer cases and fingertip replantation cases. Results: In all cases, anastomoses were performed without complications such as inadvertent catching of the back wall of the vessel during the procedure or the need for reanastomoses. The average time required to complete the anastomosis was 16.4 ± 3.20 minutes using the hemi IVaS technique. All flaps survived in the supermicrosurgical perforator-to-perforator anastomosis as well as fingertip replantation cases. Conclusions: Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery. PMID:29263952

  18. Intravascular haemolysis: a potential missed diagnosis.

    Science.gov (United States)

    Sinclair, David; Briston, Philip; Rutland, Emma

    2002-01-01

    Raised serum bilirubin is a common finding as part of a routine "liver function test" profile. This case describes a patient with a raised serum bilirubin that was eventually found to be caused by intravascular haemolysis. The tests that confirmed the cause were instigated by clinical biochemistry staff but not before the patient had undergone unnecessary invasive procedures and had the diagnosis delayed by some time. The case is a reminder to biochemistry and haematology laboratories and clinical staff to investigate the possibility of haemolysis as well as hepatitis and Gilbert's disease as a cause of an isolated raised bilirubin.

  19. Intravascular imaging with a storage phosphor detector

    Science.gov (United States)

    Shikhaliev, Polad M.; Petrek, Peter; Matthews, Kenneth L., II; Fritz, Shannon G.; Bujenovic, L. Steven; Xu, Tong

    2010-05-01

    The aim of this study is to develop and test an intravascular positron imaging system based on a storage phosphor detector for imaging and detecting vulnerable plaques of human coronary arteries. The radiotracer F18-FDG accumulates in vulnerable plaques with inflammation of the overlying cap. The vulnerable plaques can, therefore, be imaged by recording positrons emitted from F18-FDG with a detector inserted into the artery. A prototype intravascular detector was constructed based on storage phosphor. The detector uses a flexible storage phosphor tube with 55 mm length, 2 mm diameter and 0.28 mm wall thickness. The intravascular detector is guided into the vessel using x-ray fluoroscopy and the accumulated x-ray signal must be erased prior to positron imaging. For this purpose, a light diffuser, 0.9 mm in diameter and 55 mm in length, was inserted into the detector tube. The light diffuser was connected to a laser source through a 2 m long optical fiber. The diffuser redirected the 0.38 W laser light to the inner surface of the phosphor detector to erase it. A heart phantom with 300 cm3 volume and three coronary arteries with 3.2 mm diameter and with several plaques was constructed. FDG solution with 0.5 µCi cm-3 activity concentration was filled in the heart and coronary arteries. The detector was inserted in a coronary artery and the signal from the plaques and surrounding background activity was recorded for 2 min. Then the phosphor detector was extracted and read out using a storage phosphor reader. The light diffuser erased the signal resulting from fluoroscopic exposure to level below that encountered during positron imaging. Vulnerable plaques with area activities higher than 1.2 nCi mm-2 were visualized by the detector. This activity is a factor of 10-20 lower than that expected in human vulnerable plaques. The detector was able to image the internal surface of the coronary vessels with 50 mm length and 360° circumference. Spatial resolution was 0

  20. Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

    NARCIS (Netherlands)

    Maresca, D.; Adams, S.; Maresca, B.; Van der Steen, A.F.W.

    2014-01-01

    Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound

  1. Mapping intravascular ultrasound controversies in interventional cardiology practice

    NARCIS (Netherlands)

    Maresca, David; Adams, Samantha; Maresca, Bruno; van der Steen, Antonius F W

    2014-01-01

    Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound

  2. Role of informed consent for intravascular contrast media

    International Nuclear Information System (INIS)

    Hopper, K.D.; Tyler, H.N. Jr.

    1988-01-01

    To evaluate the usefulness of different degrees of informed consent for intravascular contrast media, the authors divided 100 patients into four groups: (1) informed consent with no information on intravascular contrast media, (2) simple written informed consent that detailed common risks, (3) detailed written informed consent that detailed all known risks, and (4) MD informed consent, during which a radiologist discussed all known risks of intravascular contrast media. Physician counseling time for group 4 averaged 11.4 minutes. On a postprocedure test about the common complications and risk factors of intravascular contrast media, the average scores were: group 1, 38.4%; group 2, 68.2%; group 3, 63.2%; and group 4, 69.8%. There was no statistical difference between groups 2-4 on the postprocedure test. If informed consent is to be used prior to intravascular contrast media administration, a simple written consent detailing the common risks and risk factors appears to be the best method

  3. Calculo de la Barra Antivuelco de un Vehículo Automotor.

    Directory of Open Access Journals (Sweden)

    Javier García de la Figal

    2005-09-01

    Full Text Available El presente trabajo trata acerca del calculo de la barra antivuelco del FORD modelo A, desarrollado por elInstituto de Desarrollo Automotriz, IDA, teniendo en cuenta las fuerzas que la cinta de seguridad de losautomovilistas, ejerce sobre la citada barra, ante un choque que provoca una aceleración de 20 g en elvehículo. El calculo se hace mediante la confección de un modelo de elementos finitos de la barra y lacarrocería, para lo cual se hace uso de un programa profesional de elementos finitos.Se determinan los esfuerzos máximos y los equivalentes, tanto de las partes metálicas del sistema, queson fundamentalmente tubos de acero, como de las partes de material compuesto (poliéster con fibras devidrio E, propios de la carrocería del vehículo. Todo lo cual permite hacer los cálculos y comprobacionesa resistencia de todo el conjunto. Así mismo, se determinan los desplazamientos en todos los sentidos detodos las partes del sistema, para poder realizar los correspondientes análisis de rigidez.El objetivo final de todos los análisis es determinar lo adecuado o no de las soluciones y materialespropuestos para el sistema, bajo la acción de la citada carga de impacto.

  4. Recommendations of the EVA GEC ESTRO Working Group: prescribing, recording, and reporting in endovascular brachytherapy. Quality assurance, equipment, personnel and education

    International Nuclear Information System (INIS)

    Poetter, Richard; Limbergen, Erik van; Dries, Wim; Popowski, Youri; Coen, Veronique; Fellner, Claudia; Georg, Dietmar; Kirisits, Christian; Levendag, Peter; Marijnissen, Hans; Marsiglia, Hugo; Mazeron, Jean-Jaques; Pokrajac, Boris; Scalliet, Pierre; Tamburini, Vittorio

    2001-01-01

    Endovascular brachytherapy is a new, rapidly growing field of interest in radiotherapy for the prevention of neointimal hyperplasia after angioplasty in both coronary and peripheral arteries. Many physics aspects of these treatments have already been addressed in the report of the American Association of Physicists in Medicine task group on 'Intravascular brachytherapy', but up to now there are no generally accepted recommendations for recording and reporting radiation doses and volumes. The terminology to be used by all individuals involved in such treatments (radiation oncologists, physicists, and interventionalists) is not clearly defined. The Endovascular Groupe Europeen de Curietherapie/European Society for Therapeutic Radiology and Oncology Working Group in this document presents recommendations for a common language for general use in endovascular brachytherapy. This proposal addresses general terms and concepts for target and dose specification as well as detailed recommendations for dose prescription, recording and reporting in endovascular brachytherapy for both peripheral and coronary arteries. Additionally, quality assurance and radiation safety aspects are briefly addressed, as are aspects related to equipment, personnel, and training and education related to endovascular brachytherapy

  5. Discrimination of intravascular lumen and dissections in single intravascular ultrasound images using subtraction, conventional averaging and saline flush

    NARCIS (Netherlands)

    G. Pasterkamp (Gerard); M.S. van der Heiden (M.); M.J. Post (Mark); C. Borst (Cornelius); E.J. Gussenhoven (Elma); H. Pieterman; H. van Urk (Hero); N. Bom (Klaas)

    1995-01-01

    textabstractWith current 30-MHz intravascular ultrasound systems, flowing blood may cause considerable backscatter which in real-time images is characterized by dynamic speckle. However, in a single intravascular ultrasound image (still-frame) the discrimination between arterial lumen and wall may

  6. Brachytherapy dosimeter with silicon photomultipliers

    Energy Technology Data Exchange (ETDEWEB)

    Moutinho, L.M., E-mail: moutinho@ua.pt [i3N, Physics Department, University of Aveiro (Portugal); Castro, I.F.C. [i3N, Physics Department, University of Aveiro (Portugal); Peralta, L. [Faculdade de Ciências da Universidade de Lisboa (Portugal); Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Lisboa (Portugal); Abreu, M.C. [Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Lisboa (Portugal); Veloso, J.F.C.A. [i3N, Physics Department, University of Aveiro (Portugal)

    2015-07-01

    In-vivo and in-situ measurement of the radiation dose administered during brachytherapy faces several technical challenges, requiring a very compact, tissue-equivalent, linear and highly sensitive dosimeter, particularly in low-dose rate brachytherapy procedures, which use radioactive seeds with low energy and low dose deposition rate. In this work we present a scintillating optical fiber dosimeter composed of a flexible sensitive probe and a dedicated electronic readout system based on silicon photomultiplier photodetection, capable of operating both in pulse and current modes. The performance of the scintillating fiber optic dosimeter was evaluated in low energy regimes, using an X-ray tube operating at voltages of 40–50 kV and currents below 1 mA, to assess minimum dose response of the scintillating fiber. The dosimeter shows a linear response with dose and is capable of detecting mGy dose variations like an ionization chamber. Besides fulfilling all the requirements for a dosimeter in brachytherapy, the high sensitivity of this device makes it a suitable candidate for application in low-dose rate brachytherapy. According to Peralta and Rego [1], the BCF-10 and BCF-60 scintillating optical fibers used in dosimetry exhibit high variations in their sensitivity for photon beams in the 25–100 kVp energy range. Energy linearity for energies below 50 keV needs to be further investigated, using monochromatic X-ray photons.

  7. Brachytherapy of choroidal melanomas

    International Nuclear Information System (INIS)

    Brady, L.W.; Hernandez, J.C.

    1992-01-01

    In a compilation of nine reported series consisting of 2,024 enucleations, the five- and ten-year survivals following surgery were 63% and 43%, respectively. The 25-year survival has been reported to be 40%. In 1974 at Wills Eye Hospital and Hahnemann University, the cobalt-60 plaques technique was introduced. During the following years, other radioactive isotopes were introduced including irridium-192, iodine-125, ruthenium-106/rhodium-106 and more recently palladium-103. At the present time, iodine-125 is the most widely used radionuclide. Until now, 302 patients treated with plaque brachytherapy showed an actuarial survival of 77% and 67.8% at five and eight years, respectively. There was no significant survival difference when compared with a similar group of patients undergoing enucleation. Other retrospective studies show similar excellent results. In spite of these convincing results, the decision making process in management melanoma remains unsettled primarily due to the absence of prospective randomized trials. Because of this, the Collaborative Ocular Melanoma Study was initiated. From the standpoint of toxicity, the data are available on ocular radiation toxicity. In an analysis of 77 patients from the Wills Eye Hospital with pretreatment visual acuities of 20/25 or better, it was noted that 90% of patients who had received less than 500 Gy to the fovea retained visual acuity of 20/200 or better while only 52% of patients receiving more than 5,000 Gy to the fovea had vision of 20/200 or better. A serious late effect of radioactivity plaque treatment is scleral necrosis which may require repair or enucleation even in the absence of tumor progression. Enucleation may be necessary in approximately 10% of patients. We conclude that malignant melanoma of the uvea can be safely treated with radioactive plaques. (orig./MG) [de

  8. Intravascular catheter-related bloodstream infection.

    Science.gov (United States)

    Shah, Harshal; Bosch, Wendelyn; Thompson, Kristine M; Hellinger, Walter C

    2013-07-01

    Intravascular catheters required for the care of many hospitalized patients can give rise to bloodstream infection, a complication of care that has occurred most frequently in intensive care unit (ICU) settings. Elucidation of the pathogenesis of catheter-related bloodstream infections (CRBSIs) has guided development of effective diagnostic, management, and prevention strategies. When CRBSIs occur in the ICU, physicians must be prepared to recognize and treat them. Prevention of these infections requires careful attention to optimal catheter selection, insertion and maintenance, and to removal of catheters when they are no longer needed. This review provides a succinct summary of the epidemiology, pathogenesis, and microbiology of CRBSIs and a review of current guidance for the diagnosis, management, and prevention of these infections.

  9. Death following intravascular administration of contrast media

    International Nuclear Information System (INIS)

    Shehadi, W.H.

    1985-01-01

    Adverse reactions to intravascularly administered contrast media preceding death and the autopsy findings in 44 patients are presented. There is a wide scatter of the age distribution of fatal reactions. The highest incidence is in the 50-70 year age group. Similar observations were obtained from the 405 deaths due to contrast media reported to the Food and Drug Administration of the United States. In the same age group the number of reactions is highest, likewise the autopsy findings. The predominant autopsy findings are pulmonary edema, congestion and hemorrhage; arteriosclerosis, both general and coronary. In the younger age group the autopsy findings are limited mostly to the respiratory tract. Fatal reactions to contrast media occur often without warning and most deaths occur within 15 min to 6 hours. Reactions to contrast media occur without relation to sex or age. (orig.)

  10. Quinine-Induced Disseminated Intravascular Coagulation

    Directory of Open Access Journals (Sweden)

    Firas Abed

    2016-01-01

    Full Text Available Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC, albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence.

  11. Chronic Disseminated Intravascular Coagulation: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Abul Kalam Azad

    2009-11-01

    Full Text Available In health there is a balance between the coagulation and anti-coagulation systems, but in disseminated intravascular coagulation (DIC the coagulation mechanism is activated inappropriately and in a diffuse way. This may lead to thrombosis, but more often haemorrhage occurs when the clotting factors are exhausted. DIC may present as acute, subacute, and rarely chronic form. Here we present a case of chronic DIC following pelvic inflammatory disease (PID as a consequence of repeated menstruation regulation (MR. We treated her with fresh frozen plasma, fresh blood, doxycycline with significant clinical improvement.DOI: 10.3329/bsmmuj.v1i1.3696 BSMMU J 2008; 1(1: 33-34

  12. Ventricular metastasis resulting in disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Davis Ian D

    2005-05-01

    Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

  13. Education and Propagation of Intravascular Surgery in Okinawa

    Science.gov (United States)

    Harakuni, T.; Hyodo, A.; Shingaki, T.; Kugai, M.; Kinjyo, T.; Kinjyo, T.; Tsuchida, H.; Sugimoto, K.; Yoshii, Y.

    2004-01-01

    Summary Okinawa is an island located on the southwest edge of the Japanese Islands in which about 1,300,000 people live, and is an area where self-conclusion type medical treatment is desired. In this area, intravascular surgery was only performed for several cases per year until 1998. From May 1999, intravascular surgery started being performed in earnest, and 140 or more cases of intravascular surgery per year were performed in 2002. In the meantime, various measures for the propagation and development of intravascular surgery that we undertook led to the increase in the number of cases. As a result, the choice of medical treatment has increased by propagating these medical treatments, and it seems that this has contributed to the welfare of the people of Okinawa. PMID:20587285

  14. Physical aspects of radioisotope brachytherapy

    International Nuclear Information System (INIS)

    1967-01-01

    The present report represents an attempt to provide, within a necessarily limited compass, an authoritative guide to all important physical aspects of the use of sealed gamma sources in radiotherapy. Within the report, reference is made wherever necessary to the more extensive but scattered literature on this subject. While this report attempts to cover all the physical aspects of radioisotope 'brachytherapy' it does not, of course, deal exhaustively with any one part of the subject. 384 refs, 3 figs, 6 tabs

  15. [Which modality for prostate brachytherapy?].

    Science.gov (United States)

    Bossi, A

    2010-10-01

    Brachytherapy techniques by permanent implant of radioactive sources or by temporary high-dose-rate (HDR) fractions are nowadays extensively used for the treatment of prostatic carcinoma. Long-term results (at 20 years) concerning large amount of patients have been published by major centers confirming both in terms of efficacy and toxicities that permanent implant of radioactive iodine-125 seeds yields at least the same good results of surgery and of external beam irradiation when proposed to patients affected by low-risk disease. For intermediate to high-risk tumors, HDR temporary implants are proposed as a boost for dose escalation. For both techniques, several topics still need to be clarified dealing with a recent enlargement of indications (HDR alone for low-risk, iodine-125 seeds boost for intermediate-high-risk cancers), or with technical aspects (loose seeds versus linked ones, number of fractions and dose for HDR protocols), while dosimetric issues have only recently been addressed by cooperatives groups. Last but not least, there is a real need to address and clearly characterize the correct definition of biochemical disease control both for iodine permanent implant and for HDR implant. New challenges are facing the prostate-brachytherapy community in the near future: local relapse after external beam radiotherapy are currently managed by several salvage treatments (prostatectomy, cryo, high intensity focused ultrasounds [HIFU]) but the role of reirradiation by brachytherapy is also actively investigated. Focal therapy has gained considerable interest in the last 5 years aiming at treating only the area of cancer foci inside the prostate and preserving nearby healthy tissues. Encouraging results have been obtained with the so-called "minimally invasive" approaches and both permanent seed implantation and HDR brachytherapy techniques may be worthwhile testing in this setting because of their capability of exactly sculpting the dose inside the prostatic

  16. Radiation safety and gynaecological brachytherapy

    International Nuclear Information System (INIS)

    Crawford, L.

    1985-01-01

    In 1983, the Radiation Control Section of the South Australian Health Commission conducted an investigation into radiation safety practices in gynaecological brachytherapy. Part of the investigation included a study of the transportation of radioactive sources between hospitals. Several deficiences in radiation safety were found in the way these sources were being transported. New transport regulations came into force in South Australia in July 1984 and since then there have been many changes in the transportation procedure

  17. Definitive Brachytherapy for Kaposi's Sarcoma

    International Nuclear Information System (INIS)

    Williams, A.; Ezzell, G.; Zalupski, M.; Fontanesi, J.

    1996-01-01

    Purpose: To assess the efficacy and possible complications in patients diagnosed with Kaposi's sarcoma and treated with definitive brachytherapy. Methods and Materials: Between January, 1995 and December, 1995, four patients with Kaposi's sarcoma (KS) were treated with brachytherapy. Three patients, all with positive HIV status were treated using Iridium 192 (Ir-192) sources via a high-dose rate remote afterloader. One patient with endemic KS was treated using the application of catheters loaded with Californium 252. Eight sites were treated and included scalp, feet, nose, penis, hand, neck, and back. Dose rate for Ir-192 was 330cGy/fx to a total dose of 990cGy. The Californium was delivered as 100nGy/b.i.d. to a total dose of 900nGy. Follow-up as ranged from 2-6 months. Results: All four patients remain alive. Seven of eight sites have had complete clinical response and each patient has reported durable pain relief that has not subsided through last follow-up of 1/96. Two of eight sites, both treated with surface mold technique with Californium 252 developed moist desquamation. The remaining six sites did not demonstrate significant toxicity. Conclusion: Brachytherapy can offer Kaposi's sarcoma patients results that are equivalent to external beam radiation therapy, with minimal complications, a shorter treatment time and potential cost effectiveness

  18. Algorithm for the calculation of a steam generator efficiency; Algoritmo para el calculo de la eficiencia de un generador de vapor

    Energy Technology Data Exchange (ETDEWEB)

    Franco, David; Ambriz, Juan Jose; Romero Paredes, Hernando [Universidad Autonoma Metropolitana-Iztapalapa, Mexico, D. F. (Mexico)

    1994-12-31

    The efficiency calculation of steam generators is not always simple. The purpose of this paper is to propose an algorithm for the calculation of steam generators efficiency, easy to understand and carry out, in the form of a series of steps to be followed. It takes as starting point that the person in charge of applying these calculations has knowledge of the combustion processes and thermodynamic principles that rule such processes. [Espanol] El calculo de la eficiencia de los generadores de vapor no siempre es sencillo, el presente trabajo tiene como objetivo el de proponer un algoritmo de calculo de eficiencia de generadores de vapor, el cual sea facil de entender y de llevar a cabo, en forma de una serie de pasos a seguir. Se toma como punto de partida, que la persona encargada de aplicar estos calculos tenga el conocimiento de los procesos de combustion y principios termodinamicos que rigen tales procesos.

  19. Afterloading: The Technique That Rescued Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Aronowitz, Jesse N., E-mail: jesse.aronowitz@umassmemorial.org

    2015-07-01

    Although brachytherapy had been established as a highly effective modality for the treatment of cancer, its application was threatened by mid-20th century due to appreciation of the radiation hazard to health care workers. This review examines how the introduction of afterloading eliminated exposure and ushered in a brachytherapy renaissance.

  20. Interstitial prostate brachytherapy. LDR-PDR-HDR

    International Nuclear Information System (INIS)

    Kovacs, Gyoergy; Hoskin, Peter

    2013-01-01

    The first comprehensive overview of interstitial brachytherapy for the management of local or locally advanced prostate cancer. Written by an interdisciplinary team who have been responsible for the successful GEC-ESTRO/EAU Teaching Course. Discusses in detail patient selection, the results of different methods, the role of imaging, and medical physics issues. Prostate brachytherapy has been the subject of heated debate among surgeons and the proponents of the various brachytherapy methods. This very first interdisciplinary book on the subject provides a comprehensive overview of innovations in low dose rate (LDR), high dose rate (HDR), and pulsed dose rate (PDR) interstitial brachytherapy for the management of local or locally advanced prostate cancer. In addition to detailed chapters on patient selection and the use of imaging in diagnostics, treatment guidance, and implantation control, background chapters are included on related medical physics issues such as treatment planning and quality assurance. The results obtained with the different treatment options and the difficult task of salvage treatment are fully discussed. All chapters have been written by internationally recognized experts in their fields who for more than a decade have formed the teaching staff responsible for the successful GEC-ESTRO/EAU Prostate Brachytherapy Teaching Course. This book will be invaluable in informing residents and others of the scientific background and potential of modern prostate brachytherapy. It will also prove a useful source of up-to-date information for those who specialize in prostate brachytherapy or intend to start an interstitial brachytherapy service.

  1. Intravascular Large B-Cell Lymphoma

    Directory of Open Access Journals (Sweden)

    Maria S. Khan MD, FACP

    2014-03-01

    Full Text Available Case Presentation . A 69-year-old Hispanic male, with a past history of diabetes and coronary disease, was admitted for fever, diarrhea, and confusion of 4 weeks duration. Physical examination showed a disoriented patient with multiple ecchymoses, possible ascites, and bilateral scrotal swelling. Hemoglobin was 6.7, prothrombin time (PT 21.4 seconds with international normalized ratio 2.1, partial thromboplastin time (PTT 55.6 seconds, fibrin split 10 µg/L, and lactate dehydrogenase (LDH 1231 IU/L. Except for a positive DNA test for Epstein–Barr virus (EBV infection, extensive diagnostic workup for infections, malignancy, or a neurological cause was negative. Mixing studies revealed a nonspecific inhibitor of PT and PTT but Factor VIII levels were normal. The patient was empirically treated with antibiotics but developed hypotension and died on day 27 of admission. At autopsy, patient was found to have intravascular diffuse large B-cell lymphoma involving skin, testes, lung, and muscles. The malignant cells were positive for CD20, CD791, Mum-1, and Pax-5 and negative for CD3, CD5, CD10, CD30, and Bcl-6. The malignant cells were 100% positive for Ki-67. Discussion . Intravascular large cell B-cell lymphoma (IVLBCL is rare form of diffuse large B-cell lymphoma and tends to proliferate within small blood vessels, particularly capillaries and postcapillary venules. The cause of its affinity for vascular bed remains unknown. In many reports, IVLBCL was associated with HIV, HHV8, and EBV infections. The fact that our case showed evidence of EBV infection lends support to the association of this diagnosis to viral illness. The available literature on this subject is scant, and in many cases, the diagnosis was made only at autopsy. The typical presentation of this disorder is with B symptoms, progressive neurologic deficits, and skin findings. Bone marrow, spleen, and liver are involved in a minority of patients. Nearly all patients have elevated LDH

  2. Dynamic rotating-shield brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yunlong [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 (United States); Flynn, Ryan T.; Kim, Yusung [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Yang, Wenjun [Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Wu, Xiaodong [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 and Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)

    2013-12-15

    Purpose: To present dynamic rotating shield brachytherapy (D-RSBT), a novel form of high-dose-rate brachytherapy (HDR-BT) with electronic brachytherapy source, where the radiation shield is capable of changing emission angles during the radiation delivery process.Methods: A D-RSBT system uses two layers of independently rotating tungsten alloy shields, each with a 180° azimuthal emission angle. The D-RSBT planning is separated into two stages: anchor plan optimization and optimal sequencing. In the anchor plan optimization, anchor plans are generated by maximizing the D{sub 90} for the high-risk clinical-tumor-volume (HR-CTV) assuming a fixed azimuthal emission angle of 11.25°. In the optimal sequencing, treatment plans that most closely approximate the anchor plans under the delivery-time constraint will be efficiently computed. Treatment plans for five cervical cancer patients were generated for D-RSBT, single-shield RSBT (S-RSBT), and {sup 192}Ir-based intracavitary brachytherapy with supplementary interstitial brachytherapy (IS + ICBT) assuming five treatment fractions. External beam radiotherapy doses of 45 Gy in 25 fractions of 1.8 Gy each were accounted for. The high-risk clinical target volume (HR-CTV) doses were escalated such that the D{sub 2cc} of the rectum, sigmoid colon, or bladder reached its tolerance equivalent dose in 2 Gy fractions (EQD2 with α/β= 3 Gy) of 75 Gy, 75 Gy, or 90 Gy, respectively.Results: For the patients considered, IS + ICBT had an average total dwell time of 5.7 minutes/fraction (min/fx) assuming a 10 Ci{sup 192}Ir source, and the average HR-CTV D{sub 90} was 78.9 Gy. In order to match the HR-CTV D{sub 90} of IS + ICBT, D-RSBT required an average of 10.1 min/fx more delivery time, and S-RSBT required 6.7 min/fx more. If an additional 20 min/fx of delivery time is allowed beyond that of the IS + ICBT case, D-RSBT and S-RSBT increased the HR-CTV D{sub 90} above IS + ICBT by an average of 16.3 Gy and 9.1 Gy, respectively

  3. [Intravascular lymphomatosis. A report of three cases].

    Science.gov (United States)

    Menéndez Calderón, M J; Seguí Riesco, M E; Argüelles, M; Nuño Mateo, J

    2005-01-01

    Intravascular lymphomatosis (IVL) is a rare malignancy characterized by a proliferation of atypical lymphoid cells occluding small blood vessels (venules, capillaries and small arteries). The symptoms are caused by embolisms due to massive proliferation. Nervous system and skin are the most common sites of involvement but all organs may be involved, although it is typified by the absence of malignant cells in lymphoid tissues. We describe three cases of IVL: first patient was a 57 years old man with rapidly progressive dementia and neurological involvements and second case of a 69 years old man hospitalised with predominant symptoms in the lung (cough, dyspnea and fever), and a woman presenting as fever of unknown origin (FUO) with systemic inflammatory response syndrome. In all cases that we reported have been diagnosed post-mortem because of rapid progression of a multisystem disease and the absence of pathognomonic clinical manifestations. Diagnosis can be made using biopsy of one of the involved organs. In conclusion, we propose that IVL should be included in the differential diagnosis of acute confusional state, dementia or other unexplained neurological manifestations, fever of unknown origin, vasculitis, occult neoplasia or infections with signs of a systemic disease and marked elevation of serum lactate dehydrogenase (LDH).

  4. Disseminated intravascular coagulation in solid tumors

    International Nuclear Information System (INIS)

    Terzieff, V.; Alonso, I.; Vázquez, A.

    2004-01-01

    It is estimated that 20-25% of cases of disseminated intravascular coagulation (DIC) relate to an underlying neoplasia primarily hematologic. It is estimated that about 5% of patients with solid tumors have CID clinic, although the incidence of subclinical alterations is much higher. The CID is not limited to the activation of the coagulation cascade, which leads to bleeding micro thrombosis and consumption of coagulation factors. Solid tumors are frequently associated adenocarcinomas producers mucin (especially gastric), usually in the context of a disseminated disease. The mucin may act as a promoter of the cascade, but probably it is a multi-event. High levels of TNF to produced by the tumor mass and chemotherapy-induced cell lysis have Also linked. Although the bleeding is usually oriented diagnosis, the most frequent cause of death is thrombosis. There are no specific tests for diagnosis. Elevated levels of D-dimer and products oriented fibrinogen degradation diagnosis. No reduction fibrinogen and almost always, one thrombocytopenia consumption. Treatment is complex and there is no consensus on many points. To recover the lost factors for consumption, it is recommended to use fresh frozen plasma and / or washed red blood cells. the heparin anticoagulation low dose is indicated since the disease causal can not be controlled quickly, but should not be initiated if there thrombocytopenia 50.000.El under profuse bleeding can require the use of tranexamic acid or EACA. Acute DIC, the case of our patient, is rare and very serious

  5. Rotational multispectral fluorescence lifetime imaging and intravascular ultrasound: bimodal system for intravascular applications

    Science.gov (United States)

    Ma, Dinglong; Bec, Julien; Yankelevich, Diego R.; Gorpas, Dimitris; Fatakdawala, Hussain; Marcu, Laura

    2014-06-01

    We report the development and validation of a hybrid intravascular diagnostic system combining multispectral fluorescence lifetime imaging (FLIm) and intravascular ultrasound (IVUS) for cardiovascular imaging applications. A prototype FLIm system based on fluorescence pulse sampling technique providing information on artery biochemical composition was integrated with a commercial IVUS system providing information on artery morphology. A customized 3-Fr bimodal catheter combining a rotational side-view fiberoptic and a 40-MHz IVUS transducer was constructed for sequential helical scanning (rotation and pullback) of tubular structures. Validation of this bimodal approach was conducted in pig heart coronary arteries. Spatial resolution, fluorescence detection efficiency, pulse broadening effect, and lifetime measurement variability of the FLIm system were systematically evaluated. Current results show that this system is capable of temporarily resolving the fluorescence emission simultaneously in multiple spectral channels in a single pullback sequence. Accurate measurements of fluorescence decay characteristics from arterial segments can be obtained rapidly (e.g., 20 mm in 5 s), and accurate co-registration of fluorescence and ultrasound features can be achieved. The current finding demonstrates the compatibility of FLIm instrumentation with in vivo clinical investigations and its potential to complement conventional IVUS during catheterization procedures.

  6. American Brachytherapy Society recommendations for reporting morbidity after prostate brachytherapy

    International Nuclear Information System (INIS)

    Nag, Subir; Ellis, Rodney J.; Merrick, Gregory S.; Bahnson, Robert; Wallner, Kent; Stock, Richard

    2002-01-01

    Purpose: To standardize the reporting of brachytherapy-related prostate morbidity to guide ongoing clinical practice and future investigations. Methods: Members of the American Brachytherapy Society (ABS) with expertise in prostate brachytherapy performed a literature review and, guided by their clinical experience, formulated specific recommendations for reporting on morbidity related to prostate brachytherapy. Results: The ABS recommends using validated, patient-administered health-related quality-of-life instruments for the determination of baseline and follow-up data regarding bowel, urinary, and sexual function. Both actuarial and crude incidences should be reported, along with the temporal resolution of specific complications, and correlated with the doses to the normal tissues. The International Prostate Symptom Score is recommended to assess urinary morbidity, and any dysuria, gross hematuria, urinary retention, incontinence, or medication use should be quantified. Likewise, the ''Sexual Health Inventory for Men,'' which includes the specific erectile questions of the International Index of Erectile Function, is the preferred instrument for reporting sexual function, and the loss of sexual desire, incidence of hematospermia, painful orgasm (orgasmalgia), altered orgasm intensity, decreased ejaculatory volume, use of erectile aids, and use of hormones for androgen deprivation should be quantified. The ABS recommends adoption of the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer acute and late radiation morbidity scoring scheme for reporting rectal morbidity and noting the incidence of rectal steroid, laser, or antidiarrheal use. Conclusion: It is important to focus on health-related quality-of-life issues in the treatment of prostate cancer, because the control rates are very similar between appropriate treatment modalities. The ABS recommends using the International Prostate Symptom Score, International Index of

  7. International Standardization of the Clinical Dosimetry of Beta Radiation Brachytherapy Sources: Progress of an ISO Standard

    Science.gov (United States)

    Soares, Christopher

    2006-03-01

    In 2004 a new work item proposal (NWIP) was accepted by the International Organization for Standardization (ISO) Technical Committee 85 (TC85 -- Nuclear Energy), Subcommittee 2 (Radiation Protection) for the development of a standard for the clinical dosimetry of beta radiation sources used for brachytherapy. To develop this standard, a new Working Group (WG 22 - Ionizing Radiation Dosimetry and Protocols in Medical Applications) was formed. The standard is based on the work of an ad-hoc working group initiated by the Dosimetry task group of the Deutsches Insitiut für Normung (DIN). Initially the work was geared mainly towards the needs of intravascular brachytherapy, but with the decline of this application, more focus has been placed on the challenges of accurate dosimetry for the concave eye plaques used to treat ocular melanoma. Guidance is given for dosimetry formalisms, reference data to be used, calibrations, measurement methods, modeling, uncertainty determinations, treatment planning and reporting, and clinical quality control. The document is currently undergoing review by the ISO member bodies for acceptance as a Committee Draft (CD) with publication of the final standard expected by 2007. There are opportunities for other ISO standards for medical dosimetry within the framework of WG22.

  8. What is the future of brachytherapy?

    International Nuclear Information System (INIS)

    Gerbaulet, A.P.

    1999-01-01

    This review first questions the future of brachytherapy, then briefly provides a retrospective account of its development. Before any decision is made to use brachytherapy, certain preliminary considerations must be examined thoroughly. Following this cautionary introduction, an assessment of the developments in this field over the past ten years is made via the results obtained from various surveys carried out in France. These results provide information regarding the principal indications for brachytherapy, and a breakdown of the data for the different treatment centres. This examination then leads to speculation regarding the future, and how these indications for brachytherapy and associated techniques could develop for the main tumour sites. The last part of this article covers the essential factors involved in the future of brachytherapy, i.e., clinical, radiobiological, imaging, quality control, radio-physical and technological considerations. These factors are closely related and often overlap. They are also included in the context of a more general discussion on brachytherapy compared to other therapeutic methods, and on the need to adopt a common language, without which no meaningful comparison of the results or quality of treatment is possible; the necessity for specific teaching of this subject is also advocated. In conclusion, the ethical and socio-economic problems encountered in medicine are discussed in the context of brachytherapy. (author)

  9. Fulminant intravascular lymphomatosis mimicking acute haemorrhagic leukoencephalopathy.

    Science.gov (United States)

    Marino, D; Sicurelli, F; Cerase, A; Tripodi, S; Cintorino, M; Lazzi, S; Federico, A

    2012-09-15

    Intravascular lymphomatosis (IVL) is a rare non-Hodgkin's lymphoma, usually of B cell lineage, characterized by massive angiotropic growth. The clinical presentation of IVL may include changes in mental status, non-localizing neurological deficits, seizures, fever of unknown origin and skin changes. Because of its rarity and the absence of specific diagnostic procedures except for cerebral biopsy, diagnosis is often postmortem. Brain MRI usually shows non-specific abnormalities. The purpose of this case report is to increase the knowledge of clinical and neuroimaging features of IVL by describing the findings observed in a 71-year-old patient. A 71-year-old male was admitted for right hemiparesis, acute cognitive impairment and febricula. A bone marrow biopsy resulted normal. He then developed a rapid progressive impairment of his mental status and left hemisoma motor seizures. Brain CT and MRI were interpreted as consistent with acute haemorrhagic leukoencephalopathy (AHLE), including multiple areas of restricted diffusion without gadolinium enhancement and a small focal area of gadolinium enhancement in the left temporal lobe white matter. The patient died within a few days and the autopsy led to the diagnosis of IVL. IVL may present with a variety of clinical signs and symptoms, including stroke and hemiparesis. IVL may mimic AHLE at brain MRI. However, the evidence of multiple areas of restricted diffusion without gadolinium enhancement and of a small area of gadolinium enhancement could have led to the correct diagnosis. IVL should be added to the differential diagnosis of AHLE at brain MRI. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Brachytherapy in cutaneous periocular tumors

    International Nuclear Information System (INIS)

    Petriz, L.; Sole, J.M.; Cinos, C.; Gutierrez, Bayard L.; Gutierrez, Miguelez C.; Rodriguez, D.

    1996-01-01

    INTRODUCTION: Cutaneous tumors are treated surgically or with radiotherapy. Similar local control and disease-free survival are been reported using the two arms mentioned. In cutaneous periocular tumors, surgery represents an anatomical and irreversible deformity in contrast from radiation therapy that preserves anatomical sites MATERIAL AND METHODS: From June 1993 to December 1995, 6 patients with cutaneous periocular tumors (1 dermatofibrosarcoma protuberans, 1 squamous carcinoma and 4 basal cell carcinoma) have been treated with radical brachytherapy in CSUB. This tumors were located in epicantus (3 cases), superior eyelid (1 case) and free bord of inferior eyelid (2 cases). The technique used consists in interstitial application of plastic tubs and manual loading with iridium-192. Two wires were used in eyelid lesions (3 cases) and 3 wires when lesion was located in epicantus (except one patient who needed 11). Four patients received brachytherapy for primary tumors and two patients for local relapse after surgical management who previously had been treated with electron beam (42 Gy and 60 Gy with lent protection). Doses were especified to 85% isodoses (Paris system) except one case (isodose 70%) and they were 60 Gy (one patient) and 65 Gy (five patients). Lineal activity ranged from 5.21 to 7.99 cGy/h (medium 6.3 cGy/h) and duration treatment were between 30.77 h and 77.66 h. Only one patient used an ocular lent protector at time of brachytherapy. Follow-up was 2, 2, 6, 9, 10 and 27 months. RESULTS: During the treatment, all patients presented local hematoma and conjuntivitis that resolved with topical treatment. Acromy and telangiectassia have been seen in only one patient who received electron beam therapy previously. Lost of eyelashes were seen in two patients treated for parpebral lesions. None cataractas and lacrimal obstruction are reported. Five patients are live and well whitout disease and one patient died from intercurrent disease with local

  11. Definition study of the project Dosimetry Brachytherapy

    International Nuclear Information System (INIS)

    Bultman, J.

    1989-05-01

    The purpose of the research project Dosimetry Brachytherapy is the standardization of calibration methods and quality control procedures used for Brachytherapy sources. Proposals to develop measurement standards and methods for calibrating these sources are presented. Brachytherapy sources will be calibrated in terms of reference airkerma rate or in terms of absorbed dose in water. Therefore, in this project, special attention will be given to the in-phantom measurement method described by Meertens and the use of re-entrant ionisation chambers as transfer standards. In this report, a workplan and time schedule is included. (author). 19 refs.; 1 fig

  12. Guidelines for comprehensive quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    Goldson, A.L.; Nibhanupudy, J.R.

    1984-01-01

    Brachytherapy treatment techniques can provide significant improvement in local control and overall survival, but only when quality assurance can be guaranteed. To establish brachytherapy quality assurance, basic requirements for three predetermined subdivisions of clinical institutions will be forwarded. These are: (1) centers having minimum requirements to provide brachytherapy, (2) intermediate centers such as regional or community hospitals, and (3) optimal centers such as university hospital and cancer centers. This presentation will highlight personnel needs, equipment requirements, academic activities, clinical experience with these systems and proposed quality assurance guidelines

  13. The Clinical Atlas of Intravascular Optical Coherence Tomography for iPad

    DEFF Research Database (Denmark)

    Radu, Maria D

    2012-01-01

    The first comprehensive educational tool devoted exclusively to intravascular OCT is now available from PCR publishing.......The first comprehensive educational tool devoted exclusively to intravascular OCT is now available from PCR publishing....

  14. Low molecular weight heparin attenuates multiple organ failure in a murine model of disseminated intravascular coagulation

    NARCIS (Netherlands)

    Slofstra, Sjoukje H.; van 't Veer, Cornelis; Buurman, Wim A.; Reitsma, Pieter H.; ten Cate, Hugo; Spek, C. Arnold

    2005-01-01

    OBJECTIVE: Bacterial sepsis causes widespread vascular inflammation that frequently leads to disseminated intravascular coagulation (DIC). Although intravascular coagulation contributes to organ failure, it is often debated whether anticoagulant therapy produces any beneficial effects in patients

  15. Intravascular Ultrasound and its Use in Vascular Interventional Radiology

    International Nuclear Information System (INIS)

    Klepanec, A.; Vulev, I.; Vozar, M.; Balazs, T.; Madaric, J.; Holoman, M.

    2009-01-01

    Intravascular ultrasound has become in invasive vascular radiology in the last decade the important part of diagnostic and also therapeutic procedures in management of vascular diseases. The basic possibilities for the use of IVUS include diagnostic procedures in vascular pathology assessment and therapeutic indications in the field of peripheral vascular interventions (PVI). Unlike other image modalities (CT, MRI, ultrasound) IVUS enables gather unique image in r eal time r ight from the vessel lumen, what helps to add important information regarding vessel wall, plate morphology, thrombi and cross-sectional vessel area. After initial use of intravascular ultrasound in coronary circulation, using IVUS is nowadays widely extended especially in aortic diseases, carotid and renal arteries and arteries of the lower extremities. This review article summarizes possibilities of intravascular ultrasound utilization in diagnostic process and therapy from peripheral vascular diseases up to thoracoabdominal aorta diseases and our experience with this new diagnostic modality. (author)

  16. Emergency treatment by intravascular embolization in traumatic carotid cavernous fistula

    International Nuclear Information System (INIS)

    Tang Jun; Sun Zengtao; Liu Zuoqin; Liu Yanjun; Li Fengxin

    2006-01-01

    Objective: To discuss the method of intervenfional intravascular treatment in traumatic carotid cavernous fistula (TCCF) and the significance of clinical application in emergency. Methods: In 297 eases of TCCF, 36 cases were treated by interventional intravascular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery. In the 36 cases, serious epistaxis occurred in 22 eases, cortical vein inflow in 9 cases, intracranial hemorrhage in 3 cases, aggravation of eyesight in 3 cases, and limb dysfunction in 2 cases. Results: Fistula was successfully embolized and internal carotid artery remained patent in 19 cases. Complete embolization of orificium or internal carotid artery was achieved in 17 eases. The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped. Eyesight recovered in 2 eases and improved in 1 case. Limb dysfunction improved evidently in 2 cases. Conclusion: Intravascular embolization treatment is the first therapeutic choice for TCCF, especially in emergency. It is necessary, safe and effective. (authors)

  17. Potential brachytherapy nuclides of future

    International Nuclear Information System (INIS)

    Shanta, A.; Iyer, P.S.

    1993-01-01

    In the past there were relatively few radionuclides available for brachytherapy. But the situation is rapidly changing with the development of many new sources with properties that may be advantageous in certain clinical situations. In the choice of an acceptable, rather than an ideal radionuclide, it is important to consider the physical dose distribution, radiobiological effectiveness, ease of radiation protection, logistics and cost. Taking into account these factors, a number of radionuclides have been tried and more are being considered for specific type of applications. Presently, 137 Cs is the most commonly used radionuclide for intracavitary therapy and 192 Ir for interstitial therapy. 125 I has more or less replaced 198 Au for permanent implants. Clinical studies are being carried out to assess the feasibility of replacing 137 Cs with 241 Am for intracavitary applications and 125 I with 103 Pd and/or 169 Yb for interstitial permanent implants. Other radionuclides being considered are 75 Fe and 145 Sm. Neutron induced brachytherapy is a new technique being tried to ensure complete radiation safety. (author). 1 tab

  18. Extremely refractory Kawasaki disease with disseminated intravascular coagulation.

    Science.gov (United States)

    Koh, Young Kwon; Lee, Jae Hee; Park, Yeong Bong

    2017-07-01

    Disseminated intravascular coagulation is a rare complication of Kawasaki disease and appears in Kawasaki disease patients. We report a case of refractory Kawasaki disease complicated with disseminated intravascular coagulation and giant coronary aneurysm. A 5-month-old boy presented with Kawasaki disease with coagulopathy. Although the coagulopathy improved after fresh-frozen plasma and antithrombin-III administration, the fever persisted despite two rounds of intravenous immunoglobulin, along with intravenous methylprednisolone pulse therapy and infliximab administration. Despite all efforts to treatment, the patient had giant coronary aneurysms and died suddenly.

  19. 21 CFR 880.5970 - Percutaneous, implanted, long-term intravascular catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Percutaneous, implanted, long-term intravascular... and Personal Use Therapeutic Devices § 880.5970 Percutaneous, implanted, long-term intravascular catheter. (a) Identification. A percutaneous, implanted, long-term intravascular catheter is a device that...

  20. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port and...

  1. Concomitant chemoradiotherapy with high dose rate brachytherapy ...

    African Journals Online (AJOL)

    Concomitant chemoradiotherapy with high dose rate brachytherapy as a definitive treatment modality for locally advanced cervical cancer. T Refaat, A Elsaid, N Lotfy, K Kiel, W Small Jr, P Nickers, E Lartigau ...

  2. Comprehensive brachytherapy physical and clinical aspects

    CERN Document Server

    Baltas, Dimos; Meigooni, Ali S; Hoskin, Peter J

    2013-01-01

    Modern brachytherapy is one of the most important oncological treatment modalities requiring an integrated approach that utilizes new technologies, advanced clinical imaging facilities, and a thorough understanding of the radiobiological effects on different tissues, the principles of physics, dosimetry techniques and protocols, and clinical expertise. A complete overview of the field, Comprehensive Brachytherapy: Physical and Clinical Aspects is a landmark publication, presenting a detailed account of the underlying physics, design, and implementation of the techniques, along with practical guidance for practitioners. Bridging the gap between research and application, this single source brings together the technological basis, radiation dosimetry, quality assurance, and fundamentals of brachytherapy. In addition, it presents discussion of the most recent clinical practice in brachytherapy including prostate, gynecology, breast, and other clinical treatment sites. Along with exploring new clinical protocols, ...

  3. Long duration mild temperature hyperthermia and brachytherapy.

    Science.gov (United States)

    Armour, E P; Raaphorst, G P

    2004-03-01

    Combining long duration mild temperature hyperthermia (LDMH) and low dose-rate (LDR) brachytherapy to enhance therapeutic killing of cancer cells was proposed many years ago. The cellular and tumour research that supports this hypothesis is presented in this review. Research describing LDMH interaction with pulsed brachytherapy and high dose-rate brachytherapy using clinically relevant parameters are compared with LDMH/LDR brachytherapy. The mechanism by which LDMH sensitizes LDR has been established as the inhibition of sublethal damage repair. The molecular mechanisms have been shown to involve DNA repair enzymes, but the exact nature of these processes is still under investigation. The relative differences between LDMH interactions with human and rodent cells are presented to help in the understanding of possible roles of LDMH in clinical application. The role of LDMH in modifying tumour blood flow and its possible role in LDR sensitization of tumours is also presented. The positive aspects of LDMH-brachytherapy for clinical application are sixfold; (1) the thermal goals (temperature, time and volume) are achievable with currently available technology, (2) the hyperthermia by itself has no detectable toxic effects, (3) thermotolerance appears to play a minor if any role in radiation sensitization, (4) TER of around 2 can be expected, (5) hypoxic fraction may be decreased due to blood flow modification and (6) simultaneous chemotherapy may also be sensitized. Combined LDMH and brachytherapy is a cancer therapy that has established biological rationale and sufficient technical and clinical advancements to be appropriately applied. This modality is ripe for clinical testing.

  4. Acute vasculitis after endovascular brachytherapy

    International Nuclear Information System (INIS)

    Fajardo L-G, Luis F.; Prionas, Stavros D.; Kaluza, Grzegorz L.; Raizner, Albert E.

    2002-01-01

    Purpose: Angioplasty effectively relieves coronary artery stenosis but is often followed by restenosis. Endovascular radiation (β or γ) at the time of angioplasty prevents restenosis in a large proportion of vessels in swine (short term) and humans (short and long term). Little information is available about the effects of this radiation exposure beyond the wall of the coronary arteries. Methods and Materials: Samples were obtained from 76 minipigs in the course of several experiments designed to evaluate endovascular brachytherapy: 76 of 114 coronary arteries and 6 of 12 iliac arteries were exposed to endovascular radiation from 32 P sources (35 Gy at 0.5 mm from the intima). Two-thirds of the vessels had angioplasty or stenting. The vessels were systematically examined either at 28 days or at 6 months after radiation. Results: We found an unexpected lesion: acute necrotizing vasculitis in arterioles located ≤2.05 mm from the target artery. It was characterized by fibrinoid necrosis of the wall, often associated with lymphocytic exudates or thrombosis. Based on the review of perpendicular sections of tissue samples, the arterioles had received between 6 and 40 Gy. This arteriolar vasculitis occurred at 28 days in samples from 51% of irradiated coronary arteries and 100% of irradiated iliac arteries. By 6 months, the incidence of acute vasculitis decreased to 24% around the coronary arteries. However, at that time, healing vasculitis was evident, often with luminal narrowing, in 46% of samples. Vasculitis was not seen in any of 44 samples from unirradiated vessels (0%) and had no relation to angioplasty, stenting, or their sequelae. This radiation-associated vasculitis in the swine resembles the localized lymphocytic vasculitis that we have reported in tissues of humans exposed to external radiation. On the other hand, it is quite different from the various types of systemic vasculitis that occur in nonirradiated humans. Conclusion: Endoarterial brachytherapy

  5. Mechanical scanning in intravascular ultrasound imaging: Artifacts and driving mechanisms

    NARCIS (Netherlands)

    H. ten Hoff (H.); E.J. Gussenhoven (Elma); C.M. Korbijn (Carin); F. Mastik (Frits); C.T. Lancée (Charles); N. Bom (Klaas)

    1995-01-01

    textabstractObjective: Currently, intravascular ultrasound (US) imaging catheters are developed and produced to provide a complementary diagnostic method in the treatment of blood vessel obstructive disease. Typical catheter dimensions are a diameter of 1–2.5 mm and a length of 1–1.5 m. A real-time

  6. An Axial Array for Volumetric Intravascular Ultrasound Imaging

    NARCIS (Netherlands)

    Alles, E.J.

    2012-01-01

    Intravascular ultrasound (IVUS) is a medical imaging modality aimed at imaging blood vessel walls from within the vessel. Current commercial IVUS catheters are designed to yield two-dimensional cross-sectional images perpendicular to the vessel wall. By pulling the catheter back through the artery

  7. 21 CFR 880.5440 - Intravascular administration set.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intravascular administration set. 880.5440 Section 880.5440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

  8. Intravascular catheter related infections in children admitted on the ...

    African Journals Online (AJOL)

    peripheral venous intravascular catheters uncoated with no antibiotic or antiseptic, was done. Social demographic characteristics, anthropometry, clinical examination including the catheter site were determined at enrollment. The children had their blood, catheter tip and hub samples taken off for culture and sensitivity as ...

  9. Disseminated intravascular coagulation in malaria: A case report ...

    African Journals Online (AJOL)

    Disseminated intravascular coagulation (DIC) is seen in <5% of patients with severe Plasmodium falciparum malaria and is more common in cerebral malaria. Here, we report the diagnosis and management of a case of severe P. falciparum malaria with DIC. Keywords: Cerebral malaria, cytokine storm, DIC, heparin ...

  10. Disseminated intravascular coagulation in meningococcal sepsis. Case 7

    NARCIS (Netherlands)

    Zeerleder, S.; Zürcher Zenklusen, R.; Hack, C. E.; Wuillemin, W. A.

    2003-01-01

    We report on a man (age: 49 years), who died from severe meningococcal sepsis with disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome and extended skin necrosis. We discuss in detail the pathophysiology of the activation of coagulation and fibrinolysis during sepsis.

  11. Intravascular catheter sepsis | Mer | South African Medical Journal

    African Journals Online (AJOL)

    Intravascular devices are an integral component of modern-day medical practice. They are used to administer intravenous fluids, medications, blood products and parenteral nutrition. In addition, they serve as a valuable monitor of the haemodynamic status of critically ill patients.

  12. Navigation system for interstitial brachytherapy

    International Nuclear Information System (INIS)

    Strassmann, G.; Kolotas, C.; Heyd, R.

    2000-01-01

    The purpose of the stud was to develop a computed tomography (CT) based electromagnetic navigation system for interstitial brachytherapy. This is especially designed for situations when needles have to be positioned adjacent to or within critical anatomical structures. In such instances interactive 3D visualisation of the needle positions is essential. The material consisted of a Polhemus electromagnetic 3D digitizer, a Pentium 200 MHz laptop and a voice recognition for continuous speech. In addition, we developed an external reference system constructed of Perspex which could be positioned above the tumour region and attached to the patient using a non-invasive fixation method. A specially designed needle holder and patient bed were also developed. Measurements were made on a series of phantoms in order to study the efficacy and accuracy of the navigation system. The mean navigation accuracy of positioning the 20.0 cm length metallic needles within the phantoms was in the range 2.0-4.1 mm with a maximum of 5.4 mm. This is an improvement on the accuracy of a CT-guided technique which was in the range 6.1-11.3 mm with a maximum of 19.4 mm. The mean reconstruction accuracy of the implant geometry was 3.2 mm within a non-ferromagnetic environment. We found that although the needles were metallic this did not have a significant influence. We also found for our experimental setups that the CT table and operation table non-ferromagnetic parts had no significant influence on the navigation accuracy. This navigation system will be a very useful clinical tool for interstitial brachytherapy applications, particularly when critical structures have to be avoided. It also should provide a significant improvement on our existing technique

  13. 10 CFR 35.406 - Brachytherapy sources accountability.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Brachytherapy sources accountability. 35.406 Section 35....406 Brachytherapy sources accountability. (a) A licensee shall maintain accountability at all times... area. (c) A licensee shall maintain a record of the brachytherapy source accountability in accordance...

  14. 10 CFR 35.2406 - Records of brachytherapy source accountability.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of brachytherapy source accountability. 35.2406... Records of brachytherapy source accountability. (a) A licensee shall maintain a record of brachytherapy source accountability required by § 35.406 for 3 years. (b) For temporary implants, the record must...

  15. Applying gold nanoparticles as tumor-vascular disrupting agents during brachytherapy: estimation of endothelial dose enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Ngwa, Wilfred; Makrigiorgos, G Mike; Berbeco, Ross I, E-mail: mmakrigiorgos@lroc.harvard.ed [Department of Radiation Oncology, Division of Medical Physics and Biophysics, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115 (United States)

    2010-11-07

    Tumor vascular disrupting agents (VDAs) represent a promising approach to the treatment of cancer, in view of the tumor vasculature's pivotal role in tumor survival, growth and metastasis. VDAs targeting the tumor's dysmorphic endothelial cells can cause selective and rapid occlusion of the tumor vasculature, leading to tumor cell death from ischemia and extensive hemorrhagic necrosis. In this study, the potential for applying gold nanoparticles (AuNPs) as VDAs, during brachytherapy, is examined. Analytic calculations based on the electron energy loss formula of Cole were carried out to estimate the endothelial dose enhancement caused by radiation-induced photo/Auger electrons originating from AuNPs targeting the tumor endothelium. The endothelial dose enhancement factor (EDEF), representing the ratio of the dose to the endothelium with and without gold nanoparticles was calculated for different AuNP local concentrations, and endothelial cell thicknesses. Four brachytherapy sources were investigated, I-125, Pd-103, Yb-169, as well as 50 kVp x-rays. The results reveal that, even at relatively low intra-vascular AuNP concentrations, ablative dose enhancement to tumor endothelial cells due to photo/Auger electrons from the AuNPs can be achieved. Pd-103 registered the highest EDEF values of 7.4-271.5 for local AuNP concentrations ranging from 7 to 350 mg g{sup -1}, respectively. Over the same concentration range, I-125, 50 kVp and Yb-169 yielded values of 6.4-219.9, 6.3-214.5 and 4.0-99.7, respectively. Calculations of the EDEF as a function of endothelial cell thickness showed that lower energy sources like Pd-103 reach the maximum EDEF at smaller thicknesses. The results also reveal that the highest contribution to the EDEF comes from Auger electrons, apparently due to their shorter range. Overall, the data suggest that ablative dose enhancement to tumor endothelial cells can be achieved by applying tumor vasculature-targeted AuNPs as adjuvants to

  16. Calculation of integrated biological response in brachytherapy

    International Nuclear Information System (INIS)

    Dale, Roger G.; Coles, Ian P.; Deehan, Charles; O'Donoghue, Joseph A.

    1997-01-01

    Purpose: To present analytical methods for calculating or estimating the integrated biological response in brachytherapy applications, and which allow for the presence of dose gradients. Methods and Materials: The approach uses linear-quadratic (LQ) formulations to identify an equivalent biologically effective dose (BED eq ) which, if applied to a specified tissue volume, would produce the same biological effect as that achieved by a given brachytherapy application. For simple geometrical cases, BED multiplying factors have been derived which allow the equivalent BED for tumors to be estimated from a single BED value calculated at a dose reference point. For more complex brachytherapy applications a voxel-by-voxel determination of the equivalent BED will be more accurate. Equations are derived which when incorporated into brachytherapy software would facilitate such a process. Results: At both high and low dose rates, the BEDs calculated at the dose reference point are shown to be lower than the true values by an amount which depends primarily on the magnitude of the prescribed dose; the BED multiplying factors are higher for smaller prescribed doses. The multiplying factors are less dependent on the assumed radiobiological parameters. In most clinical applications involving multiple sources, particularly those in multiplanar arrays, the multiplying factors are likely to be smaller than those derived here for single sources. The overall suggestion is that the radiobiological consequences of dose gradients in well-designed brachytherapy treatments, although important, may be less significant than is sometimes supposed. The modeling exercise also demonstrates that the integrated biological effect associated with fractionated high-dose-rate (FHDR) brachytherapy will usually be different from that for an 'equivalent' continuous low-dose-rate (CLDR) regime. For practical FHDR regimes involving relatively small numbers of fractions, the integrated biological effect to

  17. Brachytherapy

    Science.gov (United States)

    ... treatment calculations. The radiation therapists are specially trained technologists who may assist in delivery of the treatments. ... a computer-controlled remote afterloading machine. X-rays , ultrasound , CT , or MRI scans may be used to ...

  18. ACPSEM brachytherapy working group recommendations for quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    Dempsey, Claire; Smith, Ryan; Nyathi, Thulani; Ceylan, Abdurrahman; Howard, Lisa; Patel, Virendra; Dam, Ras; Haworth, Annette

    2013-01-01

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups in 2011 to develop recommendation papers for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, have been subject to independent expert reviews and have also been approved by the ACPSEM Council. For the Australian audience, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Practice Standards. This publication presents the recommendations of the ACPSEM Brachytherapy Working Group (BTWG) and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendation papers. It is hoped that the users of this and other ACPSEM recommendation papers will contribute to the development of future versions through the Radiation Oncology Specialty Group of the ACPSEM.

  19. Local anesthesia for prostate brachytherapy

    International Nuclear Information System (INIS)

    Wallner, Kent; Simpson, Colleen; Roof, James; Arthurs, Sandy; Korssjoen, Tammy; Sutlief, Steven

    1999-01-01

    Purpose: To demonstrate the technique and feasibility of prostate brachytherapy performed with local anesthesia only. Methods and Materials: A 5 by 5 cm patch of perineal skin and subcutaneous tissue is anesthetized by local infiltration of 10 cc of 1% lidocaine with epinephrine, using a 25-gauge 5/8-inch needle. Immediately following injection into the subcutaneous tissues, the deeper tissues, including the pelvic floor and prostate apex, are anesthetized by injecting 15 cc lidocaine solution with approximately 8 passes of a 20-gauge 1.0-inch needle. Following subcutaneous and peri-apical lidocaine injections, the patient is brought to the simulator suite and placed in leg stirrups. The transrectal ultrasound (TRUS) probe is positioned to reproduce the planning images and a 3.5- or 6.0-inch, 22-gauge spinal needle is inserted into the peripheral planned needle tracks, monitored by TRUS. When the tips of the needles reach the prostatic base, about 1 cc of lidocaine solution is injected in the intraprostatic track, as the needle is slowly withdrawn, for a total volume of 15 cc. The implants are done with a Mick Applicator, inserting and loading groups of two to four needles, so that a maximum of only about four needles are in the patient at any one time. During the implant procedure, an additional 1 cc of lidocaine solution is injected into one or more needle tracks if the patient experiences substantial discomfort. The total dose of lidocaine is generally limited to 500 mg (50 ml of 1% solution). Results: To date, we have implanted approximately 50 patients in our simulator suite, using local anesthesia. Patients' heart rate and diastolic blood pressure usually showed moderate changes, consistent with some discomfort. The time from first subcutaneous injection and completion of the source insertion ranged from 35 to 90 minutes. Serum lidocaine levels were below or at the low range of therapeutic. There has been only one instance of acute urinary retention in the

  20. Functional intravascular volume deficit in patients before surgery

    DEFF Research Database (Denmark)

    Bundgaard-Nielsen, M; Jørgensen, C C; Secher, N H

    2010-01-01

    limited data on the volume required to establish a maximal SV before the start of surgery. Therefore, we estimated the occurrence and size of the potential functional intravascular volume deficit in surgical patients. METHODS: Patients scheduled for mastectomy (n=20), open radical prostatectomy (n=20......BACKGROUND: Stroke volume (SV) maximization with a colloid infusion, referred to as individualized goal-directed therapy, improves outcome in high-risk surgery. The fraction of patients who need intravascular volume to establish a maximal SV has, however, not been evaluated, and there are only...... deficit. RESULTS: Forty-two (70%) of the patients needed volume to establish a maximal SV. For the patients needing volume, the required amount was median 200 ml (range 200-600 ml), with no significant difference between the three groups of patients. The required volume was >or=400 ml in nine patients (15...

  1. Newer techniques for intravascular and intraoperative neurointerventional procedures

    International Nuclear Information System (INIS)

    Higashida, R.T.; Halbach, V.V.; Hieshima, G.B.; Yang, P.

    1987-01-01

    A videotape demonstrating newer techniques used in intravascular and intraoperative embolization procedures will be presented. The authors discuss the use of some of the newer embolic agents, real-time digital subtraction angiography, roadmapping techniques, and the use of microcatheters and steerable micro guide wires, which has greatly facilitated neurovascullar embolization procedures and enhanced patient safety. A number of actual intraoperative and intravascular cases will be shown demonstrating treatment of vascular malformations of the brain and spinal cord, carotid cavernous sinus fistulas, aneurysms and dural arteriovenous malformations. The indications for treatment, patient selection, technical preparation and newer methodologies and approaches to complex vascular lesions of the brain and spinal cord are discussed in detail

  2. Intravascular photoacoustic tomography for characterization of atherosclerotic lipid and inflammation

    Science.gov (United States)

    Zhang, Jian; Qin, Huan; Shi, Yujiao; Yang, Sihua; Xing, Da

    2014-09-01

    Photoacoustic imaging is a fast growing imaging technology depending on its high optical resolution of optics while taking the advantage of the high penetration depth of ultrasound. In this paper, we demonstrate the new progress in the photoacoustic imaging. Atherosclerosis is characterized by a progressive build-up of lipid in the arterial wall, which is known as plaque. Histological studies demonstrate that the primary cause of acute cardiovascular events is the rupture of atherosclerotic plaques. Lipid and inflammation within the plaque are related to influence the propensity of plaques to disrupt. Photoacoustic intravascular tomography (IVPAT) holds a great advantage in providing comprehensive morphological and functional information of plaques. Lipid relative concentration maps of atherosclerotic aorta were obtained and compared with histology. Furthermore, by selectively targeting the intravascular inflammatory cytokines, IVPAT is also capable of mapping the inflamed area and determining the degree of inflammation.

  3. Acute renal failure related to oxaliplatin-induced intravascular hemolysis.

    Science.gov (United States)

    Ulusakarya, Ayhan; Misra, Srimanta; Haydar, Mazen; Habert, Hélène; Castagne, Vincent; Gumus, Yusuf; Delmas-Marsalet, Béatrice; Machover, David

    2010-12-01

    Oxaliplatin is an effective chemotherapeutic agent frequently used in the treatment of colorectal carcinoma. Rare cases of renal failure and hemolytic reactions have been reported as separate side effects of oxaliplatin. Here we present a clinical picture of immune-related intravascular hemolysis and acute tubular necrosis in a patient receiving this drug. This case suggests a mechanistic explanation of renal failure in patients treated with oxaliplatin.

  4. Front-end IC design for intravascular ultrasound imaging

    OpenAIRE

    Yamaner, Yalçın Feysel; Yamaner, Yalcin Feysel; Cenkeramaddi, Linga Reddy; Bozkurt, Ayhan

    2008-01-01

    Capacitive micromachined ultrasonic transducers(cMUT) technology is a new trend for intravascular ultrasound (IVUS) imaging. Large bandwidth, high sensitivity and compatibility to CMOS processes makes the cMUT a better choice compared to the conventional piezoelectric transducer. To exploit the merits of cMUT technology, an accurately designed front end circuit is required. The circuit functions as an output pulse driver for the generation of the acoustic signal and buffers the return echo. F...

  5. Design of low noise transimpedance amplifier for intravascular ultrasound

    KAUST Repository

    Reda, Dina

    2009-11-01

    In this paper, we study transimpedance amplifiers for capacitive sensing applications with a focus on Intravascular Ultra Sound (IVUS). We employ RF noise cancellation technique on capacitive feedback based transimpedance amplifiers. This technique eliminates the input-referred noise of TIAs completely and enhances the dynamic range of front-end electronics. Simulation results verify the proposed technique used in two different TIA topologies employing shunt-shunt feedback. ©2009 IEEE.

  6. Renal denervation by intravascular ultrasound: Preliminary in vivo study

    Science.gov (United States)

    Sinelnikov, Yegor; McClain, Steve; Zou, Yong; Smith, David; Warnking, Reinhard

    2012-10-01

    Ultrasound denervation has recently become a subject of intense research in connection with the treatment of complex medical conditions including neurological conditions, development of pain management, reproduction of skin sensation, neuropathic pain and spasticity. The objective of this study is to investigate the use of intravascular ultrasound to produce nerve damage in renal sympathetic nerves without significant injury to the renal artery. This technique may potentially be used to treat various medical conditions, such as hypertension. The study was approved by the Institutional Animal Care and Use Committee. Ultrasound was applied to renal nerves of the swine model for histopathological evaluation. Therapeutic ultrasound energy was delivered circumferentially by an intravascular catheter maneuvered into the renal arteries. Fluoroscopic imaging was conducted pre-and post-ultrasound treatment. Animals were recovered and euthanized up to 30 hours post procedure, followed by necropsy and tissue sample collection. Histopathological examination showed evidence of extensive damage to renal nerves, characterized by nuclear pyknosis, hyalinization of stroma and multifocal hemorrhages, with little or no damage to renal arteries. This study demonstrates the feasibility of intravascular ultrasound as a minimally invasive renal denervation technique. Further studies are necessary to evaluate the long-term safety and efficacy of this technique and its related clinical significance.

  7. Asian-variant intravascular lymphoma in the African race

    Directory of Open Access Journals (Sweden)

    Holly Geyer

    2012-03-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBCL is an exceptionally rare form of non- Hodgkin lymphoma (NHL distinguished by the preferential growth of neoplastic cells within blood vessel lumen. Challenging to detect and deemed disseminated at diagnosis, this condition is characterized by a highly aggressive, inconspicuous course with a high mortality rate. We describe the case of a 48 year-old African-American female presenting with a two month history of low-grade fevers and malaise. Laboratory data was notable for anemia, thrombocytopenia, elevated liver function tests, and hematuria. An extensive workup for infectious, rheumatologic and malignant causes was negative. Her symptoms progressed and within two weeks, she was admitted for disseminated intravascular coagulation (DIC. Her course was complicated by diffuse pulmonary hemorrhage and ultimately, care was withdrawn. Autopsy identified widespread CD-20 positive intravascular large B-cell lymphoma with significant hepatosplenic involvement, characteristic of the Asian variant IVLBCL. This case uniquely highlights development of the Asian variant IVLBVL in a previously undescribed race. Identified by its intraluminal vascular growth pattern, IVLBCL generally spares lymphatic channels. Diagnosis and differentiation of this condition from other hematological malignancies via skin, visceral and bone marrow biopsy is imperative as anthracycline-containing chemotherapies may significantly improve clinical outcomes. This article outlines the common presentation, natural course, and treatment options of IVLBCL, along with the histopathology, immunohistochemistry, and chromosomal aberrations common to this condition.

  8. Disseminated intravascular coagulation and massive obstetric hemorrhage. Management dilemma.

    Science.gov (United States)

    Al-Nuaim, Lulu A; Mustafa, Mohamed S; Abdel Gader, Abdel Galil M

    2002-06-01

    The objective of this retrospective study is to reflect on our experience on an optimal management for major postpartum hemorrhage, which would prevent the occurrence and complications of disseminated intravascular coagulation and minimize maternal mortality and morbidity. Ten cases out of the 30,000 of total deliveries of severe obstetric hemorrhage associated with disseminated intravascular coagulation were studied. This study was carried out over a 7 year period, October 1988 through to September 1995, at the Obstetric Unit, King Khalid University Teaching Hospital, Riyadh, Kingdom of Saudi Arabia. All of the 10 women received packed red blood cells, 8 had fresh frozen plasma, and 6 received platelet transfusion. The 10 cases developed disseminated intravascular coagulation following medical and surgical management, all women needed hysterectomy, 4 subtotal, 6 total, and 5 women had relaparotomy and pelvic packing. Two had bladder injuries. There was no maternal death. An early resort to hysterectomy when conservative measures fail, will minimize maternal morbidity and mortality. In case of continuous bleeding after hysterectomy, pelvic packing proved to be effective.

  9. Extramedullary Hematopoiesis in Uterine Leiomyoma Associated with Numerous Intravascular Thrombi

    Directory of Open Access Journals (Sweden)

    Xiaoyan Cui

    2014-01-01

    Full Text Available We report a case of extramedullary hematopoiesis (EMH in uterine leiomyoma and associated numerous intravascular thrombi. A 29-year-old nulliparous female presented with heavy vaginal bleeding and a hematocrit of 22%. No bone marrow biopsy has been performed. She had a history of uterine leiomyomata and menorrhagia for a year. A transvaginal ultrasound confirmed the presence of a uterine leiomyoma. The patient was treated conservatively with oral contraceptive pills due to desire for fertility. However, she continued to have heavy vaginal bleeding and developed bilateral upper extremity deep vein thrombosis and multiple superficial vein thromboses after two months. An exploratory laparotomy with uterine myomectomy was performed. Gross examination of the specimen revealed a single nodular mass measuring 10.0×9.5×7.5 cm with a white-tan swirling cut surface. Microscopic examination revealed benign smooth muscle consistent with leiomyoma and numerous intravascular thrombi both with areas of EMH. Immunohistochemical stains confirmed the presence of all three benign lineages of hematopoietic cells. Occurrence of EMH in uterine leiomyoma and intravascular thrombi is very rare. It may be related to systemic hematopoietic stimulation due to severe chronic anemia and local presence of hematopoietic growth factors and/or cytokines.

  10. Teaching drawn from brachytherapy accidents

    International Nuclear Information System (INIS)

    Pinillos, L.

    2009-01-01

    The first incidents concern the transport of the sources, bad packaging or bad sealing of the sources. The incidents occurring during the use are the most frequent. They come from mechanical problems or human errors as the unit of computer command or the transfer cable of the source. A power failure affected the safety program, causing a calculation error after the input of incorrect data. The most of reported errors occurred during fractionated treatments, so the errors can be compensated by adjusting the doses at the following session. The worst case was the death of a woman where the source stayed inside the body after the treatment. Radiation monitoring in the treatment room should avoid this kind of accident. The brachytherapy represents 500 000 acts by year, any error can be serious. The accident reports concern all the chain of procedure, among them a death whom first cause was a human error. A team respecting the procedures of quality assurance is indispensable to the accident prevention; the accidents report is important because it allows a sharing of lessons drawn from the past errors to prevent from occurring. (N.C.)

  11. American brachytherapy society (ABS) consensus guidelines for brachytherapy of esophageal cancer

    International Nuclear Information System (INIS)

    Gaspar, Laurie E.; Nag, Subir; Herskovic, Arnold; Mantravadi, Rao; Speiser, Burton

    1997-01-01

    Introduction: There is wide variation in the indications, treatment regimens, and dosimetry for brachytherapy in the treatment of cancer of the esophagus. No guidelines for optimal therapy currently exist. Methods and Materials: Utilizing published reports and clinical experience, representatives of the Clinical Research Committee of the American Brachytherapy Society (ABS) formulated guidelines for brachytherapy in esophageal cancer. Results: Recommendations were made for brachytherapy in the definitive and palliative treatment of esophageal cancer. (A) Definitive treatment: Good candidates for brachytherapy include patients with unifocal thoracic adeno- or squamous cancers ≤ 10 cm in length, with no evidence of intra-abdominal or metastatic disease. Contraindications include tracheal or bronchial involvement, cervical esophagus location, or stenosis that cannot be bypassed. The esophageal brachytherapy applicator should have an external diameter of 6-10 mm. If 5FU-based chemotherapy and 45-50-Gy external beam are used, recommended brachytherapy is either: (i) HDR 10 Gy in two weekly fractions of 5 Gy each; or (ii) LDR 20 Gy in a single course at 0.4-1 Gy/hr. All doses are specified 1 cm from the midsource or middwell position. Brachytherapy should follow external beam radiation therapy and should not be given concurrently with chemotherapy. (B) Palliative treatment: Patients with adeno- or squamous cancers of the thoracic esophagus with distant metastases or unresectable local disease progression/recurrence after definitive radiation treatment should be considered for brachytherapy with palliative intent. After limited dose (30 Gy) EBRT, the recommended brachytherapy is either: (i) HDR 10-14 Gy in one or two fractions; or (ii) LDR 20-25 Gy in a single course at 0.4-1 Gy/hr. The need for external beam radiation in newly diagnosed patients with a life expectancy of less than 3 months is controversial. In these cases, HDR of 15-20 Gy in two to four fractions or

  12. Comparison between calculation methods of dose rates in gynecologic brachytherapy; Comparacion entre metodos de calculo de tasa de dosis en braquiterapia ginecologica8

    Energy Technology Data Exchange (ETDEWEB)

    Vianello, E.A.; Biaggio, M.F.; Dr, M.F.; Almeida, C.E. de [Laboratorio de Ciencias Radiologicas- (L.C.R.)-D.B.B.- UERJ- R. Sao Francisco Xavier, 524- Pav. HLC- sala 136- CEP 20550-013 Rio de Janeiro (Brazil)

    1998-12-31

    In treatments with radiations for gynecologic tumors is necessary to evaluate the quality of the results obtained by different calculation methods for the dose rates on the points of clinical interest (A, rectal, vesicle). The present work compares the results obtained by two methods. The Manual Calibration Method (MCM) tri dimensional (Vianello E., et.al. 1998), using orthogonal radiographs for each patient in treatment, and the Theraplan/T P-11 planning system (Thratonics International Limited 1990) this last one verified experimentally (Vianello et.al. 1996). The results show that MCM can be used in the physical-clinical practice with a percentile difference comparable at the computerized programs. (Author)

  13. Endorectal high dose rate brachytherapy quality assurance

    International Nuclear Information System (INIS)

    Devic, S.; Vuong, T.; Evans, M.; Podgorsak, E.

    2008-01-01

    We describe our quality assurance method for preoperative high dose rate (HDR) brachytherapy of endorectal tumours. Reproduction of the treatment planning dose distribution on a daily basis is crucial for treatment success. Due to the cylindrical symmetry, two types of adjustments are necessary: applicator rotation and dose distribution shift along the applicator axis. (author)

  14. Palladium-103 brachytherapy for prostate carcinoma

    International Nuclear Information System (INIS)

    Blasko, John C.; Grimm, Peter D.; Sylvester, John E.; Badiozamani, Kas Ray; Hoak, David; Cavanagh, William

    2000-01-01

    Purpose: A report of biochemical outcomes for patients treated with palladium-103 (Pd-103) brachytherapy over a fixed time interval. Methods and Materials: Two hundred thirty patients with clinical stage T1-T2 prostate cancer were treated with Pd-103 brachytherapy and followed with prostate-specific antigen (PSA) determinations. Kaplan-Meier estimates of biochemical failure on the basis of two consecutive elevations of PSA were utilized. Multivariate risk groups were constructed. Aggregate PSA response by time interval was assessed. Results: The overall biochemical control rate achieved at 9 years was 83.5%. Failures were local 3.0%; distant 6.1%; PSA progression only 4.3%. Significant risk factors contributing to failure were serum PSA greater than 10 ng/ml and Gleason sum of 7 or greater. Five-year biochemical control for those exhibiting neither risk factor was 94%; one risk factor, 82%; both risk factors, 65%. When all 1354 PSA determinations obtained for this cohort were considered, the patients with a proportion of PSAs ≤ 0.5 ng/ml continued to increase until at least 48 months post-therapy. These data conformed to a median PSA half-life of 96.2 days. Conclusions: Prostate brachytherapy with Pd-103 achieves a high rate of biochemical and clinical control in patients with clinically organ-confined disease. PSA response following brachytherapy with low-dose-rate isotopes is protracted

  15. The hazy dawn of brachytherapy

    International Nuclear Information System (INIS)

    Dutreix, J.; Tubiana, M.; Pierquin, B.

    1998-01-01

    The discovery of radium by Pierre and Marie Curie in December 1898 opened a new era in science and within a few years provided medicine with a new means of tumor treatment. Their personal contribution to the start and early development of clinical applications should not be overlooked. The Curies did not limit their support to providing radium sources to medical pioneers but took a deep interest in the horizons of radiumtherapy. Pierre was one of the first to search for and demonstrate a biological effect of radium radiation. He investigated the radioactivity of the waters of hydrotherapeutic resorts. Marie took care of the measurement of the medical sources personally, convinced that the result of the treatment depends on the precise knowledge of the amount of radium applied. Her perseverance resulted in the establishment of the Institut du Radium (1909) in which, besides the physico-chemical laboratory, a biological department was set up. The latter became the Fondation Curie (1920), a leading medical center of treatment and training, with an integrated team of physicists, radiobiologists and clinicians led by Regaud. One hundred years after the discovery of radium, patients benefit today from the extensive clinical experience that has been collected over the years and from sophisticated developments in application techniques, dosimetry and quality assurance; the professional risk has been precisely assessed and the improvements in material and procedure have enabled the medical personnel to work in hazard-free conditions. This outcome results from the continuous progress that the pioneers gave impulse to. This paper intends to recall their efforts and achievements, as well as the difficulties and the problems they encountered during the first 2 decades when the sturdy foundations of brachytherapy were built. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  16. Prostate brachytherapy in Ghana: our initial experience

    Directory of Open Access Journals (Sweden)

    James Edward Mensah

    2016-10-01

    Full Text Available Purpose: This study presents the experience of a brachytherapy team in Ghana with a focus on technology transfer and outcome. The team was initially proctored by experienced physicians from Europe and South Africa. Material and methods : A total of 90 consecutive patients underwent either brachytherapy alone or brachytherapy in combination with external beam radiotherapy for prostate carcinoma between July 2008 and February 2014 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were classified as low-risk, intermediate, and high-risk according to the National Comprehensive Cancer Network (NCCN criteria. All low-risk and some intermediate risk group patients were treated with seed implantation alone. Some intermediate and all high-risk group patients received brachytherapy combined with external beam radiotherapy. Results: The median patient age was 64.0 years (range 46-78 years. The median follow-up was 58 months (range 18-74 months. Twelve patients experienced biochemical failure including one patient who had evidence of metastatic disease and died of prostate cancer. Freedom from biochemical failure rates for low, intermediate, and high-risk cases were 95.4%, 90.9%, and 70.8%, respectively. Clinical parameters predictive of biochemical outcome included: clinical stage, Gleason score, and risk group. Pre-treatment prostate specific antigen (PSA was not a statistically significant predictor of biochemical failure. Sixty-nine patients (76.6% experienced grade 1 urinary symptoms in the form of frequency, urgency, and poor stream. These symptoms were mostly self-limiting. Four patients needed catheterization for urinary retention (grade 2. One patient developed a recto urethral fistula (grade 3 following banding for hemorrhoids. Conclusions : Our results compare favorably with those reported by other institutions with more extensive experience. We believe therefore that, interstitial permanent brachytherapy can be safely and effectively

  17. Automated intraoperative calibration for prostate cancer brachytherapy

    International Nuclear Information System (INIS)

    Kuiran Chen, Thomas; Heffter, Tamas; Lasso, Andras; Pinter, Csaba; Abolmaesumi, Purang; Burdette, E. Clif; Fichtinger, Gabor

    2011-01-01

    Purpose: Prostate cancer brachytherapy relies on an accurate spatial registration between the implant needles and the TRUS image, called ''calibration''. The authors propose a new device and a fast, automatic method to calibrate the brachytherapy system in the operating room, with instant error feedback. Methods: A device was CAD-designed and precision-engineered, which mechanically couples a calibration phantom with an exact replica of the standard brachytherapy template. From real-time TRUS images acquired from the calibration device and processed by the calibration system, the coordinate transformation between the brachytherapy template and the TRUS images was computed automatically. The system instantly generated a report of the target reconstruction accuracy based on the current calibration outcome. Results: Four types of validation tests were conducted. First, 50 independent, real-time calibration trials yielded an average of 0.57 ± 0.13 mm line reconstruction error (LRE) relative to ground truth. Second, the averaged LRE was 0.37 ± 0.25 mm relative to ground truth in tests with six different commercial TRUS scanners operating at similar imaging settings. Furthermore, testing with five different commercial stepper systems yielded an average of 0.29 ± 0.16 mm LRE relative to ground truth. Finally, the system achieved an average of 0.56 ± 0.27 mm target registration error (TRE) relative to ground truth in needle insertion tests through the template in a water tank. Conclusions: The proposed automatic, intraoperative calibration system for prostate cancer brachytherapy has achieved high accuracy, precision, and robustness.

  18. Image Guided Cervical Brachytherapy: 2014 Survey of the American Brachytherapy Society.

    Science.gov (United States)

    Grover, Surbhi; Harkenrider, Matthew M; Cho, Linda P; Erickson, Beth; Small, Christina; Small, William; Viswanathan, Akila N

    2016-03-01

    To provide an update of the 2007 American brachytherapy survey on image-based brachytherapy, which showed that in the setting of treatment planning for gynecologic brachytherapy, although computed tomography (CT) was often used for treatment planning, most brachytherapists used point A for dose specification. A 45-question electronic survey on cervical cancer brachytherapy practice patterns was sent to all American Brachytherapy Society members and additional radiation oncologists and physicists based in the United States between January and September 2014. Responses from the 2007 survey and the present survey were compared using the χ(2) test. There were 370 respondents. Of those, only respondents, not in training, who treat more than 1 cervical cancer patient per year and practice in the United States, were included in the analysis (219). For dose specification to the target (cervix and tumor), 95% always use CT, and 34% always use MRI. However, 46% use point A only for dose specification to the target. There was a lot of variation in parameters used for dose evaluation of target volume and normal tissues. Compared with the 2007 survey, use of MRI has increased from 2% to 34% (Pimage-based brachytherapy has increased in the United States since the 2007 survey, there is room for further growth, particularly with the use of MRI. This increase may be in part due to educational initiatives. However, there is still significant heterogeneity in brachytherapy practice in the United States, and future efforts should be geared toward standardizing treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Image Guided Cervical Brachytherapy: 2014 Survey of the American Brachytherapy Society

    Energy Technology Data Exchange (ETDEWEB)

    Grover, Surbhi, E-mail: Surbhi.grover@uphs.upenn.edu [Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Harkenrider, Matthew M. [Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois (United States); Cho, Linda P. [Department of Radiation Oncology, Brigham & Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Erickson, Beth [Department Radiation Oncology, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Small, Christina [Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois (United States); Small, William [Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois (United States); Viswanathan, Akila N. [Department of Radiation Oncology, Brigham & Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2016-03-01

    Purpose: To provide an update of the 2007 American brachytherapy survey on image-based brachytherapy, which showed that in the setting of treatment planning for gynecologic brachytherapy, although computed tomography (CT) was often used for treatment planning, most brachytherapists used point A for dose specification. Methods and Materials: A 45-question electronic survey on cervical cancer brachytherapy practice patterns was sent to all American Brachytherapy Society members and additional radiation oncologists and physicists based in the United States between January and September 2014. Responses from the 2007 survey and the present survey were compared using the χ{sup 2} test. Results: There were 370 respondents. Of those, only respondents, not in training, who treat more than 1 cervical cancer patient per year and practice in the United States, were included in the analysis (219). For dose specification to the target (cervix and tumor), 95% always use CT, and 34% always use MRI. However, 46% use point A only for dose specification to the target. There was a lot of variation in parameters used for dose evaluation of target volume and normal tissues. Compared with the 2007 survey, use of MRI has increased from 2% to 34% (P<.0001) for dose specification to the target. Use of volume-based dose delineation to the target has increased from 14% to 52% (P<.0001). Conclusion: Although use of image-based brachytherapy has increased in the United States since the 2007 survey, there is room for further growth, particularly with the use of MRI. This increase may be in part due to educational initiatives. However, there is still significant heterogeneity in brachytherapy practice in the United States, and future efforts should be geared toward standardizing treatment.

  20. Development of applications in Internet for the calculation of solar control devices; Desarrollo de una aplicacion en Internet para el calculo de dispositivos de control solar

    Energy Technology Data Exchange (ETDEWEB)

    Perez V, Jesus B; Robles G, Saul; Villa M, Hector A; Cabanillas L, Rafael E [Universidad de Sonora, Hermosillo, Sonora (Mexico)

    2000-07-01

    In this work the development of an interactive software, visible over the World Wide Web, is presented to support the basic calculation required to control the solar gain inside buildings and houses. The site has two main parts: one part describes in a very required parameters to design devices for the control of the illumination inside the buildings, like overhangs and wingwalls for shading. The other part has the routines and procedures to calculate the sun position for any date and position over the earth, and the horizontal and vertical protection angles. The part to implement the calculations has been developed as a Java applet which can run on any platform and let the users, in an interactive way, to get the results. This software makes possible that any Internet user can run the application from his/her own computer without having to compile of use sophisticated procedures as it happens with traditional languages. With this web site it is intended to cover the necessity of having simple and reliable means for architects and civil engineers to support the use of solar energy and the saving of energy in bioclimatic design of buildings. [Spanish] En este trabajo se presenta el desarrollo de un sitio interactivo visible en el World Wide Web (WWW) que pretende servir de apoyo para los calculos basicos de control de asoleamiento en viviendas y edificios. El sitio esta conformado por dos partes principales: una parte cubre el aspecto informativo, donde en forma sencilla y clara, se explican los conceptos y parametros necesarios para disenar los dispositivos de control, alerones y parteluces. La otra parte contiene los procedimientos y las rutinas de calculo para la determinacion de la posicion solar para cualquier fecha del ano desde cualquier punto sobre la tierra, asi como los angulos de sombreado vertical y horizontal. Para la realizacion de los calculos se ha construido un applet de Java, el cual puede ejecutarse desde cualquier plataforma de computacion y

  1. Cost effective method of manual afterloading 192Ir brachytherapy

    International Nuclear Information System (INIS)

    Mohan, R.; Ravishankar, B.; Muralkrishna, B.V.

    2001-01-01

    Full text: In radiotherapy, brachytherapy mode of treatment has equal importance like the external beam radiotherapy. In our hospital we have manual afterloading 137 Cs kit supplied by BRIT for intracavitary treatment of carcinoma cervix and vaginal cases. In July 1999, we also started afterloading 192 Ir brachytherapy. For a hospital like ours, where funds are minimal, it is impossible to procure remote afterloading brachytherapy unit, which is very costly. So we have developed the cost-effective 192 Ir manual brachytherapy and so far we have done 60 cases which include intraluminal and interstitial cases

  2. Histamine release and endothelial leakage from an intravascular contrast medium

    Energy Technology Data Exchange (ETDEWEB)

    Raininko, R.

    1981-04-01

    The endothelial injury produced by meglumine iodamide was studied in the rat aorta. A mixture of blood and contrast medium was more toxic to the endothelium than the pure contrast agent. This difference disappeared after premedication with antihistamine, which did not affect the injury produced by the pure contrast agent. Meglumine iodamide appears to cause a release of histamine from blood but not from the aortic endothelium nor from surrounding tissues in amounts demonstrable by this method. Leucocytes are a source of histamine after intravascular contrast medium administration.

  3. Retinal and choroidal intravascular spectral-domain optical coherence tomography

    DEFF Research Database (Denmark)

    Willerslev, Anne; Li, Xiao Qiang; Cordtz, Peter

    2014-01-01

    on longitudinal scans and a figure-of-eight configuration on cross-sectional scans. Intravascular reflectivity decreased with increasingly oblique angles of observation and was absent when blood flow was parallel to the line of sight. The high blood flow in the choroidal vessels in healthy subjects and the low......-OCT profile of the blood column in retinal vessels with normal blood flow. Both structure and total reflectivity faded when blood flow was lower or higher than normal or at oblique angles to the line of sight. In conclusion, SD-OCT scans of the vessels in the posterior pole of the eye may assist the clinical...

  4. Why Have So Many Intravascular Glucose Monitoring Devices Failed?

    Science.gov (United States)

    Smith, John L; Rice, Mark J

    2015-07-01

    Secondary to the inherent limitations of both point-of-care and central laboratory glucose technologies, continuous glucose measurement has recently enjoyed a high level of investment. Because of the perceived advantages by some of measuring in the intravascular space compared to the subcutaneous tissue, a number of technologies have been developed. In this review, we evaluate nine systems that have shown promise, although only one of these has been cleared for sale in the United States. The detection methodology, regulatory status, technical issues, and company circumstance surrounding each technology are examined. © 2015 Diabetes Technology Society.

  5. Recurring extracranial internal carotid artery vasospasm detected by intravascular ultrasound.

    Science.gov (United States)

    Dembo, Tomohisa; Tanahashi, Norio

    2012-01-01

    A 24-year-old woman presented with headache and left-sided focal signs following multiple episodes of right monocular visual impairment. Magnetic resonance angiography revealed a decreased vascular image intensity due to a suspicious stenosis in the right internal carotid artery (ICA). The stenosis was not demonstrated on duplex sonography as it was beyond the field of view of the investigation. Intravascular ultrasound (IVUS) revealed that the outer vessel diameter was significantly reduced during stenosis, supporting the presence of vasospasm. Idiopathic recurrent extracranial ICA vasospasm was diagnosed. Recurrent vasospasms of extracranial ICA may be a distinct entity that can cause ischemic stroke.

  6. Assessing mechanical properties with intravascular or endoscopic optical coherence tomography

    Science.gov (United States)

    Lamouche, G.; Azarnoush, H.; Vergnole, S.; Pazos, V.; Bisaillon, C.-E.; Debergue, P.; Boulet, B.; Diraddo, R.

    2011-03-01

    We explore the potential of intravascular or endoscopic optical coherence tomography (OCT) to extract relevant mechanical properties of a tissue deformed by an inflating balloon. Tubular OCT phantoms with different mechanical properties are fabricated. The phantoms are deformed by an inflating balloon, and the deformation is monitored with OCT. A quantitative description of the phantom deformation is obtained by segmenting the OCT images. Two strategies to extract the mechanical properties from this quantitative data are presented: by comparing to a finite-element simulation and by performing a mechanical analysis.

  7. Intravascular stenting (IVaS) method for fingertip replantation.

    Science.gov (United States)

    Narushima, Mitsunaga; Mihara, Makoto; Koshima, Isao; Gonda, Koichi; Takuya, Iida; Kato, Harunosuke; Nakanishi, Kenji; Yamamoto, Yusuke; Araki, Jun; Abe, Hiroaki; Mundinger, Gerhard S; Kikuchi, Kazuki; Uehara, Eri

    2009-01-01

    Remarkable progress has been made in microsurgery. However, fingertip replantation following amputation has not gained much popularity because of its technical difficulty. We have developed the intravascular stenting (IVaS) method, in which a nylon monofilament is placed inside the vessel lumen to act as a temporary stent, facilitating anastomosis completion. This report describes 7 fingertip replantations using the IVaS method. Intravascular stent size varied from 4-0 to 6-0 (0.199-0.07 mm diameter). There were no cases in which the back wall of a vessel became inadvertently caught in the anastomosis. The overall survival rate for distal digital replants was 85% (6/7 replants). It is very difficult to evenly anastomose vessels of differing diameter, especially on a supermicrosurgical scale. In this respect, the IVaS method plays a role in stably anchoring the 2 vessel ends, allowing for the even spacing of suture knots, even in vessels of different caliber. Because of its ease of use and exactitude, many surgeons may be able to use the IVaS method to reliably complete small anastomoses in fingertip replantations.

  8. High speed intravascular photoacoustic imaging of atherosclerotic arteries (Conference Presentation)

    Science.gov (United States)

    Piao, Zhonglie; Ma, Teng; Qu, Yueqiao; Li, Jiawen; Yu, Mingyue; He, Youmin; Shung, K. Kirk; Zhou, Qifa; Kim, Chang-Seok; Chen, Zhongping

    2016-02-01

    Cardiovascular disease is the leading cause of death in the industrialized nations. Accurate quantification of both the morphology and composition of lipid-rich vulnerable atherosclerotic plaque are essential for early detection and optimal treatment in clinics. In previous works, intravascular photoacoustic (IVPA) imaging for detection of lipid-rich plaque within coronary artery walls has been demonstrated in ex vivo, but the imaging speed is still limited. In order to increase the imaging speed, a high repetition rate laser is needed. In this work, we present a high speed integrated IVPA/US imaging system with a 500 Hz optical parametric oscillator laser at 1725 nm. A miniature catheter with 1.0 mm outer diameter was designed with a 200 μm multimode fiber and an ultrasound transducer with 45 MHz center frequency. The fiber was polished at 38 degree and enclosed in a glass capillary for total internal reflection. An optical/electrical rotary junction and pull-back mechanism was applied for rotating and linearly scanning the catheter to obtain three-dimensional imaging. Atherosclerotic rabbit abdominal aorta was imaged as two frame/second at 1725 nm. Furthermore, by wide tuning range of the laser wavelength from 1680 nm to 1770 nm, spectroscopic photoacoustic analysis of lipid-mimicking phantom and an human atherosclerotic artery was performed ex vivo. The results demonstrated that the developed IVPA/US imaging system is capable for high speed intravascular imaging for plaque detection.

  9. Late adverse reactions to intravascular iodinated contrast media

    International Nuclear Information System (INIS)

    Webb, Judith A.W.; Stacul, Fulvio; Thomsen, Henrik S.; Morcos, Sameh K.

    2003-01-01

    Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions. (orig.)

  10. An Implantable Intravascular Pressure Sensor for a Ventricular Assist Device

    Directory of Open Access Journals (Sweden)

    Luigi Brancato

    2016-08-01

    Full Text Available The aim of this study is to investigate the intravascular application of a micro-electro-mechanical system (MEMS pressure sensor to directly measure the hemodynamic characteristics of a ventricular assist device (VAD. A bio- and hemo-compatible packaging strategy is implemented, based on a ceramic thick film process. A commercial sub-millimeter piezoresistive sensor is attached to an alumina substrate, and a double coating of polydimethylsiloxane (PDMS and parylene-C is applied. The final size of the packaged device is 2.6 mm by 3.6 mm by 1.8 mm. A prototype electronic circuit for conditioning and read-out of the pressure signal is developed, satisfying the VAD-specific requirements of low power consumption (less than 14.5 mW in continuous mode and small form factor. The packaged sensor has been submitted to extensive in vitro tests. The device displayed a temperature-independent sensitivity (12 μ V/V/mmHg and good in vitro stability when exposed to the continuous flow of saline solution (less than 0.05 mmHg/day drift after 50 h. During in vivo validation, the transducer has been successfully used to record the arterial pressure waveform of a female sheep. A small, intravascular sensor to continuously register the blood pressure at the inflow and the outflow of a VAD is developed and successfully validated in vivo.

  11. A review of the clinical experience in pulsed dose rate brachytherapy

    NARCIS (Netherlands)

    Balgobind, Brian V.; Koedooder, Kees; Ordoñez Zúñiga, Diego; Dávila Fajardo, Raquel; Rasch, Coen R. N.; Pieters, Bradley R.

    2015-01-01

    Pulsed dose rate (PDR) brachytherapy is a treatment modality that combines physical advantages of high dose rate (HDR) brachytherapy with the radiobiological advantages of low dose rate brachytherapy. The aim of this review was to describe the effective clinical use of PDR brachytherapy worldwide in

  12. The evolution of brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Rivard, Mark J.; Venselaar, Jack L. M.; Beaulieu, Luc

    2009-01-01

    Brachytherapy is a mature treatment modality that has benefited from technological advances. Treatment planning has advanced from simple lookup tables to complex, computer-based dose-calculation algorithms. The current approach is based on the AAPM TG-43 formalism with recent advances in acquiring single-source dose distributions. However, this formalism has clinically relevant limitations for calculating patient dose. Dose-calculation algorithms are being developed based on Monte Carlo methods, collapsed cone, and solving the linear Boltzmann transport equation. In addition to improved dose-calculation tools, planning systems and brachytherapy treatment planning will account for material heterogeneities, scatter conditions, radiobiology, and image guidance. The AAPM, ESTRO, and other professional societies are working to coordinate clinical integration of these advancements. This Vision 20/20 article provides insight into these endeavors.

  13. Sexual function after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Galbreath, R.W.; Merrick, G.S.; Butler, W.M.; Stipetich, R.L.; Abel, L.J.; Lief, J.H.

    2001-01-01

    Purpose: To determine the incidence of potency preservation following permanent prostate brachytherapy and to evaluate the effect of multiple clinical and treatment parameters on penile erectile function. Materials and Methods: 425 patients underwent permanent prostate brachytherapy from April 1995 to October 1999. 209 patients who were potent prior to brachytherapy and currently not receiving hormonal manipulation were mailed an International Index of Erectile Function (IIEF) questionnaire with a pre-addressed stamped envelope. 180 patients completed and returned the questionnaire. Median patient follow-up was 39 months (range 18-74 months). Pre-implant erectile function was assigned using a three-tiered scoring system (2 = erections always or nearly always sufficient for vaginal penetration; 1 = erections sufficient for vaginal penetration but considered suboptimal; 0 = the inability to obtain erections and/or erections inadequate for vaginal penetration). Post-implant potency was defined as an IIEF score >11. Clinical parameters evaluated for sexual function included patient age, clinical T stage, elapsed time since implantation, hypertension, diabetes mellitus, and tobacco consumption. Evaluated treatment parameters included the utilization of neoadjuvant hormonal manipulation and the choice of isotope. The efficacy of sildenafil citrate in brachytherapy induced erectile dysfunction (ED) was also evaluated. Results: A pre-treatment erectile function score of 2 and 1 were assigned to 126 and 54 patients respectively. With 6 year follow up, 39% of patients maintained potency following prostate brachytherapy with a plateau on the curve. Post-implant preservation of potency (IIEF>11) correlated with pre-implant erectile function (50% versus 14% for pre-implant scores of 2 and 1 respectively, p≤0.0001), patient age (56%, 38%, and 23% for patients <60 years of age, 60-69 years of age, and ≥70 years of age respectively, p=0.012) and a history of diabetes mellitus

  14. Procedures for calibration of brachytherapy sources

    International Nuclear Information System (INIS)

    Alfonso Laguardia, R.; Alonso Samper, J.L.; Morales Lopez, J.L.; Saez Nunez, D.G.

    1997-01-01

    Brachytherapy source strength verification is a responsibility of the user of these source, in fact of the Medical Physicists in charge of this issue in a Radiotherapy Service. The calibration procedures in the users conditions are shown. Specifics methods for source strength determination are recommended, both for High Dose Rate (HDR) sources with Remote Afterloading equipment and for Low Dose Rate sources. The The results of the calibration of HDR Remote After loaders are indicated

  15. Development of a brachytherapy audit checklist tool.

    Science.gov (United States)

    Prisciandaro, Joann; Hadley, Scott; Jolly, Shruti; Lee, Choonik; Roberson, Peter; Roberts, Donald; Ritter, Timothy

    2015-01-01

    To develop a brachytherapy audit checklist that could be used to prepare for Nuclear Regulatory Commission or agreement state inspections, to aid in readiness for a practice accreditation visit, or to be used as an annual internal audit tool. Six board-certified medical physicists and one radiation oncologist conducted a thorough review of brachytherapy-related literature and practice guidelines published by professional organizations and federal regulations. The team members worked at two facilities that are part of a large, academic health care center. Checklist items were given a score based on their judged importance. Four clinical sites performed an audit of their program using the checklist. The sites were asked to score each item based on a defined severity scale for their noncompliance, and final audit scores were tallied by summing the products of importance score and severity score for each item. The final audit checklist, which is available online, contains 83 items. The audit scores from the beta sites ranged from 17 to 71 (out of 690) and identified a total of 7-16 noncompliance items. The total time to conduct the audit ranged from 1.5 to 5 hours. A comprehensive audit checklist was developed which can be implemented by any facility that wishes to perform a program audit in support of their own brachytherapy program. The checklist is designed to allow users to identify areas of noncompliance and to prioritize how these items are addressed to minimize deviations from nationally-recognized standards. Copyright © 2015 American Brachytherapy Society. All rights reserved.

  16. Brachytherapy treatment with high dose rate

    International Nuclear Information System (INIS)

    Santana Rodriguez, Sergio Marcelino; Rodriguez Rodriguez, Lissi Lisbet; Ciscal Chiclana, Onelio Alberto

    2009-01-01

    Retrospectively analyze results and prognostic factors of cervical cancer patients treated with radio concomitant cisplatin-based chemotherapy, radiation therapy combined modality. Methods: From January 2003 to December 2007, 198 patients with invasive cervical cancer were treated at the Oncology Department of Hospital Robau Celestino Hernandez (brachytherapy performed at INOR). The most common age group was 31 to 40 years. The histology in squamous cell carcinoma accounted for 84.3% of cases. The treatment consisted of external pelvic irradiation and vaginal brachytherapy, high dose rate. Concomitant chemotherapy consisted of cisplatin 40 mg/m2 weekly with a maximum of 70 mg for 5 weeks. Results: 66.2% of patients completed 5 cycles of chemotherapy. The median overall survival was 39 months, overall survival, disease-free survival and survival free of locoregional recurrence at 5 years of 78%, 76% and 78.6% respectively .. We found that clinical stage, histological type (adenocarcinoma worst outcome) were statistically related to level of response. Conclusions: Treatment with external pelvic radiation, brachytherapy and concurrent weekly cisplatin in patients with stage IIIB cervical cancer is feasible in the Chilean public health system, well tolerated and results comparable to international literature. (Author)

  17. Radioactive seed immobilization techniques for interstitial brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Yan, K.; Podder, T.; Buzurovic, I.; Hu, Y.; Dicker, A.; Valicenti, R.; Yu, Y. [Thomas Jefferson University, Department of Radiation Oncology, Philadelphia, PA (United States); Messing, E. [University of Rochester, Departments of Urology and Surgery, Rochester, NY (United States); Rubens, D. [University of Rochester, Departments of Imaging Science and Surgery, Rochester, NY (United States); Sarkar, N. [Vanderbilt University, Department of Mechanical Engineering, Nashville, TN (United States); Ng, W. [Nangyang Technical University, School of Mechanical and Aerospace Engineering, Singapore (Singapore)

    2008-06-15

    In prostate brachytherapy, seeds can detach from their deposited sites and move locally in the pelvis or migrate to distant sites including the pulmonary and cardiac regions. Undesirable consequences of seed migration include inadequate dose coverage of the prostate and tissue irradiation effects at the site of migration. Thus, it is clinically important to develop seed immobilization techniques. We first analyze the possible causes for seed movement, and propose three potential techniques for seed immobilization: (1) surgical glue, (2) laser coagulation and (3) diathermy coagulation. The feasibility of each method is explored. Experiments were carried out using fresh bovine livers to investigate the efficacy of seed immobilization using surgical glue. Results have shown that the surgical glue can effectively immobilize the seeds. Evaluation of the radiation dose distribution revealed that the non-immobilized seed movement would change the planned isodose distribution considerably; while by using surgical glue method to immobilize the seeds, the changes were negligible. Prostate brachytherapy seed immobilization is necessary and three alternative mechanisms are promising for addressing this issue. Experiments for exploring the efficacy of the other two proposed methods are ongoing. Devices compatible with the brachytherapy procedure will be designed in future. (orig.)

  18. Dosimetry in high dose rate endoluminal brachytherapy

    International Nuclear Information System (INIS)

    Uno, Takashi; Kotaka, Kikuo; Itami, Jun

    1994-01-01

    In endoluminal brachytherapy for the tracheobronchial tree, esophagus, and bile duct, a reference point for dose calculation has been often settled at 1 cm outside from the middle of source travel path. In the current study, a change in the ratio of the reference point dose on the convex to concave side (Dq/Dp) was calculated, provided the source travel path bends as is the case in most endoluminal brachytherapies. Point source was presumed to move stepwise at 1 cm interval from 4 to 13 locations. Retention time at each location was calculated by personal computer so as to deliver equal dose at 1 cm from the linear travel path. With the retention time remaining constant, the change of Dq/Dp was assessed by bending the source travel path. Results indicated that the length of the source travel path and radius of its curve influenced the pattern of change in Dq/Dp. Therefore, it was concluded that the difference in reference dose on the convex and concave side of the curved path is not negligible under certain conditions in endoluminal brachytherapy. In order to maintain the ratio more than 0.9, relatively greater radius was required when the source travel path was decreased. (author)

  19. Brachytherapy in treatment of vaginal cancer

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2016-01-01

    Full Text Available Characteristics of diagnosis and treatment of different types of primary vaginal cancer are highlighted, the role and place of brachytherapy as independent method or combined treatment modality for this pathology is shown in the review. Epidemiological data on incidence of vaginal cancer in Russia are represented, presumptive mechanisms for development of the disease, risk factors, histological types, features of the course, clinical presentation, diagnostic algorithm are described. Treatment methods for primary vaginal cancer according to world standards such as surgery, radiotherapy and systemic drug therapy are covered. Specifics of radiological methods of treatment (low-dose rate and high-dose rate brachytherapy, including the combination with external beam radiotherapy according to the stage of the disease, are shown in details. The results of several large foreign clinical trials for efficiency of different methods of radiotherapy are discussed. The combination of brachytherapy on primary tumor with external radiation therapy to the lymph nodes was confirmed to be the most effective modality. The conclusion on opportunities of different methods of radiotherapy in treatment of vaginal cancer was made.

  20. Brachytherapy in the treatment of cervical cancer: a review

    Directory of Open Access Journals (Sweden)

    Banerjee R

    2014-05-01

    Full Text Available Robyn Banerjee,1 Mitchell Kamrava21Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada; 2Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USAAbstract: Dramatic advances have been made in brachytherapy for cervical cancer. Radiation treatment planning has evolved from two-dimensional to three-dimensional, incorporating magnetic resonance imaging and/or computed tomography into the treatment paradigm. This allows for better delineation and coverage of the tumor, as well as improved avoidance of surrounding organs. Consequently, advanced brachytherapy can achieve very high rates of local control with a reduction in morbidity, compared with historic approaches. This review provides an overview of state-of-the-art gynecologic brachytherapy, with a focus on recent advances and their implications for women with cervical cancer.Keywords: cervical cancer, brachytherapy, image-guided brachytherapy

  1. Accelerated partial breast irradiation utilizing balloon brachytherapy techniques

    International Nuclear Information System (INIS)

    Strauss, Jonathan B.; Dickler, Adam

    2009-01-01

    To overcome the barriers to BCT, methods of PBI in the setting of breast conservation have been explored. The method of PBI with the longest published follow-up is multi-catheter interstitial brachytherapy. Balloon-based brachytherapy with the MammoSite brachytherapy applicator was designed to simplify the brachytherapy procedure for PBI, enhance the reproducibility of the dosimetry, and improve patient comfort. The rates of local recurrence following PBI with the MammoSite applicator have been low, but there are few published reports and follow-up has been relatively short. The cosmetic outcomes and toxicity of MammoSite PBI are comparable to those seen after multicatheter-based PBI. Additional methods of balloon brachytherapy, including Xoft and SenoRx Contura have been developed. Finally, long-term follow-up after PBI is important for the welfare of individual patients and in order to establish the efficacy, late toxicity and cosmetic outcomes of this technique.

  2. Penile brachytherapy: Results for 49 patients

    International Nuclear Information System (INIS)

    Crook, Juanita M.; Jezioranski, John; Grimard, Laval; Esche, Bernd; Pond, G.

    2005-01-01

    Purpose: To report results for 49 men with squamous cell carcinoma (SCC) of the penis treated with primary penile interstitial brachytherapy at one of two institutions: the Ottawa Regional Cancer Center, Ottawa, and the Princess Margaret Hospital, Toronto, Ontario, Canada. Methods and Materials: From September 1989 to September 2003, 49 men (mean age, 58 years; range, 22-93 years) had brachytherapy for penile SCC. Fifty-one percent of tumors were T1, 33% T2, and 8% T3; 4% were in situ and 4% Tx. Grade was well differentiated in 31%, moderate in 45%, and poor in 2%; grade was unspecified for 20%. One tumor was verrucous. All tumors in Toronto had pulsed dose rate (PDR) brachytherapy (n = 23), whereas those in Ottawa had either Iridium wire (n 22) or seeds (n = 4). Four patients had a single plane implant with a plastic tube technique, and all others had a volume implant with predrilled acrylic templates and two or three parallel planes of needles (median, six needles). Mean needle spacing was 13.5 mm (range, 10-18 mm), mean dose rate was 65 cGy/h (range, 33-160 cGy/h), and mean duration was 98.8 h (range, 36-188 h). Dose rates for PDR brachytherapy were 50-61.2 cGy/h, with no correction in total dose, which was 60 Gy in all cases. Results: Median follow-up was 33.4 months (range, 4-140 months). At 5 years, actuarial overall survival was 78.3% and cause-specific survival 90.0%. Four men died of penile cancer, and 6 died of other causes with no evidence of recurrence. The cumulative incidence rate for never having experienced any type of failure at 5 years was 64.4% and for local failure was 85.3%. All 5 patients with local failure were successfully salvaged by surgery; 2 other men required penectomy for necrosis. The soft tissue necrosis rate was 16% and the urethral stenosis rate 12%. Of 8 men with regional failure, 5 were salvaged by lymph node dissection with or without external radiation. All 4 men with distant failure died of disease. Of 49 men, 42 had an intact

  3. Erectile function after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Galbreath, Robert W.; Stipetich, Robin L.; Abel, Laurie J.; Lief, Jonathan H.

    2002-01-01

    Purpose: To determine the incidence of potency preservation after permanent prostate brachytherapy using a validated patient-administered questionnaire and to evaluate the effect of multiple clinical and treatment parameters on penile erectile function. Methods and Materials: Four hundred twenty-five patients underwent permanent prostate brachytherapy from April 1995 to October 1999. Two hundred nine patients who were potent before brachytherapy and who at the time of the survey were not receiving hormonal therapy were mailed the specific erectile questions of the International Index of Erectile Function (IIEF) questionnaire with a self-addressed stamped envelope. The questionnaire consisted of 5 questions, with a maximal score of 25. Of the 209 patients, 181 (87%) completed and returned the questionnaire. The mean and median follow-up was 40.4±14.9 and 40.6 months, respectively (range 19-75). Preimplant erectile function was assigned using a three-tiered scoring system (2 = erections always or nearly always sufficient for vaginal penetration; 1 = erections sufficient for vaginal penetration but considered suboptimal; 0 = the inability to obtain erections and/or erections inadequate for vaginal penetration). Postimplant potency was defined as an IIEF score ≥11. The clinical parameters evaluated for erectile function included patient age, preimplant potency, clinical T-stage, pretreatment prostate-specific antigen level, Gleason score, elapsed time after implantation, hypertension, diabetes mellitus, and tobacco consumption. Treatment parameters included radiation dose to the prostate gland, use of hormonal manipulation, use of supplemental external beam radiotherapy (EBRT), choice of isotope, prostate volume, and planning volume. The efficacy of sildenafil citrate in brachytherapy-induced erectile dysfunction (ED) was also evaluated. Results: Pretreatment erectile function scores of 2 and 1 were assigned to 125 and 56 patients, respectively. With a 6-year follow

  4. Nanoparticles for intravascular applications: physicochemical characterization and cytotoxicity testing.

    Science.gov (United States)

    Matuszak, Jasmin; Baumgartner, Jens; Zaloga, Jan; Juenet, Maya; da Silva, Acarília Eduardo; Franke, Danielle; Almer, Gunter; Texier, Isabelle; Faivre, Damien; Metselaar, Josbert M; Navarro, Fabrice P; Chauvierre, Cédric; Prassl, Ruth; Dézsi, László; Urbanics, Rudolf; Alexiou, Christoph; Mangge, Harald; Szebeni, János; Letourneur, Didier; Cicha, Iwona

    2016-03-01

    We report the physicochemical analysis of nanosystems intended for cardiovascular applications and their toxicological characterization in static and dynamic cell culture conditions. Size, polydispersity and ζ-potential were determined in 10 nanoparticle systems including liposomes, lipid nanoparticles, polymeric and iron oxide nanoparticles. Nanoparticle effects on primary human endothelial cell viability were monitored using real-time cell analysis and live-cell microscopy in static conditions, and in a flow model of arterial bifurcations. The majority of tested nanosystems were well tolerated by endothelial cells up to the concentration of 100 μg/ml in static, and up to 400 μg/ml in dynamic conditions. Pilot experiments in a pig model showed that intravenous administration of liposomal nanoparticles did not evoke the hypersensitivity reaction. These findings are of importance for future clinical use of nanosystems intended for intravascular applications.

  5. Intravascular Myopericytoma in the Heel: Case Report and Literature Review

    Science.gov (United States)

    Valero, José; Salcini, José L.; Gordillo, Luis; Gallart, José; González, David; Deus, Javier; Lahoz, Manuel

    2015-01-01

    Abstract Intravascular myopericytoma (IVMP), regarded as a variant of myopericytoma, is a rare tumor. Very few cases have been described, none in the foot. The first case of IVMP located in the heel of the foot is described in this article. A literature review is reported of all cases of IVMP published in the English literature. A 48-year-old man possessed an IVMP on the heel of the right foot. The physical examination and histopathological and ultrasound studies are described. The literature review yielded 5 cases of IVMP, 2 of which were in the thigh and 1 each in the oral mucosa, the periorbital region, and the leg. The possibility that these lesions may be malignant suggests that the histopathological study of vascular tumors should include immunohistochemical tests. PMID:25789958

  6. Theoretical model of intravascular paramagnetic tracers effect on tissue relaxation

    DEFF Research Database (Denmark)

    Kjølby, Birgitte Fuglsang; Østergaard, Leif; Kiselev, Valerij G

    2006-01-01

    The concentration of MRI tracers cannot be measured directly by MRI and is commonly evaluated indirectly using their relaxation effect. This study develops a comprehensive theoretical model to describe the transverse relaxation in perfused tissue caused by intravascular tracers. The model takes...... into account a number of individual compartments. The signal dephasing is simulated in a semianalytical way by embedding Monte Carlo simulations in the framework of analytical theory. This approach yields a tool for fast, realistic simulation of the change in the transverse relaxation. The results indicate...... with bulk blood. The enhancement of relaxation in tissue is due to the contrast in magnetic susceptibility between blood vessels and parenchyma induced by the presence of paramagnetic tracer. Beyond the perfusion measurements, the results can be applied to quantitation of functional MRI and to vessel size...

  7. Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas

    Directory of Open Access Journals (Sweden)

    Faruk Altinel

    2014-06-01

    Full Text Available Traumatic injury is one of the most important cause of disseminated intravascular coagulation (DIC. It occurs because of blood loss and hemodilution due to fluid resuscitation. The incidence of trauma associated DIC is mainly higher in the craniocerebral traumas. Even though craniocerebral trauma related DIC is well defined, the pathophysiology has been poorly characterized in the literature. Due to the fact that brain tissue is highly significant for procoagulant molecules, craniocerebral traumas are closely related to DIC. In the current study, 30 patients admitted to emergency room have been considered on the first and fifth day of admission to the hospital for the coagulation tests to evaluate DIC in both two groups. [Cukurova Med J 2014; 39(3.000: 488-495

  8. Scary gas: intravascular, intracranial, and intraspinal ectopic gas (part III).

    Science.gov (United States)

    Sandstrom, Claire K; Osman, Sherif F; Linnau, Ken F

    2017-08-01

    While ectopic gas can be a sign of dangerous disease requiring immediate medical or surgical intervention, it can also be an incidental and benign finding. Intravenous gas and spinal vacuum gas are common and almost always benign. Intravascular gas is most often related to instrumentation and, if intraarticular, can cause end-organ ischemia; however, treatment is usually supportive. Pneumocephalus arises from a communication with paranasal sinuses or mastoids more often than from meningeal infection and can usually be managed nonoperatively. In part 3 of this series, the different causes of ectopic gas in the vessels, skull, and spine are reviewed, as are the imaging features that can help to narrow the differential diagnosis.

  9. Mathematical Modeling of Intravascular Blood Coagulation under Wall Shear Stress

    Science.gov (United States)

    Rukhlenko, Oleksii S.; Dudchenko, Olga A.; Zlobina, Ksenia E.; Guria, Georgy Th.

    2015-01-01

    Increased shear stress such as observed at local stenosis may cause drastic changes in the permeability of the vessel wall to procoagulants and thus initiate intravascular blood coagulation. In this paper we suggest a mathematical model to investigate how shear stress-induced permeability influences the thrombogenic potential of atherosclerotic plaques. Numerical analysis of the model reveals the existence of two hydrodynamic thresholds for activation of blood coagulation in the system and unveils typical scenarios of thrombus formation. The dependence of blood coagulation development on the intensity of blood flow, as well as on geometrical parameters of atherosclerotic plaque is described. Relevant parametric diagrams are drawn. The results suggest a previously unrecognized role of relatively small plaques (resulting in less than 50% of the lumen area reduction) in atherothrombosis and have important implications for the existing stenting guidelines. PMID:26222505

  10. Robust intravascular optical coherence elastography by line correlations

    International Nuclear Information System (INIS)

    Soest, Gijs van; Mastik, Frits; Jong, Nico de; Steen, Anton F W van der

    2007-01-01

    We present a new method for intravascular optical coherence elastography, which is robust against motion artefacts. It employs the correlation between adjacent lines, instead of subsequent frames. Pressure to deform the tissue is applied synchronously with the line scan rate of the optical coherence tomography (OCT) instrument. The viability of the method is demonstrated with a simulation study. We find that the root mean square (rms) error of the displacement estimate is 0.55 μm, and the rms error of the strain is 0.6%. It is shown that high-strain spots in the vessel wall, such as observed at the sites of vulnerable atherosclerotic lesions, can be detected with the technique

  11. The american brachytherapy society recommendations for permanent prostate brachytherapy postimplant dosimetric analysis

    International Nuclear Information System (INIS)

    Nag, Subir; Bice, William; Wyngaert, Keith de; Prestidge, Bradley; Stock, Richard; Yu Yan

    2000-01-01

    Purpose: The purpose of this report is to establish guidelines for postimplant dosimetric analysis of permanent prostate brachytherapy. Methods: Members of the American Brachytherapy Society (ABS) with expertise in prostate dosimetry evaluation performed a literature review and supplemented with their clinical experience formulated guidelines for performing and analyzing postimplant dosimetry of permanent prostate brachytherapy. Results: The ABS recommends that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy for optimal patient care. At present, computed tomography (CT)-based dosimetry is recommended, based on availability cost and the ability to image the prostate as well as the seeds. Additional plane radiographs should be obtained to verify the seed count. Until the ideal postoperative interval for CT scanning has been determined, each center should perform dosimetric evaluation of prostate implants at a consistent postoperative interval. This interval should be reported. Isodose displays should be obtained at 50%, 80%, 90%, 100%, 150%, and 200% of the prescription dose and displayed on multiple cross-sectional images of the prostate. A dose-volume histogram (DVH) of the prostate should be performed and the D 90 (dose to 90% of the prostate gland) reported by all centers. Additionally, the D 80, D 100, the fractional V 80, V 90, V 100, V 150, and V 200, (i.e., the percentage of prostate volume receiving 80%, 90%, 100%, 150%, and 200% of the prescribed dose, respectively), the rectal, and urethral doses should be reported and ultimately correlated with clinical outcome in the research environment. On-line real-time dosimetry, the effects of dose heterogeneity, and the effects of tissue heterogeneity need further investigation. Conclusion: It is essential that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy. Guidelines were established for the performance

  12. Multihelix rotating shield brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States); Kim, Yusung; Flynn, Ryan T., E-mail: ryan-flynn@uiowa.edu [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Wu, Xiaodong [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States)

    2015-11-15

    Purpose: To present a novel brachytherapy technique, called multihelix rotating shield brachytherapy (H-RSBT), for the precise angular and linear positioning of a partial shield in a curved applicator. H-RSBT mechanically enables the dose delivery using only linear translational motion of the radiation source/shield combination. The previously proposed approach of serial rotating shield brachytherapy (S-RSBT), in which the partial shield is rotated to several angular positions at each source dwell position [W. Yang et al., “Rotating-shield brachytherapy for cervical cancer,” Phys. Med. Biol. 58, 3931–3941 (2013)], is mechanically challenging to implement in a curved applicator, and H-RSBT is proposed as a feasible solution. Methods: A Henschke-type applicator, designed for an electronic brachytherapy source (Xoft Axxent™) and a 0.5 mm thick tungsten partial shield with 180° or 45° azimuthal emission angles and 116° asymmetric zenith angle, is proposed. The interior wall of the applicator contains six evenly spaced helical keyways that rigidly define the emission direction of the partial radiation shield as a function of depth in the applicator. The shield contains three uniformly distributed protruding keys on its exterior wall and is attached to the source such that it rotates freely, thus longitudinal translational motion of the source is transferred to rotational motion of the shield. S-RSBT and H-RSBT treatment plans with 180° and 45° azimuthal emission angles were generated for five cervical cancer patients with a diverse range of high-risk target volume (HR-CTV) shapes and applicator positions. For each patient, the total number of emission angles was held nearly constant for S-RSBT and H-RSBT by using dwell positions separated by 5 and 1.7 mm, respectively, and emission directions separated by 22.5° and 60°, respectively. Treatment delivery time and tumor coverage (D{sub 90} of HR-CTV) were the two metrics used as the basis for evaluation and

  13. Biology of dose rate in brachytherapy

    International Nuclear Information System (INIS)

    Brenner, David J.

    1995-01-01

    Purpose: This course is designed for practitioners and beginners in brachytherapy. The aim is to review biological principles underlying brachytherapy, to understand why current treatment regimes are the way they are, and to discuss what the future may hold in store. Brachytherapy has a long history. It was suggested as long ago as 1903 by Alexander Graham Bell, and the optimal application of this technique has been a subject of debate ever since. 'Brachy' means 'short', and the essential features of conventional brachytherapy are: positioning of the source a short distance from, or in, the tumor, allowing good dose distributions; short overall treatment times, to counter tumor repopulation; low dose rate, enabling a good therapeutic advantage between tumor control and damage to late-responding tissue. The advantages of good dose distributions speak for themselves; in some situations, as we shall see, computer-based dose optimization can be used to improve them still further. The advantages of short overall times stem from the fact that accelerated repopulation of the tumor typically begins a few weeks after the start of a radiation treatment. If all the radiation can be crammed in before that time, the risks of tumor repopulation can be considerably reduced. In fact even external-beam radiotherapy is moving in this direction, with the use of highly accelerated protocols. The advantages of low dose rate stem from the differential response to fractionation of early- and late-responding tissues. Essentially, lowering the dose rate spares late-responding tissue more than it does early-responding tissue such as tumors. We shall also discuss some recent innovations in the context of the general principles that have been outlined. For example, High dose rate brachytherapy, particularly for the uterine cervix: Does it work? If so, when and why? Use of Ir-192 sources, with a half life of 70 days: Should corrections be made for changing biological effectiveness as the dose

  14. Caudal epidural anesthesia during intracavitary brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    Isoyama-Shirakawa, Yuko; Abe, Madoka; Nakamura, Katsumasa

    2015-01-01

    It has been suggested that pain control during intracavitary brachytherapy for cervical cancer is insufficient in most hospitals in Japan. Our hospital began using caudal epidural anesthesia during high-dose-rate (HDR) intracavitary brachytherapy in 2011. The purpose of the present study was to retrospectively investigate the effects of caudal epidural anesthesia during HDR intracavitary brachytherapy for cervical cancer patients. Caudal epidural anesthesia for 34 cervical cancer patients was performed during HDR intracavitary brachytherapy between October 2011 and August 2013. We used the patients' self-reported Numeric Rating Scale (NRS) score at the first session of HDR intracavitary brachytherapy as a subjective evaluation of pain. We compared NRS scores of the patients with anesthesia with those of 30 patients who underwent HDR intracavitary brachytherapy without sacral epidural anesthesia at our hospital between May 2010 and August 2011. Caudal epidural anesthesia succeeded in 33 patients (97%), and the NRS score was recorded in 30 patients. The mean NRS score of the anesthesia group was 5.17 ± 2.97, significantly lower than that of the control group's 6.80 ± 2.59 (P = 0.035). The caudal epidural block resulted in no side-effects. Caudal epidural anesthesia is an effective and safe anesthesia option during HDR intracavitary brachytherapy for cervical cancer. (author)

  15. The dosimetry of brachytherapy-induced erectile dysfunction

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.

    2003-01-01

    There is emerging evidence that brachytherapy-induced erectile dysfunction (ED) is technique-related and may be minimized by careful attention to source placement. Herein, we review the relationship between radiation doses to the prostate gland/surrounding structures and the development of brachytherapy-induced ED. The permanent prostate brachytherapy literature was reviewed using MEDLINE searches to ensure completeness. Although the site-specific structure associated with brachytherapy-induced ED remains unknown, there is an increasing body of data implicating the proximal penis. With day 0 CT-based dosimetry, the dose to 50% (D 50 ) and 25% (D 25 ) of the bulb of the penis should be maintained below 40% and 60% mPD, respectively, while the crura D 50 should be maintained below 28% mPD to maximize post-brachytherapy potency. To date, there is no data to suggest that either radiation doses to the neurovascular bundles or choice of isotope is associated with brachytherapy-induced ED, while conflicting data has been reported regarding radiation dose to the prostate and the use of supplemental external beam radiation therapy. Although the etiology of brachytherapy-induced ED is likely multifactorial, the available data supports the proximal penis as an important site-specific structure. Refinements in implant technique, including preplanning and intraoperative seed placement, will result in lower radiation doses to the proximal penis with potential improvement in potency preservation

  16. Iridium-192 sources production for brachytherapy use

    International Nuclear Information System (INIS)

    Rostelato, Maria Elisa Chuery Martins

    1997-01-01

    The incidence of cancer increases every year in Brazil and turns out to be one of the most important causes of mortality. Some of the patients are treated with brachytherapy, a form of lesion treatment which is based on the insertion of sources into tumors, in this particular case, activated iridium wires. During this process, the ionizing radiation efficiently destroys the malignant cells. These iridium wires have a nucleus made out of an iridium-platinum alloy 20-30/70-80 of 0,1 mm in diameter either coated by platinum or encased in a platinum tube. The technique consists in irradiating the wire in the reactor neutron flux in order to produce iridium-192. The linear activity goes from 1 mCi/cm to 4 mCi/cm and the basic characteristic, which is required, is the homogeneity of the activation along the wire. It should not present a dispersion exceeding 5% on a wire measuring 50 cm in length, 0.5 mm or 0.3 mm in diameter. Several experiments were carried out in order to define the activation parameters. Wires from different origins were analyzed. It was concluded that United States of America and France wires were found to be perfectly adequate for brachytherapy purposes and have therefore been sent to specialized hospitals and successfully applied to cancer patients. Considering that the major purpose of this work is to make this product more accessible in Brazil, at a cost reflecting the Brazilian reality, the IPEN is promoting the preparation of iridium-192 sources to be used in brachytherapy, on a national level. (author)

  17. Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

    DEFF Research Database (Denmark)

    Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated...

  18. Effect of catecholamines and insulin on plasma volume and intravascular mass of albumin in man

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J; Larsen, S

    1989-01-01

    1. The effect of intravenous catecholamine infusions and of intravenous insulin on plasma volume and intravascular mass of albumin was investigated in healthy males. 2. Physiological doses of adrenaline (0.5 microgram/min and 3 microgram/min) increased peripheral venous packed cell volume....../min, packed cell volume increased, plasma volume decreased and intravascular mass of albumin decreased significantly. During noradrenaline infusion at 6 micrograms/min, packed cell volume increased and plasma volume decreased, but intravascular mass of albumin did not change. 4. Application...... of a hyperinsulinaemic, euglycaemic glucose clamp led to an increase in transcapillary escape rate of albumin and a decrease in intravascular mass of albumin. Packed cell volume remained constant, while plasma volume, measured by radiolabelled albumin, decreased. 5. We conclude that the previously reported changes...

  19. Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention to Treat Left Main Coronary Artery Disease.

    Science.gov (United States)

    De Maria, Giovanni Luigi; Banning, Adrian P

    2017-05-01

    Due to its potential prognostic implications and technical complexity, revascularisation of left main coronary artery (LMCA) disease requires careful consideration. Since publication of the results of the SYNTAX study, and more recently the EXCEL and NOBLE trials, there has been particular interest in percutaneous revascularisation of the LMCA. It is becoming clear that percutaneous revascularisation of LMCA disease requires appropriate lesion preparation and carefully optimised stenting in order to offer patients a treatment option as effective as coronary artery bypass grafting. For this reason intravascular imaging, and especially intravascular ultrasound, is becoming a key procedural step in LMCA percutaneous coronary intervention. In the current review paper we analyse the role of intravascular imaging with intravascular ultrasound in LMCA percutaneous coronary intervention, focusing on the main applications in this context from lesion assessment to stent sizing and optimisation.

  20. Accuracy of electrocardiographic-gated versus nongated volumetric intravascular ultrasound measurements of coronary arterial narrowing

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per

    2007-01-01

    Intravascular ultrasound (IVUS) allows precise measurements of plaque plus media (P+M) volume and neointimal hyperplasia after coronary artery stenting. Conventional IVUS volumetric analysis is performed mostly without electrocardiographically gated acquisition, and the IVUS images are selected...

  1. Interstitial brachytherapy for orbital soft tissue sarcoma: an innovative technique.

    Science.gov (United States)

    Laskar, Siddhartha; Pilar, Avinash; Khanna, Nehal; Ghadi, Yogesh

    2017-10-01

    To report an innovative technique of interstitial brachytherapy developed for treatment of orbital soft tissue tumors. A 4-month-old child diagnosed with rhabdomyosarcoma of orbit was treated with multiagent chemotherapy (CTh) and brachytherapy. Pre-planning computed tomography (CT) images were obtained and clinical target volume (CTV) was defined using the pre-treatment magnetic resonance imaging (MRI). Brachytherapy plan was generated for deciding optimal catheter placement. With the child under general anesthesia, catheter entry points were extrapolated and marked on the skin as determined from the pre-planning CT scan. Implantation of catheters was performed as per pre-determined catheter position and depths. Brachytherapy plan was generated and evaluated using dose volume histograms (DVH). A comparative external beam radiotherapy (EBRT) plan using RapidArc was also generated for the CTV with a 3 mm margin as the planning target volume (PTV). The mean CTV dose with brachytherapy was 158% compared to 101% with RapidArc. The CTV V 100 was 90% for brachytherapy vs. 95% for RapidArc. The mean dose to Lt Lens were 51% and 60%, respectively for brachytherapy and RapidArc, while the corresponding mean doses to the bony orbit were 39% and 68%, respectively. Follow-up MRI at 3 months showed complete response of the tumor. Interstitial brachytherapy for orbit using this innovative technique is a safe and effective modality of local treatment for appropriately selected orbital soft tissue tumors. Brachytherapy resulted in excellent disease control with significant reduction of dose to surrounding ocular structures compared to EBRT.

  2. A study of Brachytherapy for Intraocular Tumor

    International Nuclear Information System (INIS)

    Ji, Kwang Soo; Yoo, Dae Hyun; Lee, Sung Goo; Kim, Jae Hu; Ji, Young Hun

    1996-01-01

    The eye enucleation or external-beam radiation therapy that has been commonly used for the treatment of intraocular tumor have demerits of visual loss and in deficiency of effective tumor dose. Recently, brachytherapy using the plaques containing radioisotope-now treatment method that decrease the demerits of the above mentioned treatment methods and increase the treatment effect-is introduced and performed in the countries, Our purpose of this research is to design suitable shape of plaque for the ophthalmic brachytherapy, and to measure absorbed doses of Ir-192 ophthalmic plaque and thereby calculate the exact radiation dose of tumor and it's adjacent normal tissue. In order to brachytherapy for intraocular tumor, 1. to determine the eye model and selected suitable radioisotope 2. to design the suitable shape of plaque 3. to measure transmission factor and dose distribution for custom made plaques 4. to compare with the these data and results of computer dose calculation models. The result were as followed. 1. Eye model was determined as a 25 mm diameter sphere, Ir-192 was considered the most appropriate as radioisotope for brachytherapy, because of the size, half, energy and availability. 2. Considering the biological response with human tissue and protection of exposed dose, we made the plaques with gold, of which size were 15 mm, 17 mm and 20 mm in diameter, and 1.5 mm in thickness. 3. Transmission factor of plaques are all 0.71 with TLD and film dosimetry at the surface of plaques and 0.45, 0.49 at 1.5 mm distance of surface, respectively. 4. As compared the measured data for the plaque with Ir-192 seeds to results of computer dose calculation model by Gary Luxton et al. and CAP-PLAN (Radiation Treatment Planning System), absorbed doses are within ±10% and distance deviations are within 0.4 mm Maximum error is -11.3% and 0.8 mm, respectively. As a result of it, we can treat the intraocular tumor more effectively by using custom made gold plaque and Ir-192

  3. Experiences with alanine dosimetry in afterloading brachytherapy

    International Nuclear Information System (INIS)

    Eberhardt, H.-J.; Gohs, U.

    1996-01-01

    At the present, the most commonly used dosimetry for radiotherapy applications are ionisation chambers and thermoluminescent dosimeters (TLD). However, there are some undesirable characteristics of these dosimetry systems, such as large detection volume (ionisation chamber) as well as fading of the radiation induced signal with time and destructive readout (TLG). The present study is an investigation into the use of the alanine/ESR dosimetry in fractionated afterloading brachytherapy during the whole radiotherapy course. There are some qualities which make alanine dosimetry attractive. These are the linear energy response, low fading under standard conditions, and the nondestructive readout. Thus the alanine dosimetry makes possible cumulative dose measurements during the radiotherapy course and an archival storage. By ionizing radiation (gamma, e, n, p, charged particles) free radicals (unpaired electrons) are produced in the amino acid alanine. The continuous wave electron spin resonance (ESR) spectroscopy is used to determine the number of free radicals, which is proportional to the absorbed dose and the alanine content of the dosimeter. The ESR measurements were made at room temperature using a Bruker EPR analyzer EMS-104. The dosimeters used in the test are alanine pellets (23.72 mg weight, 4.9 mm diameter, 1 mm height) as well as flexible alanine film dosimeters (thickness about 500 μm). The dosimeters consist of a blend of L-alpha-alanine and a binder. The alanine content of the pellets and the film dosimeters is about 88 % and 50 % by weight, respectively. The dosimeters for the calculation of the dose-effect-relationship were irradiated at the Physical-Technical Bundesanstalt in Braunschweig by a standard 60Co source. The maximum deviation from the calculated linear function is about 0.12 Gy in the dose range up to 80 Gy. The goal of medical applications was the superficial dose measurement in afterloading brachytherapy during the radiotherapy course in

  4. Gallium SPECT detection of neoplastic intravascular obstruction of the superior vena cava

    International Nuclear Information System (INIS)

    Swayne, L.C.; Kaplan, I.L.

    1989-01-01

    A rare case of an intravascular neoplastic obstruction of the superior vena cava is discussed. The lesion was detected with gallium single photon emission computed tomography (SPECT) despite a normal appearance on a concurrent radiographic CT study. A computer-generated composite SPECT-CT image confirmed the intravascular localization of the radioisotope, and a subsequent CT-guided transthoracic needle biopsy revealed a poorly differentiated adenocarcinoma

  5. [Cardiovascular depression and intravascular hemolysis secondary to ethanol injection for arteriovenous malformation].

    Science.gov (United States)

    Cai, Mei-Hua; Su, Li-Xin; Qiu, Lin

    2016-08-01

    Ethanol is the only liquid embolization agent which can cure arteriovenous malformation. Complications of ethanol embolization are not rare including local tissue injury, intravascular hemolysis and cardiovascular depression even collapse, etc. This report presented a case of long time cardiovascular depression and intravascular hemolysis secondary to ethanol embolotherapy of right ear. In order to avoid the fatal complications that are associated with ethanol sclerotherapy, anesthesiologists should consider the use of continuously invasive hemodynamic monitoring while surgeons should carefully choose the dose of ethanol.

  6. Brachytherapy in the treatment of cervical cancer: a review.

    Science.gov (United States)

    Banerjee, Robyn; Kamrava, Mitchell

    2014-01-01

    Dramatic advances have been made in brachytherapy for cervical cancer. Radiation treatment planning has evolved from two-dimensional to three-dimensional, incorporating magnetic resonance imaging and/or computed tomography into the treatment paradigm. This allows for better delineation and coverage of the tumor, as well as improved avoidance of surrounding organs. Consequently, advanced brachytherapy can achieve very high rates of local control with a reduction in morbidity, compared with historic approaches. This review provides an overview of state-of-the-art gynecologic brachytherapy, with a focus on recent advances and their implications for women with cervical cancer.

  7. High dose rate brachytherapy for superficial cancer of the esophagus

    International Nuclear Information System (INIS)

    Maingon, Philippe; D'Hombres, Anne; Truc, Gilles; Barillot, Isabelle; Michiels, Christophe; Bedenne, Laurent; Horiot, Jean Claude

    2000-01-01

    Purpose: We analyzed our experience with external radiotherapy, combined modality treatment, or HDR brachytherapy alone to limited esophageal cancers. Methods and Materials: From 1991 to 1996, 25 patients with limited superficial esophagus carcinomas were treated by high dose rate brachytherapy. The mean age was 63 years (43-86 years). Five patients showed superficial local recurrence after external radiotherapy. Eleven patients without invasion of the basal membrane were staged as Tis. Fourteen patients with tumors involving the submucosa without spreading to the muscle were staged as T1. Treatment consisted of HDR brachytherapy alone in 13 patients, external radiotherapy and brachytherapy in 8 cases, and concomitant chemo- and radiotherapy in 4 cases. External beam radiation was administered to a total dose of 50 Gy using 2 Gy daily fractions in 5 weeks. In cases of HDR brachytherapy alone (13 patients), 6 applications were performed once a week. Results: The mean follow-up is 31 months (range 24-96 months). Twelve patients received 2 applications and 13 patients received 6 applications. Twelve patients experienced a failure (48%), 11/12 located in the esophagus, all of them in the treated volume. One patient presented an isolated distant metastasis. In the patients treated for superficial recurrence, 4/5 were locally controlled (80%) by brachytherapy alone. After brachytherapy alone, 8/13 patients were controlled (61%). The mean disease-free survival is 14 months (1-36 months). Overall survival is 76% at 1 year, 37% at 2 years, and 14% at 3 years. Overall survival for Tis patients is 24% vs. 20% for T1 (p 0.83). Overall survival for patients treated by HDR brachytherapy alone is 43%. One patient presented with a fistula with local failure after external radiotherapy and brachytherapy. Four stenosis were registered, two were diagnosed on barium swallowing without symptoms, and two required dilatations. Conclusion: High dose rate brachytherapy permits the treating

  8. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    International Nuclear Information System (INIS)

    Koo, Kevin S.H.; Dowd, Christopher F.; Hess, Christopher P.; Mathes, Erin F.; Frieden, Ilona J.; Rosbe, Kristina W.; Hoffman, William Y.

    2015-01-01

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  9. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Kevin S.H. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dowd, Christopher F.; Hess, Christopher P. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Mathes, Erin F.; Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, San Francisco, CA (United States); Rosbe, Kristina W. [University of California, San Francisco, Department of Otolaryngology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Surgery, San Francisco, CA (United States)

    2015-10-15

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  10. Coatings of nanoparticles applied to brachytherapy treatments

    International Nuclear Information System (INIS)

    Gonzalez, Andreza A.D.C.C.; Rostelato, Maria Elisa C.M.; Souza, Carla D.; Rodrigues, Bruna T.; Souza, Daiane C.B.; Zeituni, Carlos A.; Nogueira, Beatriz R.

    2017-01-01

    Brachytherapy is a treatment for cancer in which the radiation is placed close or in contact with the region to be treated saving the surrounding healthy tissues. Nanotechnology is the science that studies the properties of nanometric materials. Nanobrachytherapy in a new field that unites the advantages of brachytherapy with the small size in the nanoparticle, resulting in an even less invasive treatment. In view of the synthesis of the nanoparticles and their use, there is a fundamental role that is made by the coatings, which not only have the function of avoiding the aggregation of particles, but also stabilize and control their functional properties. Among the range of coatings, the most outstanding are polyethylene glycol (PEG) and gum arabica (GA). PEG improves the surface properties of nanoparticles and presents high stability under biomedical conditions. After the synthesis of gold nanoparticles was developed, PEG and gum arabica were successfully incorporated into the surface. In a vial of pyrex, 1 ml of coating agent and 1 ml of nanoparticles was left under gentle shaking for 2 hours. Incorporation was confirmed by DLS and HRTEM. GA requires further study. (author)

  11. Evaluation of resins for use in brachytherapy

    International Nuclear Information System (INIS)

    Carvalho, Luiz Claudio F.M. Garcia; Ferraz, Wilmar Barbosa; Chrcanovic, Bruno Ramos; Santos, Ana Maria M.

    2011-01-01

    Brachytherapy is an advanced cancer treatment where radioactive seeds or sources are placed near or directly into the tumor thus reducing the radiation exposure in the surrounding healthy tissues. Prostate cancer can be treated with interstitial brachytherapy in initial stage of the disease in which tiny radioactive seeds with cylindrical geometry are used. Several kinds of seeds have been developed in order to obtain a better dose distribution around them and with a lower cost manufacturing. These seeds consist of an encapsulation, a radionuclide carrier, and X-ray marker. Among the materials that have potential for innovation in the construction of seeds, biocompatible resins appear as an important option. In this paper, we present some characterization results with Fourier transform infrared spectroscopic (FTIR) and ultraviolet-visible spectroscopy (UV-vis) performed on two types of resins in which curing temperatures for each one were varied as also the results of coatings with these resins under titanium substrates. Interactions of these resins in contact with the simulated body fluid were evaluated by atomic force microscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy. (author)

  12. Evaluation of resins for use in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, Luiz Claudio F.M. Garcia; Ferraz, Wilmar Barbosa; Chrcanovic, Bruno Ramos; Santos, Ana Maria M., E-mail: ferrazw@cdtn.b, E-mail: amms@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    Brachytherapy is an advanced cancer treatment where radioactive seeds or sources are placed near or directly into the tumor thus reducing the radiation exposure in the surrounding healthy tissues. Prostate cancer can be treated with interstitial brachytherapy in initial stage of the disease in which tiny radioactive seeds with cylindrical geometry are used. Several kinds of seeds have been developed in order to obtain a better dose distribution around them and with a lower cost manufacturing. These seeds consist of an encapsulation, a radionuclide carrier, and X-ray marker. Among the materials that have potential for innovation in the construction of seeds, biocompatible resins appear as an important option. In this paper, we present some characterization results with Fourier transform infrared spectroscopic (FTIR) and ultraviolet-visible spectroscopy (UV-vis) performed on two types of resins in which curing temperatures for each one were varied as also the results of coatings with these resins under titanium substrates. Interactions of these resins in contact with the simulated body fluid were evaluated by atomic force microscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy. (author)

  13. Coatings of nanoparticles applied to brachytherapy treatments

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Andreza A.D.C.C.; Rostelato, Maria Elisa C.M.; Souza, Carla D.; Rodrigues, Bruna T.; Souza, Daiane C.B.; Zeituni, Carlos A.; Nogueira, Beatriz R., E-mail: ccg.andreza@gmail.com, E-mail: elisaros@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2017-07-01

    Brachytherapy is a treatment for cancer in which the radiation is placed close or in contact with the region to be treated saving the surrounding healthy tissues. Nanotechnology is the science that studies the properties of nanometric materials. Nanobrachytherapy in a new field that unites the advantages of brachytherapy with the small size in the nanoparticle, resulting in an even less invasive treatment. In view of the synthesis of the nanoparticles and their use, there is a fundamental role that is made by the coatings, which not only have the function of avoiding the aggregation of particles, but also stabilize and control their functional properties. Among the range of coatings, the most outstanding are polyethylene glycol (PEG) and gum arabica (GA). PEG improves the surface properties of nanoparticles and presents high stability under biomedical conditions. After the synthesis of gold nanoparticles was developed, PEG and gum arabica were successfully incorporated into the surface. In a vial of pyrex, 1 ml of coating agent and 1 ml of nanoparticles was left under gentle shaking for 2 hours. Incorporation was confirmed by DLS and HRTEM. GA requires further study. (author)

  14. Perioperative neutron brachytherapy with californium-252.

    Science.gov (United States)

    Vtyurin, B M; Medvedev, V S; Ivanov, V N; Anikin, V A; Ivanova, L F

    1992-01-01

    Between 1973 and 1988, 495 patients were treated with Cf-252 neutron brachytherapy. Cf-252 neutron therapy sources developed in the USSR has been used in the trial. A numerical reconstruction method for localization of Cf-252 cell coordinates by projections on orthogonal radiographs has been designed and used for treatment planning. Eight (1.6%) patients with recurrent and persistent head and neck tumors and ages from 32 to 48 years (mean age 43 years) were treated with Cf-252 perioperative neutron brachytherapy. There were three patients with oral cavity, one with oropharynx, three with parotid gland cancers, and one with a skin tumor. The dose rate ranged fro 3.2 cGy/h to 11.1 cG/h, the minimal peripheral dose ranged from 3 Gy to 8 Gy. Initial local control was achieved in all patients. Local recurrence developed in two cases. Three patients died in first year after therapy. Three patients died during the second year. Two patients are long term cures, one patient more than nine years and one eight years, that is 25% of the treated patients.

  15. Brachytherapy. High dose rate brachytherapy - Radiation protection: medical sheet ED 4287

    International Nuclear Information System (INIS)

    Celier, D.; Aubert, B.; Vidal, J.P.; Biau, A.; Lahaye, T.; Gauron, C.; Barret, C.; Boisserie, G.; Branchet, E.; Gambini, D.; Gondran, C.; Le Guen, B.; Guerin, C.; Nguyen, S.; Pierrat, N.; Sarrazin, T.; Donnarieix, D.

    2010-02-01

    After having indicated the required authorization to implement brachytherapy techniques, this document presents the various aspects and measures related to radiation protection when performing high-dose-rate brachytherapy treatments. It presents the concerned personnel, describes the operational process, indicates the associated hazards and the risk related to ionizing radiation, and describes how the risk is to be assessed and how exposure levels are to be determined (elements of risk assessment, delimitation of controlled and monitored areas, personnel classification, and choice of the dose monitoring method). It describes the various components of a risk management strategy (risk reduction, technical measures regarding the installation and the personnel, training and information, prevention and medical monitoring). It briefly presents how risk management is to be assessed, and mentions other related risks (biological risk, handling and posture, handling of heavy loads, mental workload, chemical risk)

  16. Brachytherapy. Pulsed dose rate brachytherapy - Radiation protection: medical sheet ED 4250

    International Nuclear Information System (INIS)

    Celier, D.; Aubert, B.; Vidal, J.P.; Biau, A.; Lahaye, T.; Gauron, C.; Barret, C.; Boisserie, G.; Branchet, E.; Gambini, D.; Gondran, C.; Le Guen, B.; Guerin, C.; Nguyen, S.; Pierrat, N.; Sarrazin, T.; Donnarieix, D.

    2009-06-01

    After having indicated the required authorization to implement brachytherapy techniques, this document presents the various aspects and measures related to radiation protection when performing pulsed-dose-rate brachytherapy treatments. It presents the concerned personnel, describes the operational process, indicates the associated hazards and the risk related to ionizing radiation, and describes how the risk is to be assessed and how exposure levels are to be determined (elements of risk assessment, delimitation of controlled and monitored areas, personnel classification, and choice of the dose monitoring method). It describes the various components of a risk management strategy (risk reduction, technical measures regarding the installation and the personnel, training and information, prevention and medical monitoring). It briefly presents how risk management is to be assessed, and mentions other related risks (biological risk, handling and posture, handling of heavy loads, mental workload, chemical risk)

  17. Radiotherapy and Brachytherapy : Proceedings of the NATO Advanced Study Institute on Physics of Modern Radiotherapy & Brachytherapy

    CERN Document Server

    Lemoigne, Yves

    2009-01-01

    This volume collects a series of lectures presented at the tenth ESI School held at Archamps (FR) in November 2007 and dedicated to radiotherapy and brachytherapy. The lectures focus on the multiple facets of radiotherapy in general, including external radiotherapy (often called teletherapy) as well as internal radiotherapy (called brachytherapy). Radiotherapy strategy and dose management as well as the decisive role of digital imaging in the associated clinical practice are developed in several articles. Grouped under the discipline of Conformal Radiotherapy (CRT), numerous modern techniques, from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT), are explained in detail. The importance of treatment planning based upon patient data from digital imaging (Computed Tomography) is also underlined. Finally, despite the quasi- totality of patients being presently treated with gamma and X-rays, novel powerful tools are emerging using proton and light ions (like carbon ions) beams, bound to bec...

  18. BRIT manual after loading brachytherapy kit for intracavitary: initial experience

    International Nuclear Information System (INIS)

    Aggarwal, Lalit M.; Mandal, Abhijit; Asthana, Anupam K.; Shahi, Uday P.; Pradhan, Satyajit

    2007-01-01

    Brachytherapy continues to serve as an important and rapidly evolving tool in the management of cancer. Technological developments in the last two decades have dramatic impact on the safe practice of brachytherapy. A wide range of brachytherapy sources and equipment are available for new therapeutic possibilities. However, decision making with regard to new brachytherapy facilities are need based and depend on the patient load, socioeconomic status of the patients, and funds available with the institution. Remote afterloading equipments are fast replacing the Manual After Loading (MAL) systems. However, keeping in view the large number of patients, who can not afford expensive treatment, the utility of manual after loading system which is inexpensive, cannot be ignored

  19. Nursing intervention in gynecologic brachytherapy under general anesthesia

    International Nuclear Information System (INIS)

    Maeda, Shoko; Goto, Yukimi; Nagai, Michiyo; Hashiguchi, Chikako; Fujii, Osamu; Ota, Yosuke; Tsujino, Kayoko; Soejima, Toshinori; Kato, Hiromi

    2010-01-01

    We reconsidered our nursing intervention in gynecologic intracavitary brachytherapy as general anesthesia was introduced. We recognized that safety, comfort, privacy protection and relief of anxiety of the patients were important points for nursing with corporation of other medical staffs. (author)

  20. Treatment of the prostate cancer with high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Martinez, Alvaro; Torres Silva, Felipe

    2002-01-01

    The prostate cancer treatment in early stages is controversial. The high dose rate brachytherapy has been used like monotherapy or boost with external beam radiotherapy in advanced disease. This paper describes the technique and the advantages over other modalities

  1. Image-Based Brachytherapy for the Treatment of Cervical Cancer

    International Nuclear Information System (INIS)

    Harkenrider, Matthew M.; Alite, Fiori; Silva, Scott R.; Small, William

    2015-01-01

    Cervical cancer is a disease that requires considerable multidisciplinary coordination of care and labor in order to maximize tumor control and survival while minimizing treatment-related toxicity. As with external beam radiation therapy, the use of advanced imaging and 3-dimensional treatment planning has generated a paradigm shift in the delivery of brachytherapy for the treatment of cervical cancer. The use of image-based brachytherapy, most commonly with magnetic resonance imaging (MRI), requires additional attention and effort by the treating physician to prescribe dose to the proper volume and account for adjacent organs at risk. This represents a dramatic change from the classic Manchester approach of orthogonal radiographic images and prescribing dose to point A. We reviewed the history and currently evolving data and recommendations for the clinical use of image-based brachytherapy with an emphasis on MRI-based brachytherapy

  2. Manual on brachytherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    In addition to a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry, this booklet includes information about radiation protection procedures for brachytherapy

  3. Measurement and calculation of dynamic coefficients in hydrodynamic bearings of gas films; Medicion y calculo de coeficientes dinamicos en cojinetes hidrodinamicos de peliculas de gas

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz, Rafael O.; Di Liscia, Marcelo H.; Diaz, Sergio E. [Universidad Simon Bolivar, Sartendejas, Baruta (Venezuela)

    2007-11-15

    dynamic coefficients. [Spanish] La identificacion de los coeficientes dinamicos en cojinetes de aire es fundamental para un adecuado analisis rotodinamico. El presente trabajo muestra el desarrollo de un algoritmo que permite la obtencion directa de los coeficientes dinamicos en cojinetes hidrodinamicos de aire tanto de forma numerica como experimental. El banco de pruebas utilizado consta de dos cojinetes magneticos, los cuales soportan al rotor en sus extremos y a su vez funcionan como actuadores permitiendo inducir orbitas controladas en el rotor. El cojinete de prueba se encuentra ubicado entre los cojinetes magneticos. Las fuerzas dinamicas generadas en el cojinete de aire se registran a partir de tres celdas de carga. El algoritmo fue desarrollado en un codigo comercial de programacion grafica, a traves del cual se pueden colectar, controlar y procesar las senales. El comportamiento no lineal de este tipo de cojinetes dificulta el calculo de los coeficientes dinamicos, por esta razon el procesamiento de las senales en espacio frecuencial facilita de cierta manera su manejo. Por otra parte, el modelo numerico se comparo con los resultados experimentales obteniendo aproximaciones aceptables tanto en magnitud como en comportamiento. El calculo de los coeficientes dinamicos numericos se realizo resolviendo la ecuacion diferencial de Reynolds para un fluido compresible en el espesor de la pelicula de gas, tomando en consideracion el flujo masico del fluido que se introduce, asi como la perdida de presion que sufre el mismo al pasar a traves de los orificios de alimentacion. Los metodos numericos utilizados incluyen la resolucion de la ecuacion diferencial de Reynolds por diferencias finitas, el calculo del perfil de presiones realizando iteraciones sucesivas y el calculo de las fuerzas hidrodinamicas a traves de una integracion numerica de Simpson. Los coeficientes dinamicos numericos fueron hallados aplicando una tecnica de minimos cuadrados a las fuerzas hidrodinamicas

  4. Image-robot coupling for the prostate brachytherapy

    International Nuclear Information System (INIS)

    Coelen, V.; Lartigau, E.; Merzouki, R.

    2009-01-01

    The results allows to contemplate a robot use in the prostate brachytherapy but equally in other applications such prostate biopsy. The tests to come are going to be directed towards on the use of a prostate phantom in order to calibrate the ultrasonography. thereafter, we contemplate the conception of an intelligent gripping system placed on the robot arm and allowing a good control in closed loop of the brachytherapy needle placement and allowing the setting up of an online monitoring. (N.C.)

  5. Resolving the brachytherapy challenges with government funded hospital.

    Science.gov (United States)

    Nikam, D S; Jagtap, A S; Vinothraj, R

    2016-01-01

    The objective of this study is to rationalize the feasibility and cost-effectiveness of high dose rate (HDR) cobalt 60 (Co-60) source versus 192-Iridium (192-Ir) source brachytherapy in government funded hospitals and treatment interruption gap because of exchange of sources. A retrospective study of gynecological cancer patients, treated by radiotherapy with curative intent between April 2005 and September 2012 was conducted. We analyzed the total number of patients treated for external beam radiotherapy (EBRT) and brachytherapy (Intracavitary brachytherapy or cylindrical vaginal source). The dates for 192-Ir sources installation and the last date and first date of brachytherapy procedure before and after source installation respectively were also analyzed and calculated the gap in days for brachytherapy interruptions. The study was analyzed the records of 2005 to September 2012 year where eight 192-Ir sources were installed. The mean gap between treatment interruptions was 123.12 days (range 1-647 days). The Institutional incidence of gynecological cancer where radiotherapy was treatment modality (except ovary) is 34.9 percent. Around 52.25 percent of patients who received EBRT at this institute were referred to outside hospital for brachytherapy because of unavailability of Iridium source. The cost for 5 year duration for single cobalt source is approximately 20-22 lakhs while for 15 Iridium sources is approximately 52-53 lakhs. The combined HDR Co-60 brachytherapy and EBRT provide a useful modality in the treatment of gynecological cancer where radiotherapy is indicated, the treatment interruption because of source exchange is longer and can be minimized by using cobalt source as it is cost-effective and has 5 year working life. Thus, Co-60 source for brachytherapy is a feasible option for government funded hospitals in developing countries.

  6. Review of advanced catheter technologies in radiation oncology brachytherapy procedures

    OpenAIRE

    Zhou J; Zamdborg L; Sebastian E

    2015-01-01

    Jun Zhou,1,2 Leonid Zamdborg,1 Evelyn Sebastian1 1Department of Radiation Oncology, Beaumont Health System, 2Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Abstract: The development of new catheter and applicator technologies in recent years has significantly improved treatment accuracy, efficiency, and outcomes in brachytherapy. In this paper, we review these advances, focusing on the performance of catheter imaging and reconstruction techniques in brachytherapy ...

  7. The diagnosis and management of disseminated intravascular coagulation.

    Science.gov (United States)

    Taylor, Fletcher B; Kinasewitz, Gary T

    2002-09-01

    This review describes disseminated intravascular coagulation (DIC) as a syndrome in which hemostatic factors are activated. The syndrome ranges in severity from a decompensated coagulopathy (overt-DIC) to the subclinical compensated activation of hemostatic factors (nonovert DIC). The first part of this review emphasizes two points. First, activation of the hemostatic system is controlled by a vast network of capillaries and venules through anticoagulant and anti-inflammatory regulatory factors that operate from the endothelium (e.g., protein C and thrombomodulin, tissue factor pathway inhibitor). These hemostatic regulators can be overridden by procoagulant disorders such as amniotic fluid embolism or degraded by proinflammatory disorders such as sepsis. Second, because this link between the microvascular endothelium and circulating hemostatic factors is so close, even a relatively mild disturbance of the microvasculature targeted by the inflammatory process may be reflected systemically by changes in molecular biomarkers of hemostatic activity. Therefore, application of criteria for the diagnosis of nonovert DIC should be of value in detecting a compensated response to inflammatory stress of the microvasculature in patients who are at risk before they develop an uncompensated over DIC response and organ failure. The second part of this review covers the recent experience investigators have had in diagnosing and following the response of patients to treatment with biomarkers.

  8. Monolithic CMUT on CMOS Integration for Intravascular Ultrasound Applications

    Science.gov (United States)

    Zahorian, Jaime; Hochman, Michael; Xu, Toby; Satir, Sarp; Gurun, Gokce; Karaman, Mustafa; Degertekin, F. Levent

    2012-01-01

    One of the most important promises of capacitive micromachined ultrasonic transducer (CMUT) technology is integration with electronics. This approach is required to minimize the parasitic capacitances in the receive mode, especially in catheter based volumetric imaging arrays where the elements need to be small. Furthermore, optimization of the available silicon area and minimized number of connections occurs when the CMUTs are fabricated directly above the associated electronics. Here, we describe successful fabrication and performance evaluation of CMUT arrays for intravascular imaging on custom designed CMOS receiver electronics from a commercial IC foundry. The CMUT on CMOS process starts with surface isolation and mechanical planarization of the CMOS electronics to reduce topography. The rest of the CMUT fabrication is achieved by modifying a low temperature micromachining process through the addition of a single mask and developing a dry etching step to produce sloped sidewalls for simple and reliable CMUT to CMOS interconnection. This CMUT to CMOS interconnect method reduced the parasitic capacitance by a factor of 200 when compared with a standard wire bonding method. Characterization experiments indicate that the CMUT on CMOS elements are uniform in frequency response and are similar to CMUTs simultaneously fabricated on standard silicon wafers without electronics integration. Experiments on a 1.6 mm diameter dual-ring CMUT array with a 15 MHz center frequency show that both the CMUTs and the integrated CMOS electronics are fully functional. The SNR measurements indicate that the performance is adequate for imaging CTOs located 1 cm away from the CMUT array. PMID:23443701

  9. Primary intravascular large B-cell lymphoma of pituitary

    Directory of Open Access Journals (Sweden)

    K R Anila

    2012-01-01

    Full Text Available A 68-year-old retired nurse, who was a known hypertensive on medication, presented with prolonged fever of 2-month duration without any clinical evidence of infection. On examination she had altered mental status. She also had other nonspecific complaints such as sleep disturbances, loss of weight, etc. On investigation, she was found to have anemia, thrombocytopenia, raised erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and lactate dehydrogenase (LDH values. She also had electrolyte imbalance. Radiological evaluation of brain showed mass lesion in the sella turcica, suggestive of pituitary adenoma. Biochemical evaluation showed hypopituitarism. Trans-sphenoidal biopsy was done. Based on histopathological and immunohistochemical findings a diagnosis of intravascular large B-cell lymphoma (IVLBCL of pituitary was made. Our patient′s condition deteriorated rapidly and she succumbed to her illness before therapy could be initiated. We are reporting this case because of the rare subtype of large B-cell lymphoma presenting at an extremely unusual primary site.

  10. Intravascular ultrasound assessed incomplete stent apposition and stent fracture in stent thrombosis after bare metal versus drug-eluting stent treatment the Nordic Intravascular Ultrasound Study (NIVUS)

    DEFF Research Database (Denmark)

    Kosonen, Petteri; Vikman, Saila; Jensen, Lisette Okkels

    2013-01-01

    This prospective multicenter registry used intravascular ultrasound (IVUS) in patients with definite stent thrombosis (ST) to compare rates of incomplete stent apposition (ISA), stent fracture and stent expansion in patients treated with drug-eluting (DES) versus bare metal (BMS) stents. ST...

  11. Evaluation of the French practices in brachytherapy using surveys

    International Nuclear Information System (INIS)

    Delattre, B.; Cormier, L.; Borgogno, C.; Descotes, J.L.; Peiffert, D.; Hannoun-Levie, J.M.; Moreau, J.L.

    2017-01-01

    Prostate cancer brachytherapy can be used as an alternative to the radical prostatectomy and radiotherapy. In the low-risk group, specific survivals are up to 95% after 10 years. The aim of the study is to describe the practices in brachytherapy in France. A survey made by AFU (French Urologic Association) and SFRO (French Society Of Oncological Radiotherapy) assessing the practices in brachytherapy in France was sent to all the urologists and radiotherapists even if they did not practice it. In total, 1417 surveys were sent, 285 were received coming from 211 urologists (74%) and 74 radiotherapists (26%). Sixty (21%) practiced brachytherapy (31 urologists, 29 radiotherapists). Low dose rate with permanent implants was used in 83,3%. Brachytherapy was advised for low-risk group by 90% who responded the survey, 73% used it in intermediate risk and only 13% in high risk. Brachytherapy is hardly used in low risk prostate cancer. It probably needs a reconsideration of recommendations due to the good results in association with a good picking. The urologist radiotherapist couple is essential in the overall care of the patient. (authors)

  12. [Evaluation of the French practices in brachytherapy using surveys].

    Science.gov (United States)

    Delattre, B; Cormier, L; Borgogno, C; Descotes, J L; Peiffert, D; Hannoun-Levi, J M; Moreau, J L

    2017-10-01

    Prostate cancer brachytherapy can be used as an alternative to the radical prostatectomy and radiotherapy. In the low-risk group, specific survivals are up to 95% after 10years. The aim of the study is to describe the practices in brachytherapy in France. A survey made by AFU (French Urologic Association) and SFRO (French Society Of Oncological Radiotherapy) assessing the practices in brachytherapy in France was sent to all the urologists and radiotherapists even if they did not practice it. In total, 1417 surveys were sent, 285 were received coming from 211 urologists (74%) and 74 radiotherapists (26%). Sixty (21%) practiced brachytherapy (31 urologists, 29 radiotherapists). Low dose rate with permanent implants was used in 83,3%. Brachytherapy was advised for low-risk group by 90% who responded the survey, 73% used it in intermediate risk and only 13% in high risk. Brachytherapy is hardly used in low risk prostate cancer. It probably needs a reconsideration of recommendations due to the good results in association with a good picking. The urologist-radiotherapist couple is essential in the overall care of the patient. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. MO-B-BRC-01: Introduction [Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Prisciandaro, J. [University of Michigan (United States)

    2016-06-15

    Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR is U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.

  14. Role of brachytherapy in the treatment of localized prostate cancer

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available The review is devoted to application of brachytherapy for treating the localized prostate cancer (PC. Statistics for incidence and detectability of this pathology and its dynamics for recent years are represented. Brief analysis of other methods which are conveniently used for treatment of PC, such as radical prostatectomy and external-beam radiotherapy, was performed. Advantages and disadvantages of these methods have been discussed. Brief history about the development of brachytherapy from first experience to wide-spread use in clinical practice is reported. The detailed review of series of large trials from Russia and other countries for efficiency and safety of brachytherapy in patients with prostate cancer for recent 15 years is also represented. Two types of brachytherapy in current clinical oncology i.e. low-dose technique with permanent implantation of microsources and high-dose temporary isotope implantation, specifics of its application in different groups of patients have been described. The procedure of brachytherapy and its three main steps i.e. planning, implantation and control assessment after implantation have been characterized in details. The conclusion about benefits of using of brachytherapy in the treatment of prostate cancer as minimally invasive and efficient method was made. 

  15. The evolution of computerized treatment planning for brachytherapy: American contributions.

    Science.gov (United States)

    Aronowitz, Jesse N; Rivard, Mark J

    2014-06-01

    To outline the evolution of computerized brachytherapy treatment planning in the United States through a review of technological developments and clinical practice refinements. A literature review was performed and interviews were conducted with six participants in the development of computerized treatment planning for brachytherapy. Computerized brachytherapy treatment planning software was initially developed in the Physics Departments of New York's Memorial Hospital (by Nelson, Meurk and Balter), and Houston's M. D. Anderson Hospital (by Stovall and Shalek). These public-domain programs could be used by institutions with adequate computational resources; other clinics had access to them via Memorial's and Anderson's teletype-based computational services. Commercial brachytherapy treatment planning programs designed to run on smaller computers (Prowess, ROCS, MMS), were developed in the late 1980s and early 1990s. These systems brought interactive dosimetry into the clinic and surgical theatre. Brachytherapy treatment planning has evolved from systems of rigid implant rules to individualized pre- and intra-operative treatment plans, and post-operative dosimetric assessments. Brachytherapy dose distributions were initially calculated on public domain programs on large regionally located computers. With the progression of computer miniaturization and increase in processor speeds, proprietary software was commercially developed for microcomputers that offered increased functionality and integration with clinical practice.

  16. Electronic brachytherapy management of atypical fibroxanthoma: report of 8 lesions

    Directory of Open Access Journals (Sweden)

    Stephen Doggett

    2017-01-01

    Full Text Available Purpose : To evaluate the suitability of treating atypical fibroxanthoma (AFX, an uncommon skin malignancy, with electronic brachytherapy. Material and methods : From Feb 2013 to Sep 2014, we were referred a total of 8 cases of AFX in 7 patients, all involving the scalp. All of them were treated with electronic brachytherapy 50 Kev radiations (Xoft Axxent®, Fremont, California. All lesions received 40 Gy in two fractions per week with 5mm margins. Results : At a median follow-up of 23.7 months, the local recurrence rate is 12.5%. The single lesion that failed was not debulked surgically prior to electronic brachytherapy. Conclusions : To our knowledge, this is the first report in the literature on the use of radiation therapy as curative primary treatment for AFX. No contraindication to the use of radiations is found in the literature, with surgery being the sole treatment for AFX noted. Our recurrence rate is 0% for debulked lesions. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for debulked AFX. Multiple excisions, skin grafting, and wound care can be avoided in elderly patients by the use of electronic brachytherapy.

  17. Cost savings and clinical acceptability of an intravascular line tip culture triage policy.

    Science.gov (United States)

    Colston, J; Batchelor, B; Bowler, I C J W

    2013-05-01

    Culture of intravascular line tips is useful for the diagnosis of intravascular line-related phlebitis and bacteraemia. However, the test lacks specificity, with a low predictive value for intravascular line bacteraemia. A recent randomised study showed that predictive value could be increased and costs reduced by refrigerating intravascular lines and retrieving them for culture only if there was a bacteraemia in the seven days before or after the intravascular line was received. We studied whether a similar triage policy could be introduced into our 1400-bed National Health Service (NHS) teaching hospital in the UK. We assessed cost reduction in the laboratory and clinical acceptability. Data regarding the number of intravascular lines received, stored and cultured and blood cultures received was retrieved from the microbiology computer, for five-month periods before and after the introduction of the new triage policy. Of the 134 intravascular line tips received in the five months after the policy had been introduced, 101 (75%) were stored without retrieval and 33 were cultured. Of these, 7/134 (5%) were culture positive and three matched a concurrent blood culture. Audit showed that compliance with the policy was >98%. The estimated annual cost reduction following the introduction of the policy was £3,166.96. The policy was acceptable to clinicians. The policy was both cost saving and clinically acceptable. If the policy were adopted throughout the NHS in the UK, the annual cost saving to the service might be in the order of £300,000. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. A review of the clinical experience in pulsed dose rate brachytherapy.

    Science.gov (United States)

    Balgobind, Brian V; Koedooder, Kees; Ordoñez Zúñiga, Diego; Dávila Fajardo, Raquel; Rasch, Coen R N; Pieters, Bradley R

    2015-01-01

    Pulsed dose rate (PDR) brachytherapy is a treatment modality that combines physical advantages of high dose rate (HDR) brachytherapy with the radiobiological advantages of low dose rate brachytherapy. The aim of this review was to describe the effective clinical use of PDR brachytherapy worldwide in different tumour locations. We found 66 articles reporting on clinical PDR brachytherapy including the treatment procedure and outcome. Moreover, PDR brachytherapy has been applied in almost all tumour sites for which brachytherapy is indicated and with good local control and low toxicity. The main advantage of PDR is, because of the small pulse sizes used, the ability to spare normal tissue. In certain cases, HDR resembles PDR brachytherapy by the use of multifractionated low-fraction dose.

  19. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for head-and-neck carcinoma

    International Nuclear Information System (INIS)

    Nag, Subir; Cano, Elmer R.; Demanes, D. Jeffrey; Puthawala, Ajmel A.; Vikram, Bhadrasain

    2001-01-01

    Purpose: To develop recommendations for use of high-dose-rate (HDR) brachytherapy in patients with head-and-neck cancer. Methods: A panel consisting of members of the American Brachytherapy Society (ABS) performed a literature review, added information based upon their clinical experience, and formulated recommendations for head-and-neck HDR brachytherapy. Results: The ABS recommends the use of brachytherapy as a component of the treatment of head-and-neck tumors. However, the ABS recognizes that some radiation oncologists are reluctant to employ brachytherapy in the head-and-neck region because of the complexity of the postoperative management and concerns about radiation safety. In this regard, HDR eliminates unwanted radiation exposure and thereby permits unrestricted delivery of clinical care to these brachytherapy patients. The ABS made specific recommendations for previously untreated and recurrent head-and-neck cancer patients on patient selection criteria, implant techniques, target volume definition, and HDR treatment parameters (such as time, dose, and fractionation schedules). Suggestions were provided for treatment with HDR alone and in combination with external beam radiation therapy. It should be recognized that only limited experiences exist with HDR brachytherapy in patients with head-and-neck cancers. Therefore, some of these suggested doses have not been extensively tested in clinical practice. Hence, these guidelines will be updated as significant new outcome data are available. Any clinician following these guidelines is expected to use clinical judgment to determine an individual patient's treatment. Conclusions: Little has been published in the clinical literature on HDR brachytherapy in head-and-neck cancer. Based upon the available information and the clinical experience of the panel members, general and site-specific recommendations were offered. Areas for further investigations were identified

  20. Predictors of Metastatic Disease After Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Forsythe, Kevin [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Burri, Ryan [Department of Radiation Oncology, New York-Presbyterian Hospital, New York, NY (United States); Stone, Nelson [Department of Urology, Mount Sinai School of Medicine, New York, NY (United States); Stock, Richard G., E-mail: richard.stock@moutsinai.org [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States)

    2012-06-01

    Purpose: To identify predictors of metastatic disease after brachytherapy treatment for prostate cancer. Methods and Materials: All patients who received either brachytherapy alone (implant) or brachytherapy in combination with external beam radiation therapy for treatment of localized prostate cancer at The Mount Sinai Hospital between June 1990 and March 2007 with a minimum follow-up of 2 years were included. Univariate and multivariable analyses were performed on the following variables: risk group, Gleason score (GS), clinical T stage, pretreatment prostate-specific antigen level, post-treatment prostate-specific antigen doubling time (PSA-DT), treatment type (implant vs. implant plus external beam radiation therapy), treatment era, total biological effective dose, use of androgen deprivation therapy, age at diagnosis, and race. PSA-DT was analyzed in the following ordinate groups: 0 to 90 days, 91 to 180 days, 180 to 360 days, and greater than 360 days. Results: We included 1,887 patients in this study. Metastases developed in 47 of these patients. The 10-year freedom from distant metastasis (FFDM) rate for the entire population was 95.1%. Median follow-up was 6 years (range, 2-15 years). The only two significant predictors of metastatic disease by multivariable analyses were GS and PSA-DT (p < 0.001 for both variables). Estimated 10-year FFDM rates for GS of 6 or less, GS of 7, and GS of 8 or greater were 97.9%, 94.3%, and 76.1%, respectively (p < 0.001). Estimated FFDM rates for PSA-DT of 0 to 90 days, 91 to 180 days, 181 to 360 days, and greater than 360 days were 17.5%, 67.9%, 74%, and 94.8%, respectively (p < 0.001). Estimated 10-year FFDM rates for the low-, intermediate-, and high-risk groups were 98.6%, 96.2%, and 86.7%, respectively. A demographic shift to patients presenting with higher-grade disease in more recent years was observed. Conclusions: GS and post-treatment PSA-DT are both statistically significant independent predictors of metastatic

  1. Human error in remote Afterloading Brachytherapy

    International Nuclear Information System (INIS)

    Quinn, M.L.; Callan, J.; Schoenfeld, I.; Serig, D.

    1994-01-01

    Remote Afterloading Brachytherapy (RAB) is a medical process used in the treatment of cancer. RAB uses a computer-controlled device to remotely insert and remove radioactive sources close to a target (or tumor) in the body. Some RAB problems affecting the radiation dose to the patient have been reported and attributed to human error. To determine the root cause of human error in the RAB system, a human factors team visited 23 RAB treatment sites in the US. The team observed RAB treatment planning and delivery, interviewed RAB personnel, and performed walk-throughs, during which staff demonstrated the procedures and practices used in performing RAB tasks. Factors leading to human error in the RAB system were identified. The impact of those factors on the performance of RAB was then evaluated and prioritized in terms of safety significance. Finally, the project identified and evaluated alternative approaches for resolving the safety significant problems related to human error

  2. Epoxy resins used to seal brachytherapy seed

    International Nuclear Information System (INIS)

    Ferreira, Natalia Carolina Camargos; Ferraz, Wilmar Barbosa; Reis, Sergio Carneiro dos; Santos, Ana Maria Matildes dos

    2013-01-01

    Prostate cancer treatment with brachytherapy is recommended for patients with cancer at an early stage. In this treatment, small radioactive seeds are implanted directly in the prostate gland. These seeds are composed at least of one radionuclide carrier and an X-ray marker enclosed within a metallic tube usually sealed by laser process. This process is expensive and, furthermore, it can provoke a partial volatilization of the radionuclide and change the isotropy in dose distribution around the seed. In this paper, we present a new sealing process using epoxy resin. Three kinds of resins were utilized and characterized by scanning electron microscopy (SEM), energy dispersive X ray (EDS) and by differential scanning calorimetry (DSC) after immersion in simulated body fluid (SBF) and in sodium iodine solution (NaI). The sealing process showed excellent potential to replace the sealing laser usually employed. (author)

  3. Interstitial brachytherapy in carcinoma of the penis

    Energy Technology Data Exchange (ETDEWEB)

    Chaudhary, A.J.; Ghosh, S.; Bhalavat, R.L. [Tata Memorial Hospital, Mumbai (India). Dept. of Radiation Oncology; Kulkarni, J.N. [Tata Memorial Hospital, Mumbai (India). Dept. of Surgery; Sequeira, B.V.E. [Tata Memorial Hospital, Mumbai (India). Dept. of Medical Physics

    1999-01-01

    Aim: Keeping in line with the increasing emphasis on organ preservation, we at the Tata Memorial Hospital have evaluated the role of Ir-192 interstitial implant as regards local control, functional and cosmetic outcome in early as well as locally recurrent carcinoma of the distal penis. Patients and Methods: From October 1988 to December 1996, 23 patients with histopathologically proven cancer of the penis were treated with radical radiation therapy using Ir-192 temporary interstitial implant. Our patients were in the age group of 20 to 60 years. The primary lesions were T1 and 7, T2 in 7 and recurrent in 9 patients. Only 7 patients had palpable groin nodes at presentation, all of which were pathologically negative. The median dose of implant was 50 Gy (range 40 to 60 Gy), using the LDR afterloading system and the Paris system of implant rules for dosimetry. Follow-up ranged from 4 to 117 months (median 24 months). Results: At last follow-up 18 of the 23 patients remained locally controlled with implant alone. Three patients failed only locally, 2 locoregionally and 1 only at the groin. Of the 5 patients who failed locally, 4 were successfully salvaged with partial penectomy and remained controlled when last seen. Local control with implant alone at 8 years was 70% by life table analysis. The patients had excellent functional and cosmetic outcome. We did not record any case of skin or softtissue necrosis. Only 2 patients developed meatal stenosis, both of which were treated endoscopically. Conclusion: Our results lead us to interpret that interstitial brachytherapy with Ir-192 offers excellent local control rates with preservation of organ and function. Penectomy can be reserved as a means for effective salvage. (orig.) [Deutsch] Ziel: Das Prinzip des Organerhalts gewinnt in der Onkologie zunehmend an Bedeutung. Ziel dieser Untersuchung war es, die Rolle der interstitiellen Brachytherapie mit Ir-192 zur Behandlung des fruehen und rezidivierten Peniskarzinoms zu

  4. Paddle-based rotating-shield brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yunlong; Xu, Weiyu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 (United States); Flynn, Ryan T.; Kim, Yusung; Bhatia, Sudershan K.; Buatti, John M. [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, Iowa 52242 (United States); Wu, Xiaodong, E-mail: xiaodong-wu@uiowa.edu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 and Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)

    2015-10-15

    Purpose: The authors present a novel paddle-based rotating-shield brachytherapy (P-RSBT) method, whose radiation-attenuating shields are formed with a multileaf collimator (MLC), consisting of retractable paddles, to achieve intensity modulation in high-dose-rate brachytherapy. Methods: Five cervical cancer patients using an intrauterine tandem applicator were considered to assess the potential benefit of the P-RSBT method. The P-RSBT source used was a 50 kV electronic brachytherapy source (Xoft Axxent™). The paddles can be retracted independently to form multiple emission windows around the source for radiation delivery. The MLC was assumed to be rotatable. P-RSBT treatment plans were generated using the asymmetric dose–volume optimization with smoothness control method [Liu et al., Med. Phys. 41(11), 111709 (11pp.) (2014)] with a delivery time constraint, different paddle sizes, and different rotation strides. The number of treatment fractions (fx) was assumed to be five. As brachytherapy is delivered as a boost for cervical cancer, the dose distribution for each case includes the dose from external beam radiotherapy as well, which is 45 Gy in 25 fx. The high-risk clinical target volume (HR-CTV) doses were escalated until the minimum dose to the hottest 2 cm{sup 3} (D{sub 2cm{sup 3}}) of either the rectum, sigmoid colon, or bladder reached their tolerance doses of 75, 75, and 90 Gy{sub 3}, respectively, expressed as equivalent doses in 2 Gy fractions (EQD2 with α/β = 3 Gy). Results: P-RSBT outperformed the two other RSBT delivery techniques, single-shield RSBT (S-RSBT) and dynamic-shield RSBT (D-RSBT), with a properly selected paddle size. If the paddle size was angled at 60°, the average D{sub 90} increases for the delivery plans by P-RSBT on the five cases, compared to S-RSBT, were 2.2, 8.3, 12.6, 11.9, and 9.1 Gy{sub 10}, respectively, with delivery times of 10, 15, 20, 25, and 30 min/fx. The increases in HR-CTV D{sub 90}, compared to D-RSBT, were 16

  5. Fast dose optimization for rotating shield brachytherapy.

    Science.gov (United States)

    Cho, Myung; Wu, Xiaodong; Dadkhah, Hossein; Yi, Jirong; Flynn, Ryan T; Kim, Yusung; Xu, Weiyu

    2017-10-01

    To provide a fast computational method, based on the proximal graph solver (POGS) - A convex optimization solver using the alternating direction method of multipliers (ADMM), for calculating an optimal treatment plan in rotating shield brachytherapy (RSBT). RSBT treatment planning has more degrees of freedom than conventional high-dose-rate brachytherapy due to the addition of emission direction, and this necessitates a fast optimization technique to enable clinical usage. The multi-helix RSBT (H-RSBT) delivery technique was investigated for five representative cervical cancer patients. Treatment plans were generated for all patients using the POGS method and the commercially available solver IBM ILOG CPLEX. The rectum, bladder, sigmoid colon, high-risk clinical target volume (HR-CTV), and HR-CTV boundary were the structures included in our optimization, which applied an asymmetric dose-volume optimization with smoothness control. Dose calculation resolution was 1 × 1 × 3 mm 3 for all cases. The H-RSBT applicator had 6 helices, with 33.3 mm of translation along the applicator per helical rotation and 1.7 mm spacing between dwell positions, yielding 17.5° emission angle spacing per 5 mm along the applicator. For each patient, HR-CTV D 90 , HR-CTV D 100 , rectum D 2cc , sigmoid D 2cc , and bladder D 2cc matched within 1% for CPLEX and POGS methods. Also, similar EQD2 values between CPLEX and POGS methods were obtained. POGS was around 18 times faster than CPLEX. For all patients, total optimization times were 32.1-65.4 s for CPLEX and 2.1-3.9 s for POGS. POGS reduced treatment plan optimization time approximately 18 times for RSBT with similar HR-CTV D 90 , organ at risk (OAR) D 2cc values, and EQD2 values compared to CPLEX, which is significant progress toward clinical translation of RSBT. © 2017 American Association of Physicists in Medicine.

  6. Ruthenium-106 plaque brachytherapy for uveal melanoma.

    Science.gov (United States)

    Tarmann, Lisa; Wackernagel, Werner; Avian, Alexander; Mayer, Christoph; Schneider, Mona; Winkler, Peter; Langmann, Gerald

    2015-12-01

    To report on local tumour control, eye preservation and visual outcome after ruthenium-106 brachytherapy for uveal melanoma. Medical records of 143 eyes with uveal melanoma, treated by ruthenium-106 brachytherapy between 1997 and 2012 at one single centre, were included. Primary outcome measures were local tumour control, eye preservation and visual outcome. The influence of patient, tumour and treatment parameters on outcome was analysed by time to event analysis and competing risk regression. The median overall follow-up was 37.9 months. Tumour control: recurrent tumour growth was observed in 17 patients. The estimated local tumour recurrence rate at 12, 24 and 48 months after irradiation was 3%, 8.4% and 14.7%, respectively. The only significant risk factors for tumour recurrence were age (p=0.046) and reduced initial visual acuity (VA, p=0.045). No significant difference could be shown for tumour size or tumour category (T1-T2 vs T3-T4), and for any other tumour or treatment parameters (including combined transpupillary thermo-therapy (TTT)).Eye preservation: The likelihood of keeping the eye 12, 24 and 48 months after irradiation was 97.7%, 94.7% and 91.8%, respectively. Most significant risk factors for secondary enucleation were initial VA (peye preservation and visual function. Adjunct sandwich therapy resulted in worse visual outcome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. What to Know about Brachytherapy (A Type of Internal Radiation Therapy)

    Science.gov (United States)

    ... What To Know About Brachytherapy (A Type of Internal Radiation Therapy) “I asked questions. My doctor took the time ... most. Understanding Radiation Therapy: Brachytherapy (A Type of Internal Radiation Therapy) Types of brachytherapy: Low-dose rate (LDR) implants ...

  8. Imminent Cardiac Risk Assessment via Optical Intravascular Biochemical Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wetzel, D.; Wetzel, L; Wetzel, M; Lodder, R

    2009-01-01

    Heart disease is by far the biggest killer in the United States, and type II diabetes, which affects 8% of the U.S. population, is on the rise. In many cases, the acute coronary syndrome and/or sudden cardiac death occurs without warning. Atherosclerosis has known behavioral, genetic and dietary risk factors. However, our laboratory studies with animal models and human post-mortem tissue using FT-IR microspectroscopy reveal the chemical microstructure within arteries and in the arterial walls themselves. These include spectra obtained from the aortas of ApoE-/- knockout mice on sucrose and normal diets showing lipid deposition in the former case. Also pre-aneurysm chemical images of knockout mouse aorta walls, and spectra of plaque excised from a living human patient are shown for comparison. In keeping with the theme of the SPEC 2008 conference Spectroscopic Diagnosis of Disease this paper describes the background and potential value of a new catheter-based system to provide in vivo biochemical analysis of plaque in human coronary arteries. We report the following: (1) results of FT-IR microspectroscopy on animal models of vascular disease to illustrate the localized chemical distinctions between pathological and normal tissue, (2) current diagnostic techniques used for risk assessment of patients with potential unstable coronary syndromes, and (3) the advantages and limitations of each of these techniques illustrated with patent care histories, related in the first person, by the physician coauthors. Note that the physician comments clarify the contribution of each diagnostic technique to imminent cardiac risk assessment in a clinical setting, leading to the appreciation of what localized intravascular chemical analysis can contribute as an add-on diagnostic tool. The quality of medical imaging has improved dramatically since the turn of the century. Among clinical non-invasive diagnostic tools, laboratory tests of body fluids, EKG, and physical examination are

  9. Monolithic CMUT-on-CMOS integration for intravascular ultrasound applications.

    Science.gov (United States)

    Zahorian, Jaime; Hochman, Michael; Xu, Toby; Satir, Sarp; Gurun, Gokce; Karaman, Mustafa; Degertekin, F Levent

    2011-12-01

    One of the most important promises of capacitive micromachined ultrasonic transducer (CMUT) technology is integration with electronics. This approach is required to minimize the parasitic capacitances in the receive mode, especially in catheter-based volumetric imaging arrays, for which the elements must be small. Furthermore, optimization of the available silicon area and minimized number of connections occurs when the CMUTs are fabricated directly above the associated electronics. Here, we describe successful fabrication and performance evaluation of CMUT arrays for intravascular imaging on custom-designed CMOS receiver electronics from a commercial IC foundry. The CMUT-on-CMOS process starts with surface isolation and mechanical planarization of the CMOS electronics to reduce topography. The rest of the CMUT fabrication is achieved by modifying a low-temperature micromachining process through the addition of a single mask and developing a dry etching step to produce sloped sidewalls for simple and reliable CMUT-to-CMOS interconnection. This CMUT-to-CMOS interconnect method reduced the parasitic capacitance by a factor of 200 when compared with a standard wire-bonding method. Characterization experiments indicate that the CMUT-on-CMOS elements are uniform in frequency response and are similar to CMUTs simultaneously fabricated on standard silicon wafers without electronics integration. Ex- periments on a 1.6-mm-diameter dual-ring CMUT array with a center frequency of 15 MHz show that both the CMUTs and the integrated CMOS electronics are fully functional. The SNR measurements indicate that the performance is adequate for imaging chronic total occlusions located 1 cm from the CMUT array.

  10. Protection against high intravascular pressure in giraffe legs.

    Science.gov (United States)

    Petersen, Karin K; Hørlyck, Arne; Ostergaard, Kristine H; Andresen, Joergen; Broegger, Torbjoern; Skovgaard, Nini; Telinius, Niklas; Laher, Ismael; Bertelsen, Mads F; Grøndahl, Carsten; Smerup, Morten; Secher, Niels H; Brøndum, Emil; Hasenkam, John M; Wang, Tobias; Baandrup, Ulrik; Aalkjaer, Christian

    2013-11-01

    The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the artery. Histology of the isolated median artery confirmed dense sympathetic innervation at the narrowing. Structure and contractility of small arteries from muscular beds in the leg and neck were compared. The arteries from the legs demonstrated an increased media thickness-to-lumen diameter ratio, increased media volume, and increased numbers of smooth muscle cells per segment length and furthermore, they contracted more strongly than arteries from the neck (500 ± 49 vs. 318 ± 43 mmHg; n = 6 legs and neck, respectively). Finally, the transient increase in interstitial fluid pressure following injection of saline was 5.5 ± 1.7 times larger (n = 8) in the leg than in the neck. We conclude that 1) tissue compliance in the legs is low; 2) large arteries of the legs function as resistance arteries; and 3) structural adaptation of small muscle arteries allows them to develop an extraordinary tension. All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure.

  11. ARCOCT: Automatic detection of lumen border in intravascular OCT images.

    Science.gov (United States)

    Cheimariotis, Grigorios-Aris; Chatzizisis, Yiannis S; Koutkias, Vassilis G; Toutouzas, Konstantinos; Giannopoulos, Andreas; Riga, Maria; Chouvarda, Ioanna; Antoniadis, Antonios P; Doulaverakis, Charalambos; Tsamboulatidis, Ioannis; Kompatsiaris, Ioannis; Giannoglou, George D; Maglaveras, Nicos

    2017-11-01

    Intravascular optical coherence tomography (OCT) is an invaluable tool for the detection of pathological features on the arterial wall and the investigation of post-stenting complications. Computational lumen border detection in OCT images is highly advantageous, since it may support rapid morphometric analysis. However, automatic detection is very challenging, since OCT images typically include various artifacts that impact image clarity, including features such as side branches and intraluminal blood presence. This paper presents ARCOCT, a segmentation method for fully-automatic detection of lumen border in OCT images. ARCOCT relies on multiple, consecutive processing steps, accounting for image preparation, contour extraction and refinement. In particular, for contour extraction ARCOCT employs the transformation of OCT images based on physical characteristics such as reflectivity and absorption of the tissue and, for contour refinement, local regression using weighted linear least squares and a 2nd degree polynomial model is employed to achieve artifact and small-branch correction as well as smoothness of the artery mesh. Our major focus was to achieve accurate contour delineation in the various types of OCT images, i.e., even in challenging cases with branches and artifacts. ARCOCT has been assessed in a dataset of 1812 images (308 from stented and 1504 from native segments) obtained from 20 patients. ARCOCT was compared against ground-truth manual segmentation performed by experts on the basis of various geometric features (e.g. area, perimeter, radius, diameter, centroid, etc.) and closed contour matching indicators (the Dice index, the Hausdorff distance and the undirected average distance), using standard statistical analysis methods. The proposed method was proven very efficient and close to the ground-truth, exhibiting non statistically-significant differences for most of the examined metrics. ARCOCT allows accurate and fully-automated lumen border

  12. SEPSIS-ASSOCIATED DISSEMINATED INTRAVASCULAR COAGULATION AND THROMBOEMBOLIC DISEASE

    Directory of Open Access Journals (Sweden)

    Nicola Semeraro

    2010-08-01

    Full Text Available Sepsis is almost invariably associated with haemostatic abnormalities ranging from subclinical activation of blood coagulation (hypercoagulability, which may contribute to localized venous thromboembolism, to acute disseminated intravascular coagulation (DIC, characterized by massive thrombin formation and widespread microvascular thrombosis, partly responsible of the multiple organ dysfunction syndrome (MODS, and subsequent consumption of platelets and coagulation proteins causing, in most severe cases, bleeding manifestations. There is general agreement that the key event underlying this life-threatening sepsis complication is the overwhelming inflammatory host response to the infectious agent leading to the overexpression of inflammatory mediators. Mechanistically, the latter, together with the micro-organism and its derivatives, causes DIC by 1 up-regulation of procoagulant molecules, primarily tissue factor (TF, which is produced mainly by stimulated monocytes-macrophages and by specific cells in target tissues; 2 impairment of physiological anticoagulant pathways (antithrombin, protein C pathway, tissue factor pathway inhibitor, which is orchestrated mainly by dysfunctional endothelial cells (ECs; and 3 suppression of fibrinolysis due to increased plasminogen activator inhibitor-1 (PAI-1 by ECs and likely also to thrombin-mediated  activation of thrombin-activatable fibrinolysis inhibitor (TAFI. Notably, clotting enzymes non only lead to microvascular thrombosis but can also elicit cellular responses that amplify the inflammatory reactions. Inflammatory mediators can also cause, directly or indirectly, cell apoptosis or necrosis and recent evidence indicates that products released from dead cells, such as nuclear proteins (particularly extracellular histones, are able to propagate further inflammation, coagulation, cell death and MODS. These insights into the pathogenetic mechanisms of DIC and MODS may have important implications for the

  13. Methods for prostate stabilization during transperineal LDR brachytherapy

    International Nuclear Information System (INIS)

    Podder, Tarun; Yu Yan; Sherman, Jason; Rubens, Deborah; Strang, John; Messing, Edward; Ng, Wan-Sing

    2008-01-01

    In traditional prostate brachytherapy procedures for a low-dose-rate (LDR) radiation seed implant, stabilizing needles are first inserted to provide some rigidity and support to the prostate. Ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of two types of needle geometries (regular brachytherapy needle and hooked needle) and several clinically feasible configurations of the stabilization needles. To understand and assess the prostate movement during seed implantation, we collected in vivo data from patients during actual brachytherapy procedures. In vitro experimentation with tissue-equivalent phantoms allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization with the hooked needles compared to the regular brachytherapy needles (more than 40% in bilateral parallel needle configuration). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (more than 60%). When the hooked needles were angulated for stabilization, further reduction in prostate displacement was observed. In general, for convenience of dosimetric planning and to avoid needle collision, all needles are desired to be in a parallel configuration. In this configuration, hooked needles provide improved stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in seed implantation using a robotic system. We have developed nonlinear spring-damper model for the prostate movement which can be used for adapting dosimetric planning during brachytherapy as well as for developing more realistic haptic devices and

  14. National audit of a system for rectal contact brachytherapy

    Directory of Open Access Journals (Sweden)

    Laia Humbert-Vidan

    2017-01-01

    Full Text Available Background and purpose: Contact brachytherapy is used for the treatment of early rectal cancer. An overview of the current status of quality assurance of the rectal contact brachytherapy systems in the UK, based on a national audit, was undertaken in order to assist users in optimising their own practices. Material and methods: Four UK centres using the Papillon 50 contact brachytherapy system were audited. Measurements included beam quality, output and radiation field size and uniformity. Test frequencies and tolerances were reviewed and compared to both existing recommendations and published reviews on other kV and electronic brachytherapy systems. External validation of dosimetric measurements was provided by the National Physical Laboratory. Results: The maximum host/audit discrepancy in beam quality determination was 6.5%; this resulted in absorbed dose variations of 0.2%. The host/audit agreement in absorbed dose determination was within 2.2%. The median of the radiation field uniformity measurements was 2.7% and the host/audit agreement in field size was within 1 mm. Test tolerances and frequencies were within the national recommendations for kV units. Conclusions: The dosimetric characterisation of the Papillon 50 was validated by the audit measurements for all participating centres, thus providing reassurance that the implementation had been performed within the standards stated in previously published audit work and recommendations for kV and electronic brachytherapy units. However, optimised and standardised quality assurance testing could be achieved by reducing some methodological differences observed. Keywords: Contact brachytherapy, Electronic brachytherapy, Audit

  15. Intravascular lymphoma presenting as a specific pulmonary embolism and acute respiratory failure: a case report

    Directory of Open Access Journals (Sweden)

    Georgin-Lavialle Sophie

    2009-05-01

    Full Text Available Abstract Introduction The occurrence of an intravascular lymphoma with severe pulmonary involvement mimicking pulmonary embolism is described. Case presentation A 38-year-old man was referred to our intensive care unit with acute respiratory failure and long lasting fever. Appropriate investigations failed to demonstrate any bacterial, viral, parasitic or mycobacterial infection. A chest computed tomography scan ruled out any proximal or sub-segmental pulmonary embolism but the ventilation/perfusion lung scan concluded that there was a high probability of pulmonary embolism. The cutaneous biopsy pathology diagnosed intravascular lymphoma. Conclusion Intravascular lymphoma is a rare disease characterized by exclusive or predominant growth of neoplastic cells within the lumina of small blood vessels. Lung involvement seems to be common, but predominant lung presentation of this disease is rare. In our patient, urgent chemotherapy, along with adequate supportive care allowed complete recovery.

  16. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  17. Vaginal brachytherapy for postoperative endometrial cancer: 2014 Survey of the American Brachytherapy Society.

    Science.gov (United States)

    Harkenrider, Matthew M; Grover, Surbhi; Erickson, Beth A; Viswanathan, Akila N; Small, Christina; Kliethermes, Stephanie; Small, William

    2016-01-01

    Report current practice patterns for postoperative endometrial cancer emphasizing vaginal brachytherapy (VBT). A 38-item survey was e-mailed to 1,598 American Brachytherapy Society (ABS) members and 4,329 US radiation oncologists in 2014 totaling 5,710 recipients. Responses of practitioners who had delivered VBT in the previous 12 months were included in the analysis. Responses were tabulated to determine relative frequency distributions. χ(2) analysis was used to compare current results with those from the 2003 ABS survey. A total of 331 respondents initiated the VBT survey, of whom 289 (87.3%) administered VBT in the prior 12 months. Lymph node dissection and number of nodes removed influenced treatment decisions for 90.5% and 69.8%, respectively. High-dose-rate was used by 96.2%. The most common vaginal length treated was 4 cm (31.0%). Three-dimensional planning was used by 83.2% with 73.4% of those for the first fraction only. Doses to normal tissues were reported by 79.8%. About half optimized to the location of dose specification and/or normal tissues. As monotherapy, the most common prescriptions were 7 Gy for three fractions to 0.5-cm depth and 6 Gy for five fractions to the surface. As a boost, the most common prescriptions were 5 Gy for three fractions to 0.5-cm depth and 6 Gy for three fractions to the vaginal surface. Optimization points were placed at the apex and lateral vagina by 73.1%. Secondary quality assurance checks were performed by 98.9%. VBT is a common adjuvant therapy for endometrial cancer patients, most commonly with HDR. Fractionation and planning processes are variable but generally align with ABS recommendations. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. Multiple cerebral infarcts and intravascular central nervous system lymphoma: a rare but potentially treatable association.

    Science.gov (United States)

    Cruto, Catarina; Taipa, Ricardo; Monteiro, Cecília; Moreira, Isabel; Melo-Pires, Manuel; Correia, Manuel

    2013-02-15

    Intravascular large B-cell lymphoma (IVLBCL) is a rare lymphoproliferative disorder characterized by massive intravascular growth of lymphoma cells with a predilection for the central nervous system (CNS). Diagnosis is generally delayed by variable clinical presentation and nonspecific laboratory findings. Brain biopsy is the gold standard diagnostic test. Prognosis is poor with a high mortality rate. We report a case of "in vivo" diagnosis of IVLBCL presenting with rapidly progressive encephalopathy secondary to multiple cerebral infarcts. This case highlights IVLBCL as a possible cause of unexplained multifocal and recurrent strokes. Earlier diagnosis and consequent earlier treatment may be associated with better prognosis. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Brachytherapy - not pulsed and low rate brachytherapy. Medical radiation protection - ED 4248

    International Nuclear Information System (INIS)

    2008-06-01

    After an indication of authorizations required to perform brachytherapy, this sheet indicates the concerned personnel, indicates the different treatment steps, briefly describes the risk related to ionizing radiations, indicates the various aspects of risk assessment and of determination of exposure levels (definition of controlled and monitored areas, personnel classification, possible methods for dose monitoring), presents the strategy for risk management (rules regarding risk reduction, technical measures regarding the installation, individual technical measures, training and information, prevention and medical monitoring) and how this risk management can be assessed

  20. The American College of Radiology and the American Brachytherapy Society practice parameter for the performance of radionuclide-based high-dose-rate brachytherapy.

    Science.gov (United States)

    Erickson, Beth A; Bittner, Nathan H J; Chadha, Manjeet; Mourtada, Firas; Demanes, D Jeffrey

    Brachytherapy is a radiation therapy method in which radionuclide sources are used to deliver a radiation dose at a distance of up to a few centimeters by surface, intracavitary, intraluminal, or interstitial application. This practice parameter refers only to the use of radionuclides for brachytherapy. Brachytherapy alone or combined with external beam therapy plays an important role in the management and treatment of patients with cancer. High-dose-rate (HDR) brachytherapy uses radionuclides such as iridium-192 at dose rates of 20 cGy per minute (12 Gy per hour) or more to a designated target point or volume. High-dose-rate (HDR) brachytherapy is indicated for treating malignant or benign tumors where the treatment volume or targeted points are defined and accessible. Copyright © 2016 American Brachytherapy Society and American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Multicenter evaluation of temporary intravascular shunt use in vascular trauma.

    Science.gov (United States)

    Inaba, Kenji; Aksoy, Hande; Seamon, Mark J; Marks, Joshua A; Duchesne, Juan; Schroll, Rebecca; Fox, Charles J; Pieracci, Fredric M; Moore, Ernest E; Joseph, Bellal; Haider, Ansab A; Harvin, John A; Lawless, Ryan A; Cannon, Jeremy; Holland, Seth R; Demetriades, Demetrios

    2016-03-01

    The indications and outcomes associated with temporary intravascular shunting (TIVS) for vascular trauma in the civilian sector are poorly understood. The objective of this study was to perform a contemporary multicenter review of TIVS use and outcomes. Patients sustaining vascular trauma, requiring TIVS insertion (January 2005 to December 2013), were retrospectively identified at seven Level I trauma centers. Clinical demographics, operative details, and outcomes were abstracted. A total of 213 injuries (2.7%; 94.8% arterial) requiring TIVS were identified in 7,385 patients with vascular injuries. Median age was 27.0 years (range, 4-89 years), 91.0% were male, Glasgow Coma Scale (GCS) score was 15.0 (interquartile range, 4.0), Injury Severity Score (ISS) was 16.0 (interquartile range, 15.0), 26.0% had an ISS of 25 or greater, and 71.1% had penetrating injuries. The most common mechanism was gunshot wound (62.7%), followed by auto versus pedestrian (11.4%) and motor vehicle collision (6.5%). Shunts were placed for damage control in 63.4%, staged repair for combined orthopedic and vascular injuries in 36.1%, and for insufficient surgeon skill set in 0.5%. The most common vessel shunted was the superficial femoral artery (23.9%), followed by popliteal artery (18.8%) and brachial artery (13.2%). An argyle shunt (81.2%) was the most common conduit, followed by Pruitt-Inahara (9.4%). Dwell time was less than 6 hours in 61.4%, 24 hours in 86.5%, 48 hours in 95.9%, with only 4.1% remaining in place for more than 48 hours. Of the patients, 81.6% survived to definitive repair, and 79.6% survived overall. Complications included shunt thrombosis (5.6%) and dislodgment (1.4%). There was no association between dwell time and shunt thrombosis. The use of a noncommercial shunt (chest tube/feeding tube) did not impact shunt thrombosis but was an independent risk factor for subsequent graft failure. The limb salvage rate was 96.3%. No deaths could be attributed to a shunt

  2. Radiological protection of patients in brachytherapy

    International Nuclear Information System (INIS)

    Sacc, Ricardo; Herrero, Flavia

    2008-01-01

    Full text: The prefix 'brachy' means short-range, so brachytherapy is the administration of radiation therapy using small radioactive sources in the form of needles, tubes, wires or seeds, which are placed within the tumor -interstitial form- or very near of it, superficially or in an endo-cavity form. This technique, which was limited by the size of the primary tumor, has the advantage, that the radiation, can be adjusted to the size and shape of the tumor volume and the radioisotope used, - short range -, is selected with the criteria of getting the dose in the organs at risk, as low as possible, making what it is known as conformal radiotherapy. Radioactive sources may be permanent or temporary implants. The application of radioactive material, can be manually or automatically. In the first case, a major breakthrough from the radioprotection point of view, was the use of afterloading devices, methodology highly recommended to reduce the radiation exposure to staff. With the development of technology, remotely controlled afterloading devices were introduced, which in addition to complying with the above requirement, allow the source to move in different positions along catheters housed in one or more channels, making therapeutic brachytherapy treatments in tumor volumes possible, that due to its length, decades ago would have been an unthinkable deal. In all cases, sources, which may vary from the 3 mm in length, 125 Iodine or 198 Gold seeds, to extensive wires of 192 Iridium, are encapsulated for two main purposes: preventing leakage of radioactive material and absorption of unwanted radiation, alpha and beta, produced by the radioactive decay. Consequently, it should be highly unlikely that the radioactive material, could be lost or located in the patient, in a different place of the one that was planned. However, history shows us the opposite. Its is known the kind of deterministic effect that radiation is going to produce in the tumor, where the severity of

  3. Auger Electron Therapy And Brachytherapy Tumor Treatment

    International Nuclear Information System (INIS)

    Laster, B.H.; Shani, G.

    2002-01-01

    Auger Electron Therapy (AET) is a binary approach for improving cancer radiotherapy. It involves the selective targeting of an atom to tumor cells using physiological pathway. The atom is then irradiated by a specific radiation that produces secondary radiation called Auger electrons. One of the problems associated with the clinical application of AET, is that the energy of the photons required for stimulating photoelectric absorption in most of the available high Z target atoms, is too low to achieve penetration through normal surrounding tissues to the depth of the tumor, when an external source is used. The solution is therefore the use of a brachytherapy technique. There are two other problems associated with the use of radiation as a cancer treatment. The first is the limitation on radiation dose to the normal tissue within the treatment volume. The second problem is the limitation imposed by the miniscule size of the critical target of the cell, namely the DNA (0.25% of the cell mass). The solution to the first problem can be achieved by using the brachytherapy technique. The second problem can be resolved by placing the radiation source in close position to the DNA. AET, as we apply it, provides the two solutions to the two problems. When a photon is absorbed by an electron in the K or L shell of an high Z atom, the electron is ejected from the atom, creating a vacancy in the shell. This vacancy is immediately filled with an electron from an upper shell. The energy difference between the two shells is sometimes emitted as an x-ray, however, frequently the energy is transferred to an outer shell electron that is emitted as an Auger electron. These electrons are emitted at energies of up to ∼30 keV and therefore have a very short range in the cell. They will deposit all their energy within 20-30 nm from the point of emission. i.e. all the energy is deposited in the DNA. In our work indium is used as the high Z atom

  4. Interstitial rotating shield brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Adams, Quentin E.; Xu, Jinghzu; Breitbach, Elizabeth K.; Li, Xing; Rockey, William R.; Kim, Yusung; Wu, Xiaodong; Flynn, Ryan T.; Enger, Shirin A.

    2014-01-01

    Purpose: To present a novel needle, catheter, and radiation source system for interstitial rotating shield brachytherapy (I-RSBT) of the prostate. I-RSBT is a promising technique for reducing urethra, rectum, and bladder dose relative to conventional interstitial high-dose-rate brachytherapy (HDR-BT). Methods: A wire-mounted 62 GBq 153 Gd source is proposed with an encapsulated diameter of 0.59 mm, active diameter of 0.44 mm, and active length of 10 mm. A concept model I-RSBT needle/catheter pair was constructed using concentric 50 and 75 μm thick nickel-titanium alloy (nitinol) tubes. The needle is 16-gauge (1.651 mm) in outer diameter and the catheter contains a 535 μm thick platinum shield. I-RSBT and conventional HDR-BT treatment plans for a prostate cancer patient were generated based on Monte Carlo dose calculations. In order to minimize urethral dose, urethral dose gradient volumes within 0–5 mm of the urethra surface were allowed to receive doses less than the prescribed dose of 100%. Results: The platinum shield reduced the dose rate on the shielded side of the source at 1 cm off-axis to 6.4% of the dose rate on the unshielded side. For the case considered, for the same minimum dose to the hottest 98% of the clinical target volume (D 98% ), I-RSBT reduced urethral D 0.1cc below that of conventional HDR-BT by 29%, 33%, 38%, and 44% for urethral dose gradient volumes within 0, 1, 3, and 5 mm of the urethra surface, respectively. Percentages are expressed relative to the prescription dose of 100%. For the case considered, for the same urethral dose gradient volumes, rectum D 1cc was reduced by 7%, 6%, 6%, and 6%, respectively, and bladder D 1cc was reduced by 4%, 5%, 5%, and 6%, respectively. Treatment time to deliver 20 Gy with I-RSBT was 154 min with ten 62 GBq 153 Gd sources. Conclusions: For the case considered, the proposed 153 Gd-based I-RSBT system has the potential to lower the urethral dose relative to HDR-BT by 29%–44% if the clinician allows

  5. The needs for brachytherapy source calibrations in the United States

    International Nuclear Information System (INIS)

    Coursey, B.M.; Goodman, L.J.; Hoppes, D.D.; Loevinger, R.; McLaughlin, W.L.; Soares, C.G.; Weaver, J.T.

    1992-01-01

    Brachytherapy sources of beta and gamma radiation ('brachy' is from the Greek, meaning 'near') have a long history of use in interstitial, intracavitary, intraluminal, and ocular radiation therapy. In the past the US national standards for these sources were often specified in activity or milligram radium equivalent. With the introduction of new radionuclide sources to replace radium, source strength calibrations are now expressed as air kerma rate at a meter. In this paper, we review the NIST standards for brachytherapy sources, list some of the common radionuclides and source encapsulations in use in the US radiology community, and describe the latest NIST work, in collaboration with several US medical institutions, on a method of two- and three-dimensional dose mapping of brachytherapy sources using radiochromic films. (orig.)

  6. Developing a Verification and Training Phantom for Gynecological Brachytherapy System

    Directory of Open Access Journals (Sweden)

    Mahbobeh Nazarnejad

    2012-03-01

    Full Text Available Introduction Dosimetric accuracy is a major issue in the quality assurance (QA program for treatment planning systems (TPS. An important contribution to this process has been a proper dosimetry method to guarantee the accuracy of delivered dose to the tumor. In brachytherapy (BT of gynecological (Gyn cancer it is usual to insert a combination of tandem and ovoid applicators with a complicated geometry which makes their dosimetry verification difficult and important. Therefore, evaluation and verification of dose distribution is necessary for accurate dose delivery to the patients. Materials and Methods The solid phantom was made from Perspex slabs as a tool for intracavitary brachytherapy dosimetric QA. Film dosimetry (EDR2 was done for a combination of ovoid and tandem applicators introduced by Flexitron brachytherapy system. Treatment planning was also done with Flexiplan 3D-TPS to irradiate films sandwiched between phantom slabs. Isodose curves obtained from treatment planning system and the films were compared with each other in 2D and 3D manners. Results The brachytherapy solid phantom was constructed with slabs. It was possible to insert tandems and ovoids loaded with radioactive source of Ir-192 subsequently. Relative error was 3-8.6% and average relative error was 5.08% in comparison with the films and TPS isodose curves. Conclusion Our results showed that the difference between TPS and the measurements is well within the acceptable boundaries and below the action level according to AAPM TG.45. Our findings showed that this phantom after minor corrections can be used as a method of choice for inter-comparison analysis of TPS and to fill the existing gap for accurate QA program in intracavitary brachytherapy. The constructed phantom also showed that it can be a valuable tool for verification of accurate dose delivery to the patients as well as training for brachytherapy residents and physics students.

  7. Imaging method for monitoring delivery of high dose rate brachytherapy

    Science.gov (United States)

    Weisenberger, Andrew G; Majewski, Stanislaw

    2012-10-23

    A method for in-situ monitoring both the balloon/cavity and the radioactive source in brachytherapy treatment utilizing using at least one pair of miniature gamma cameras to acquire separate images of: 1) the radioactive source as it is moved in the tumor volume during brachytherapy; and 2) a relatively low intensity radiation source produced by either an injected radiopharmaceutical rendering cancerous tissue visible or from a radioactive solution filling a balloon surgically implanted into the cavity formed by the surgical resection of a tumor.

  8. Volume correction factor in time dose relationships in brachytherapy

    International Nuclear Information System (INIS)

    Supe, S.J.; Sasane, J.B.

    1987-01-01

    Paterson's clinical data about the maximum tolerance doses for various volumes of interstitial implants with Ra-226 delivered in seven days was made use of in deriving volume correction factors for TDF and CRE concepts respectively for brachytherapy. The derived volume correction factors for TDF and for CRE differ fromthe one assumed for CRE by Kirk et al. and implied for TDF by Goitein. A normalising volume of 70 cc has been suggested for both CRE and TDF concepts for brachytherapy. A table showing the volume corrected TDF is presented for various volumes and dose rates for continuous irradiation. The use of this table is illustrated with examples. (orig.) [de

  9. Brachytherapy in vulvar cancer: analysis of 18 patients

    International Nuclear Information System (INIS)

    Frezza, G.; Baldissera, A.; Bernardi, L.; Bunkheila, F.; Galuppi, A.; Salvi, F.

    1996-01-01

    INTRODUCTION: Vulvar cancer is a rather common neoplasm in elderly patients. Surgery, followed eventually by postoperative radiotherapy, is the treatment of choice. The results of exclusive radiotherapy (external beam irradiation and/or brachytherapy) are not well defined and in the recent literature only small series are reported. Radiotherapy however is the only therapeutic option in patients who are not fit for radical surgery. It is thus necessary to review its indications and its modalities. PATIENTS METHODS AND RESULTS: From 1990 to 1994 18 pts with a diagnosis of squamous cell carcinoma of the vulva have been submitted to brachytherapy. Age ranged from 60 to 92 years (mean age 76, 1 ys). 14 pts were treated at diagnosis (11 pts) or for recurrent disease after surgery (3 pts). In 8 of them brachytherapy (total dose 35-45 Gy, dose rate: 0,4-0,78 Gy/h) was preceded by external beam irradiation (Co60 or electron beam, 40-50 Gy to primary and inguinal nodes); 6 pts were treated with brachytherapy alone (58-60 Gy; dose rate 0,44-0,63 Gy/h). 4 pts underwent to brachytherapy alone for local recurrence after surgery and postoperative radiotherapy (total dose 45-60 Gy; dose rate 0,37-0,49 Gy/h). Brachytherapy was always performed with 192 Ir. Plastic tubes (2 to 5 lines) were used for single plane implantation of small exophytic lesions limited to the labia (8 cases); a perineal template (10 cases) was employed in lesions extended to the vaginal mucosa or involving the clitoris or the area of the perineum. (10(14)) pts treated at diagnosis are alive and free from local recurrence after 11-48 mos. 3 of them, treated with brachytherapy alone, have presented a nodal recurrence in the groin after 14, 15 and 27 mos. respectively. All of them are alive and free from disease after surgery and external radiotherapy. None of the pts treated for recurrent disease after surgery + external beam radiotherapy has achieved a local control. CONCLUSION: Brachytherapy alone or

  10. Validation of GPUMCD for low-energy brachytherapy seed dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Hissoiny, Sami; Ozell, Benoit; Despres, Philippe; Carrier, Jean-Francois [Ecole polytechnique de Montreal, Departement de genie informatique et genie logiciel, 2500 chemin de Polytechnique, Montreal, QC, H3T 1J4 (Canada); Departement de radio-oncologie, Centre hospitalier universitaire de Quebec (CHUQ), 11 Cote du Palais, Quebec, QC, G1R 2J6 (Canada); Departement de physique, Universite de Montreal, Montreal, QC (Canada) and Departement de radio-oncologie and Centre de recherche du CHUM, Centre hospitalier de l' Universite de Montreal (CHUM), Montreal, QC, H2L 4M1 (Canada)

    2011-07-15

    Purpose: To validate GPUMCD, a new package for fast Monte Carlo dose calculations based on the GPU (graphics processing unit), as a tool for low-energy single seed brachytherapy dosimetry for specific seed models. As the currently accepted method of dose calculation in low-energy brachytherapy computations relies on severe approximations, a Monte Carlo based approach would result in more accurate dose calculations, taking in to consideration the patient anatomy as well as interseed attenuation. The first step is to evaluate the capability of GPUMCD to reproduce low-energy, single source, brachytherapy calculations which could ultimately result in fast and accurate, Monte Carlo based, brachytherapy dose calculations for routine planning. Methods: A mixed geometry engine was integrated to GPUMCD capable of handling parametric as well as voxelized geometries. In order to evaluate GPUMCD for brachytherapy calculations, several dosimetry parameters were computed and compared to values found in the literature. These parameters, defined by the AAPM Task-Group No. 43, are the radial dose function, the 2D anisotropy function, and the dose rate constant. These three parameters were computed for two different brachytherapy sources: the Amersham OncoSeed 6711 and the Imagyn IsoStar IS-12501. Results: GPUMCD was shown to yield dosimetric parameters similar to those found in the literature. It reproduces radial dose functions to within 1.25% for both sources in the 0.5< r <10 cm range. The 2D anisotropy function was found to be within 3% at r = 5 cm and within 4% at r = 1 cm. The dose rate constants obtained were within the range of other values reported in the literature.Conclusion: GPUMCD was shown to be able to reproduce various TG-43 parameters for two different low-energy brachytherapy sources found in the literature. The next step is to test GPUMCD as a fast clinical Monte Carlo brachytherapy dose calculations with multiple seeds and patient geometry, potentially providing

  11. Dose optimisation in single plane interstitial brachytherapy.

    Science.gov (United States)

    Tanderup, Kari; Hellebust, Taran Paulsen; Honoré, Henriette Benedicte; Nielsen, Søren Kynde; Olsen, Dag Rune; Grau, Cai; Lindegaard, Jacob Christian

    2006-10-01

    Brachytherapy dose distributions can be optimised by modulation of source dwell times. In this study dose optimisation in single planar interstitial implants was evaluated in order to quantify the potential benefit in patients. In 14 patients, treated for recurrent rectal and cervical cancer, flexible catheters were sutured intra-operatively to the tumour bed in areas with compromised surgical margin. Both non-optimised, geometrically and graphically optimised CT -based dose plans were made. The overdose index (OI), homogeneity index (HI), conformal index (COIN), minimum target dose, and high dose volumes were evaluated. The dependence of OI, HI, and COIN on target volume and implant regularity was evaluated. In addition, 12 theoretical implant configurations were analyzed. Geometrical and graphical optimisation improved the dose plans significantly with graphical optimisation being superior. Graphically optimised dose plans showed a significant decrease of 18%+/-9% in high dose volume (pusability of these parameters for comparison of dose plans between patients. Dwell time optimisation significantly improved the dose distribution regarding homogeneity, conformity, minimum target dose, and size of high dose volumes. Graphical optimisation is fast, reproducible and superior to geometric optimisation.

  12. Dose optimisation in single plane interstitial brachytherapy

    DEFF Research Database (Denmark)

    Tanderup, Kari; Hellebust, Taran Paulsen; Honoré, Henriette Benedicte

    2006-01-01

    BACKGROUND AND PURPOSE: Brachytherapy dose distributions can be optimised       by modulation of source dwell times. In this study dose optimisation in       single planar interstitial implants was evaluated in order to quantify the       potential benefit in patients. MATERIAL AND METHODS: In 14...... patients,       treated for recurrent rectal and cervical cancer, flexible catheters were       sutured intra-operatively to the tumour bed in areas with compromised       surgical margin. Both non-optimised, geometrically and graphically       optimised CT -based dose plans were made. The overdose index...... (OI),       homogeneity index (HI), conformal index (COIN), minimum target dose, and       high dose volumes were evaluated. The dependence of OI, HI, and COIN on       target volume and implant regularity was evaluated. In addition, 12       theoretical implant configurations were analyzed. RESULTS...

  13. Dose assessment for brachytherapy with Henschke applicator

    International Nuclear Information System (INIS)

    Yu, Pei-Chieh; Chao, Tsi-Chian; Tung, Chuan-Jong; Wu, Ching-Jung; Lee, Chung-Chi

    2011-01-01

    Dose perturbation caused by the Henschke applicator is a major concern for the brachytherapy planning system (BPS) in recent years. To investigate dose impact owing to neglect of the metal shielding effect, Monte Carlo (MC) simulation, BPS calculation, and film measurement have been performed for dose assessment in a water phantom. Additionally, a cylindrical air cavity representing the rectum was added into the MC simulation to study its effect on dose distribution. Monte Carlo N-Particle Transport Code (MCNP) was used in this study to simulate the dose distribution using a mesh tally. This Monte Carlo simulation has been validated using the TG-43 data in a previous report. For the measurement, the Henschke applicator was placed in a specially-designed phantom, and Gafchromic films were inserted in the center plane for 2D dose assessment. Isodose distributions with and without the Henschke applicator by the MC simulation show significant deviation from those by the BPS. For MC simulation, the isodose curves shrank more significantly when the metal applicator was applied. For the impact of the added air cavity, the results indicate that it is hard to distinguish between with and without the cavity. Thus, the rectum cavity has little impact on the dose distribution around the Henschke applicator.

  14. Intravascular large B-cell lymphoma : remission after rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy

    NARCIS (Netherlands)

    Horváth, Barbara; Demeter, Judit; Eros, Nóra; Hársing, Judit; Csomor, Judit; Matolcsy, András; Bottlik, Gyula; Gyori, Gabriella; Marschalkó, Márta; Kárpáti, Sarolta

    2009-01-01

    Intravascular lymphoma is an uncommon, very aggressive extranodal non-Hodgkin lymphoma that most frequently involves the skin and central nervous system. Most cases are of B-cell origin; T-cell phenotype is extremely rare. Malignant cells proliferate within the lumens of capillaries, arterioles,

  15. [Disseminated intravascular coagulation in a patient with polyarteritis nodosa and bilateral hypoacusis].

    Science.gov (United States)

    Lahulla Pastor, F; Méndez García, M J; Sanmartín, J V; Palacios de las Heras, E; Hurtado Santos, J

    2000-03-01

    We describe the case of a 44-years-old female patient with a panarteritis nodosa preceded by a rapid progressive bilateral deafness after an acute otitis media. Once on treatment with steroids and cyclophosphamide, she developed a disseminated intravascular coagulation, with a fatal evolution not justifiable by a different cause apart from her main disease.

  16. Disseminated intravascular coagulation as an unusual presentation of an Epstein-Barr virus infection

    NARCIS (Netherlands)

    van Steijn, JHM; van Tol, KM; van Essen, LH; Gans, ROB

    2000-01-01

    Epstein-Barr viral (EBV)-infection usually presents as fever, sore throat, fatigue, lymphadenopathy and atypical lymphocytosis. We describe a patient with disseminated intravascular coagulation as the presenting symptom caused by a primary EBV infection. (C) 2000 Elsevier Science B.V. All rights

  17. Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

    DEFF Research Database (Denmark)

    Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated the...

  18. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies

    DEFF Research Database (Denmark)

    Tearney, Guillermo J; Regar, Evelyn; Akasaka, Takashi

    2012-01-01

    The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the di...... the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease....

  19. Effect of catecholamines and insulin on plasma volume and intravascular mass of albumin in man

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J; Larsen, S

    1989-01-01

    1. The effect of intravenous catecholamine infusions and of intravenous insulin on plasma volume and intravascular mass of albumin was investigated in healthy males. 2. Physiological doses of adrenaline (0.5 microgram/min and 3 microgram/min) increased peripheral venous packed cell volume signifi...

  20. No change in impedance upon intravascular injection of D5W.

    Science.gov (United States)

    Chin, James; Tsui, Ban C H

    2010-06-01

    Electrical impedance increases following test injections of non-conducting solutions around nerves; however, this increase should diminish rapidly with intravascular needle placement, wherein the systemic circulation will dissipate the solution. For this observational study, we hypothesized that the impedance increases significantly at the perineural space after an injection of 5% dextrose in water (D5W), but that it does not increase correspondingly at the intravascular location After Ethics Research Board approval, electrical impedance was measured by a nerve stimulator displaying resistance, Stimuplex HNS 12, before and during (30 sec) an injection of D5W 3 mL: 1) during intravenous cannula placement using an insulated stimulating needle sheathed in its plastic cannula, MultiSet NanoLine with 18G needle; and 2) during needle placement (Pajunk 22G insulated) for an ultrasound-guided supraclavicular block in patients undergoing hand surgery. The impedance changes at each location were analyzed and compared. Data were collected from 16 patients. Baseline impedance was lower intravascularly (mean 16.5 +/- standard deviation 7.2 kOmega) compared with perineurally (23.5 +/- 8.3 kOmega) (P = 0.037). Peak impedance after intravascular D5W injection was 20.1 +/- 6.8 kOmega, which was not a significant change (P = 0.15). In contrast, peak impedance after perineural D5W injection was 58.6 +/- 29.1 kOmega, an increase of 35.1 +/- 26.4 kOmega (155 +/- 117%), and then it reached a plateau of 36.7 +/- 19.6 kOmega. The increase in impedance was significantly greater at the perineural location (P < 0.0001). The absence of a significant increase in impedance upon injection of D5W prior to injection of local anesthetic may provide useful information to warn of intravascular injection.

  1. COAGULACIÓN INTRAVASCULAR DISEMINADA SECUNDARIA A ANEURISMA AÓRTICO DIAGNOSTICADA TRAS EXTRACCIÓN DENTAL

    OpenAIRE

    Cuevas-Ruiz MV; De la Nogal B; Cuevas-Ruiz B

    2006-01-01

    RESUMEN:Las manifestaciones de la coagulación intravascular diseminada (CID) están determinadas por la causa subyacente; sin embargo, en los casos de CID compensada el diagnóstico se basa en las pruebas de laboratorio.Presentamos el caso de un varón de 81 años al que se diagnostico de una coagulación intravascular diseminada secundaria a un aneurisma gigante de ambas ilíacas tras una extracción dentaria. SUMMARYThe clinical presentation of disseminated intravascular coagulopathy (DIC) is dete...

  2. Intraoperative planning and evaluation of permanent prostate brachytherapy: report of the American Brachytherapy Society.

    Science.gov (United States)

    Nag, S; Ciezki, J P; Cormack, R; Doggett, S; DeWyngaert, K; Edmundson, G K; Stock, R G; Stone, N N; Yu, Y; Zelefsky, M J

    2001-12-01

    The preplanned technique used for permanent prostate brachytherapy has limitations that may be overcome by intraoperative planning. The goal of the American Brachytherapy Society (ABS) project was to assess the current intraoperative planning process and explore the potential for improvement in intraoperative treatment planning (ITP). Members of the ABS with expertise in ITP performed a literature review, reviewed their clinical experience with ITP, and explored the potential for improving the technique. The ABS proposes the following terminology in regard to prostate planning process: *Preplanning--Creation of a plan a few days or weeks before the implant procedure. *Intraoperative planning--Treatment planning in the operating room (OR): the patient and transrectal ultrasound probe are not moved between the volume study and the seed insertion procedure. * Intraoperative preplanning--Creation of a plan in the OR just before the implant procedure, with immediate execution of the plan. *Interactive planning--Stepwise refinement of the treatment plan using computerized dose calculations derived from image-based needle position feedback. *Dynamic dose calculation--Constant updating of dose distribution calculations using continuous deposited seed position feedback. Both intraoperative preplanning and interactive planning are currently feasible and commercially available and may help to overcome many of the limitations of the preplanning technique. Dosimetric feedback based on imaged needle positions can be used to modify the ITP. However, the dynamic changes in prostate size and shape and in seed position that occur during the implant are not yet quantifiable with current technology, and ITP does not obviate the need for postimplant dosimetric analysis. The major current limitation of ITP is the inability to localize the seeds in relation to the prostate. Dynamic dose calculation can become a reality once these issues are solved. Future advances can be expected in

  3. Brachytherapy in Europe: philosophies, current practice and future directions

    International Nuclear Information System (INIS)

    Haworth, A.

    2000-01-01

    Full text: Five months sabbatical leave provided an opportunity to visit six radiotherapy centres in France, Holland and England. While brachytherapy philosophies and practices within each country were similar, there were considerable differences in attitudes between countries. The Institute Gustave Roussy, home of the Paris System and host for the French sector confirmed that the Paris System is still very much the preferred dosimetry method in this part of the world. Though their preference for low dose rate brachytherapy is still evident, high dose rate brachytherapy has found some applications but the rules of the Paris System are never far away and the words 'what about the hyperdose sleeve' are firmly implanted into this visitor's brain. The use of real time dosimetry for I-125 prostate brachytherapy at the Institute Curie (Paris) provided an interesting contrast to the standard pre and post implant dosimetry techniques commonly employed elsewhere. The two Dutch centres on the itinerary, in stark contrast to the traditional techniques seen in France, have applied the power of computers to investigate optimisation of the classic dosimetry systems and called on the analysis techniques (DVH, NTCP, TCP etc) now familiar to us all in external beam therapy. The Cookridge Hospital in England fitted somewhere between the French and Dutch centres. This centre showed how both modern and traditional techniques could be applied in an efficient way for a large variety of treatment sites. Copyright (2000) Australasian College of Physical Scientists and Engineers in Medicine

  4. Dose determination in breast tumor in brachytherapy using Iridium-192

    International Nuclear Information System (INIS)

    Okuno, S.F.

    1984-01-01

    Thermoluminescent dosimetry studies in vivo and in vitro aiming to determing radiation dose in the breast tumor, in brachytherapy using Iridium-192 was done. The correlation between radiation doses in tumor and external surface of the breast was investigated for correcting the time interval of radiation source implantation. (author) [pt

  5. Iodine-125 brachytherapy for prostate cancer: first published Australian experience

    International Nuclear Information System (INIS)

    Joseph, David J.; Woo, Tony C.S.; Haworth, Annette

    2004-01-01

    With the emergence of new imaging and implant'techniques, prostate brachytherapy has become increasingly popular over the last decade. Brachytherapy promises to deliver twice the biologically effective dose as conventional external beam treatments without increasing the dose to tissues surrounding the prostate. However, there are few or no published Australian series of its efficacy in the clinic. We present the experience of one of the first centres in Australia to offer this service to its patients: a series from Sir Charles Gairdner Hospital in Western Australia. We present data on the efficacy of brachytherapy in maintaining prostate specific antigen levels, as well as the rate of urinary, rectal and sexual complications. Our results compare favourably with other brachytherapy and external beam treatment series. We believe that with the increasing trend towards dose escalation and novel therapies, standardized measurements of success and failure need to be better defined, and that randomized trials comparing modalities are needed to improve the management of prostate cancer Copyright (2004) Blackwell Publishing Asia Pty Ltd

  6. Saving bladders with brachytherapy: implantation technique and results.

    NARCIS (Netherlands)

    Steen-Banasik, E.M. van der; Visser, A.G.; Reinders, J.G.; Heijbroek, R.P.; Idema, J.G.; Janssen, T.G.; Leer, J.W.H.

    2002-01-01

    PURPOSE: To analyze and report the treatment results of brachytherapy for solitary bladder cancer in the Arnhem Radiotherapy Institute. METHODS AND MATERIALS: Between January 1983 and October 1998, 63 patients with a solitary bladder tumor were treated with a combination of transurethral resection,

  7. Transit dose calculation in high dose rate brachytherapy (HDR ...

    African Journals Online (AJOL)

    Transit doses around a high dose rate 192Ir brachytherapy source were calculated using Sievert Integral at positions where the moving source was located exactly between two adjacent dwell positions. The correspond-ing transit dose rates were obtained by using energy absorption coefficients. Discrete step sizes of 0.25 ...

  8. Calculation of the Transit Dose in HDR Brachytherapy Based on ...

    African Journals Online (AJOL)

    The Monte Carlo method, which is the gold standard for accurate dose calculations in radiotherapy, was used to obtain the transit doses around a high dose rate (HDR) brachytherapy implant with thirteen dwell points. The midpoints of each of the inter-dwell separations, of step size 0.25 cm, were representative of the ...

  9. Postoperative brachytherapy for endometrial cancer using a ring applicator

    NARCIS (Netherlands)

    Vanneste, Ben G. L.; Meijnen, Philip; Hammerstein, Chris S. J.; Bijker, Nina; van Os, Rob M.; Stalpers, Lukas J. A.; Pieters, Bradley R.

    2015-01-01

    BACKGROUND: To evaluate the rate of vaginal, pelvic, and distant failures and acute toxicity after postoperative vaginal vault brachytherapy (VBT) delivered by a ring applicator in women with high intermediate-risk endometrial cancer. METHODS AND MATERIALS: A total of 100 patients were treated with

  10. Radiation exposure of nursing personnel to brachytherapy patients

    International Nuclear Information System (INIS)

    Cobb, P.D.; Kase, K.R.; Bjaerngard, B.E.

    1978-01-01

    The radiation exposure of nursing personnel to brachytherapy patients has been analyzed from data collected during the years 1973-1976, at four different hospitals. The average annual dose per exposed nurse ranged between 25 and 150 mrem. The radiation exposure per nurse was found to be proportional to the total potential exposure and was uncorrelated with the size of the nursing staff. (author)

  11. Independent brachytherapy plan verification software: Improving efficacy and efficiency

    International Nuclear Information System (INIS)

    Damato, Antonio L.; Devlin, Phillip M.; Bhagwat, Mandar S.; Buzurovic, Ivan; Friesen, Scott; Hansen, Jorgen L.; Lee, Larissa J.; Molodowitch, Christina; Nguyen, Paul L.; O’Farrell, Desmond A.; Viswanathan, Akila N.; Williams, Christopher L.; Killoran, Joseph H.; Cormack, Robert A.

    2014-01-01

    Background and purpose: To compare the pre-treatment brachytherapy plan verification by a physicist assisted by custom plan verification software (SAV) with those performed manually (MV). Materials and methods: All HDR brachytherapy plans used for treatment in 2013, verified using either SAV or MV, were retrospectively reviewed. Error rate (number of errors/number of plans) was measured and verification time calculated. All HDR brachytherapy safety events recorded between 2010 and 2013 were identified. The rate of patient-related safety events (number of events/number of fractions treated) and the impact of SAV on the underlying errors were assessed. Results: Three/106 errors (2.8%) were found in the SAV group and 24/273 (8.8%) in the MV group (p = 0.046). The mean ±1 standard deviation plan verification time was 8.4 ± 4.0 min for SAV and 11.6 ± 5.3 for MV (p = 0.006). Seven safety events out of 4729 fractions delivered (0.15%) were identified. Four events (57%) were associated with plan verification and could have been detected by SAV. Conclusions: We found a safety event rate in HDR brachytherapy of 0.15%. SAV significantly reduced the number of undetected errors in HDR treatment plans compared to MV, and reduced the time required for plan verification

  12. Endobronchial brachytherapy: the Saint-Louis Hospital experience

    International Nuclear Information System (INIS)

    Hennequin, C.; Durdux, C.; Housset, M.; Maylin, C.; Tredaniel, J.; Zalcman, G.; Hirsch, A.; Dray, M.; Manoux, D.; Perret, M.

    1997-01-01

    During the evolution of lung cancer, bronchial obstruction is often noticed and is sometimes responsible for serious symptoms. Several methods of des-obstruction can be proposed, including brachytherapy. Materials and methods: One hundred forty-nine patients, presenting with endobronchial brachytherapy were included into the study. Seventy-three were treated with curative intent, 47 with palliative intent and 29 with a combination of external irradiation and brachytherapy. We usually delivered a series of two 7-Gy fractions (1 cm from the catheter), the treatment being repeated one, two or three times. Results: When all symptoms were taken into account, respiratory function improvement was present in 79% of the patients. Among the 132 tumors that could be evaluated via a new endoscopy 2 months after treatment, 64 (48.5%) were in complete histological remission. The median survival was 14.4 months for the patients treated with curative intent. Eleven massive hemoptyses and 13 radiation bronchitides were observed. Conclusion: These results confirm the feasibility and good results related to endobronchial brachytherapy, though controlled studies are needed to better define its place in the therapeutic strategy of bronchial carcinomas. (authors)

  13. Brachytherapy treatment planning algorithm applied to prostate cancer

    Science.gov (United States)

    Herrera-Rodríguez, M. R.; Martínez-Dávalos, A.

    2000-10-01

    An application of Genetic Algorithms (GAs) for treatment planning optimization in prostate brachytherapy is presented. The importance of multi-objective selection criteria based on the contour of the volume of interest and radiosensitive structures such as the rectum and urethra is discussed. First results are obtained for a simple test case which presents radial symmetry.

  14. Pulsed dose rate brachytherapy – is it the right way?

    Directory of Open Access Journals (Sweden)

    Janusz Skowronek

    2010-10-01

    Full Text Available Pulsed dose rate (PDR-BT treatment is a brachytherapy modality that combines physical advantages of high-doserate (HDR-BT technology (isodose optimization, radiation safety with the radiobiological advantages of low-dose-rate (LDR-BT brachytherapy. Pulsed brachytherapy consists of using stronger radiation source than for LDR-BT and producing series of short exposures of 10 to 30 minutes in every hour to approximately the same total dose in the sameoverall time as with the LDR-BT. Modern afterloading equipment offers certain advantages over interstitial or intracavitaryinsertion of separate needles, tubes, seeds or wires. Isodose volumes in tissues can be created flexibly by a combinationof careful placement of the catheter and the adjustment of the dwell times of the computerized stepping source.Automatic removal of the radiation sources into a shielded safe eliminates radiation exposures to staff and visitors.Radiation exposure is also eliminated to the staff who formerly loaded and unloaded multiplicity of radioactive sources into the catheters, ovoids, tubes etc. This review based on summarized clinical investigations, analyses the feasibility and the background to introduce this brachytherapy technique and chosen clinical applications of PDR-BT.

  15. Electromagnetic tracking for treatment verification in interstitial brachytherapy

    DEFF Research Database (Denmark)

    Bert, Christoph; Kellermeier, Markus; Tanderup, Kari

    2016-01-01

    Electromagnetic tracking (EMT) is used in several medical fields to determine the position and orientation of dedicated sensors, e.g., attached to surgical tools. Recently, EMT has been introduced to brachytherapy for implant reconstruction and error detection. The manuscript briefly summarizes t...

  16. Factors influencing outcome of I-125 prostate cancer brachytherapy

    NARCIS (Netherlands)

    Hinnen, K.A.

    2011-01-01

    Brachytherapy is becoming an increasingly popular prostate cancer treatment, probably due to the specific advantages of the procedure, such as the minimal invasiveness and the lower chance of impotence and incontinence. Nonetheless, because of the long follow-up that is required to obtain prostate

  17. Brachytherapy dose measurements in heterogeneous tissues

    Energy Technology Data Exchange (ETDEWEB)

    Paiva F, G.; Luvizotto, J.; Salles C, T.; Guimaraes A, P. C.; Dalledone S, P. de T.; Yoriyaz, H. [Instituto de Pesquisas Energeticas e Nucleares / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Rubo, R., E-mail: gabrielpaivafonseca@gmail.com [Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, 05403-900 Sao Paulo (Brazil)

    2014-08-15

    Recently, Beau lieu et al. published an article providing guidance for Model-Based Dose Calculation Algorithms (MBDCAs), where tissue heterogeneity considerations are addressed. It is well-known that T G-43 formalism which considers only water medium is limited and significant dose differences have been found comparing both methodologies. The aim of the present work is to experimentally quantify dose values in heterogeneous medium using different dose measurement methods and techniques and compare them with those obtained with Monte Carlo simulations. Experiments have been performed using a Nucletron micro Selectron-Hdr Ir-192 brachytherapy source and a heterogeneous phantom composed by PMMA and different tissue equivalent cylinders like bone, lungs and muscle. Several dose measurements were obtained using tissue equivalent materials with height 1.8 cm and 4.3 cm positioned between the radiation source and the detectors. Radiochromic films, TLDs and MOSFET S have been used for the dose measurements. Film dosimetry has been performed using two methodologies: a) linearization for dose-response curve based on calibration curves to create a functional form that linearize s the dose response and b) 177 multichannel analysis dosimetry where the multiple color channels are analyzed allowing to address not only disturbances in the measurements caused by thickness variation in the film layer, but also, separate other external influences in the film response. All experiments have been simulated using the MCNP5 Monte Carlo radiation transport code. Comparison of experimental results are in good agreement with calculated dose values with differences less than 6% for almost all cases. (Author)

  18. Interstitial brachytherapy in carcinoma of the penis

    International Nuclear Information System (INIS)

    Chaudhary, A.J.; Ghosh, S.; Bhalavat, R.L.; Kulkarni, J.N.; Sequeira, B.V.E.

    1999-01-01

    Aim: Keeping in line with the increasing emphasis on organ preservation, we at the Tata Memorial Hospital have evaluated the role of Ir-192 interstitial implant as regards local control, functional and cosmetic outcome in early as well as locally recurrent carcinoma of the distal penis. Patients and Methods: From October 1988 to December 1996, 23 patients with histopathologically proven cancer of the penis were treated with radical radiation therapy using Ir-192 temporary interstitial implant. Our patients were in the age group of 20 to 60 years. The primary lesions were T1 and 7, T2 in 7 and recurrent in 9 patients. Only 7 patients had palpable groin nodes at presentation, all of which were pathologically negative. The median dose of implant was 50 Gy (range 40 to 60 Gy), using the LDR afterloading system and the Paris system of implant rules for dosimetry. Follow-up ranged from 4 to 117 months (median 24 months). Results: At last follow-up 18 of the 23 patients remained locally controlled with implant alone. Three patients failed only locally, 2 locoregionally and 1 only at the groin. Of the 5 patients who failed locally, 4 were successfully salvaged with partial penectomy and remained controlled when last seen. Local control with implant alone at 8 years was 70% by life table analysis. The patients had excellent functional and cosmetic outcome. We did not record any case of skin or softtissue necrosis. Only 2 patients developed meatal stenosis, both of which were treated endoscopically. Conclusion: Our results lead us to interpret that interstitial brachytherapy with Ir-192 offers excellent local control rates with preservation of organ and function. Penectomy can be reserved as a means for effective salvage. (orig.) [de

  19. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Directory of Open Access Journals (Sweden)

    Samia de Freitas Brandao

    2013-07-01

    Full Text Available Objective Comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and Methods Simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results Intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h-1.p-1.s, respectively, on the healthy tissue, on the balloon periphery and on the I 1 and I 2 tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h-1.p-1.s, respectively on the healthy tissue, on the target tumor and on the I 1 and I 2 infiltration zones. Conclusion Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones.

  20. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Samia de Freitas, E-mail: samiabrandao@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Campos, Tarcisio Passos Ribeiro de [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2013-06-15

    Objective: comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and methods: simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results: intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively, on the healthy tissue, on the balloon periphery and on the /{sub 1} and /{sub 2} tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively on the healthy tissue, on the target tumor and on the /{sub 1} and /{sub 2} infiltration zones. Conclusion: Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones. (author)

  1. An assessment of the radiological impact of brachytherapy application in Metro Manila hospitals

    International Nuclear Information System (INIS)

    Palattao, M.V.B.; Venida, L.L.; Loterina, R.A.; Espiritu, R.T.

    1996-01-01

    One of the most important uses of radioactive sources in medicine is the application of brachytherapy technology. Brachytherapy is a method of radiation therapy where an encapsulated radioactive source delivers gamma or beta radiation into a tumor site. The paper describes different categories of brachytherapy applications involving manual insertion or afterloading and remote afterloading techniques. A list of five hospitals in Metro Manila practicing different techniques of brachytherapy are enumerated. Because of the widespread uses of radioactive sources in brachytherapy technology in medicine, inadequate control in its use had led to a number of incidents resulting to unnecessary exposure of radiation workers, patients and general public. This study was initiated to determine the radilogical hazards involved in brachytherapy applications. It presents contingency scenarios and their projected radiological consequences. (author). 7 refs., 2 tabs

  2. Prostate specific antigen (PSA) kinetics after 125I seed implantation (permanent Brachytherapy) for localized prostate cancer

    International Nuclear Information System (INIS)

    Ebara, Shin; Katayama, Norihisa; Manabe, Daisuke

    2007-01-01

    Prostatic specific antigen (PSA) bounce (over 0.1 ng/ml) was observed in 25.7% of patients (18 of 70) within 30 month after brachytherapy in our series. Several reports demonstrated that PSA bounce was observed in 30-50% of patients, observed within 2 years after brachytherapy and continued following 1 year. PSA bounce should be considered when assessing a patient with a rising PSA level before PSA nadir was achieved 4-5 years after brachytherapy. (author)

  3. Advantages of high-dose rate (HDR) brachytherapy in treatment of prostate cancer

    Science.gov (United States)

    Molokov, A. A.; Vanina, E. A.; Tseluyko, S. S.

    2017-09-01

    One of the modern methods of preserving organs radiation treatment is brachytherapy. This article analyzes the results of prostate brachytherapy. These studies of the advantages of high dose brachytherapy lead to the conclusion that this method of radiation treatment for prostate cancer has a favorable advantage in comparison with remote sensing methods, and is competitive, preserving organs in comparison to surgical methods of treatment. The use of the method of polyfocal transperineal biopsy during the brachytherapy session provides information on the volumetric spread of prostate cancer and adjust the dosimetry plan taking into account the obtained data.

  4. Low variation and high reproducibility in plaque volume with intravascular ultrasound

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Pedersen, Knud Erik

    2004-01-01

    BACKGROUND: Intravascular ultrasound (IVUS) has several advantages compared to angiography when evaluating coronary atherosclerosis in the vessel wall. METHODS: The accuracy, reproducibility, and short-time spontaneous variation in volume of vessel, plaque and lumen were studied by electrocardiog......BACKGROUND: Intravascular ultrasound (IVUS) has several advantages compared to angiography when evaluating coronary atherosclerosis in the vessel wall. METHODS: The accuracy, reproducibility, and short-time spontaneous variation in volume of vessel, plaque and lumen were studied...... by electrocardiographic-gated three-dimensional (3D) IVUS in 20 male patients with ischaemic heart disease (IHD). RESULTS: The study lesions were angiographically insignificant, with a length of the analysed segment on 11.4+/-5.9 mm. At baseline the mean minimal lumen diameter was 2.41+/-0.59 mm, minimal lumen area 4......=0.804; pIVUS is a highly reproducible method when applied on coronary artery...

  5. Intravascular Papillary Endothelial Hyperplasia Associated with Venous Pool Arising in the Lower Lip: A Case Report

    Directory of Open Access Journals (Sweden)

    Hisanobu Yonezawa

    2009-01-01

    Full Text Available Intravascular papillary endothelial hyperplasia is a benign nonneoplastic vascular lesion that consists of endothelial cells with abundant vascular tissue with papillary proliferation. An adult female had a painless growing dark red nodule on the left side of the lower lip and often touched and gnawed at it for more than 4 years. The lesion was a tender, smooth mass approximately 1 cm in diameter without discoloration reaction. Magnetic resonance imaging of the lesion showed specific findings. She was diagnosed clinically as having mimicked hemangioma, and the lesion was totally excised under local anesthesia. Histopathological examination revealed that papillary proliferated endothelial cells with venous pool, and the lesion was diagnosed as intravascular papillary endothelial hyperplasia associated with venous pool. There has been no recurrence for more than 1 year. Despite the benign nature of this lesion, it could have been mistaken for a malignant tumor because of its clinical course and radiologic findings.

  6. Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Glover, Guy W; Thomas, Richard M; Vamvakas, George

    2016-01-01

    BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest and may be achieved using a variety of cooling devices. This study was conducted to explore the performance and outcomes for intravascular versus surface devices for targeted temperature management after...... out-of-hospital cardiac arrest. METHOD: A retrospective analysis of data from the Targeted Temperature Management trial. N = 934. A total of 240 patients (26%) managed with intravascular versus 694 (74%) with surface devices. Devices were assessed for speed and precision during the induction......, maintenance and rewarming phases in addition to adverse events. All-cause mortality, as well as a composite of poor neurological function or death, as evaluated by the Cerebral Performance Category and modified Rankin scale were analysed. RESULTS: For patients managed at 33 °C there was no difference between...

  7. dose in cervical cancer intracavitary brachytherapy

    Directory of Open Access Journals (Sweden)

    Zahra Siavashpour

    2016-04-01

    Full Text Available Purpose: To analyze the optimum organ filling point for organs at risk (OARs dose in cervical cancer high-dose-rate (HDR brachytherapy. Material and methods : In a retrospective study, 32 locally advanced cervical cancer patients (97 insertions who were treated with 3D conformal external beam radiation therapy (EBRT and concurrent chemotherapy during 2010-2013 were included. Rotterdam HDR tandem-ovoid applicators were used and computed tomography (CT scanning was performed after each insertion. The OARs delineation and GEC-ESTRO-based clinical target volumes (CTVs contouring was followed by 3D forward planning. Then, dose volume histogram (DVH parameters of organs were recorded and patients were classified based on their OARs volumes, as well as their inserted tandem length. Results : The absorbed dose to point A ranged between 6.5-7.5 Gy. D 0.1cm ³ and D 2cm ³ of the bladder significantly increased with the bladder volume enlargement (p value < 0.05. By increasing the bladder volume up to about 140 cm3, the rectum dose was also increased. For the cases with bladder volumes higher than 140 cm3, the rectum dose decreased. For bladder volumes lower than 75 cm3, the sigmoid dose decreased; however, for bladder volumes higher than 75 cm3, the sigmoid dose increased. The D 2cm ³ of the bladder and rectum were higher for longer tandems than for shorter ones, respectively. The divergence of the obtained results for different tandem lengths became wider by the extension of the bladder volume. The rectum and sigmoid volume had a direct impact on increasing their D 0.1cm ³ and D 2cm ³, as well as decreasing their D 10 , D 30 , and D 50 . Conclusions : There is a relationship between the volumes of OARs and their received doses. Selecting a bladder with a volume of about 70 cm3 or less proved to be better with regards to the dose to the bladder, rectum, and sigmoid.

  8. Association of insulin resistance and coronary artery remodeling: an intravascular ultrasound study

    OpenAIRE

    Kim, Sang-Hoon; Moon, Jae-Youn; Lim, Yeong Min; Kim, Kyung Ho; Yang, Woo-In; Sung, Jung-Hoon; Yoo, Seung Min; Kim, In Jai; Lim, Sang-Wook; Cha, Dong-Hun; Cho, Seung-Yun

    2015-01-01

    Background There are few studies that investigated the correlation between insulin resistance (IR) and the coronary artery remodeling. The aim of the study is to investigate the association of IR measured by homeostasis model assessment of insulin resistance (HOMA-IR) and coronary artery remodeling evaluated by intravascular ultrasound (IVUS). Methods A total of 298 consecutive patients who received percutaneous coronary interventions under IVUS guidance were retrospectively enrolled. The val...

  9. Imaging findings for intravascular large B-cell lymphoma of the liver

    Directory of Open Access Journals (Sweden)

    Jungmin Bae

    2015-09-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBCL is a rare subtype of extranodal diffuse large B-cell lymphoma that most commonly involves the central nervous system and skin. To our knowledge, no state-of-the art imaging findings have been reported for hepatic IVLBCL in the English literature. We report the first case of hepatic involvement of IVLBCL along with a literature review.

  10. Novel Double-Needle System That Can Prevent Intravascular Injection of Any Filler

    Directory of Open Access Journals (Sweden)

    Hsiang Huang, MD

    2017-09-01

    Full Text Available Summary:. A new type of needle system combines 2 parts, an inner needle and an outer needle. The inner needle is used for filler injection and the outer needle acts as a guiding needle that can observe blood reflow when inserting into the vessel lumen during injection process. This new needle system can be used for all kinds of filler, providing real time monitoring for physician and preventing intravascular injection of any filler.

  11. THROMBOPHILIA AND INTENSITY OF THE INTRAVASCULAR MICROCOAGULATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATHEROTHROMBOSIS

    Directory of Open Access Journals (Sweden)

    E. A. Shelest

    2015-09-01

    Full Text Available Aim. To study the intensity of the intravascular microcoagulation in patients with atherothrombosis (AT, chronic obstructive pulmonary disease (COPD and thrombophilia.Material and methods. 115 patients were enrolled into the study: 37 patients with COPD (22 with thrombophilia and 15 without thrombophilia; 37 patients with AT (23 with thrombophilia and 14 without thrombophilia; 41 patients with COPD+AT (24 with thrombophilia and 17 without thrombophilia. In the control group 53 healthy people (39 with thrombophilia and 14 without thrombophilia were included. Median age was 62 (56.5, 69 years. The intensity of intravascular microcoagulation was measured: platelet factor 4 (PF4 by ELISA, D-dimer by ELISA, XIIa-dependent fibrinolysis (time. Polymerase chain reaction was used for detection of such trombophilia parameters as Leiden mutation, prothrombin gene mutation 20210A, mutation in the gene of methylenetetrahydrofolate reductase (MTHFR and plasminogen activator inhibitor-1 (PAI-1.Results. The level of PF4 and D-dimer was significantly higher while fibrinolytic activity was lower in COPD (103.5 ME/ml, 70 ng/ml, 650 s, respectively, AT (127.1 ME/ml, 96,9 ng/ml, 850 s, respectively and COPD+AT (136.5 ME/ml, 106.5 ng/ml, 1148 s, respectively groups as compared with the control group (p<0.05. When analyzing the level of intravascular coagulation parameters in patients with thrombophilia and without it, levels of PF4, D-dimer and XIIa-dependent fibrinolysis (time were significantly higher in thrombophilia subgroups among all patients (p<0.05. In patients with thrombophilia levels of these parameters were significantly higher in those with two or more thrombophilia gene polymorphisms than with one (p<0.01.Conclusion. The intensity of intravascular microcoagulation increases in patients with thrombophilia, atherothrombosis and COPD.

  12. Comparison Between the Polymyxins and Gentamicin in Preventing Endotoxin-Induced Intravascular Coagulation and Leukopenia

    Science.gov (United States)

    Corrigan, James J.; Bell, Bobbie M.

    1971-01-01

    Three antimicrobial agents were evaluated as to their ability to neutralize the toxic effects of endotoxin in rabbits. These consisted of two cyclic polypeptides, polymyxin B sulfate and colymycin M (sodium colistimethate), and an aminoglycoside, gentamicin sulfate. Polymyxin B regularly prevented endotoxin-induced leukopenia, thrombocytopenia, and disseminated intravascular coagulation. Colymycin M had similar activity but was not as effective as polymyxin B. Gentamicin demonstrated no neutralizing ability in this study. PMID:4343409

  13. Serial intravascular ultrasound assessment of changes in coronary atherosclerotic plaque dimensions and composition: an update

    DEFF Research Database (Denmark)

    Hartmann, Marc; Huisman, Jennifer; Böse, Dirk

    2011-01-01

    This manuscript reviews the use of serial intravascular ultrasound (IVUS) examination of coronary atherosclerosis in recent observational studies and randomized trials that revealed the effects of cholesterol-lowering and lipid-modifying therapies and offered novel insight into plaque progression....... Finally, we report on the evaluation of true vessel remodelling in recent serial IVUS trials and discuss the future perspective of serial invasive imaging of coronary atherosclerosis....

  14. Distribution of [35S] taurine in mouse retina after intravitreal and intravascular injection

    International Nuclear Information System (INIS)

    Pourcho, R.G.

    1977-01-01

    The distribution of [ 35 S] taurine in mouse retinae was studied by autoradiographic techniques after either intravitreal or intravascular injection. The route of injection did not affect the final localization. The major sites of label accumulation were the outer nuclear layer, the inner nuclear layer, and Mueller cell processes adjacent to the vitreal surface. The distribution was consistent with the interpretation that taurine was localized within two cellular compartments of mouse retina, photoreceptor cells and Mueller cells. (author)

  15. A lesson from intravascular imaging: insights for recognizing a spontaneous coronary artery dissection.

    Science.gov (United States)

    Buccheri, Dario; Milazzo, Diego; Geraci, Salvatore; Vaccaro, Giovanni; Caramanno, Giuseppe

    2017-12-01

    Spontaneous coronary artery dissection (SCAD) is still today an underdiagnosed disease due to the absence of angiographic hallmarks in more than 70% of cases. In several cases, an intravascular imaging is a sole tool for recognizing a dissection. Particularly, optical coherence tomography analysis (OCT) could represent the gold standard technique of easy interpretation and prompt diagnosis. Here we present a rare case of multivessel spontaneous coronary artery disease (SCAD) with atypical collateral circulation.

  16. The relationship between intravascular volume expansion and natriuresis in developing puppies.

    Science.gov (United States)

    Aladjem, M; Spitzer, A; Goldsmith, D I

    1982-10-01

    The role played by the relative degree of expansion of the intravascular and extravascular compartments in limiting the natriuretic response of fluid-loaded developing animals was determined in 1-, 2-, 3- and 6-wk-old puppies. Volume expansion was induced by infusing either isotonic saline, 10% body weight or isoncotic albumin in saline 5% body weight, and measurements of glomerular filtration rate, sodium excretion, fractional excretion of sodium, and plasma volume were made. Each expansion procedure resulted in an increase in the absolute excretion of sodium at all ages (P less than 0.001). The greatest natriuretic effect was observed in the 3-wk-old puppies, the average of the two solutions being 19, 30, 70, and 28 muEq/min/kg in the 1, 2, 3, and 6-wk-old animals, respectively. The difference in natriuresis among the age groups was due predominantly to differences in the magnitude of the increase in fractional excretion of sodium. At all ages, a greater absolute excretion of sodium was encountered during volume expansion with saline than observed with albumin (P less than 0.05). The intravascular volume increased by a similar % at all ages (P greater than 0.1), and saline and albumin yielded equivalent degrees of intravascular expansion (approximately 50%). The results demonstrate that age-related changes in natriuretic response to volume expansion cannot be attributed to differences in either the degree of expansion or the distribution of the load. In addition, the observations indicate that the mechanism underlying the difference between the response to isotonic saline and isoncotic albumin in saline is already operative at birth, and that it is independent of nephron heterogeneity since the proportion of superficial nephrons must have changed during the period of nephrogenesis. The collecting duct, which is sensitive to both isotonic saline and isoncotic albumin, is likely to be responsible for the parallel development of the renal response to these two

  17. Evaluation of CT virtual intravascular endoscopy in fenestrated stent grafts: a preliminary study

    International Nuclear Information System (INIS)

    Sun, Z.; Allen, Y.; Fitzsimmons, B.; Hartely, D.; Lawrence-Brown, M.

    2007-01-01

    We aim in this study to investigate the potential value of CT virtual intravascular endoscopy in patients diagnosed with abdominal aortic aneurysms undergoing fenestrated stent grafts. Both pre-and post-fenestration (within 3 months of implantation) multislice CT data were collected in eight patients and used for generation of virtual endoscopy images in our preliminary study. Variable fenestrations were deployed in 25 aortic branches with scallop fenestration implanted in six aortic ostia, large fenestration in four aortic ostia and small fenestration in 15 renal ostia, respectively. Measurements of the aortic ostia diameters both pre- and post-fenestration were successfully performed with virtual intravascular endoscopy visualization, and endovascular stents as well as their relationship to the aortic ostia were clearly demonstrated. Our results showed that there was no significant change of diameter of the aortic ostia following fenestrated stem grafts. Endovascular stents were clearly visualized on virtual endoscopy images, and no apparent deformity or malrotation was observed in this small group. Our preliminary study provides new insights into anatomic configuration/dimension of aortic ostia and endovascular stents, and virtual intravascular endoscopy could be a valuable technique to follow-up patients treated with fenestrated stent grafts. (orig.)

  18. FD-OCT and IVUS intravascular imaging modalities in peripheral vasculature.

    Science.gov (United States)

    Spiliopoulos, S; Kitrou, P; Katsanos, K; Karnabatidis, D

    2017-02-01

    Intra-Vascular Ultra-Sound (IVUS) and Frequency Domain-Optical Coherence Tomography (FD-OCT), in vivo, intra-vascular, imaging modalities, widely used in the field of coronary disease, have been recently implemented in peripheral endovascular procedures, for procedural assessment, plaque characterization and determination of predictors of treatment outcomes. Their unique characteristics have also been used in order to provide additional features and improve the performance of re-entry devices and atherotomes. Areas covered: Present review focuses on available literature regarding these two promising imaging technologies in the peripheral vasculature, highlighting the added value produced by their use in endovascular therapy, their limitations and their utilization in new endovascular devices. Authors also provide their future perspective and the possible benefits in understanding vascular behavior and lesion characterization in peripheral endovascular interventions. Expert commentary: By providing both quantitative but also qualitative data on vessel and lesion morphology, intravascular imaging modalities offer a valid solution for endovascular treatment evaluation and outcome presentation homogeneity.

  19. Disseminated intravascular coagulation caused by moojenactivase, a procoagulant snake venom metalloprotease.

    Science.gov (United States)

    Sartim, Marco A; Cezarette, Gabriel N; Jacob-Ferreira, Anna L; Frantz, Fabiani G; Faccioli, Lucia H; Sampaio, Suely V

    2017-10-01

    Snake venom toxins that activate coagulation factors are key players in the process of venom-induced coagulopathy, and account for severe clinical manifestations. The present study applies a variety of biochemical, hematological, and histopathological approaches to broadly investigate the intravascular and systemic effects of moojenactivase (MooA), the first described PIIId subclass metalloprotease isolated from Bothrops sp. venom that activates coagulation factors. MooA induced consumption coagulopathy with high toxic potency, characterized by prolongation of prothrombin and activated partial thromboplastin time, consumption of fibrinogen and the plasma coagulation factors X and II, and thrombocytopenia. MooA promoted leukocytosis and expression of the proinflammatory cytokines interleukin-6 and tumor necrosis factor-α, accompanied by tissue factor-dependent procoagulant activity in peripheral blood mononuclear cells. This metalloprotease also caused intravascular hemolysis, elevated plasma levels of creatine kinase-MB, aspartate transaminase, and urea/creatinine, and induced morphopathological alterations in erythrocytes, heart, kidney, and lungs associated with thrombosis and hemorrhage. Diagnosis of MooA-induced disseminated intravascular coagulation represents an important approach to better understand the pathophysiology of Bothrops envenomation and develop novel therapeutic strategies targeting hemostatic disturbances. Copyright © 2017. Published by Elsevier B.V.

  20. An experimental method for detecting blood splatter from retractable phlebotomy and intravascular devices.

    Science.gov (United States)

    Haiduven, Donna; Applegarth, Shawn; Shroff, Miloni

    2009-03-01

    This study was designed to evaluate the safety of retractable intravascular devices in terms of their potential to produce blood splatter. A method for measuring this blood splatter designed by the research team was used to evaluate 3 specific intravascular devices. Scientific filters were positioned around the retraction mechanisms of the devices and weighed with an analytical scale, both before and after activation, in a simulated vein containing mock venous blood. The difference in filter mass was used as the primary unit of analysis to detect blood splatter. In addition, the filters were visually inspected for the presence or absence of blood. A paired t-test revealed significant differences in the prefilter and postfilter groups for 2 of the 3 devices tested (P blood was detected on 23% to 40% of the scientific filters for 2 of the devices. Our findings indicate a potential for bloodborne pathogen exposure with the use of intravascular devices with a retractable mechanism. This experiment may serve as a model in the design and implementation of future sharps device evaluation protocols to validate the threat of bloodborne pathogen exposure.

  1. The lateral neostriatum is necessary for compensatory ingestive behaviour after intravascular dehydration in female rats.

    Science.gov (United States)

    Lelos, M J; Harrison, D J; Rosser, A E; Dunnett, S B

    2013-12-01

    Aberrant striatal function results in an array of physiological symptoms, including impaired consummatory and regulatory behaviours, which can lead to weight loss and dehydration. It was hypothesised, therefore, that cell loss in the neostriatum may contribute to altered fluid intake by regulating physiological signals related to dehydration status. To test this theory, rats with lesions of the lateral neostriatum and sham controls underwent a series of physiological challenges, including the experimental induction of intracellular and intravascular dehydration. No baseline differences in prandial or non-prandial drinking were observed, nor were differences in locomotor activity evident between groups. Furthermore, intracellular dehydration increased water intake in lesion rats in a manner comparable to sham rats. Interestingly, a specific impairment was evident in lesion rats after subcutaneous injection of poly-ethylene glycol was used to induce intravascular dehydration, such that lesion rats failed to adapt their water intake to this physiological change. The results suggest that the striatal lesions resulted in regulatory dysfunction by impairing motivational control over compensatory ingestive behaviour after intravascular hydration, while the physiological signals related to dehydration remain intact. Loss of these cells in neurodegenerative disorders, such Huntington's disease, may contribute to regulatory changes evident in the course of the disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Cardiovascular disease in haemodialysis: role of the intravascular innate immune system.

    Science.gov (United States)

    Ekdahl, Kristina N; Soveri, Inga; Hilborn, Jöns; Fellström, Bengt; Nilsson, Bo

    2017-05-01

    Haemodialysis is a life-saving renal replacement modality for end-stage renal disease, but this therapy also represents a major challenge to the intravascular innate immune system, which is comprised of the complement, contact and coagulation systems. Chronic inflammation is strongly associated with cardiovascular disease (CVD) in patients on haemodialysis. Biomaterial-induced contact activation of proteins within the plasma cascade systems occurs during haemodialysis and initially leads to local generation of inflammatory mediators on the biomaterial surface. The inflammation is spread by soluble activation products and mediators that are generated during haemodialysis and transported in the extracorporeal circuit back into the patient together with activated leukocytes and platelets. The combined effect is activation of the endothelium of the cardiovascular system, which loses its anti-thrombotic and anti-inflammatory properties, leading to atherogenesis and arteriosclerosis. This concept suggests that maximum suppression of the intravascular innate immune system is needed to minimize the risk of CVD in patients on haemodialysis. A potential approach to achieve this goal is to treat patients with broad-specificity systemic drugs that target more than one of the intravascular cascade systems. Alternatively, 'stealth' biomaterials that cause minimal cascade system activation could be used in haemodialysis circuits.

  3. Trends in the Utilization of Brachytherapy in Cervical Cancer in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kathy, E-mail: Kathy.Han@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario (Canada); Milosevic, Michael; Fyles, Anthony [Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario (Canada); Pintilie, Melania [Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario (Canada); Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States)

    2013-09-01

    Purpose: To determine the trends in brachytherapy use in cervical cancer in the United States and to identify factors and survival benefits associated with brachytherapy treatment. Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 7359 patients with stages IB2-IVA cervical cancer treated with external beam radiation therapy (EBRT) between 1988 and 2009. Propensity score matching was used to adjust for differences between patients who received brachytherapy and those who did not from 2000 onward (after the National Cancer Institute alert recommending concurrent chemotherapy). Results: Sixty-three percent of the 7359 women received brachytherapy in combination with EBRT, and 37% received EBRT alone. The brachytherapy utilization rate has decreased from 83% in 1988 to 58% in 2009 (P<.001), with a sharp decline of 23% in 2003 to 43%. Factors associated with higher odds of brachytherapy use include younger age, married (vs single) patients, earlier years of diagnosis, earlier stage and certain SEER regions. In the propensity score-matched cohort, brachytherapy treatment was associated with higher 4-year cause-specific survival (CSS; 64.3% vs 51.5%, P<.001) and overall survival (OS; 58.2% vs 46.2%, P<.001). Brachytherapy treatment was independently associated with better CSS (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.57-0.71), and OS (HR 0.66; 95% CI, 0.60 to 0.74). Conclusions: This population-based analysis reveals a concerning decline in brachytherapy utilization and significant geographic disparities in the delivery of brachytherapy in the United States. Brachytherapy use is independently associated with significantly higher CSS and OS and should be implemented in all feasible cases.

  4. Dose calculation and isodose curves determination in brachytherapy

    International Nuclear Information System (INIS)

    Maranhao, Frederico B.; Lima, Fernando R.A.; Khoury, Helen J.

    2000-01-01

    Brachytherapy is a form of cancer treatment in which small radioactive sources are placed inside of, or close to small tumors, in order to cause tissue necrosis and, consequently, to interrupt the tumor growth process. A very important aspect to the planning of this therapy is the calculation of dose distributions in the tumor and nearby tissues, to avoid the unnecessary irradiation of healthy tissue. The objective of this work is to develop a computer program that will permit treatment planning for brachytherapy at low dose rates, minimizing the possible errors introduced when such calculations are done manually. Results obtained showed good agreement with those from programs such as BRA, which is widely used in medical practice. (author)

  5. Cervical cancer. Application of MR imaging in brachytherapy

    International Nuclear Information System (INIS)

    Ebe, Kazuyu; Matsunaga, Naofumi

    1996-01-01

    For the purpose of application of MRI in arrangement of brachytherapy of cervical cancer, a method was proposed to see the radiation doses in surrounding tissues by superimposing the dose distribution pattern of the radiation source on the MR image. The applicator for the source was filled with water to get its T2-weighted image and was inserted in the patients. The MRI apparatus was Siemens Magnetom Vision (1.5T) with phased array coil. T2-weighted sagittal and coronary images were taken by turbospin echo and HASTE methods. The section thickness was 5 mm. The dose distribution pattern was superimposed on the frontal and lateral images by Siemens Mevaplan to see the doses in surrounding tissues. In 4 patients, it was possible to estimate the radiation dose in the posterior wall of bladder, anterior wall of rectum and urinary duct. The method is promising for arranging brachytherapy of cervical cancer. (K.H.)

  6. Review of advanced catheter technologies in radiation oncology brachytherapy procedures

    International Nuclear Information System (INIS)

    Zhou, Jun; Zamdborg, Leonid; Sebastian, Evelyn

    2015-01-01

    The development of new catheter and applicator technologies in recent years has significantly improved treatment accuracy, efficiency, and outcomes in brachytherapy. In this paper, we review these advances, focusing on the performance of catheter imaging and reconstruction techniques in brachytherapy procedures using magnetic resonance images and electromagnetic tracking. The accuracy of catheter reconstruction, imaging artifacts, and other notable properties of plastic and titanium applicators in gynecologic treatments are reviewed. The accuracy, noise performance, and limitations of electromagnetic tracking for catheter reconstruction are discussed. Several newly developed applicators for accelerated partial breast irradiation and gynecologic treatments are also reviewed. New hypofractionated high dose rate treatment schemes in prostate cancer and accelerated partial breast irradiation are presented

  7. Ultrasonography-guided cobalt-60 brachytherapy for malignant glioma

    International Nuclear Information System (INIS)

    Sakai, Noboru; Takenaka, Katsunobu; Ueda, Tatsuya

    1989-01-01

    Brachytherapy with cobalt-60 source is reported. In this method it is characterized that the source is inserted interstitially with remote control system by after-loading method via outer catheter (using tandem tube), which was established in the center of residual tumor, using ultrasonography guide with trepanation, or intraoperatively put within the dead space after tumor resection. Six cases of deep-seated and recurrent malignant glioma, were treated with this method. A total dose of 20 to 45 Gy (10 to 15 Gy/day for 2 to 3 days) was delivered to the target. Additionally conventional external irradiation was followed. The effect of cobalt-60 brachytherapy on such tumors were favorable especially for well-circumscribed glioma less than 3 cm on CT scan. (author)

  8. Dosimetry Studies of a Special Applicator for Post Hysterectomy Brachytherapy

    International Nuclear Information System (INIS)

    Schwob, N.; Shani, G.; Orion, I.

    2004-01-01

    The treatment of uterine cancer can include surgery, external beam radiotherapy and brachytherapy. The brachytherapy of the vagina stump is usually performed by inserting a radioactive source into a one channel cylindrical applicator. The resulting isodoses map from such treatment contains elliptical lines, while the target region is quite flat. A new eight-channel applicator has been developed at Hadassah University Hospital in order to obtain a flatter isodoses map (Figure 1). An 192 Ir source is loaded from the Nucletron microSelectron PDR afterloading system, step by step, at pre-selected dwell points in every channel, with pre-calculated irradiation dwell time. The particular irradiation program for every patient, the dose distribution and the isodoses were calculated using a treatment planning system (TPS) and the plan had been optimized [1]. In routine work, this is the only practical way to find the dose distribution obtained during the treatment

  9. Cataract extraction after brachytherapy for malignant melanoma of the choroid

    International Nuclear Information System (INIS)

    Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G.

    1991-01-01

    Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid

  10. [Basic principles and results of brachytherapy in gynecological oncology].

    Science.gov (United States)

    Kanaev, S V; Turkevich, V G; Baranov, S B; Savel'eva, V V

    2014-01-01

    The fundamental basics of contact radiation therapy (brachytherapy) for gynecological cancer are presented. During brachytherapy the principles of conformal radiotherapy should be implemented, the aim of which is to sum the maximum possible dose of radiation to the tumor and decrease the dose load in adjacent organs and tissues, which allows reducing the frequency of radiation damage at treatment of primary tumors. It is really feasible only on modern technological level, thanks to precision topometry preparation, optimal computer dosimetrical and radiobiological planning of each session and radiotherapy in general. Successful local and long-term results of the contact radiation therapy for cancer of cervix and endometrium are due to optimal anatomical and topometrical ratio of the tumor localization, radioactive sources, and also physical and radiobiological laws of distribution and effects of ionizing radiation, the dose load accounting rules.

  11. Study of two different radioactive sources for prostate brachytherapy treatment

    International Nuclear Information System (INIS)

    Pereira Neves, Lucio; Perini, Ana Paula; Souza Santos, William de; Caldas, Linda V.E.; Belinato, Walmir

    2015-01-01

    In this study we evaluated two radioactive sources for brachytherapy treatments. Our main goal was to quantify the absorbed doses on organs and tissues of an adult male patient, submitted to a brachytherapy treatment with two radioactive sources. We evaluated a 192 Ir and a 125 I radioactive sources. The 192 Ir radioactive source is a cylinder with 0.09 cm in diameter and 0.415 cm long. The 125 I radioactive source is also a cylinder, with 0.08 cm in diameter and 0.45 cm long. To evaluate the absorbed dose distribution on the prostate, and other organs and tissues of an adult man, a male virtual anthropomorphic phantom MASH, coupled in the radiation transport code MCNPX 2.7.0, was employed.We simulated 75, 90 and 102 radioactive sources of 125 I and one of 192 Ir, inside the prostate, as normally used in these treatments, and each treatment was simulated separately. As this phantom was developed in a supine position, the displacement of the internal organs of the chest, compression of the lungs and reduction of the sagittal diameter were all taken into account. For the 192 Ir, the higher doses values were obtained for the prostate and surrounding organs, as the colon, gonads and bladder. Considering the 125 I sources, with photons with lower energies, the doses to organs that are far from the prostate were lower. All values for the dose rates are in agreement with those recommended for brachytherapy treatments. Besides that, the new seeds evaluated in this work present usefulness as a new tool in prostate brachytherapy treatments, and the methodology employed in this work may be applied for other radiation sources, or treatments. (authors)

  12. Water equivalent phantom materials for 192 Ir brachytherapy

    OpenAIRE

    Schoenfeld, Andreas A.; Harder, Dietrich; Poppe, Björn; Chofor, Ndimofor

    2015-01-01

    Several solid phantom materials have been tested regarding their suitability as water substitutes for dosimetric measurements in brachytherapy with 192Ir as a typical high energy photon emitter. The radial variations of the spectral photon fluence, of the total, primary and scattered photon fluence and of the absorbed dose to water in the transversal plane of the tested cylindrical phantoms surrounding a centric and coaxially arranged Varian GammaMed afterloading 192Ir brach...

  13. Study of two different radioactive sources for prostate brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Pereira Neves, Lucio; Perini, Ana Paula [Instituto de Fisica, Universidade Federal de Uberlandia, Caixa Postal 593, 38400-902, Uberlandia, MG (Brazil); Souza Santos, William de; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares, Comissao Nacional de Energia Nuclear, IPENCNEN/SP, Av. Prof. Lineu Prestes, 2242, Cidade Universitaria, 05508-000 Sao Paulo, SP (Brazil); Belinato, Walmir [Departamento de Ensino, Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia, Campus Vitoria da Conquista, Zabele, Av. Amazonas 3150, 45030-220 Vitoria da Conquista, BA (Brazil)

    2015-07-01

    In this study we evaluated two radioactive sources for brachytherapy treatments. Our main goal was to quantify the absorbed doses on organs and tissues of an adult male patient, submitted to a brachytherapy treatment with two radioactive sources. We evaluated a {sup 192}Ir and a {sup 125}I radioactive sources. The {sup 192}Ir radioactive source is a cylinder with 0.09 cm in diameter and 0.415 cm long. The {sup 125}I radioactive source is also a cylinder, with 0.08 cm in diameter and 0.45 cm long. To evaluate the absorbed dose distribution on the prostate, and other organs and tissues of an adult man, a male virtual anthropomorphic phantom MASH, coupled in the radiation transport code MCNPX 2.7.0, was employed.We simulated 75, 90 and 102 radioactive sources of {sup 125}I and one of {sup 192}Ir, inside the prostate, as normally used in these treatments, and each treatment was simulated separately. As this phantom was developed in a supine position, the displacement of the internal organs of the chest, compression of the lungs and reduction of the sagittal diameter were all taken into account. For the {sup 192}Ir, the higher doses values were obtained for the prostate and surrounding organs, as the colon, gonads and bladder. Considering the {sup 125}I sources, with photons with lower energies, the doses to organs that are far from the prostate were lower. All values for the dose rates are in agreement with those recommended for brachytherapy treatments. Besides that, the new seeds evaluated in this work present usefulness as a new tool in prostate brachytherapy treatments, and the methodology employed in this work may be applied for other radiation sources, or treatments. (authors)

  14. Primary calibration of coiled 103Pd brachytherapy sources

    International Nuclear Information System (INIS)

    Paxton, Adam B.; Culberson, Wesley S.; DeWerd, Larry A.; Micka, John A.

    2008-01-01

    Coiled 103 Pd brachytherapy sources have been developed by RadioMed Corporation for use as low-dose-rate (LDR) interstitial implants. The coiled sources are provided in integer lengths from 1 to 6 cm and address many common issues seen with traditional LDR brachytherapy sources. The current standard for determining the air-kerma strength (S K ) of low-energy LDR brachytherapy sources is the National Institute of Standards and Technology's Wide-Angle Free-Air Chamber (NIST WAFAC). Due to geometric limitations, however, the NIST WAFAC is unable to determine the S K of sources longer than 1 cm. This project utilized the University of Wisconsin's Variable-Aperture Free-Air Chamber (UW VAFAC) to determine the S K of the longer coiled sources. The UW VAFAC has shown agreement in S K values of 1 cm length coils to within 1% of those determined with the NIST WAFAC, but the UW VAFAC does not share the same geometric limitations as the NIST WAFAC. A new source holder was constructed to hold the coiled sources in place during measurements with the UW VAFAC. Correction factors for the increased length of the sources have been determined and applied to the measurements. Using the new source holder and corrections, the S K of 3 and 6 cm coiled sources has been determined. Corrected UW VAFAC data and ionization current measurements from well chambers have been used to determine calibration coefficients for use in the measurement of 3 and 6 cm coiled sources in well chambers. Thus, the UW VAFAC has provided the first transferable, primary measurement of low-energy LDR brachytherapy sources with lengths greater than 1 cm

  15. Brachytherapy in Lip Carcinoma: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Guibert, Mireille, E-mail: mireilleguib@voila.fr [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); David, Isabelle [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Vergez, Sebastien [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); Rives, Michel [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Filleron, Thomas [Department of Epidemiology, Claudius Regaud Institut, Toulouse (France); Bonnet, Jacques; Delannes, Martine [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France)

    2011-12-01

    Purpose: The aim of this study was to evaluate the effectiveness of low-dose-rate brachytherapy for local control and relapse-free survival in squamous cell and basal cell carcinomas of the lips. We compared two groups: one with tumors on the skin and the other with tumors on the lip. Patients and methods: All patients had been treated at Claudius Regaud Cancer Centre from 1990 to 2008 for squamous cell or basal cell carcinoma. Low-dose-rate brachytherapy was performed with iridium 192 wires according to the Paris system rules. On average, the dose delivered was 65 Gy. Results: 172 consecutive patients were included in our study; 69 had skin carcinoma (squamous cell or basal cell), and 92 had squamous cell mucosal carcinoma. The average follow-up time was 5.4 years. In the skin cancer group, there were five local recurrences and one lymph node recurrence. In the mucosal cancer group, there were ten local recurrences and five lymph node recurrences. The 8-year relapse-free survival for the entire population was 80%. The 8-year relapse-free survival was 85% for skin carcinoma 75% for mucosal carcinoma, with no significant difference between groups. The functional results were satisfactory for 99% of patients, and the cosmetic results were satisfactory for 92%. Maximal toxicity observed was Grade 2. Conclusions: Low-dose-rate brachytherapy can be used to treat lip carcinomas at Stages T1 and T2 as the only treatment with excellent results for local control and relapse-free survival. The benefits of brachytherapy are also cosmetic and functional, with 91% of patients having no side effects.

  16. Brachytherapy and radical prostatectomy in patients with early prostate cancer

    Directory of Open Access Journals (Sweden)

    Adriana Souza Sérgio Ferreira

    2015-10-01

    Full Text Available Summary Objective: this study analyzes the survival of prostate cancer patients cared for at a hospital in Minas Gerais, Brazil according to one of the following treatments: iodine-125 seed implantation or radical prostatectomy. From January 2002 to December 2005, 129 patients underwent either brachytherapy (64 patients or surgery (65 patients. Methods: all had prostate-specific antigen, Gleason scores and clinical stage recorded prior to treatment. Biochemical relapse was defined as prostate-specific antigen (PSA>0.4ng/mL for radical prostatectomy, and any elevation equal or higher than 2ng/mL over the PSA nadir for implanted patients. To analyze the effect of treatment on biochemical recurrence-free survival (BRFS, Kaplan-Meier curves and Cox regression were generated. Mean follow-up time was 56.1 months for patients with the implant, and 26.6 months for those operated on. BRFS in 5 years was 69% (95% CI: 58.18-77.45 for the whole cohort. Discussion: when stratified according to treatment, survival of patients who had undergone brachytherapy (79.70% was higher to those operated on (44.30%; pvalue= 0.0056. Upon multivariate analysis, independent predictors were iPSA (HR: 2.91, 95% CI: 1,32-6,42, Gleason score (HR: 2.18, 95% CI: 1,00-4,81 and treatment modality (HR: 2.61, 95% CI: 1.18-5,75. Risk of biochemical failure was higher with surgery than brachytherapy, which may be related to the failure criteria adopted, which is different for each therapy, as well as the high rate of histological progression between preoperative prostate biopsy and surgical specimen. Conclusion: it was found that brachytherapy is a good therapeutic option for low risk prostate cancer.

  17. Photon energy-fluence correction factor in low energy brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Antunes, Paula C.G.; Yoriyaz, Hélio [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Vijande, Javier; Giménez-Alventosa, Vicent; Ballester, Facundo, E-mail: pacrisguian@gmail.com [Department of Atomic, Molecular, and Nuclear Physics and Instituto de Física Corpuscular (UV-CSIC), University of Valencia (Spain)

    2017-07-01

    The AAPM TG-43 brachytherapy dosimetry formalism has become a standard for brachytherapy dosimetry worldwide; it implicitly assumes that charged-particle equilibrium (CPE) exists for the determination of absorbed dose to water at different locations. At the time of relating dose to tissue and dose to water, or vice versa, it is usually assumed that the photon fluence in water and in tissues are practically identical, so that the absorbed dose in the two media can be related by their ratio of mass energy-absorption coefficients. The purpose of this work is to study the influence of photon energy-fluence in different media and to evaluate a proposal for energy-fluence correction factors for the conversion between dose-to-tissue (D{sub tis}) and dose-to-water (D{sub w}). State-of-the art Monte Carlo (MC) calculations are used to score photon fluence differential in energy in water and in various human tissues (muscle, adipose and bone) in two different codes, MCNP and PENELOPE, which in all cases include a realistic modeling of the {sup 125}I low-energy brachytherapy seed in order to benchmark the formalism proposed. A correction is introduced that is based on the ratio of the water-to-tissue photon energy-fluences using the large-cavity theory. In this work, an efficient way to correlate absorbed dose to water and absorbed dose to tissue in brachytherapy calculations at clinically relevant distances for low-energy photon emitting seed is proposed. The energy-fluence based corrections given in this work are able to correlate absorbed dose to tissue and absorbed dose to water with an accuracy better than 0.5% in the most critical cases. (author)

  18. Serum Testosterone Kinetics After Brachytherapy for Clinically Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Taira, Al V. [Western Radiation Oncology, Mountain View, CA (United States); Merrick, Gregory S., E-mail: gmerrick@urologicresearchinstitute.org [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, WV (United States); Galbreath, Robert W.; Butler, Wayne M.; Lief, Jonathan H.; Allen, Zachariah A. [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, WV (United States); Wallner, Kent E. [Puget Sound Healthcare Corporation Group Health Cooperative, University of Washington, Seattle, WA (United States)

    2012-01-01

    Purpose: To evaluate temporal changes in testosterone after prostate brachytherapy and investigate the potential impact of these changes on response to treatment. Methods and Materials: Between January 2008 and March 2009, 221 consecutive patients underwent Pd-103 brachytherapy without androgen deprivation for clinically localized prostate cancer. Prebrachytherapy prostate-specific antigen (PSA) and serum testosterone were obtained for each patient. Repeat levels were obtained 3 months after brachytherapy and at least every 6 months thereafter. Multiple clinical, treatment, and dosimetric parameters were evaluated to determine an association with temporal testosterone changes. In addition, analysis was conducted to determine if there was an association between testosterone changes and treatment outcomes or the occurrence of a PSA spike. Results: There was no significant difference in serum testosterone over time after implant (p = 0.57). 29% of men experienced an increase {>=}25%, 23% of men experienced a decrease {>=}25%, and the remaining 48% of men had no notable change in testosterone over time. There was no difference in testosterone trends between men who received external beam radiotherapy and those who did not (p = 0.12). On multivariate analysis, preimplant testosterone was the only variable that consistently predicted for changes in testosterone over time. Men with higher than average testosterone tended to experience drop in testosterone (p < 0.001), whereas men with average or below average baseline testosterone had no significant change. There was no association between men who experienced PSA spike and testosterone temporal trends (p = 0.50) nor between initial PSA response and testosterone trends (p = 0.21). Conclusion: Prostate brachytherapy does not appear to impact serum testosterone over time. Changes in serum testosterone do not appear to be associated with PSA spike phenomena nor with initial PSA response to treatment; therefore, PSA response

  19. Proposals for common definitions of reference points in gynecological brachytherapy

    International Nuclear Information System (INIS)

    Chassagne, D.; Horiot, J.C.

    1977-01-01

    In May 1975 the report of European Curietherapy Group recommended in gynecological Dosimetry by computer. Use of reference points = lymphatic trapezoid figure with 6 points, Pelvic wall, all points are refering to bony structures. Use of critical organ reference points = maximum rectum dose, bladder dose mean rectal dose. Use of 6,000 rads reference isodose described by height, width, and thickness dimensions. These proposals are the basis of a common language in gynecological brachytherapy [fr

  20. Manual on brachytherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to brachytherapy: its application and procedures guides

  1. Brachytherapy in Lip Carcinoma: Long-Term Results

    International Nuclear Information System (INIS)

    Guibert, Mireille; David, Isabelle; Vergez, Sébastien; Rives, Michel; Filleron, Thomas; Bonnet, Jacques; Delannes, Martine

    2011-01-01

    Purpose: The aim of this study was to evaluate the effectiveness of low-dose-rate brachytherapy for local control and relapse-free survival in squamous cell and basal cell carcinomas of the lips. We compared two groups: one with tumors on the skin and the other with tumors on the lip. Patients and methods: All patients had been treated at Claudius Regaud Cancer Centre from 1990 to 2008 for squamous cell or basal cell carcinoma. Low-dose-rate brachytherapy was performed with iridium 192 wires according to the Paris system rules. On average, the dose delivered was 65 Gy. Results: 172 consecutive patients were included in our study; 69 had skin carcinoma (squamous cell or basal cell), and 92 had squamous cell mucosal carcinoma. The average follow-up time was 5.4 years. In the skin cancer group, there were five local recurrences and one lymph node recurrence. In the mucosal cancer group, there were ten local recurrences and five lymph node recurrences. The 8-year relapse-free survival for the entire population was 80%. The 8-year relapse-free survival was 85% for skin carcinoma 75% for mucosal carcinoma, with no significant difference between groups. The functional results were satisfactory for 99% of patients, and the cosmetic results were satisfactory for 92%. Maximal toxicity observed was Grade 2. Conclusions: Low-dose-rate brachytherapy can be used to treat lip carcinomas at Stages T1 and T2 as the only treatment with excellent results for local control and relapse-free survival. The benefits of brachytherapy are also cosmetic and functional, with 91% of patients having no side effects.

  2. Fully automated MRI-guided robotics for prostate brachytherapy

    International Nuclear Information System (INIS)

    Stoianovici, D.; Vigaru, B.; Petrisor, D.; Muntener, M.; Patriciu, A.; Song, D.

    2008-01-01

    The uncertainties encountered in the deployment of brachytherapy seeds are related to the commonly used ultrasound imager and the basic instrumentation used for the implant. An alternative solution is under development in which a fully automated robot is used to place the seeds according to the dosimetry plan under direct MRI-guidance. Incorporation of MRI-guidance creates potential for physiological and molecular image-guided therapies. Moreover, MRI-guided brachytherapy is also enabling for re-estimating dosimetry during the procedure, because with the MRI the seeds already implanted can be localised. An MRI compatible robot (MrBot) was developed. The robot is designed for transperineal percutaneous prostate interventions, and customised for fully automated MRI-guided brachytherapy. With different end-effectors, the robot applies to other image-guided interventions of the prostate. The robot is constructed of non-magnetic and dielectric materials and is electricity free using pneumatic actuation and optic sensing. A new motor (PneuStep) was purposely developed to set this robot in motion. The robot fits alongside the patient in closed-bore MRI scanners. It is able to stay fully operational during MR imaging without deteriorating the quality of the scan. In vitro, cadaver, and animal tests showed millimetre needle targeting accuracy, and very precise seed placement. The robot tested without any interference up to 7T. The robot is the first fully automated robot to function in MRI scanners. Its first application is MRI-guided seed brachytherapy. It is capable of automated, highly accurate needle placement. Extensive testing is in progress prior to clinical trials. Preliminary results show that the robot may become a useful image-guided intervention instrument. (author)

  3. Adjuvant brachytherapy for treatment of chest wall sarcomas

    International Nuclear Information System (INIS)

    Wallner, K.E.; Nori, D.; Burt, M.; Bains, M.; McCormack, P.

    1991-01-01

    Thirty patients treated with surgical resection and brachytherapy for chest wall sarcoma at Memorial Sloan-Kettering Cancer Center from 1980 through 1987 were reviewed. Patients selected to receive adjuvant irradiation were those for whom there was doubt as to the completeness of surgical resection. Overall 5-year survival and locoregional control after brachytherapy were 65% and 54%, respectively. Locoregional control was similar for tumors treated at initial diagnosis (12 patients), at the time of recurrence (13 patients), or for tumors that were metastatic to the chest wall (five patients). Six patients with tumors larger than 10 cm in maximum dimension had a locoregional recurrence rate of 69% versus a recurrence rate of 39% for 18 patients with smaller tumors (p = 0.27). Fifty-four percent of high-grade tumors recurred locoregionally versus 28% of low-grade tumors (p = 0.37). Bone invasion or the presence of positive resection margins was not clearly associated with a higher locoregional failure rate. Only one patient (1/28; 7%) was known to have had recurrence within the irradiated area. Eight patients (8/28; 37%) had recurrence adjacent to the implanted area, and the precise failure site could not be determined for the remaining two patients. Because of the relatively high risk of regional versus in-field recurrence, patients with chest wall sarcoma who receive adjuvant treatment should be treated primarily with external-beam irradiation to allow more generous coverage of the tumor bed. Brachytherapy could be used as a tumor bed 'boost' treatment. In patients undergoing resection of recurrent tumor in a previously irradiated site, adjuvant brachytherapy, without external-beam irradiation, should be considered to reduce the risk of extensive soft tissue necrosis

  4. Radiation safety program in a high dose rate brachytherapy facility

    International Nuclear Information System (INIS)

    Rodriguez, L.V.; Hermoso, T.M.; Solis, R.C.

    2001-01-01

    The use of remote afterloading equipment has been developed to improve radiation safety in the delivery of treatment in brachytherapy. Several accidents, however, have been reported involving high dose-rate brachytherapy system. These events, together with the desire to address the concerns of radiation workers, and the anticipated adoption of the International Basic Safety Standards for Protection Against Ionizing Radiation (IAEA, 1996), led to the development of the radiation safety program at the Department of Radiotherapy, Jose R. Reyes Memorial Medical Center and at the Division of Radiation Oncology, St. Luke's Medical Center. The radiation safety program covers five major aspects: quality control/quality assurance, radiation monitoring, preventive maintenance, administrative measures and quality audit. Measures for evaluation of effectiveness of the program include decreased unnecessary exposures of patients and staff, improved accuracy in treatment delivery and increased department efficiency due to the development of staff vigilance and decreased anxiety. The success in the implementation required the participation and cooperation of all the personnel involved in the procedures and strong management support. This paper will discuss the radiation safety program for a high dose rate brachytherapy facility developed at these two institutes which may serve as a guideline for other hospitals intending to install a similar facility. (author)

  5. Ultrasound-based conformal planning for gynaecological brachytherapy

    International Nuclear Information System (INIS)

    Van Dyk, S.; Bernshaw, D.

    2008-01-01

    This report describes the evolving use of transabdominal ultrasound (TAUS) as an imaging tool to verify tandem placement, localize the treatment volume and aid conformal brachytherapy planning for both cervical and uterine corpus cancers. Two patients, one with cancer of the cervix and one with cancer of the endometrium, are used as examples to illustrate the advantages of using TAUS. TAUS is used to guide applicator insertion and check the applicator in the treatment position. The dimensions of the uterus are recorded. Brachytherapy isodose plans are generated based on these measurements. Confirmation of uterine dimensions and isodose coverage is obtained using MRI taken after the initial fraction of treatment has been delivered. We illustrate how TAUS is successfully used to correct and verify tandem placement after the patient has been moved from insertion to treatment position. We also show how to use TAUS for conformal planning, based on individually derived target dimensions. TAUS has succesfully been used to conformally plan treatment to the uterus and cervix, minimizing brachytherapy-related toxicity to surrounding structures. Ultrasound is portable, inexpensive and simple to use and allows for accurate, conformal, reproducible and adaptive treatments.

  6. Brachytherapy for treatment of cervix cancer in Madagascar

    International Nuclear Information System (INIS)

    Pignon, T.; Ratovonarivo, H.; Rafaramino, F.; Ruggieri, S.

    1993-01-01

    From March 1986 to June 1988, 60 patients with carcinoma of the uterine cervix were treated by radiotherapy alone or combined radiotherapy and surgery at the only radiotherapy-oncology department of Madagascar in Antananarivo. There were 20 stage IB, 28 stage II, 5 stage III and 7 cases where initial stage before surgery was unknown. After a limited pre-therapeutic investigation, treatment for stage IB consisted of utero-vaginal brachytherapy followed by a colpo-hysterectomy and external iliac lymphadenectomy. Others received combined external radiotherapy and brachytherapy according to the Fletcher guidelines, although 30 patients also received surgery. An obsolete and inefficient cobalt unit with lack of computerized dosimetry made the management of therapeutic schemas difficult. Nineteen patients (31.6%) were not available for follow-up immediately after the end of the treatment and one patient died from intestinal occlusion during brachytherapy. The overall rate of severe complications was 4.8%. There were 12 recurrences which occurred in stage II or in patients with unknown initial staging. At the time of analysis, 25 patients were alive: 15 stage I and 10 stage II. In this country, cervical carcinomas are the most frequent tumors: only the rehabilitation of radiotherapy facilities will allow results to be improved

  7. [Salvage radical prostatectomy for brachytherapy failure: preliminary results].

    Science.gov (United States)

    Saeedi, Y; Pop, M; Jacqmin, D

    2014-04-01

    Analysis of preliminary results in six patients operated by second-line (salvage) radical prostatectomy for local recurrence after low-dose brachytherapy. Since January 2009, six patients had an open salvage radical prostatectomy with a lymph node dissection and without neurovascular bundles preservation for a low-dose I125 brachytherapy failure. Local recurrence was confirmed by trans-rectal biopsy or TURP. All the patients had PSA increase or lower urinary tract symptoms. Bone scan and pelvis MRI were performed to detect a locally advanced disease, a lymph node involvement or the presence of bone metastasis. Pathology reports and PSA level at 1, 3, 6 and 12 months were analyzed. Salvage radical prostatectomy with lymph node dissection was performed in all patients without major complications. The PSA level was below 0.1 ng/mL in five out of six patients at 1 and 3 months. The only case of persistent PSA is treated by androgen deprivation in a pT3b N1 patient. Salvage radical prostatectomy after brachytherapy failure was feasible with a limited perioperative morbidity. This second-line curative treatment in a selected group of patients should be kept in mind. Our early results looked promising. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Development of a program for calculation of second dose and securities in brachytherapy high dose rate; Elaboracion de un programa para el segundo calculo de la dosis y seguridades en braquiterapia de alta tasa de dosis

    Energy Technology Data Exchange (ETDEWEB)

    Esteve Sanchez, S.; Martinez Albaladejo, M.; Garcia Fuentes, J. D.; Bejar Navarro, M. J.; Capuz Suarez, B.; Moris de Pablos, R.; Colmenares Fernandez, R.

    2015-07-01

    We assessed the reliability of the program with 80 patients in the usual points of prescription of each pathology. The average error of the calculation points is less than 0.3% in 95% of cases, finding the major differences in the axes of the applicators (maximum error -0.798%). The program has proved effective previously testing him with erroneous dosimetry. Thanks to the implementation of this program is achieved by the calculation of the dose and part of the process of quality assurance program in a few minutes, highlighting the case of HDR prostate due to having a limited time. Having separate data sheet allows each institution to its protocols modify parameters. (Author)

  9. Validity of the formalism of calculation in surface TG-43 brachytherapy high dose rate; Validez del formalismo de calculo del TG-43 en braquiterapia superficial con alta tase de dosis

    Energy Technology Data Exchange (ETDEWEB)

    Granero, D.; Perez-Calatayud, J.; Vijande, J.; Ballester, F.; Rivard, M. J.

    2013-07-01

    The purpose of this work is to evaluate the clinical implications and limitations in implant surface with a source of HDR very close or in contact with the surface of the skin, also studied the effect of bolus on the implant. The two available radionuclides have been studied commercially in HDR, Ir-192 and Co-60 units. (Author)

  10. [Brachytherapy in France: current situation and economic outlook due to the unavailability of iridium wires].

    Science.gov (United States)

    Le Vu, B; Boucher, S

    2014-10-01

    In 2013, about 6000 patients were treated with brachytherapy, the number diminishing by 2.6% per year since 2008. Prostate, breast and gynecological cancers are the most common types of cancers. Since 2008, the number of brachytherapy facilities has decreased by 18%. In medicoeconomic terms, brachytherapy faces many problems: the coding system is outdated; brachytherapy treatments cost as much as internal radiation; fees do not cover costs; since iridium wire has disappeared from the market, the technique will be transferred to more expensive high-speed or pulse dose rates. The French financing grid based on the national study of costs lags behind changes in such treatments and in the best of cases, hospitals resorting to alternatives such as in-hospital brachytherapy are funded at 46% of their additional costs. Brachytherapy is a reference technique. With intense pressure on hospital pricing, financing brachytherapy facilities will become even more problematic as a consequence of the disappearance of iridium 192 wires. The case of brachytherapy illustrates the limits of the French financing system and raises serious doubts as to its responsiveness. Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  11. A compilation of current regulations, standards and guidelines in remote afterloading brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tortorelli, J.P.; Simion, G.P.; Kozlowski, S.D. [Idaho National Engineering Lab., Idaho Falls, ID (United States)

    1994-10-01

    Over a dozen government and professional organizations in the United States and Europe have issued regulations and guidance concerning quality management in the practice of remote afterloading brachytherapy. Information from the publications of these organizations was collected and collated for this report. This report provides the brachytherapy licensee access to a broad field of quality management information in a single, topically organized document.

  12. A compilation of current regulations, standards and guidelines in remote afterloading brachytherapy

    International Nuclear Information System (INIS)

    Tortorelli, J.P.; Simion, G.P.; Kozlowski, S.D.

    1994-10-01

    Over a dozen government and professional organizations in the United States and Europe have issued regulations and guidance concerning quality management in the practice of remote afterloading brachytherapy. Information from the publications of these organizations was collected and collated for this report. This report provides the brachytherapy licensee access to a broad field of quality management information in a single, topically organized document

  13. Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shaitelman, Simona F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Grace L., E-mail: glsmith@mdanderson.org [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2016-03-15

    Purpose: We compared toxicities after brachytherapy versus external beam radiation therapy (EBRT) in contemporary breast cancer patients. Methods and Materials: Using MarketScan healthcare claims, we identified 64,112 women treated from 2003 to 2012 with lumpectomy followed by radiation (brachytherapy vs EBRT). Brachytherapy was further classified by multichannel versus single-channel applicator approach. We identified the risks and predictors of 1-year infectious and noninfectious postoperative adverse events using logistic regression and temporal trends using Cochran-Armitage tests. We estimated the 5-year Kaplan-Meier cumulative incidence of radiation-associated adverse events. Results: A total of 4522 (7.1%) patients received brachytherapy (50.2% multichannel vs 48.7% single-channel applicator). The overall risk of infectious adverse events was higher after brachytherapy than after EBRT (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.09-1.34, P<.001). However, over time, the frequency of infectious adverse events after brachytherapy decreased, from 17.3% in 2003 to 11.6% in 2012, and was stable after EBRT at 9.7%. Beyond 2007, there were no longer excess infections with brachytherapy (P=.97). The overall risk of noninfectious adverse events was higher after brachytherapy than after EBRT (OR=2.27; 95% CI 2.09-2.47, P<.0001). Over time, the frequency of noninfectious adverse events detected increased: after multichannel brachytherapy, from 9.1% in 2004 to 18.9% in 2012 (Ptrend = .64); single-channel brachytherapy, from 12.8% to 29.8% (Ptrend<.001); and EBRT, from 6.1% to 10.3% (Ptrend<.0001). The risk was significantly higher with single-channel than with multichannel brachytherapy (hazard ratio = 1.32; 95% CI 1.03-1.69, P=.03). Of noninfectious adverse events, 70.9% were seroma. Seroma significantly increased breast pain risk (P<.0001). Patients with underlying diabetes, cardiovascular disease, and treatment with chemotherapy had increased

  14. Dosimetry Modeling for Focal Low-Dose-Rate Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Al-Qaisieh, Bashar [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Mason, Josh, E-mail: joshua.mason@nhs.net [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Bownes, Peter; Henry, Ann [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Dickinson, Louise [Division of Surgery and Interventional Science, University College London, London (United Kingdom); Department of Radiology, Northwick Park Hospital, London North West NHS Trust, London (United Kingdom); Ahmed, Hashim U. [Division of Surgery and Interventional Science, University College London, London (United Kingdom); University College London Hospital, London (United Kingdom); Emberton, Mark [University College London Hospital, London (United Kingdom); Langley, Stephen [St Luke' s Cancer Centre, Guildford (United Kingdom)

    2015-07-15

    Purpose: Focal brachytherapy targeted to an individual lesion(s) within the prostate may reduce side effects experienced with whole-gland brachytherapy. The outcomes of a consensus meeting on focal prostate brachytherapy were used to investigate optimal dosimetry of focal low-dose-rate (LDR) prostate brachytherapy targeted using multiparametric magnetic resonance imaging (mp-MRI) and transperineal template prostate mapping (TPM) biopsy, including the effects of random and systematic seed displacements and interseed attenuation (ISA). Methods and Materials: Nine patients were selected according to clinical characteristics and concordance of TPM and mp-MRI. Retrospectively, 3 treatment plans were analyzed for each case: whole-gland (WG), hemi-gland (hemi), and ultra-focal (UF) plans, with 145-Gy prescription dose and identical dose constraints for each plan. Plan robustness to seed displacement and ISA were assessed using Monte Carlo simulations. Results: WG plans used a mean 28 needles and 81 seeds, hemi plans used 17 needles and 56 seeds, and UF plans used 12 needles and 25 seeds. Mean D90 (minimum dose received by 90% of the target) and V100 (percentage of the target that receives 100% dose) values were 181.3 Gy and 99.8% for the prostate in WG plans, 195.7 Gy and 97.8% for the hemi-prostate in hemi plans, and 218.3 Gy and 99.8% for the focal target in UF plans. Mean urethra D10 was 205.9 Gy, 191.4 Gy, and 92.4 Gy in WG, hemi, and UF plans, respectively. Mean rectum D2 cm{sup 3} was 107.5 Gy, 77.0 Gy, and 42.7 Gy in WG, hemi, and UF plans, respectively. Focal plans were more sensitive to seed displacement errors: random shifts with a standard deviation of 4 mm reduced mean target D90 by 14.0%, 20.5%, and 32.0% for WG, hemi, and UF plans, respectively. ISA has a similar impact on dose-volume histogram parameters for all plan types. Conclusions: Treatment planning for focal LDR brachytherapy is feasible. Dose constraints are easily met with a notable

  15. Determining profile of dose distribution for PD-103 brachytherapy source

    International Nuclear Information System (INIS)

    Berkay, Camgoz; Mehmet, N. Kumru; Gultekin, Yegin

    2006-01-01

    Full text: Brachytherapy is a particular radiotherapy for cancer treatments. By destructing cancerous cells using radiation, the treatment proceeded. When alive tissues are subject it is hazardous to study experimental. For brachytherapy sources generally are studied as theoretical using computer simulation. General concept of the treatment is to locate the radioactive source into cancerous area of related tissue. In computer studies Monte Carlo mathematical method that is in principle based on random number generations, is used. Palladium radioisotope is LDR (Low radiation Dose Rate) source. Main radioactive material was coated with titanium cylinder with 3mm length, 0.25 mm radius. There are two parts of Pd-103 in the titanium cylinder. It is impossible to investigate differential effects come from two part as experimental. Because the source dimensions are small compared with measurement distances. So there is only simulation method. In dosimetric studies it is aimed to determine absorbed dose distribution in tissue as radial and angular. In nuclear physics it is obligation to use computer based methods for researchers. Radiation studies have hazards for scientist and people interacted with radiation. When hazard exceed over recommended limits or physical conditions are not suitable (long work time, non economical experiments, inadequate sensitivity of materials etc.) it is unavoidable to simulate works and experiments before practices of scientific methods in life. In medical area, usage of radiation is required computational work for cancer treatments. Some computational studies are routine in clinics and other studies have scientific development purposes. In brachytherapy studies there are significant differences between experimental measurements and theoretical (computer based) output data. Errors of data taken from experimental studies are larger than simulation values errors. In design of a new brachytherapy source it is important to consider detailed

  16. Ocular Response of Choroidal Melanoma With Monosomy 3 Versus Disomy 3 After Iodine-125 Brachytherapy

    International Nuclear Information System (INIS)

    Marathe, Omkar S.; Wu, Jeffrey; Lee, Steve P.; Yu Fei; Burgess, Barry L.; Leu Min; Straatsma, Bradley R.; McCannel, Tara A.

    2011-01-01

    Purpose: To report the ocular response of choroidal melanoma with monosomy 3 vs. disomy 3 after 125 I brachytherapy. Methods and Materials: We evaluated patients with ciliochoroidal melanoma managed with fine needle aspiration biopsy immediately before plaque application for 125 I brachytherapy between January 1, 2005 and December 31, 2008. Patients with (1) cytopathologic diagnosis of melanoma, (2) melanoma chromosome 3 status identified by fluorescence in situ hybridization, and (3) 6 or more months of follow-up after brachytherapy were sorted by monosomy 3 vs. disomy 3 and compared by Kruskal-Wallis test. Results: Among 40 ciliochoroidal melanomas (40 patients), 15 had monosomy 3 and 25 had disomy 3. Monosomy 3 melanomas had a median greatest basal diameter of 12.00 mm and a median tumor thickness of 6.69 mm before brachytherapy; at a median of 1.75 years after brachytherapy, median thickness was 3.10 mm. Median percentage decrease in tumor thickness was 48.3%. Disomy 3 melanomas had a median greatest basal diameter of 10.00 mm and median tumor thickness of 3.19 mm before brachytherapy; at a median of 2.00 years after brachytherapy, median tumor thickness was 2.37 mm. The median percentage decrease in tumor thickness was 22.7%. Monosomy 3 melanomas were statistically greater in size than disomy 3 melanomas (p < 0.001) and showed a greater decrease in tumor thickness after brachytherapy (p = 0.006). Conclusion: In this study, ciliochoroidal melanomas with monosomy 3 were significantly greater in size than disomy 3 melanoma and showed a significantly greater decrease in thickness at a median of 1.75 years after brachytherapy. The greater decrease in monosomy 3 melanoma thickness after brachytherapy is consistent with other malignancies in which more aggressive pathology has been shown to be associated with a greater initial response to radiotherapy.

  17. Ocular Response of Choroidal Melanoma With Monosomy 3 Versus Disomy 3 After Iodine-125 Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Marathe, Omkar S. [David Geffen School of Medicine, University of Los Angeles, Los Angeles, CA (United States); Wu, Jeffrey; Lee, Steve P. [Department of Radiation Oncology, University of Los Angeles, Los Angeles, CA (United States); Yu Fei; Burgess, Barry L. [Department of Ophthalmology, The Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); Leu Min [Department of Radiation Oncology, University of Los Angeles, Los Angeles, CA (United States); Straatsma, Bradley R. [Department of Ophthalmology, The Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); McCannel, Tara A., E-mail: TMcCannel@jsei.ucla.edu [Department of Ophthalmology, Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); Jonsson Comprehensive Cancer Center, University of Los Angeles, Los Angeles, CA (United States)

    2011-11-15

    Purpose: To report the ocular response of choroidal melanoma with monosomy 3 vs. disomy 3 after {sup 125}I brachytherapy. Methods and Materials: We evaluated patients with ciliochoroidal melanoma managed with fine needle aspiration biopsy immediately before plaque application for {sup 125}I brachytherapy between January 1, 2005 and December 31, 2008. Patients with (1) cytopathologic diagnosis of melanoma, (2) melanoma chromosome 3 status identified by fluorescence in situ hybridization, and (3) 6 or more months of follow-up after brachytherapy were sorted by monosomy 3 vs. disomy 3 and compared by Kruskal-Wallis test. Results: Among 40 ciliochoroidal melanomas (40 patients), 15 had monosomy 3 and 25 had disomy 3. Monosomy 3 melanomas had a median greatest basal diameter of 12.00 mm and a median tumor thickness of 6.69 mm before brachytherapy; at a median of 1.75 years after brachytherapy, median thickness was 3.10 mm. Median percentage decrease in tumor thickness was 48.3%. Disomy 3 melanomas had a median greatest basal diameter of 10.00 mm and median tumor thickness of 3.19 mm before brachytherapy; at a median of 2.00 years after brachytherapy, median tumor thickness was 2.37 mm. The median percentage decrease in tumor thickness was 22.7%. Monosomy 3 melanomas were statistically greater in size than disomy 3 melanomas (p < 0.001) and showed a greater decrease in tumor thickness after brachytherapy (p = 0.006). Conclusion: In this study, ciliochoroidal melanomas with monosomy 3 were significantly greater in size than disomy 3 melanoma and showed a significantly greater decrease in thickness at a median of 1.75 years after brachytherapy. The greater decrease in monosomy 3 melanoma thickness after brachytherapy is consistent with other malignancies in which more aggressive pathology has been shown to be associated with a greater initial response to radiotherapy.

  18. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR

    International Nuclear Information System (INIS)

    Craciunescu, O; Todor, D; Leeuw, A de

    2014-01-01

    In recent years, with the advent of high/pulsed dose rate afterloading technology, advanced treatment planning systems, CT/MRI compatible applicators, and advanced imaging platforms, image-guided adaptive brachytherapy treatments (IGABT) have started to play an ever increasing role in modern radiation therapy. The most accurate way to approach IGABT treatment is to provide the infrastructure that combines in a single setting an appropriate imaging device, a treatment planning system, and a treatment unit. The Brachytherapy Suite is not a new concept, yet the modern suites are incorporating state-of-the-art imaging (MRI, CBCT equipped simulators, CT, and /or US) that require correct integration with each other and with the treatment planning and delivery systems. Arguably, an MRI-equipped Brachytherapy Suite is the ideal setup for real-time adaptive brachytherapy treatments. The main impediment to MRI-IGABT adoption is access to MRI scanners. Very few radiation oncology departments currently house MRI scanners, and even fewer in a dedicated Brachytherapy Suite. CBCT equipped simulators are increasingly offered by manufacturers as part of a Brachytherapy Suite installation. If optimized, images acquired can be used for treatment planning, or can be registered with other imaging modalities. This infrastructure is relevant for all forms of brachytherapy, especially those utilizing multi-fractionated courses of treatment such as prostate and cervix. Moreover, for prostate brachytherapy, US imaging systems can be part of the suite to allow for real-time HDR/LDR treatments. Learning Objectives: Understand the adaptive workflow of MR-based IGBT for cervical cancer. Familiarize with commissioning aspects of a CBCT equipped simulator with emphasis on brachytherapy applications Learn about the current status and future developments in US-based prostate brachytherapy

  19. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR

    Energy Technology Data Exchange (ETDEWEB)

    Craciunescu, O [Duke University Medical Center, Durham, NC (United States); Todor, D [Virginia Commonwealth University, Richmond, VA (United States); Leeuw, A de

    2014-06-15

    In recent years, with the advent of high/pulsed dose rate afterloading technology, advanced treatment planning systems, CT/MRI compatible applicators, and advanced imaging platforms, image-guided adaptive brachytherapy treatments (IGABT) have started to play an ever increasing role in modern radiation therapy. The most accurate way to approach IGABT treatment is to provide the infrastructure that combines in a single setting an appropriate imaging device, a treatment planning system, and a treatment unit. The Brachytherapy Suite is not a new concept, yet the modern suites are incorporating state-of-the-art imaging (MRI, CBCT equipped simulators, CT, and /or US) that require correct integration with each other and with the treatment planning and delivery systems. Arguably, an MRI-equipped Brachytherapy Suite is the ideal setup for real-time adaptive brachytherapy treatments. The main impediment to MRI-IGABT adoption is access to MRI scanners. Very few radiation oncology departments currently house MRI scanners, and even fewer in a dedicated Brachytherapy Suite. CBCT equipped simulators are increasingly offered by manufacturers as part of a Brachytherapy Suite installation. If optimized, images acquired can be used for treatment planning, or can be registered with other imaging modalities. This infrastructure is relevant for all forms of brachytherapy, especially those utilizing multi-fractionated courses of treatment such as prostate and cervix. Moreover, for prostate brachytherapy, US imaging systems can be part of the suite to allow for real-time HDR/LDR treatments. Learning Objectives: Understand the adaptive workflow of MR-based IGBT for cervical cancer. Familiarize with commissioning aspects of a CBCT equipped simulator with emphasis on brachytherapy applications Learn about the current status and future developments in US-based prostate brachytherapy.

  20. Interstitial high-dose-rate brachytherapy in the treatment of base of tongue carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Takacsi-Nagy, Z.; Polgar, C.; Somogyi, A.; Major, T.; Fodor, J.; Nemeth, G. [Dept. of Radiotherapy, National Inst. of Oncology, Budapest (Hungary); Oberna, F. [Dept. of Maxillofacial Surgery, St. Rokus Hospital, Budapest (Hungary); Remenar, E.; Kasler, M. [Dept. of Head and Neck, Maxillofacial and Reconstructive Plastic Surgery, National Inst. of Oncology, Budapest (Hungary)

    2004-12-01

    Background and purpose: to date none of the studies examined the feasibility and efficacy of interstitial high-dose-rate (HDR) brachytherapy in the treatment of carcinoma of the tongue base. Therefore the aim of this study was to contribute to this issue. Patients and methods: between 1992 and 2000 37 patients (mean age 55 years) with T1-4 and NO-3 carcinoma of the base of tongue were presented. Neck dissection was carried out in twelve cases (32%). 30 patients with advanced stage received brachytherapy boost after 50-66.5 Gy (mean, 60 Gy) locoregional external beam irradiation (EBI) and 7 patients with early stage (T1-2, NO) were managed locally with wide tumor excision and sole brachytherapy. 4 of them underwent neck dissection and the others were subjected to 50 Gy regional EBI. The mean dose of boost and sole brachytherapy was 18 Gy and 28 Gy, respectively. Results: the median follow-up time for surviving patients was 51 months. The 7 sole brachytherapy patients are living with no evidence of disease. For patients treated with EBI and brachytherapy boost, the 5-year actuarial rate of local, locoregional recurrence-free and overall survival was 60%, 52% and 46%, respectively. For all patients in univariate analysis larger tumor size (T4 vs. T1-3) was significant negative predictor of local (RR: 7.23) and locoregional control (RR: 3.87), but nodal involvement was not. Delayed soft tissue ulceration and osteoradionecrosis occurred in 4 (13%) EBI and brachytherapy treated patients. None of the sole brachytherapy patients experienced severe late radiation toxicity. Conclusion: EBI combined with interstitial HDR brachytherapy boost result in acceptable local tumor control with low incidence of late side effects in patients with advanced disease. Fractionated sole HDR brachytherapy following tumor excision is a feasible treatment option for patients with early stage cancer and gives excellent local results. (orig.)

  1. Calibration of brachytherapy sources. Guidelines on standardized procedures for the calibration of brachytherapy sources at Secondary Standard Dosimetry Laboratories (SSDLs) and hospitals

    International Nuclear Information System (INIS)

    1999-04-01

    Today, irradiation by brachytherapy is considered an essential part of the treatment for almost all the sites of cancer. With the improved localization techniques and treatment planning systems, it is now possible to have precise and reproducible dose delivery. However, the desired clinical results can only be achieved with a good clinical and dosimetric practice, i.e. with the implementation of a comprehensive quality assurance (QA) programme which includes detailed quality control procedures. As summarized in the present report, accidents in brachytherapy treatments have been caused due to the lack of traceable calibration of the sources, due to the incorrect use of quantities and units, or errors made in the dose calculation procedure. The International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources has established a requirement on the calibration of sources used for medical exposure. For sources used in brachytherapy treatments, a calibration traceable to a standards dosimetry laboratory is required. The present report deals with the calibration of brachytherapy sources and related quality control (QC) measurements, QC of ionization chambers and safety aspects related to the calibration procedures. It does not include safety aspects related to the clinical use of brachytherapy sources, which have been addressed in a recent IAEA publication, IAEA-TECDOC-1040, 'Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects'. The procedures recommended in this report yield traceability to internationally accepted standards. It must be realized, however, that a comprehensive QA programme for brachytherapy cannot rest on source calibration alone, but must ensure QC of all the equipment and techniques that are used for the dose delivery to the patient. The present publication incorporates the reports of several consultants meetings in the field of

  2. Thickness calculation software of the thermal insulation in facilities using thermal solar energy; Software para el calculo de espesores del aislante termico en instalaciones de aprovechamiento de energia solar termica

    Energy Technology Data Exchange (ETDEWEB)

    Portillo Jimenez, Canek [Universidad Autonoma de Sinaloa, Culiacan, Sinaloa (Mexico)]. E-mail: cnk@uas.uasnet.mx

    2010-11-15

    It is presented a software application for calculating the thickness of the thermal insulation used in various facilities where there are thermal systems using solar energy. The software facilitates the calculation of the thermal cover thickness over components such as pipes (flat or round), storage and other devices that require thermal protection, installed in outdoors or indoors. The software was programmed in Visual Basic by following the technical specifications of the current regulations in the field. Application examples are performed, obtaining certain results that are discussed briefly. [Spanish] Se presenta un software de aplicacion para el calculo de los espesores de los aislantes termicos, utilizados en diferentes instalaciones donde existen sistemas de aprovechamiento termico de energia solar. El software facilita el calculo del grosor del recubrimiento termico en componentes tales como: tuberias (planas o circulares), depositos acumuladores y otros aparatos que necesiten proteccion termica, instalados en exteriores o en interiores. El software fue programado en Visual Basic siguiendo las especificaciones tecnicas de la normatividad vigente en la materia. Se realizan ejemplos de aplicacion, donde se obtienen ciertos resultados de los cuales se hace una breve discusion.

  3. In vitro experiments on PDR brachytherapy; In-Vitro-Untersuchungen zur PDR-Brachytherapie

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, P.; Frank, C. [Klinik fuer Radioonkologie, St. Marien-Krankenhaus, Siegen (Germany); Weber, K.J. [Abt. fuer Strahlentherapie, Radiologische Klinik, Heidelberg Univ. (Germany)

    1998-07-01

    Simulating the clinical situation in PDR brachytherapy, fractionation experiments were carried out in the dose rate gradient of afterloading sources. Different dose levels were produced with the same number of fractions in the same overall incubation time. The fractionation schedules which were to be compared with a CLDR reference curve were: 40x0.47 Gy, 20x0.94 Gy, 10x1.88 Gy, 5x3.76 Gy, 2x9.4 Gy given in a period of 20 h and 1x18.8 Gy as a `single dose` exposition. As measured by flow cytometry, the influence of the dose rate in the pulse on cell survival and on cell cycle distribution under superfractionation was examined on V79 cells. V79 spheroids as a model for a slowly growing tumor, reacted according to the radiobiological calculations, as a CLDR equivalancy was achieved with increasing fractionation. Rapidly growing V79 monolayer cells showed an inverse fractionation effect. A superfractionated irradiation with pulses of 0.94 Gy/h respectively 0.47 Gy/0.5 h was significantly more effective than the CLDR irradiation. This inverse fractionation effect in log-phase V79 cells could be attributed to the accumulation of cycling cells in the radiosensitive G2/M phase (G2 block) during protected exposure which was drastically more pronounced for the pulsed scheme. HeLa cells were rather insensitive to changes of fractionation. Superfractionation as well as hypofractionation yielded CLDR equivalent survival curves. (orig./MG) [Deutsch] In Anlehnung an die klinischen Verhaeltnisse der PDR-Brachytherapie wurden Fraktionierungsexperimente im Dosis-Leistungs-Gradienten von Afterloading-Quellen durchgefuehrt. Unterschiedliche Strahlendosen wurden mit der jeweils gleichen Anzahl von Fraktionen und in der jeweils gleichen `Gesamtinkubationszeit` erzeugt. Folgende Fraktionierungen wurden mit einer CLDR-Referenzkurve verglichen: 40x0,47 Gy, 20x0,94 Gy, 10x1,88 Gy, 5x3,76 Gy, 2x9,4 Gy in jeweils 20 Stunden und einmal 18,8 Gy als `Single-dose-`Exposition. Zusaetzlich wurden

  4. Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2).

    Science.gov (United States)

    Lyden, Patrick; Hemmen, Thomas; Grotta, James; Rapp, Karen; Ernstrom, Karin; Rzesiewicz, Teresa; Parker, Stephanie; Concha, Mauricio; Hussain, Syed; Agarwal, Sachin; Meyer, Brett; Jurf, Julie; Altafullah, Irfan; Raman, Rema

    2016-12-01

    Therapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. Therapeutic hypothermia for acute ischemic stroke is safe and feasible in pilot trials. We designed a study protocol to provide safer, faster therapeutic hypothermia in stroke patients. Safety procedures and 4°C saline infusions for faster cooling were added to the ICTuS trial (Intravascular Cooling in the Treatment of Stroke) protocol. A femoral venous intravascular cooling catheter after intravenous recombinant tissue-type plasminogen activator in eligible patients provided 24 hours cooling followed by a 12-hour rewarm. Serial safety assessments and imaging were performed. The primary end point was 3-month modified Rankin score 0,1. Of the intended 1600 subjects, 120 were enrolled before the study was stopped. Randomly, 63 were to receive hypothermia plus antishivering treatment and 57 normothermia. Compared with previous studies, cooling rates were improved with a cold saline bolus, without fluid overload. The intention-to-treat primary outcome of 90-day modified Rankin Score 0,1 occurred in 33% hypothermia and 38% normothermia subjects, odds ratio (95% confidence interval) of 0.81 (0.36-1.85). Serious adverse events occurred equally. Mortality was 15.9% hypothermia and 8.8% normothermia subjects, odds ratio (95% confidence interval) of 1.95 (0.56-7.79). Pneumonia occurred in 19% hypothermia versus 10.5% in normothermia subjects, odds ratio (95% confidence interval) of 1.99 (0.63-6.98). Intravascular therapeutic hypothermia was confirmed to be safe and feasible in recombinant tissue-type plasminogen activator-treated acute ischemic stroke patients. Protocol changes designed to reduce pneumonia risk appeared to fail, although the sample is small. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01123161. © 2016 American Heart Association, Inc.

  5. Polymer coating embolism from intravascular medical devices - a clinical literature review.

    Science.gov (United States)

    Chopra, Amitabh M; Mehta, Monik; Bismuth, Jean; Shapiro, Maksim; Fishbein, Michael C; Bridges, Alina G; Vinters, Harry V

    Over the past three decades, lubricious (hydrophobic and/or hydrophilic) polymer-coated devices have been increasingly adopted by interventional physicians and vascular surgeons to access and treat a wider range of clinical presentations. Recent clinical literature highlights the presence of polymer coating emboli within the anatomy - a result of coating separation from an intravascular device - and associates it with a range of adverse clinical sequelae. The 2015 U.S. Food and Drug Administration safety communication titled "Lubricious Coating Separation from Intravascular Medical Devices" acknowledges these concerns and concludes that it will work with stakeholders to develop nonclinical test methodologies, establish performance criteria, and identify gaps in current national and international device standards for coating integrity performance. Despite this communication and multiple case reports from interventional physicians, pathologists, dermatologists and other involved physician specialties, polymer coating embolism remains clinically underrecognized. This article consolidates the available literature on polymer coating embolism (1986-2016) and highlights the following relevant information for the physician: (a) the history and elusive nature of polymer coating embolism; (b) potential incidence rates of this phenomenon; (c) reported histologic findings and clinical effects of polymer emboli in the anatomy; (d) the importance of the collaborative clinician-pathologist partnership to report polymer embolism findings; and (e) the importance to study particulate release from intravascular devices so as to further understand and potentially evolve coated interventional technologies. Preliminary research on coatings highlights the potential of using iterations of coatings on medical devices that attain the desired therapeutic result and mitigate or eliminate particulates altogether. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Intravascular ultrasonic-photoacoustic (IVUP) endoscope with 2.2-mm diameter catheter for medical imaging.

    Science.gov (United States)

    Bui, Nhat Quang; Hlaing, Kyu Kyu; Nguyen, Van Phuc; Nguyen, Trung Hau; Oh, Yun-Ok; Fan, Xiao Feng; Lee, Yong Wook; Nam, Seung Yun; Kang, Hyun Wook; Oh, Junghwan

    2015-10-01

    Intravascular ultrasound (IVUS) imaging is extremely important for detection and characterization of high-risk atherosclerotic plaques as well as gastrointestinal diseases. Recently, intravascular photoacoustic (IVPA) imaging has been used to differentiate the composition of biological tissues with high optical contrast and ultrasonic resolution. The combination of these imaging techniques could provide morphological information and molecular screening to characterize abnormal tissues, which would help physicians to ensure vital therapeutic value and prognostic significance for patients before commencing therapy. In this study, integration of a high-frequency IVUS imaging catheter (45MHz, single-element, unfocused, 0.7mm in diameter) with a multi-mode optical fiber (0.6mm in core diameter, 0.22 NA), an integrated intravascular ultrasonic-photoacoustic (IVUP) imaging catheter, was developed to provide spatial and functional information on light distribution in a turbid sample. Simultaneously, IVUS imaging was co-registered to IVPA imaging to construct 3D volumetric sample images. In a phantom study, a polyvinyl alcohol (PVA) tissue-mimicking arterial vessel phantom with indocyanine green (ICG) and methylene blue (MB) inclusion was used to demonstrate the feasibility of mapping the biological dyes, which are used in cardiovascular and cancer diagnostics. For the ex vivo study, an excised sample of pig intestine with ICG was utilized to target the biomarkers present in the gastrointestinal tumors or the atherosclerotic plaques with the proposed hybrid technique. The results indicated that IVUP endoscope with the 2.2-mm diameter catheter could be a useful tool for medical imaging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Ischemia monitoring in off-pump coronary artery bypass surgery using intravascular near-infrared spectroscopy

    Directory of Open Access Journals (Sweden)

    Zerkowski Hans-Reinhard

    2006-05-01

    Full Text Available Abstract Background In off-pump coronary artery bypass surgery, manipulations on the beating heart can lead to transient interruptions of myocardial oxygen supply, which can generate an accumulation of oxygen-dependent metabolites in coronary venous blood. The objective of this study was to evaluate the reliability of intravascular near-infrared spectroscopy as a monitoring method to detect possible ischemic events in off-pump coronary artery bypass procedures. Methods In 15 elective patients undergoing off-pump myocardial revascularization, intravascular near-infrared spectroscopic analysis of coronary venous blood was performed. NIR signals were transferred through a fiberoptic catheter for signal emission and collection. For data analysis and processing, a miniature spectrophotometer with multivariate statistical package was used. Signal acquisition and analysis were performed before and after revascularization. Spectroscopic data were compared with hemodynamic parameters, electrocardiogram, transesophageal echocardiography and laboratory findings. Results A conversion to extracorporeal circulation was not necessary. The mean number of grafts per patient was 3.1 ± 0.6. An intraoperative myocardial ischemia was not evident, as indicated by electrocardiogram and transesophageal echocardiography. Continuous spectroscopic analysis showed reproducible absorption spectra of coronary sinus blood. Due to uneventful intraoperative courses, clear ischemia-related changes could be detected in none of the patients. Conclusion Our initial results show that intravascular near-infrared spectroscopy can reliably be used for an online intraoperative ischemia monitoring in off-pump coronary artery bypass surgery. However, the method has to be further evaluated and standardized to determine the role of spectroscopy in off-pump coronary artery bypass surgery.

  8. Delivery of Adeno-Associated Virus Gene Therapy by Intravascular Limb Infusion Methods.

    Science.gov (United States)

    Gruntman, Alisha M; Flotte, Terence R

    2015-09-01

    Recombinant adeno-associated virus (rAAV) can be delivered to the skeletal muscle of the limb (pelvic or thoracic) by means of regional intravascular delivery. This review summarizes the evolution of this technique to deliver rAAV either via the arterial blood supply or via the peripheral venous circulation. The focus of this review is on applications in large animal models, including preclinical studies. Based on this overview of past research, we aim to inform the design of preclinical and clinical studies.

  9. [A case of disseminated intravascular coagulation--a paraneoplastic manifestation of a borderline ovarian tumor].

    Science.gov (United States)

    Bălănescu, I; Coliţă, D; Moicean, A; Duţu, R; Stănculescu, M; Voinea, S

    1998-01-01

    A 24-year-old-woman was admitted because of disseminated intravascular coagulation (DIC), menometrorrhagia and galactorrhea. The investigations performed showed a right adnexal tumor after the equilibration of DIC with plasma substitution, we performed a right adnexectomy with limited excision of peritoneal. The pathologic examination showed a focus of endometriosis on the right ovary who had a polycystic look and a right adnexal fibromyxoma (premalignant lesion). The post operative evolution was good, with the loss of entire onco-hemato-endocrinologic picture. We describe the interrelation between DIC (paraneoplastic syndrome), menometrorrhagia and galactorrhea, the pathologic hypothesis and the treatment of DIC.

  10. Rash, disseminated intravascular coagulation and legionella: Episode 10 and a rewind into the past

    Directory of Open Access Journals (Sweden)

    Prashanth M. Thalanayar

    2015-01-01

    Full Text Available Legionella pneumophila is the most common cause of legionellosis and is one of the organisms causing atypical pneumonia. We report the presentation of disseminated intravascular coagulation (DIC and skin rash in a single case of severe Legionella pneumonia. The unique clinical presentation of a diffuse rash diagnosed as purpura fulminans and the unpredictable variations encountered during the diagnostic work-up of the case make this write-up crucial. This article synthesizes all reported cases of L. pneumonia associated with cutaneous manifestations as well as cases presenting with DIC. Furthermore, this manuscript illustrates the correlation between cutaneous and coagulopathic manifestations, and morbidity and mortality from L. pneumonia.

  11. Intravascular ultrasound assessment of remodelling and reference segment plaque burden in type-2 diabetic patients

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S

    2007-01-01

    AIMS: Intravascular ultrasound (IVUS) assesses arterial remodelling by comparing the lesion external elastic membrane (EEM) with the reference segments; however, reference segments are rarely disease-free. The aim was to assess lesion and reference segment remodelling and plaque burden in patients...... with type-2 diabetes mellitus. METHODS AND RESULTS: We used pre-intervention IVUS to study 62 de novo lesions in 43 patients with type-2 diabetes mellitus. The lesion site was the image slice with the smallest lumen cross-sectional area (CSA). The proximal and distal reference segments were the most normal...... IVUS lumen and quantitative coronary angiographic artery...

  12. Intravascular pulmonary lymphoma with good response to treatment. A case report

    Directory of Open Access Journals (Sweden)

    M. Felizardo

    2008-11-01

    Full Text Available Intravascular lymphoma is a very rare form of large B cell non-Hodgkin's lymphoma, characterised by the presence of lymphoma cells in the lumina of small vessels only, particulary in the capillaries. We report a 54 year-old female non-smoker, admitted to hospital for further examination of a four month long clinical condition involving high fever, night sweats, unqualified weight loss and progressive dyspnea. Patient's temperature was 38.5 °C, pulse 100/min and respiratory 22 cycles/min.Patient's haemoglobin was 9.4 g/dL, she had leukocytosis, elevated LDH and arterial blood gas analysis with moderate hypoxaemia (FiO2 1l/m: PaO2-63.6 mm Hg. Chest X-ray revealed diffuse interstitial changes. All the possible causes of unknown origin fever were excluded.Diagnosis was made through lung biopsy and treatment with combined chemotherapy and rituximab was prescribed leading to a 48 hours clinical remission. We present this case to show how difficult this diagnosis can be and how a good response to therapy is possible. Resumo: O linfoma intravascular é uma forma muito rara de linfoma não Hodgkin de células grandes B. Caracteriza-se pela proliferação celular tumoral de linfócitos limitada aos pequenos vasos, particularmente nos capilares. Apresentamos o caso de uma doente de 54 anos, não fumadora, que foi admitida no nosso hospital para investigação de um quadro com quatro meses de evolução de febre, sudorese nocturna, ema-grecimento não quantificado e dispneia progressiva. Ao exame objectivo apresentava-se febril, taquicárdica e polipneica. Analiticamente, destacava-se anemia, leucocitose e LDH elevada. Gasometria arterial - FiO2 1 l/m: PaO2-63,6 mm Hg. A telerradiografia de tórax revelava infiltado intersticial difuso. Foram excluídas todas as causas de febre de origem indeterminada. O diagnóstico foi realizado por biópsia pulmonar cirúrgica e foi prescrita terapêutica citostática combinada e rituximab com boa resposta cl

  13. Intravascular CNS lymphoma: Successful therapy using high-dose methotrexate-based polychemotherapy

    Directory of Open Access Journals (Sweden)

    Kebir Sied

    2012-12-01

    Full Text Available Abstract Intravascular diffuse large B-cell lymphoma limited to the CNS (cIVL is a very rare malignant disorder characterized by a selective accumulation of neoplastic lymphocytes (usually B cells within the lumen of CNS blood vessels but not in the brain parenchyma. In the past, treatment of cIVL with anthracycline-based regimens was unsatisfactory with very short survival times. In the case of cIVL presented here, high-dose methotrexate-based polychemotherapy according to the Bonn protocol plus rituximab therapy was successful and led to a complete clinical and MRI remission which is ongoing 29 months after diagnosis.

  14. [Intravascular Hemolysis Caused by Stenosis of an Elephant Trunk;Report of a Case].

    Science.gov (United States)

    Takamaru, Rikako; Kawahito, Koji; Aizawa, Kei; Misawa, Yoshio

    2017-07-01

    Symptomatic intravascular hemolysis after prosthetic aortic graft replacement is rare. It is primarily attributed to mechanical injury of red blood cells caused by stenosis of the vascular graft. A 50-year-old man presented with hemolytic anemia, 5 years after total arch replacement with an elephant trunk for type A aortic dissection. The hemolysis was caused by graft stenosis of the elephant trunk. Endovascular treatment for the stenotic elephant trunk was successfully performed. The postoperative course was uneventful, and the hemolysis was resolved immediately after operation.

  15. Tsukamurella tyrosinosolvens intravascular catheter-related bacteremia in a haematology patient: a case report.

    Science.gov (United States)

    Karunakaran, R; Halim, H A; Ng, K P; Hanifah, Y A; Chin, E; Jaafar, F L; Abubakar, S

    2011-11-01

    Tsukamurella spp. are a rare but important cause of intravascular catheter-related bacteremia in immunocompromised patients. The organism is an aerobic, Gram-positive, weakly acid-fast bacillus that is difficult to differentiate using standard laboratory methods from other aerobic actinomycetales such as Nocardia spp., Rhododoccus spp., Gordonia spp., and the rapid growing Mycobacterium spp. We report a case of Tsukamurella tyrosinosolvens catheter-related bacteremia in a 51-year-old haematology patient who responded to treatment with imipenem and subsequent line removal. 16srRNA sequencing allowed for the prompt identification of this organism.

  16. Successful Intravascular Ultrasound-Guided Transradial Coronary Intervention with a 4Fr Guiding Catheter.

    Science.gov (United States)

    Nakano, Yasuhiro; Sadamatsu, Kenji

    2016-01-01

    Minimizing the catheter size can reduce vascular access complications and contrast dye usage in coronary angiography. The small diameter of the 4Fr guiding catheter has limited the use of several angioplasty devices such as intravascular ultrasound (IVUS) in the past. However, the combination of a novel IVUS catheter and a 0.010 guidewire makes it possible to perform IVUS-guided percutaneous coronary intervention (PCI) with a 4Fr guiding catheter. We herein report the case of a 51-year-old man with silent myocardial ischemia who underwent IVUS-guided transradial PCI with a 4Fr guiding catheter.

  17. Disseminated intravascular coagulation in a patient with metastatic prostate cancer: Fatal outcome following strontium-89 therapy

    Energy Technology Data Exchange (ETDEWEB)

    Leong, C.; McKenzie, R.; Coupland, D.B. [Univ. of British Columbia, (Canada)] [and others

    1994-10-01

    A patient with metastatic prostate cancer was found to have low-grade disseminated intravascular coagulation (DIC). He had significant bone pain despite external-beam radiotherapy and was given {sup 89}Sr with subsequent thrombocytopenia and epistaxis. The patient died from generalized hemorrhage 36 days postinjection. Although it is not possible to establish a causal relationship between {sup 89}Sr and DIC, practitioners should be alert to complications associated with the primary disorder which might occur at a time to raise concern about the intervention. 8 refs., 1 tab.

  18. An Elderly Lady with Fever of Unknown Etiology and Severe Pulmonary Hypertension: Intravascular Lymphoma—An Elusive Diagnosis

    Directory of Open Access Journals (Sweden)

    Nupur Sinha

    2013-01-01

    Full Text Available Pulmonary hypertension (PH associated with malignancy, especially adenocarcinoma, is a well-known entity and is included in group V of the WHO classification. Intravascular lymphoma is a rare type of diffuse large B cell lymphoma, characterized by selective intravascular growth of malignant lymphocytes, aggressive behavior, and often a fatal course. Most of the time, diagnosis is postmortem due to the rarity and the protean manifestations of the disease. We present a rare case of an elderly patient presenting with severe pulmonary hypertension, fever of unknown etiology (FUO, and lymphadenopathy. Extensive evaluation searching for the etiology of her FUO and PH was noncontributory. The diagnosis of intravascular lymphoma was finally reached by the performance of a random abdominal fat pad biopsy and the patient was started on immunochemotherapy. She continues the follow up after 6 cycles of R-CHOP with no further febrile episodes and steady improvement in exercise tolerance.

  19. Effects of Hypoxia on Erythrocyte Membrane Properties—Implications for Intravascular Hemolysis and Purinergic Control of Blood Flow

    Directory of Open Access Journals (Sweden)

    Ryszard Grygorczyk

    2017-12-01

    Full Text Available Intravascular hemolysis occurs in hereditary, acquired, and iatrogenic hemolytic conditions but it could be also a normal physiological process contributing to intercellular signaling. New evidence suggests that intravascular hemolysis and the associated release of adenosine triphosphate (ATP may be an important mechanism for in vivo local purinergic signaling and blood flow regulation during exercise and hypoxia. However, the mechanisms that modulate hypoxia-induced RBC membrane fragility remain unclear. Here, we provide an overview of the role of RBC ATP release in the regulation of vascular tone and prevailing assumptions on the putative release mechanisms. We show importance of intravascular hemolysis as a source of ATP for local purinergic regulation of blood flow and discuss processes that regulate membrane propensity to rupture under stress and hypoxia.

  20. Offline fusion of co-registered intravascular ultrasound and frequency domain optical coherence tomography images for the analysis of human atherosclerotic plaques

    DEFF Research Database (Denmark)

    Räber, Lorenz; Heo, Jung Ho; Radu, Maria D

    2012-01-01

    To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images.......To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images....

  1. Comparison of utility of blood cultures from intravascular catheters and peripheral veins: a systematic review and decision analysis.

    Science.gov (United States)

    Falagas, Matthew E; Kazantzi, Maria S; Bliziotis, Ioannis A

    2008-01-01

    Blood cultures are sometimes obtained from intravascular catheters for convenience. However, there is controversy regarding this practice. The authors compared the diagnostic test characteristics of blood cultures obtained from intravascular catheters and peripheral veins. Relevant studies for inclusion in this review were identified through PubMed (January 1970-October 2005) and the Cochrane Central Register of Controlled Trials. Studies that reported clear definitions of true bacteraemia were included in the analysis. Two reviewers independently extracted the data. Six studies were included in the analysis, providing data for 2677 pairs of blood cultures obtained from an intravascular catheter and a peripheral venipuncture. A culture obtained from an intravascular catheter was found to be a diagnostic test for bacteraemia with better sensitivity (OR 1.85, 95 % CI 1.14-2.99, fixed effects model) and better negative predictive value (almost with statistical significance) (OR 1.55, 95 % CI 0.999-2.39, fixed effects model) but with less specificity (OR 0.33, 95 % CI 0.18-0.59, random effects model) and lower positive predictive value (OR 0.41, 95 % CI 0.23-0.76, random effects model) compared to a culture taken by peripheral venipuncture. In a group of 1000 patients, eight additional patients with true bacteraemia would be identified and 59 falsely diagnosed as having bacteraemia by a blood culture obtained from an intravascular catheter compared to results of the peripheral blood culture. Given the consequences of undertreating patients with bacteraemia, the authors believe that, based on the available evidence, at least one blood culture should be obtained from the intravascular catheter.

  2. The dosimetry of prostate brachytherapy-induced urethral strictures

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Tollenaar, Bryan G.; Galbreath, Robert W.; Lief, Jonathan H.

    2002-01-01

    Purpose: There is a paucity of data regarding the incidence of urethral strictures after prostate brachytherapy. In this study, we evaluate multiple clinical, treatment, and dosimetric parameters to identify factors associated with the development of brachytherapy-induced urethral strictures. Methods and Materials: 425 patients underwent transperineal ultrasound-guided prostate brachytherapy using either 103 Pd or 125 I for clinical T1b/T3a NxM0 (1997, American Joint Committee on Cancer) adenocarcinoma of the prostate gland from April 1995 to October 1999. No patient was lost to follow-up. 221 patients were implanted with 103 Pd and 204 patients with 125 I. The median patient age was 68 years (range 48-81 years). The median follow-up was 35.2 months (range 15-72 months). Follow-up was calculated from the day of implantation. Thirteen patients developed brachytherapy-induced strictures, and all strictures involved the membranous urethra. A control group of 35 patients was rigorously matched to the stricture patients in terms of treatment approach; i.e., choice of isotope, plus or minus radiation therapy, and plus or minus hormonal manipulation. Nine of the 13 stricture patients had detailed Day 0 urethral dosimetry available for review. The apex of the prostate gland and the membranous urethra were defined by CT evaluation. Urethral dosimetry was reported for the prostatic urethra, the apical slice of the prostate gland, and the membranous urethra which was defined as extending 20 mm in length. Results: The 5-year actuarial risk of a urethral stricture was 5.3%, with a median time to development of 26.6 months (range 7.8-44.1 months). Of multiple clinical and treatment parameters evaluated, only the duration of hormonal manipulation (>4 months, p=0.011) was predictive for the development of a urethral stricture. The radiation dose to the membranous urethra was significantly greater in patients with strictures than those without: 97.6%±20.8% vs. 81.0%±19.8% of

  3. High-dose-rate brachytherapy in uterine cervical carcinoma

    International Nuclear Information System (INIS)

    Patel, Firuza D.; Rai, Bhavana; Mallick, Indranil; Sharma, Suresh C.

    2005-01-01

    Purpose: High-dose-rate (HDR) brachytherapy is in wide use for curative treatment of cervical cancer. The American Brachytherapy Society has recommended that the individual fraction size be <7.5 Gy and the range of fractions should be four to eight; however, many fractionation schedules, varying from institution to institution, are in use. We use 9 Gy/fraction of HDR in two to five fractions in patients with carcinoma of the uterine cervix. We found that our results and toxicity were comparable to those reported in the literature and hereby present our experience with this fractionation schedule. Methods and Materials: A total of 121 patients with Stage I-III carcinoma of the uterine cervix were treated with HDR brachytherapy between 1996 and 2000. The total number of patients analyzed was 113. The median patient age was 53 years, and the histopathologic type was squamous cell carcinoma in 93% of patients. The patients were subdivided into Groups 1 and 2. In Group 1, 18 patients with Stage Ib-IIb disease, tumor size <4 cm, and preserved cervical anatomy underwent simultaneous external beam radiotherapy to the pelvis to a dose of 40 Gy in 20 fractions within 4 weeks with central shielding and HDR brachytherapy of 9 Gy/fraction, given weekly, and interdigitated with external beam radiotherapy. The 95 patients in Group 2, who had Stage IIb-IIIb disease underwent external beam radiotherapy to the pelvis to a dose of 46 Gy in 23 fractions within 4.5 weeks followed by two sessions of HDR intracavitary brachytherapy of 9 Gy each given 1 week apart. The follow-up range was 3-7 years (median, 36.4 months). Late toxicity was graded according to the Radiation Therapy Oncology Group criteria. Results: The 5-year actuarial local control and disease-free survival rate was 74.5% and 62.0%, respectively. The actuarial local control rate at 5 years was 100% for Stage I, 80% for Stage II, and 67.2% for Stage III patients. The 5-year actuarial disease-free survival rate was 88.8% for

  4. Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

    Energy Technology Data Exchange (ETDEWEB)

    Krengli, M.; Deantonio, L. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); University of ' ' Piemonte Orientale' ' , Department of Translational Medicine, Novara (Italy); Masini, L.; Filomeno, A.; Gambaro, G. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); Comoli, A.M. [University Hospital Maggiore della Carita, Ophthalmology, Novara (Italy); Negri, E. [University Hospital Maggiore della Carita, Medical Physics, Novara (Italy)

    2014-03-15

    Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium ({sup 192}Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.) [German] Das Karzinom des Augenlids stellt aufgrund der funktionellen und kosmetischen Beeintraechtigungen dieser anatomischen Region eine therapeutische Herausforderung dar. Ziele der Therapie sind sowohl die Tumorkontrolle als auch ein gutes funktionelles und kosmetisches Ergebnis. Lokale Kontrolle, Toxizitaet sowie funktionelle und kosmetische Ergebnisse bei Patienten mit Karzinom des Augenlids, die mit interstitieller Brachytherapie behandelt wurden, sollten analysiert werden. Sechzig Patienten mit Karzinom des Augenlids wurden mit interstitieller Brachytherapie mit Iridium-192-Draehten

  5. Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

    Directory of Open Access Journals (Sweden)

    Kasper ME

    2015-11-01

    Full Text Available Michael E Kasper,1,2 Ahmed A Chaudhary3 1Department of Radiation Oncology, Lynn Cancer Institute at Boca Raton Regional Hospital, Boca Raton, 2Charles E. Schmidt College of Medicine, Florida Atlantic University, FL, 3North Main Radiation Oncology, Warren Alpert School of Medicine, Brown University, RI, USA Abstract: Nonmelanoma skin cancer (NMSC is an increasing health care issue in the United States, significantly affecting quality of life and impacting health care costs. Radiotherapy has a long history in the treatment of NMSC. Shortly after the discovery of X-rays and 226Radium, physicians cured patients with NMSC using these new treatments. Both X-ray therapy and brachytherapy have evolved over the years, ultimately delivering higher cure rates and lower toxicity. Electronic brachytherapy for NMSC is based on the technical and clinical data obtained from radionuclide skin surface brachytherapy and the small skin surface applicators developed over the past 25 years. The purpose of this review is to introduce electronic brachytherapy in the context of the history, data, and utilization of traditional radiotherapy and brachytherapy. Keywords: electronic brachytherapy, superficial radiotherapy, skin surface brachytherapy, electron beam therapy, nonmelanoma skin cancer, basal cell carcinoma, squamous cell carcinoma

  6. Three-dimensional tomosynthetic image restoration for brachytherapy source localization

    International Nuclear Information System (INIS)

    Persons, Timothy M.

    2001-01-01

    Tomosynthetic image reconstruction allows for the production of a virtually infinite number of slices from a finite number of projection views of a subject. If the reconstructed image volume is viewed in toto, and the three-dimensional (3D) impulse response is accurately known, then it is possible to solve the inverse problem (deconvolution) using canonical image restoration methods (such as Wiener filtering or solution by conjugate gradient least squares iteration) by extension to three dimensions in either the spatial or the frequency domains. This dissertation presents modified direct and iterative restoration methods for solving the inverse tomosynthetic imaging problem in 3D. The significant blur artifact that is common to tomosynthetic reconstructions is deconvolved by solving for the entire 3D image at once. The 3D impulse response is computed analytically using a fiducial reference schema as realized in a robust, self-calibrating solution to generalized tomosynthesis. 3D modulation transfer function analysis is used to characterize the tomosynthetic resolution of the 3D reconstructions. The relevant clinical application of these methods is 3D imaging for brachytherapy source localization. Conventional localization schemes for brachytherapy implants using orthogonal or stereoscopic projection radiographs suffer from scaling distortions and poor visibility of implanted seeds, resulting in compromised source tracking (reported errors: 2-4 mm) and dosimetric inaccuracy. 3D image reconstruction (using a well-chosen projection sampling scheme) and restoration of a prostate brachytherapy phantom is used for testing. The approaches presented in this work localize source centroids with submillimeter error in two Cartesian dimensions and just over one millimeter error in the third

  7. Novel prostate brachytherapy technique: Improved dosimetric and clinical outcome

    International Nuclear Information System (INIS)

    Nobes, Jenny P.; Khaksar, Sara J.; Hawkins, Maria A.; Cunningham, Melanie J.; Langley, Stephen E.M.; Laing, Robert W.

    2008-01-01

    Purpose: Erectile dysfunction following prostate brachytherapy is reported to be related to dose received by the penile bulb. To minimise this, whilst preserving prostate dosimetry, we have developed a technique for I-125 seed brachytherapy using both stranded seeds and loose seeds delivered with a Mick applicator, and implanted via the sagittal plane on trans-rectal ultrasound. Materials and methods: Post-implant dosimetry and potency rates were compared in 120 potent patients. In Group 1, 60 patients were treated using a conventional technique of seeds implanted in a modified-uniform distribution. From January 2005, a novel technique was developed using stranded seeds peripherally and centrally distributed loose seeds implanted via a Mick applicator (Group 2). The latter technique allows greater flexibility when implanting the seeds at the apex. Each patient was prescribed a minimum peripheral dose of 145 Gy. No patients received external beam radiotherapy or hormone treatment. There was no significant difference in age or pre-implant potency score (mean IIEF-5 score 22.4 vs. 22.6, p = 0.074) between the two groups. Results: The new technique delivers lower penile bulb doses (D 25 as %mPD - Group 1: 61.2 ± 35.7, Group 2: 29.7 ± 16.0, p 50 as %mPD - Group 1: 45.8 ± 26.9, Group 2: 21.4 ± 11.7, p 90 - Group 1: 147 Gy ± 21.1, Group 2: 155 Gy ± 16.7, p = 0.03). At 2 years, the potency rate was also improved: Group 1: 61.7%; Group 2: 83.3% (p = 0.008). Conclusions: In this study, the novel brachytherapy technique using both peripheral stranded seeds and central loose seeds delivered via a Mick applicator results in a lower penile bulb dose whilst improving prostate dosimetry, and may achieve higher potency rates

  8. 'Homogeneity in brachytherapy' - Dummy run experience in Belgium

    International Nuclear Information System (INIS)

    Methords

    1996-01-01

    Purpose: The homogeneity of brachytherapy treatments in Belgium was appreciated through a dummy run with two fictive patients. Materiel and Methods: All members of the Belgian Brachytherapy Board received last year a questionnaire about treatment technique, technical approach, dosimetry and treatment planning, for 2 selected clinical histories. Case 1: T1 G1 NO MO - SCC of the lateral border of the mobile tongue (dimensions: 12x10x5mm). Case 2: T1 G1 NO MO - SCC of the lateral side of the nose (10x12x3mm). Results: 10 members out of 14 from the Belgian Brachytherapy Board returned their questionnaire. Little variation has been observed regarding treatment technique, technical approach (H and N: hairpins or loops, skin: plastic tubes), dose (60-65 Gy), activity of Ir-192 (1-2 mCi/cm), definition of Gross Tumor Volume and dosimetry (Paris System). On the contrary, a large difference was observed in the definition of the Clinical Target Volume and the Treated Volume. Despite of this large difference, the ratio treated volume on clinical target volume was always satisfactory (1,2 for skin cancer - 2 for H and N cancer), indicating that the treatment was well adapted to the Clinical Target Volume in all but 1 instance. Variations of a factor 2 in the dose rate of irradiation were tolerated (40-80 cGy/h). Conclusion: Rigid guidelines are mostly followed by the responders concerning dose, dose prescription and implantation techniques. Large variations are encountered concerning safety margins (Clinical Target definition) and dose rate

  9. Endovascular brachytherapy prevents restenosis after femoropopliteal angioplasty: results of the Vienna-3 randomised multicenter study

    International Nuclear Information System (INIS)

    Pokrajac, Boris; Poetter, Richard; Wolfram, Roswitha M.; Budinsky, Alexandra C.; Kirisits, Christian; Lileg, Brigitte; Mendel, Helmuth; Sabeti, Schila; Schmid, Rainer; Minar, Erich

    2005-01-01

    Background and purpose: The aim of the trial was to investigate the effect of Iridium-192 gamma endovascular brachytherapy on reduction of restenosis after femoropopliteal angioplasty. Patients and methods: Between Oct, 1998 and Jul, 2001 a total of 134 patients have been randomized after successful angioplasty to brachytherapy or sham irradiation in a prospective, randomized, multicenter, double blind controlled trial. Patients with de novo lesion of at least 5 cm or recurrent lesion of any length after prior angioplasty have been enrolled. Brachytherapy was performed with 7 F centering catheter. Mean lesion length was 9.1 cm (1.5-25 cm) and mean intervention length 13.6 cm (4-27.5 cm) in brachytherapy cohort. Results: In placebo cohort mean lesion length was 10.3 cm (2-25 cm) and mean intervention length 14.1 cm (2-29 cm). A dose of 18 Gy was prescribed 2 mm from the surface of centering balloons. Analyzed (based on angiography) on intention to treat basis the binary restenosis rate at 12 months was 41.7% (28/67) in brachytherapy cohort and 67.1% (45/67) in placebo cohort (χ 2 test, P 30% residual stenosis after angioplasty) have been 23.4% in the brachytherapy and 53.3% in the placebo group (P<0.05), respectively. The cumulative patency rates after 24 months on intention to treat analysis were 54% in the brachytherapy and 27% in the placebo group (P<0.005). Corresponding data for as treated analysis were 77% in the brachytherapy and 39% in the placebo group (P<0.001). Late thrombosis was not seen. Conclusions: Significant reduction of restenosis rate was obtained with endovascular gamma brachytherapy after femoropopliteal angioplasty

  10. PCRELAP5: data calculation program for RELAP 5 code; PCRELAP5: programa de calculo dos dados de entrada para o codigo RELAP5

    Energy Technology Data Exchange (ETDEWEB)

    Silvestre, Larissa Jacome Barros

    2016-07-01

    Nuclear accidents in the world led to the establishment of rigorous criteria and requirements for nuclear power plant operations by the international regulatory bodies. By using specific computer programs, simulations of various accidents and transients likely to occur at any nuclear power plant are required for certifying and licensing a nuclear power plant. Based on this scenario, some sophisticated computational tools have been used such as the Reactor Excursion and Leak Analysis Program (RELAP5), which is the most widely used code for the thermo-hydraulic analysis of accidents and transients in nuclear reactors in Brazil and worldwide. A major difficulty in the simulation by using RELAP5 code is the amount of information required for the simulation of thermal-hydraulic accidents or transients. The preparation of the input data requires a great number of mathematical operations to calculate the geometry of the components. Thus, for those calculations performance and preparation of RELAP5 input data, a friendly mathematical preprocessor was designed. The Visual Basic for Application (VBA) for Microsoft Excel demonstrated to be an effective tool to perform a number of tasks in the development of the program. In order to meet the needs of RELAP5 users, the RELAP5 Calculation Program (Programa de Calculo do RELAP5 - PCRELAP5) was designed. The components of the code were codified; all entry cards including the optional cards of each one have been programmed. In addition, an English version for PCRELAP5 was provided. Furthermore, a friendly design was developed in order to minimize the time of preparation of input data and errors committed by users. In this work, the final version of this preprocessor was successfully applied for Safety Injection System (SIS) of Angra 2. (author)

  11. Computer program for the calculation of stresses in rotary equipment discs; Programas de computo para el calculo de esfuerzos en discos de equipo rotatorio

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez Delgado, Wilson; Kubiak, Janusz; Serrano Romero, Luis Enrique [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1990-12-31

    In the preliminary design and diagnosis of rotary machines is very common to utilize simple calculation methods for the mechanical and thermal stresses, dynamic and thermodynamic analysis and flow of fluids in this machines (Gutierrez et al., 1989). The analysis with these methods provides the necessary results for the project initial stage of the machine. Later on, more complex tools are employed to refine the design of some machine components. In the Gutierrez report et al., (1989) 34 programs were developed for the preliminary design and diagnosis of rotating equipment; in this article, one of them is presented in which a method for the analysis of mechanical and thermal stresses is applied in discs of uniform or variable thickness that are normally found in turbomachines and rotary equipment. [Espanol] En el diseno preliminar y diagnostico de maquinas rotatorias es muy comun emplear metodos de calculo sencillos para el analisis de esfuerzos mecanicos y termicos, analisis dinamico y termodinamico y de flujo de fluidos en estas maquinas (Gutierrez et al., 1989). El analisis con estos metodos proporcionan los resultados necesarios para la etapa del proyecto inicial de la maquina. Posteriormente, para refinar el diseno de algunos componentes de la maquina, se aplican las herramientas mas complejas. En el informe de Gutierrez et al., (1989) se desarrollan 34 programas para el diseno preliminar y diagnostico de equipo rotatorio; en este articulo, se presenta uno de ellos, en el que se emplea un metodo para el analisis de esfuerzos mecanicos y termicos en discos de espesor constante o variable que se encuentran comunmente en turbomaquinas y en equipos rotatorios.

  12. Three-dimensional dosimetry in brachytherapy: A MAGAT study

    International Nuclear Information System (INIS)

    Lin, M.-H.; Huang, T.-C.; Kao, M.-J.; Wu, Jay; Chen, C.-L.; Wu, T.-H.

    2009-01-01

    This study is to evaluate the influence of using different matrix size of smoothing filter for image post-processing and various slice thickness during MR imaging on dose estimation in Ir-192 HDR brachytherapy via normoxic polymer gel dosimeter. Our results show its sensitive nature in gel dosimeter while changing these parameters, among which the combination of 2 mm slice thickness of MR images and [5x5] smoothing filter are considered the optimal parameters to provide accurate dose estimations and isodose curves.

  13. HIGH-DOSE RATE BRACHYTHERAPY IN CARCINOMA CERVIX STAGE IIIB

    Directory of Open Access Journals (Sweden)

    Sathya Maruthavanan

    2016-07-01

    Full Text Available INTRODUCTION Radiotherapy is the standard treatment in locally advanced (IIB-IVA and early inoperable cases. The current standard of practice with curable intent is concurrent chemoradiation in which intracavitary brachytherapy is an integral component of radiotherapy. This study aims at assessing the efficacy of HDR ICBT (High-dose rate intracavitary brachytherapy in terms local response, normal tissue reactions, and feasibility. METHODS AND MATERIALS A total of 20 patients of stage IIIB cancer of the uterine cervix were enrolled in the study and were planned to receive concurrent chemotherapy weekly along with EBRT (external beam radiotherapy to a dose of 50 Gy/25 Fr. Suitability for ICBT was assessed at 40 Gy/20 Fr. 6/20 patients were suitable at 40 Gy and received HDR ICBT with a dose of 5.5 Gy to point A in 4 sessions (5.5 Gy/4 Fr. The remaining 14/20 patients completed 50 Gy and received HDR ICBT with a dose of 6 Gy to point A in 3 sessions (6 Gy/3 Fr. RESULTS A total of 66 intracavitary applications were done and only one application required dose modification due to high bladder dose, the pelvic control rate was 85% (17/20. 10% (2/20 had stable disease and 5% (1/20 had progressive disease at one year of follow up. When toxicity was considered only 15% developed grade I and grade II rectal complications. Patient compliance and acceptability was 100%. Patients were very comfortable with the short treatment time as compared with patients on LDR ICBT (low-dose rate intracavitary brachytherapy treatment interviewed during the same period. CONCLUSION This study proves that HDR brachytherapy is efficacious and feasible in carcinoma of cervix stage IIIB. It also proves that good dose distribution can be achieved with HDR intracavitary facility by the use of dose optimization. The short treatment time in HDR ICBT makes it possible to maintain this optimised dose distribution throughout the treatment providing a gain in the therapeutic ratio and

  14. Matlab Tools: An Alternative to Planning Systems in Brachytherapy Treatments

    International Nuclear Information System (INIS)

    Herrera, Higmar; Rodriguez, Mercedes; Rodriguez, Miguel

    2006-01-01

    This work proposes the use of the Matlab environment to obtain the treatment dose based on the reported data by Krishnaswamy and Liu et al. The comparison with reported measurements is showed for the Amersham source model. For the 3M source model, measurements with TLDs and a Monte Carlo simulation are compared to the data obtained by Matlab. The difference for the Amersham model is well under the 15% recommended by the IAEA and for the 3M model, although the difference is greater, the results are consistent. The good agreement to the reported data allows the Matlab calculations to be used in daily brachytherapy treatments

  15. Automatic analysis of intrinsic positional verification films brachytherapy using MATLAB

    International Nuclear Information System (INIS)

    Quiros Higueras, J. D.; Marco Blancas, N. de; Ruiz Rodriguez, J. C.

    2011-01-01

    One of the essential tests in quality control of brachytherapy equipment is verification auto load intrinsic positional radioactive source. A classic method for evaluation is the use of x-ray film and measuring the distance between the marks left by autoradiography of the source with respect to a reference. In our center has developed an automated method of measurement by the radiochromic film scanning and implementation of a macro developed in Matlab, in order to optimize time and reduce uncertainty in the measurement. The purpose of this paper is to describe the method developed, assess their uncertainty and quantify their advantages over the manual method. (Author)

  16. Salvage robot-assisted radical prostatectomy after brachytherapy: our experience

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2014-01-01

    Full Text Available In case of recurrence of prostate cancer after radiation therapy patient may be offered salvage radical prostatectomy (both open and laparoscopic/robotic, hormone therapy, and a number of alternative techniques such as salvage cryoablation, HIFU-therapy and brachytherapy. Results of monitoring of patients for 10 years after salvage treatment of prostate cancer are known only after salvage prostatectomy. Technically radical prostatectomy after radiation therapy is associated with a large number of complications if compared with primary radical prostatectomy. The most frequent complications after salvage prostatectomy include incontinence, stricture formation of urethrovesical anastomosis, rectal injury, acute urinary retention and infectious complications.

  17. The CXCR1/2 ligand NAP-2 promotes directed intravascular leukocyte migration through platelet thrombi

    Science.gov (United States)

    Ghasemzadeh, Mehran; Kaplan, Zane S.; Alwis, Imala; Schoenwaelder, Simone M.; Ashworth, Katrina J.; Westein, Erik; Hosseini, Ehteramolsadat; Salem, Hatem H.; Slattery, Robyn; McColl, Shaun R.; Hickey, Michael J.; Ruggeri, Zaverio M.; Yuan, Yuping

    2013-01-01

    Thrombosis promotes leukocyte infiltration into inflamed tissues, leading to organ injury in a broad range of diseases; however, the mechanisms by which thrombi guide leukocytes to sites of vascular injury remain ill-defined. Using mouse models of endothelial injury (traumatic or ischemia reperfusion), we demonstrate a distinct process of leukocyte recruitment, termed “directed intravascular migration,” specifically mediated by platelet thrombi. Single adherent platelets and platelet aggregates stimulated leukocyte shape change at sites of endothelial injury; however, only thrombi were capable of inducing directed intravascular leukocyte migration. Leukocyte recruitment and migration induced by platelet thrombi occurred most prominently in veins but could also occur in arteries following ischemia-reperfusion injury. In vitro studies demonstrated a major role for platelet-derived NAP-2 (CXCL-7) and its CXCR1/2 receptor in regulating leukocyte polarization and motility. In vivo studies demonstrated the presence of an NAP-2 chemotactic gradient within the thrombus body. Pharmacologic blockade of CXCR1/2 as well as genetic deletion of NAP-2 markedly reduced leukocyte shape change and intrathrombus migration. These studies define a distinct process of leukocyte migration that is initiated by homotypic adhesive interactions between platelets, leading to the development of an NAP-2 chemotactic gradient within the thrombus body that guides leukocytes to sites of vascular injury. PMID:23550035

  18. Incompatibility of water soluble contrast media and intravascular pharmacologic agents: experimental study

    International Nuclear Information System (INIS)

    Lee, Ho Kyu; Kim, Seung Hyup; Kim, Sung Jin; Lee, Young Suk; Kim, Chu Wan; Han, Man Chung

    1991-01-01

    With the development of low osmolar and nonionic contrast media in clinical practice, radiologists have enjoyed increased clinical application along with other advantages such as improvement of patient comfort and safety. Recently, radiologists have introduced many intravascular pharmacologic agents to improve diagnostic quality and patient safety. Shortly after the introduction of these agents, however, it was observed that a precipitate results when a certain pharmacologic agent is mixed with a low osmolar contrast media. These observations have prompted testing of several other drugs used for incompatibility with contrast media. To verify these reports and to investigate other medications not previously tested, the authors analyzed mixtures of contrast agents and medications in vitro and observed them for visible precipitates after operating the high-speed centrifuge. The results were as fallows: The contrast media that produced incompatibilities with some pharmacologic agents were ioxaglate, diatrizote, and iothalamate in the order of frequency. The contrast media that produced no precipitate were iopromide and ioxithalamate. The pharmacologic agents that produced precipitate with some contrast media were Papaverine, Benadryl, Protamine, Cimetidine, Regitin, and Gentamicin. Therefore, we recommend that caution should be taken to recognize incompatibilities and avoid them when intravascular pharmacologic agents of any kind may be incompatible

  19. Multiorgan dysfunction in a gravid woman with placental abruption and disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Kezić Aleksandra

    2007-01-01

    Full Text Available The most frequent obstetrical cause of coagulation disorders as disseminated intravascular coagulation is placental abruption, which can be found in women without any apparent clinical disturbances or in the state of established preeclampsia. Hypertension occurs in 5-8% of all pregnancies and may be complicated by preeclampsia. Preeclampsia is a complex clinical syndrome with insufficiently clear pathophysiology based on the damage of the vascular endothelium. As a result of this, generalized endothelial disruption in preeclampsia, a multiorgan dysfunction, can develop, most frequently reflected in the clinical presentation with hematological and renal disturbances and with a disordered function of the liver and central nervous system. We are presenting a case of a gravid woman with poorly regulated hypertension that resulted from development of preeclampsia, later complicated by placental abruption and disseminated intravascular coagulation (DIC with multi-organ dysfunction. The importance of rapid recognition of coagulation disorder and the attempt at surgical treatment aiming at removal of the triggering mechanisms of DIC was shown, suggesting all the symptomatic therapeutic measures would be ineffective. Although our patient was surgically treated in the phase of generalized disorder characterized by development of coma, acute respiratory distress syndrome and renal insufficiency when mortality was 70%, the recovery of functions of all involved organs was achieved, except for the renal function that required chronic haemodialysis treatment.

  20. Pressure-Flow Experimental Performance of New Intravascular Blood Pump Designs for Fontan Patients.

    Science.gov (United States)

    Chopski, Steven G; Fox, Carson S; Riddle, Michelle L; McKenna, Kelli L; Patel, Jay P; Rozolis, John T; Throckmorton, Amy L

    2016-03-01

    An intravascular axial flow pump is being developed as a mechanical cavopulmonary assist device for adolescent and adult patients with dysfunctional Fontan physiology. Coupling computational modeling with experimental evaluation of prototypic designs, this study examined the hydraulic performance of 11 impeller prototypes with blade stagger or twist angles varying from 100 to 600 degrees. A refined range of twisted blade angles between 300 and 400 degrees with 20-degree increments was then selected, and four additional geometries were constructed and hydraulically evaluated. The prototypes met performance expectations and produced 3-31 mm Hg for flow rates of 1-5 L/min for 6000-8000 rpm. A regression analysis was completed with all characteristic coefficients contributing significantly (P designs. The findings of the numerical model for 300-degree twisted case and the experimental results deviated within approximately 20%. In an effort to simplify the impeller geometry, this work advanced the design of this intravascular cavopulmonary assist device closer to preclinical animal testing. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  1. Plasma volume, intravascular albumin and its transcapillary escape rate in patients with extensive skin disease

    DEFF Research Database (Denmark)

    Parving, H H; Worm, A M; Rossing, N

    1976-01-01

    Plasma volume and plasma concentration and transcapillary escape rate of albumin (TER alb), i.e. the fraction of intravascular mass of albumin that passes to the extravascular space per unit time, were determined using 125I-labelled human albumin in eight patients with extensive skin disease....... Plasma volume and plasma albumin concentration were reduced (P less than 0-05). Thus the intravascular albumin mass was moderately decreased to an average of 0-55 +/- 0-06 (s.d.) g/cm height compared with a normal mean value of 0-77 +/- 0-07 (s.d.) g/cm. This 29% decrease is statistically significant (P...... less than 0-001). The transcapillary escape rate of albumin (TER alb) was significantly elevated, mean 8-6 +/- 1-1 (s.d.) % X h-1, as compared to normal subjects, mean 5-6 +/- 1-1 (s.d.) % X h-1, (+54%, P less than 0-001). The same patients were studied again after a 1-week treatment with prednisone...

  2. Elimination of Bloodstream Infections Associated with Candida albicans Biofilm in Intravascular Catheters

    Directory of Open Access Journals (Sweden)

    Freshta Akbari

    2015-06-01

    Full Text Available Intravascular catheters are among the most commonly inserted medical devices and they are known to cause a large number of catheter related bloodstream infections (BSIs. Biofilms are associated with many chronic infections due to the aggregation of microorganisms. One of these organisms is the fungus Candida albicans. It has shown to be one of the leading causes of catheter-related BSIs. The presence of biofilm on intravascular catheters provide increased tolerance against antimicrobial treatments, thus alternative treatment strategies are sought. Traditionally, many strategies, such as application of combined antimicrobials, addition of antifungals, and removal of catheters, have been practiced, but they were not successful in eradicating BSIs. Since these fungal infections can result in significant morbidity, mortality, and increased healthcare cost, other promising preventive strategies, including antimicrobial lock therapy, chelating agents, alcohol, and biofilm disruptors, have been applied. In this review, current success and failure of these new approaches, and a comparison with the previous strategies are discussed in order to understand which preventative treatment is the most effective in controlling the catheter-related BSIs.

  3. Pulmonary intravascular lymphoma detected by FDG PET-CT: a case report.

    Science.gov (United States)

    Kohan, A A; Paganini, L; Biedak, P; Arma, J I; Dalurzo, M C L; Garcia-Monaco, R D

    2013-01-01

    Intravascular lymphoma is a rare subtype of extranodal Non-Hodgkin's lymphoma. Its prognosis is poor in a high percentage of cases due to its insidious appearance and low clinical suspicion. Its diagnosis is usually only reached after an autopsy. It may affect different organs as a whole or only one organ. It is extremely rare that the lung is the only damaged organ. Its diagnosis depends of the clinician's suspicion and proper evaluation with imaging studies as well as correct selection of the organ to be biopsied. When detected on time, the treatment of choice is a combination of a series of chemotherapy associated to a monoclonal antibody (anti-CD20). We present the case of a male patient who underwent a positron emission tomography-computed tomography with 2-[F-18]-fluoro-2 deoxy-D-glucose (FDG) due to symptoms suggestive of a lymphoproliferative disease with no clear structural abnormalities. The images led to a diagnosis of pulmonary intravascular large B cell lymphoma. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

  4. Automatic classification of atherosclerotic plaques imaged with intravascular OCT (Conference Presentation)

    Science.gov (United States)

    Rico-Jimenez, Jose D.; Campos-Delgado, Daniel U.; Villiger, Martin; Bouma, Brett; Jo, Javier A.

    2016-03-01

    A novel computational method for plaque tissue characterization based on Intravascular Optical Coherence Tomography (IV-OCT) is presented. IV-OCT is becoming a powerful tool for the clinical evaluation of atherosclerotic plaques; however, it requires a trained expert for visual assessment and interpretation of the imaged plaques. Moreover, due to the inherit effect of speckle and the scattering attenuation of the optical scheme the direct interpretation of OCT images is limited. To overcome these difficulties, we propose to automatically identify the A-line profiles of the most significant plaque types (normal, fibrotic, or lipid-rich) and their respective abundance by using a probabilistic framework and blind alternated least squares to achieve the optimal decomposition. In this context, we present preliminary results of this novel probabilistic classification tool for intravascular OCT that relies on two steps. First, the B-scan is pre-processed to remove catheter artifacts, segment the lumen, select the region of interest (ROI), flatten the tissue surface, and reduce the speckle effect by a spatial entropy filter. Next, the resulting image is decomposed and its A-lines are classified by an automated strategy based on alternating-least-squares optimization. Our early results are encouraging and suggest that the proposed methodology can identify normal tissue, fibrotic and lipid-rich plaques from IV-OCT images.

  5. Use of Monte Carlo Methods in brachytherapy; Uso del metodo de Monte Carlo en braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    Granero Cabanero, D.

    2015-07-01

    The Monte Carlo method has become a fundamental tool for brachytherapy dosimetry mainly because no difficulties associated with experimental dosimetry. In brachytherapy the main handicap of experimental dosimetry is the high dose gradient near the present sources making small uncertainties in the positioning of the detectors lead to large uncertainties in the dose. This presentation will review mainly the procedure for calculating dose distributions around a fountain using the Monte Carlo method showing the difficulties inherent in these calculations. In addition we will briefly review other applications of the method of Monte Carlo in brachytherapy dosimetry, as its use in advanced calculation algorithms, calculating barriers or obtaining dose applicators around. (Author)

  6. Verification of the calculation program for brachytherapy planning system of high dose rate (PLATO)

    International Nuclear Information System (INIS)

    Almansa, J.; Alaman, C.; Perez-Alija, J.; Herrero, C.; Real, R. del; Ososrio, J. L.

    2011-01-01

    In our treatments are performed brachytherapy high dose rate since 2007. The procedures performed include gynecological intracavitary treatment and interstitial. The treatments are performed with a source of Ir-192 activity between 5 and 10 Ci such that small variations in treatment times can cause damage to the patient. In addition the Royal Decree 1566/1998 on Quality Criteria in radiotherapy establishes the need to verify the monitor units or treatment time in radiotherapy and brachytherapy. All this justifies the existence of a redundant system for brachytherapy dose calculation that can reveal any abnormality is present.

  7. Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids

    DEFF Research Database (Denmark)

    Jiang, Ping; Baumann, René; Dunst, Jürgen

    2016-01-01

    was 94%. Pigmentary abnormalities were detected in 3 patients, and an additional 6 patients had a mild delay in the wound-healing process. CONCLUSIONS: The early results of this study prove the feasibility and the efficacy of brachytherapy for the prevention of keloids. The results also suggest....... After (re-)excision of the keloids, a single brachytherapy tube was placed subcutaneously before closing the wound. The target volume covered the scar in total length. Brachytherapy was given in 3 fractions with a single dose of 6 Gy in 5 mm tissue depth. The first fraction was given within 6 hours...

  8. [Ldr brachytherapy, a minimally invasive alternative in the treatment of organ-confined prostate cancer].

    Science.gov (United States)

    Siegsmund, M; Musial, A; Weiss, J; Alken, P

    2001-09-01

    LDR Brachytherapy, a Minimally Invasive Alternative in the Treatment of Organ-Confined Prostate Cancer In den letzten Jahren erlebte die Brachytherapie mit permanenten Implantaten beim organbegrenzten Prostatakarzinom besonders in den USA, wo im Jahre 1999 mehr als 40 000 Implantationen durchgeführt wurden, eine Renaissance. Mit einer gewissen Verzögerung nimmt die Popularität dieser Methode auch in Europa immer mehr zu. Dies, obwohl die Brachytherapie keine absolut neue Methode in der Behandlung des Prostatakarzinoms ist, sie hat im Gegenteil eine lange Tradition. Copyright 2001 S. Karger GmbH, Freiburg

  9. American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review.

    Science.gov (United States)

    Harkenrider, Matthew M; Block, Alec M; Alektiar, Kaled M; Gaffney, David K; Jones, Ellen; Klopp, Ann; Viswanathan, Akila N; Small, William

    This article aims to review the risk stratification of endometrial cancer, treatment rationale, outcomes, treatment planning, and treatment recommendations of vaginal brachytherapy (VBT) in the postoperative management of endometrial cancer patients. The authors performed a thorough review of the literature and reference pertinent articles pertaining to the aims of this review. Adjuvant VBT for early-stage endometrial cancer patients results in very low rates of vaginal recurrence (0-3.1%) with low rates of late toxicity which are primarily vaginal in nature. Post-Operative Radiation Therapy in Endometrial Cancer 2 (PORTEC-2) supports that VBT results in noninferior rates of vaginal recurrence compared to external beam radiotherapy for the treatment of high-intermediate risk patients. VBT as a boost after external beam radiotherapy, in combination with chemotherapy, and for high-risk histologies have shown excellent results as well though randomized data do not exist supporting VBT boost. There are many different applicators, dose-fractionation schedules, and treatment planning techniques which all result in favorable clinical outcomes and low rates of toxicity. Recommendations have been published by the American Brachytherapy Society and the American Society of Radiation Oncology to help guide practitioners in the use of VBT. Data support that patients and physicians prefer joint decision making regarding the use of VBT, and patients often desire additional treatment for a marginal benefit in risk of recurrence. Discussions regarding adjuvant therapy for endometrial cancer are best performed in a multidisciplinary setting, and patients should be counseled properly regarding the risks and benefits of adjuvant therapy. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  10. Intravascular ultrasound assessment of minimumlumen area and intimal hyperplasia in in-stent restenosis after drug-eluting or bare-metal stent implantation. The Nordic Intravascular Ultrasound Study (NIVUS)

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Vikman, Saila; Antonsen, Lisbeth

    2017-01-01

    Introduction: Drug-eluting stents (DES) reduce the risk of restenosis after percutaneous coronary intervention. The aim of the study was to evaluate, by intravascular ultrasound (IVUS), the minimum lumen area site in the stented segment and the distribution of intimal hyperplasia in patients...

  11. Monte Carlo Simulations Validation Study: Vascular Brachytherapy Beta Sources

    International Nuclear Information System (INIS)

    Orion, I.; Koren, K.

    2004-01-01

    During the last decade many versions of angioplasty irradiation treatments have been proposed. The purpose of this unique brachytherapy is to administer a sufficient radiation dose into the vein walls in order to prevent restonosis, a clinical sequel to balloon angioplasty. The most suitable sources for this vascular brachytherapy are the β - emitters such as Re-188, P-32, and Sr-90/Y-90, with a maximum energy range of up to 2.1 MeV [1,2,3]. The radioactive catheters configurations offered for these treatments can be a simple wire [4], a fluid filled balloon or a coated stent. Each source is differently positioned inside the blood vessel, and the emitted electrons ranges therefore vary. Many types of sources and configurations were studied either experimentally or with the use of the Monte Carlo calculation technique, while most of the Monte Carlo simulations were carried out using EGS4 [5] or MCNP [6]. In this study we compared the beta-source absorbed-dose versus radial-distance of two treatment configurations using MCNP and EGS4 simulations. This comparison was aimed to discover the differences between the MCNP and the EGS4 simulation code systems in intermediate energies electron transport

  12. A Brachytherapy Plan Evaluation Tool for Interstitial Applications

    Directory of Open Access Journals (Sweden)

    Surega Anbumani

    2014-01-01

    Full Text Available Radiobiological metrics such as tumor control probability (TCP and normal tissue complication probability (NTCP help in assessing the quality of brachytherapy plans. Application of such metrics in clinics as well as research is still inadequate. This study presents the implementation of two indigenously designed plan evaluation modules: Brachy_TCP and Brachy_NTCP. Evaluation tools were constructed to compute TCP and NTCP from dose volume histograms (DVHs of any interstitial brachytherapy treatment plan. The computation module was employed to estimate probabilities of tumor control and normal tissue complications in ten cervical cancer patients based on biologically effective equivalent uniform dose (BEEUD. The tumor control and normal tissue morbidity were assessed with clinical followup and were scored. The acute toxicity was graded using common terminology criteria for adverse events (CTCAE version 4.0. Outcome score was found to be correlated with the TCP/NTCP estimates. Thus, the predictive ability of the estimates was quantified with the clinical outcomes. Biologically effective equivalent uniform dose-based formalism was found to be effective in predicting the complexities and disease control.

  13. Inverse treatment planning based on MRI for HDR prostate brachytherapy

    International Nuclear Information System (INIS)

    Citrin, Deborah; Ning, Holly; Guion, Peter; Li Guang; Susil, Robert C.; Miller, Robert W.; Lessard, Etienne; Pouliot, Jean; Xie Huchen; Capala, Jacek; Coleman, C. Norman; Camphausen, Kevin; Menard, Cynthia

    2005-01-01

    Purpose: To develop and optimize a technique for inverse treatment planning based solely on magnetic resonance imaging (MRI) during high-dose-rate brachytherapy for prostate cancer. Methods and materials: Phantom studies were performed to verify the spatial integrity of treatment planning based on MRI. Data were evaluated from 10 patients with clinically localized prostate cancer who had undergone two high-dose-rate prostate brachytherapy boosts under MRI guidance before and after pelvic radiotherapy. Treatment planning MRI scans were systematically evaluated to derive a class solution for inverse planning constraints that would reproducibly result in acceptable target and normal tissue dosimetry. Results: We verified the spatial integrity of MRI for treatment planning. MRI anatomic evaluation revealed no significant displacement of the prostate in the left lateral decubitus position, a mean distance of 14.47 mm from the prostatic apex to the penile bulb, and clear demarcation of the neurovascular bundles on postcontrast imaging. Derivation of a class solution for inverse planning constraints resulted in a mean target volume receiving 100% of the prescribed dose of 95.69%, while maintaining a rectal volume receiving 75% of the prescribed dose of <5% (mean 1.36%) and urethral volume receiving 125% of the prescribed dose of <2% (mean 0.54%). Conclusion: Systematic evaluation of image spatial integrity, delineation uncertainty, and inverse planning constraints in our procedure reduced uncertainty in planning and treatment

  14. Iodine-125 orbital brachytherapy with a prosthetic implant in situ

    Energy Technology Data Exchange (ETDEWEB)

    Stannard, Clare [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Radiation Oncology; Maree, Gert; Munro, Roger [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Medical Physics; Lecuona, Karin [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Ophthalmology; Sauerwein, Wolfgang [Universitaetsklinikum Essen (Germany). Strahlenklinik, NCTeam

    2011-05-15

    Purpose: Brachytherapy is one method of irradiating the orbit after enucleation of an eye with a malignant tumor that has a potential to recur. It consists of 6 trains of I-125 seeds placed around the periphery of the orbit, a shorter central train, and a metal disc, loaded with seeds, placed beneath the eyelids. The presence of a prosthetic orbital implant requires omission of the central train and adjustment of the activity of the seeds in the anterior orbit around the prosthesis. Patients and Methods: This is a retrospective review of the technical modifications and outcome of 12 patients treated in this manner: 6 with retinoblastoma, 5 with malignant melanoma, and 1 with an intraocular rhabdomyosarcoma. The median dose was 35.5 Gy in 73 hours for retinoblastoma and 56 Gy in 141 hours for malignant melanoma. Patients with retinoblastoma and rhabdomyosarcoma also received chemotherapy. Results: The tubes can be placed satisfactorily around the prosthesis. The increased activity in the anterior half of the tubes produced comparable dose distributions. There have been no orbital recurrences, no extrusion of the prosthesis, and cosmesis is good. Conclusion: Insertion of a prosthetic implant at the time of enucleation greatly enhances the subsequent cosmetic appearance. This should be encouraged unless there is frank tumor in the orbit. Orbital brachytherapy without the central train continues to give excellent local control. The short treatment time and good cosmesis are added advantages. The patient is spared the expense and inconvenience of removing and replacing the prosthetic implant. (orig.)

  15. Prostate HDR brachytherapy catheter displacement between planning and treatment delivery

    International Nuclear Information System (INIS)

    Whitaker, May; Hruby, George; Lovett, Aimee; Patanjali, Nitya

    2011-01-01

    Background and purpose: HDR brachytherapy is used as a conformal boost for treating prostate cancer. Given the large doses delivered, it is critical that the volume treated matches that planned. Our outpatient protocol comprises two 9 Gy fractions, two weeks apart. We prospectively assessed catheter displacement between CT planning and treatment delivery. Materials and methods: Three fiducial markers and the catheters were implanted under transrectal ultrasound guidance. Metal marker wires were inserted into 4 reference catheters before CT; marker positions relative to each other and to the marker wires were measured from the CT scout. Measurements were repeated immediately prior to treatment delivery using pelvic X-ray with marker wires in the same reference catheters. Measurements from CT scout and film were compared. For displacements of 5 mm or more, indexer positions were adjusted prior to treatment delivery. Results: Results are based on 48 implants, in 25 patients. Median time from planning CT to treatment delivery was 254 min (range 81–367 min). Median catheter displacement was 7.5 mm (range −2.9–23.9 mm), 67% of implants had displacement of 5 mm or greater. Displacements were predominantly caudal. Conclusions: Catheter displacement can occur in the 1–3 h between the planning CT scan and treatment. It is recommended that departments performing HDR prostate brachytherapy verify catheter positions immediately prior to treatment delivery.

  16. Remote afterloading for intracavitary and interstitial brachytherapy with californium-252

    Science.gov (United States)

    Tačev, Tačo; Grigorov, Grigor; Papírek, Tomáš; Kolařík, Vladimír.

    2004-01-01

    The authors present their design concept of remote afterloading for 252Cf brachytherapy with respect to characteristic peculiarities of 252Cf and the current worldwide development of remote afterloading devices. The afterloading device has been designed as a stationary radiator comprising three mutually interconnected units: (1) a control and drive unit, consisting of a control computer and a motor-driven Bowden system carrying the 252Cf source; (2) a source housed in a watertight, concrete vessel, which is stored in a strong room situated well beneath the patient's bed and (3) an afterloading application module installed in the irradiation room. As 252Cf is a nuclide with low specific activity, it was necessary to produce two independent devices for high dose rate intracavitary treatment and for low dose rate intestinal treatment. The sources may be moved arbitrarily during the treatment with a position accuracy of 0.5-1.0 mm within a distance of 520 cm from the source storage position in the strong room to the application position. The technical concept of the present automatic afterloading device for neutron brachytherapy represents one possible option of a range of conceivable design variants, which, while minimizing the technical and economic requirements, provides operating personnel with optimum protection and work safety, thus extending the applicability of high-LET radiation-based treatment methods in clinical practice.

  17. [Voiding dysfunction after brachytherapy in patients with prostate cancer].

    Science.gov (United States)

    Arlandis Guzmán, Salvador; Bonillo García, Miguel Angel; Broseta Rico, Enrique

    2009-12-01

    The development of urinary symptoms after brachytherapy is very frequent, reaching a maximum between the first and third month after the implant and returning back to normal around one year. The incidence of acute urinary retention varies between 1.5 and 27% . A low percentage of patients (0-8.7% ) will need surgery to solve an extended urinary retention or severe obstructive voiding symptoms. Alphablockers may be useful to alleviate voiding symptoms after the implant, although they do not reduce the need for surgery. There are several predictive clinical factors for development of urinary complications. A patient with high IPPS score before implant, large size prostate, obstructive functional signs (Low Q max, high postvoid residual, and obstruction urodynamic parameters) has a high risk for urinary retention or extended urinary symptoms. This has repercussion on the quality of life of the patient, making them candidates to other therapies. The performance of a peripheral implant technique (guaranteeing low doses at urethra) and avoiding the urethral plane when inserting the needles may minimize urethral damage associated with development of urinary complications. Urinary incontinence after brachytherapy is a rare complication, but its frequency increases dramatically after transurethral resection of the prostate or requiring it to solve a sustained urinary retention. It is fundamental to know this circumstance to inform the patient adequately and to plan the most careful TURP.

  18. SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT CONTRIBUTES TO THE CONTROL OF DISSEMINATED INTRAVASCULAR COAGULATION IN SEVERE LIVER IMPAIRMENT

    NARCIS (Netherlands)

    VANSAENE, HKF; STOUTENBEEK, CP; FABERNIJHOLT, R; VANSAENE, JJM

    A premature neonate with severe Coxsackie B1 hepatitis acquired in utero developed disseminated intravascular coagulation a few days after birth. The neonate did not respond to conventional treatment. Eradication of aerobic gram-negative bacilli (Enterobacteriaceae) from the gut with oral

  19. Contribution of intravascular versus interstitial purines and nitric oxide in the regulation of exercise hyperaemia in humans

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Nyberg, Michael Permin; Mortensen, Stefan Peter

    2012-01-01

    Abstract The regulation of blood flow to skeletal muscle involves a complex interaction between several locally formed vasodilators that are produced both in the skeletal muscle interstitium and intravascularly. The gas nitric oxide (NO) and the purines ATP and adenosine, are potent vasodilators...

  20. Multicenter assessment of the reproducibility of volumetric radiofrequency-based intravascular ultrasound measurements in coronary lesions that were consecutively stented

    DEFF Research Database (Denmark)

    Huisman, Jennifer; Egede, Rasmus; Rdzanek, Adam

    2012-01-01

    To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibility...

  1. Variations in clinical presentation, frequency of hemophagocytosis and clinical behavior of intravascular lymphoma diagnosed in different geographical regions

    NARCIS (Netherlands)

    Ferreri, Andrés J M; Dognini, Giuseppina P; Campo, Elías; Willemze, Rein; Seymour, John F; Bairey, Osnat; Martelli, Maurizio; De Renz, Amalia O; Doglioni, Claudio; Montalbán, Carlos; Tedeschi, Alberto; Pavlovsky, Astrid; Morgan, Sue; Uziel, Lilj; Ferracci, Massimo; Ascani, Stefano; Gianelli, Umberto; Patriarca, Carlo; Facchetti, Fabio; Dalla Libera, Alessio; Pertoldi, Barbara; Horváth, Barbara; Szomor, Arpad; Zucca, Emanuele; Cavalli, Franco; Ponzoni, Maurilio

    BACKGROUND AND OBJECTIVES: This study explored variations in the clinical manifestations of intravascular lymphoma (IVL) on the bases of the association with hemophagocytosis and the country where the diagnosis was made. DESIGN AND METHODS: The clinical features of 50 Western patients with IVL were

  2. Relationship between intravascular ultrasound parameters and fractional flow reserve in intermediate coronary artery stenosis of left anterior descending artery: intravascular ultrasound volumetric analysis.

    Science.gov (United States)

    Yang, Hyoung-Mo; Tahk, Seung-Jea; Lim, Hong-Seok; Yoon, Myeong-Ho; Choi, So-Yeon; Choi, Byoung-Joo; Jin, Xiong Jie; Hwang, Gyo-Seung; Park, Jin-Sun; Shin, Joon-Han

    2014-02-15

    The objective of this study was to assess the relationship between intravascular ultrasound (IVUS) parameters, including volumetric analysis, and fractional flow reserve (FFR). Although it is known that coronary atherosclerosis burden measured by IVUS volumetric analysis is related with clinical outcomes, its relationship with functional significance remains unknown. Both IVUS and FFR were performed in 206 cases of intermediate stenosis of the left anterior descending artery (LAD). Myocardial ischemia was assessed by FFR and maximal hyperemia was induced by continuous intracoronary adenosine infusion. FFR  0.80 were associated with larger plaque volume (181.8 ± 82.3 vs. 125.9 ± 77.9 mm3, P < 0.001) and PAV (58.9 ± 5.6 vs. 53.8 ± 7.9%, P < 0.001). IVUS parameters representing severity and extent of atheromatous plaque correlated with functional significance in LAD lesions with intermediate stenosis.

  3. Treatment of localized prostate cancer with brachytherapy: six years experience

    International Nuclear Information System (INIS)

    Martinez, Pablo; Dourado, Leandro; Giudice, Carlos; Villamil, Wenceslao; Palacios, Victor; Sardi, Mabel; Damia, Oscar

    2006-01-01

    The usage of ultrasound scan to perform prostate biopsy punctures, the new radiation therapies and the more accurate selection of patients has allowed brachytherapy to play an important role in the treatment of the localized pathology. The objective of this paper is to review the results obtained when treating the localized prostate cancer by using brachytherapy with mud 125. Materials and methods: Between December 1999 and July 2006, 100 prostate cancer patients were treated at the Hospital Italiano de Buenos Aires, using brachytherapy with mud 125. One of the patients was treated with a combined therapy (brachytherapy + external radiotherapy). For that reason, the patient was not taken into consideration for this paper. The average age was 65.95 (52-79). The tumoral stages were T1c in 81% of the patients and T2a in 19% of them. The PSA was always below 15 ng/ml, with an average of 8.92 ng/ml; inferior to 10 ng/ml in 72 patients and between 10 and 15 ng/m ml in 28 of them. The average prostate volume was 34.68 c.c. (18.70 c.c.-58.00 c.c.). The combined Gleason score was below 6 (except for three patients with Gleason 7 who had a PSA below 10, stage T1c). The dose used was 16,000 cGy as recommended by the TG43. The energy charge of each seed was between 0.28 and 0.40 mci. Thirty days later, a prostate axial computer tomography was carried out every 3 mm. with a scanning set every 5 mm. to perform a dosimetric control of the implant. Results: The average age was 65.95 (52-79). The control computer tomography showed an adequate dosimetric coverage for the entire prostate volume, with a maximum urethral dose not above 400 Gy and a maximum rectal dose below 100 Gy. The PSA of all patients decreased to a normal level 6 months after the treatment started. The average follow-up of the 71 patients able to be tested from an oncological perspective lasted 31.15 months, with a minimum of 18 and a maximum of 72 months. Currently, seven patients of those tested (9.86%) manifest

  4. Radiation Protection in Brachytherapy. Report of the SEFM Task Group on Brachytherapy; Proteccion radiologica en Braquiterapia. Informe del grupo de trabajo de Braquiterapia de la SEFM

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Calatayud, J.; Corredoira Silva, E.; Crispin Contreras, V.; Eudaldo Puell, T.; Frutos Baraja, J. de; Pino Sorroche, F.; Pujades Claumarchirant, M. C.; Richart Sancho, J.

    2015-07-01

    This document presents the report of the Brachytherapy Task Group of the Spanish Society of Medical Physics. It is dedicated to the radiation protection aspects involved in brachytherapy. The aim of this work is to include the more relevant aspects related to radiation protection issues that appear in clinical practice, and for the current equipment in Spain. Basically this report focuses on the typical contents associated with high dose rate brachytherapy with {sup 1}92Ir and {sup 6}0Co sources, and permanent seed implants with {sup 1}25I, {sup 1}03Pd and {sup 1}31Cs, which are the most current and widespread modalities. Ophthalmic brachytherapy (COMS with {sup 1}25I, {sup 1}06Ru, {sup 9}0Sr) is also included due to its availability in a significant number of spanish hospitals. The purpose of this report is to assist to the medical physicist community in establishing a radiation protection program for brachytherapy procedures, trying to solve some ambiguities in the application of legal requirements and recommendations in clinical practice. (Author)

  5. Brachytherapy of penis cancer: experience of the Gustave-Roussy Institute

    International Nuclear Information System (INIS)

    Crevoisier, R. de; Wibault, P.; M'barek, B.; Gerbaulet, A.; Haie-Meder, C.

    2006-01-01

    The interstitial brachytherapy is a conservative treatment of epidermoid carcinomas of the penis under 4 centimeters and does not invade the erectile tissue. the great majority of recurrences is under control by a surgery treatment. (N.C.)

  6. Brachytherapy, A viable option of globe salvage in treatment of large ciliary body melanocytoma

    Directory of Open Access Journals (Sweden)

    Mahesh P Shanmugam

    2014-01-01

    Full Text Available We report a case of large histopathologically proven melanocytoma of the ciliary body in a 15-year-old male, presented with rapid extraocular growth following incisional biopsy with scleral patch graft. We chose brachytherapy with Ruthenium 106 plaque over enucleation as the later was refused by the parents. The initial apical height of the tumor was 14.2 mm on ultrasonography. Two weeks after brachytherapy, the mass regressed to a size of 8.1 mm and 1 year later to 6.7 mm. This is the first case report showing the response of brachytherapy to ciliary body melanocytoma, which results in ocular and visual acuity salvation with considerable decreased in size of the tumor. The authors conclude that brachytherapy is an option in the management of non-resectable melanocytoma of the ciliary body.

  7. IPIP: A new approach to inverse planning for HDR brachytherapy by directly optimizing dosimetric indices

    OpenAIRE

    Pouliot, Jean; Cunha, Jason Adam; Hsu, I-Chow

    2011-01-01

    Purpose: Many planning methods for high dose rate (HDR) brachytherapy require an iterative approach. A set of computational parameters are hypothesized that will g ive a dose plan that meets dosimetric criteria. A dose plan is computed using these parameter

  8. Postal auditing methodology used to find out the performance of high rate brachytherapy equipment

    International Nuclear Information System (INIS)

    Morales, J.A.; Campa, R.

    1998-01-01

    This work describes results from a methodology implemented at the Secondary Laboratory for Dosimetric Calibration at CPHR used to check the brachytherapy performance at high doses rate using Cesium 137 or cobalt 60 sources

  9. A study on applying Ra needle interstitial brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Yoshida, Shunichi; Komiya, Yoshiaki; Uchida, Ikuhiro; Tashiro, Kazuyoshi

    1999-01-01

    To investigate applicability of Ra needle interstitial brachytherapy, 93 cases of oral squamous carcinoma were examined. The patients underwent Ra needle interstitial brachytherapy as thorough therapy in our hospital. The criteria of applying Ra needle interstitial brachytherapy was diameter of within 5 cm and depth within 2 cm of tumor size. Ra needle interstitial brachytherapy was applied to 82 cases of tongue, 10 cases of oral floor and one case of lower lip carcinomas. The local control rate was 92.5%, and secondary neck metastasis was 32.3% in all cases applied Ra needle interstitial brachytherapy. The results were not bad compared with surgical treatment. However, the 5-year cumulative survival rate was 64.9%, which was not good enough at the result to obtain a good local control rate and secondary neck metastasis rate. The result was relative to low treatment result of local recurrence cases with Ra needle interstitial brachytherapy. To improve the result, it is important to distinguish local recurrence from radioinduced ulcer, and to start early secondary treatment. The cases in which cervical lymph node metastasis was found as the first examination underwent neck dessection after Ra needle interstitial brachytherapy. The 5-year cumulative survival rate was 83.3% in N1 cases and 40.6% in N2 cases, and the result of N2 cases was poorer than N1 cases with a significant difference. The results indicate that a needle having a diameter of within 5 cm, depth of within 2 cm and less than N1 can be applied during Ra needle interstitial brachytherapy for complete cure of cancer. (author)

  10. 6th Annual Conference of Indian Brachytherapy Society 2016 (IBSCON 2016) Proceedings

    OpenAIRE

    Srinivasan, Venkatesan; Kuppusamy, Thayalan; Bhalavat, Rajendra L.; Mahantshetty, Umesh; Yathiraj, Prahlad H.; Kumar, Uday P.; Sharan, Krishna; Singh, Anshul; Reddy, Anusha; Fernandes, Donald; Vidyasagar, M.S.; Kumar, Rishabh; Kala, Prachi; Narayanan, Geeta S.; Mandal, Sanjeet

    2016-01-01

    Purpose To report the incidence, severity, and time of onset of late toxicities in patients of endometrial adenocarcinoma (EA) treated with external beam radiotherapy (EBRT) + brachytherapy (BT), or vaginal brachytherapy (VBT) alone. Material and methods Archives of a single institution from 2008-2015 were studied. The indications for EBRT and VBT were based on standard recommendations. EBRT was planned to 50 Gy/25 fractions/5 weeks/3DCRT with 4-field ?box? technique on a dual energy linear a...

  11. Demonstration of brachytherapy boost dose-response relationships in glioblastoma multiforme

    International Nuclear Information System (INIS)

    Sneed, Penny K.; Lamborn, Kathleen R.; Larson, David A.; Prados, Michael D.; Malec, Mary K.; McDermott, Michael W.; Weaver, Keith A.; Phillips, Theodore L.; Wara, William M.; Gutin, Philip H.

    1996-01-01

    Purpose: To evaluate brachytherapy dose-response relationships in adults with glioblastoma undergoing temporary 125 I implant boost after external beam radiotherapy. Methods and Materials: Since June 1987, orthogonal radiographs using a fiducial marker box have been used to verify brain implant source positions and generate dose-volume histograms at the University of California, San Francisco. For adults who underwent brachytherapy boost for glioblastoma from June 1987 through December 1992, tumor volumes were reoutlined to ensure consistency and dose-volume histograms were recalculated. Univariate and multivariate analyses of various patient and treatment parameters were performed evaluating for influence of dose on freedom from local failure (FFLF) and actuarial survival. Results: Of 102 implant boosts, 5 were excluded because computer plans were unavailable. For the remaining 97 patients, analyses with adjustment for known prognostic factors (age, KPS, extent of initial surgical resection) and prognostic factors identified on univariate testing (adjuvant chemotherapy) showed that higher minimum brachytherapy tumor dose was strongly associated with improved FFLF (p = 0.001). A quadratic relationship was found between total biological effective dose and survival, with a trend toward optimal survival probability at 47 Gy minimum brachytherapy tumor dose (corresponding to about 65 Gy to 95% of the tumor volume); survival decreased with lower or higher doses. Two patients expired and one requires hospice care because of brain necrosis after brachytherapy doses > 63 Gy to 95% of the tumor volume with 60 Gy to > 18 cm 3 of normal brain. Conclusion: Although higher minimum brachytherapy tumor dose was strongly associated with better local control, a brachytherapy boost dose > 50-60 Gy may result in life-threatening necrosis. We recommend careful conformation of the prescription isodose line to the contrast enhancing tumor volume, delivery of a minimum brachytherapy

  12. HDR brachytherapy as a solution in recurrences of locally advanced prostate cancer.

    Science.gov (United States)

    Łyczek, Jarosław; Kawczyńska, Maria M; Garmol, Darek; Kasprowicz, Anetta; Kulik, Anna; Dąbkowski, Mateusz; Czyżew, Beata; Gruszczyńska, Ewelina; Bijok, Michał; Kowalik, Łukasz

    2009-06-01

    The object of this study was to analyze the outcome of salvage HDR brachytherapy treatment after local failure, for patients with prostate specific antigen (PSA) failure without distant metastasis, after external beam radiation and HDR brachytherapy treatment, or after radical prostatectomy, with or without hormonal therapy. The group of 115 patients, without distant metastasis, after local failure and external beam radiation, followed by HDR brachytherapy treatment, or after radical prostatectomy, with hormonal therapy and without, have been enrolled to salvage HDR brachytherapy (SBR). All patients had minimum 3 months androgen deprivation therapy before salvage brachytherapy, which was continued until the next 9 months after SBR. Brachytherapy was administered in three 10 Gy fractions with 3 weeks gap between them. Each session of SBR was supported by trans-rectal USG real time pictures. The treatment planning was done on the base of Abacus system from Sauerwein ® or with SWIFT system from Nucletron ® . The following data were collected: Gleason score, clinical staging, the volume of the prostate, PSA before and after the initial treatment and periodically during the follow-up period. Also the time during which the PSA stays at the nadir level, patient's age and toxicity of treatments were taken into consideration. Doses from external radiotherapy or from HDR brachytherapy were recalculated to equivalent biological dose (EBD). The independence from biochemical progression in our group of patients after retreatment was 46% for patients with PSA ≤ 6 and 18% for patients with PSA > 6. Overall survival for patients with PSA ≤ 6 was 86% and 48% for patients with PSA > 6, respectively. Salvage prostate brachytherapy (SBR) can be safely performed with acceptable biochemical control and toxicity.

  13. Patterns of practice survey for brachytherapy for cervix cancer in Australia and New Zealand.

    Science.gov (United States)

    Lim, Karen; van Dyk, Sylvia; Khaw, Pearly; Veera, Jacqueline; Mileshkin, Linda; Ohanessian, Lucy; Harrison, Michelle; Vinod, Shalini K

    2017-10-01

    The purpose of this survey was to explore the current patterns of practice for brachytherapy in cervix cancer in Australia and New Zealand. The survey was also intended to explore clinician attitudes towards image-guided adaptive brachytherapy (IGABT) and identify barriers to the implementation of IGABT. Electronic surveys were sent to all radiotherapy centres in Australia and New Zealand under collaboration with Australia New Zealand Gynaecology and Oncology Group (ANZGOG), in order to identify patterns of radiotherapy practice. The survey was sent out in December 2013, with a reminder in February 2014. Of the 75 radiotherapy centres in Australia and New Zealand, 23 centres replied (31% response rate). Twenty-two responding departments treat cervix cancer with external beam radiation (EBRT) (22/23; 96%). Fourteen responses were from departments that also use intracavitary brachytherapy (14/22; 64%). The remaining eight departments who do not offer intracavitary brachytherapy referred their patients on to other centres for brachytherapy. Ultrasound was used by 86% for applicator guidance. CT and MRI were used by 79%, and 50% respectively for planning. Optimisation was based on organs at risk (93%) and target volumes (64%). Brachytherapy remains an integral component of definitive treatment for cervix cancer in Australia and New Zealand. There was increased use of soft tissue imaging modalities with emphasis on verification; high rates of volumetric planning, and adherence to a defined overall treatment period. Brachytherapy was not substituted with other EBRT modalities. Despite this, there remain barriers to implementation of image-guided brachytherapy. © 2017 The Royal Australian and New Zealand College of Radiologists.

  14. Effect of brachytherapy technique and patient characteristics on cervical cancer implant dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Anker, Christopher J., E-mail: chris.anker@hci.utah.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States); O' Donnell, Kristen [Department of Radiation Oncology, The University of Arizona, Tucson, AZ (United States); Boucher, Kenneth M. [Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (United States); Gaffney, David K. [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States)

    2013-01-01

    Our purpose was to evaluate the relationship between brachytherapy technique and patient characteristics on dose to organs-at-risk (OARs) in patients undergoing high dose rate (HDR) brachytherapy for cervical cancer. From 1998 to 2008, 31 patients with cervical cancer with full dosimetric data were identified who received definitive external-beam radiation and HDR brachytherapy with tandem and ovoid applicators. Doses were recorded at point A, the International Commission on Radiation Units and Measurements (ICRU)-38 rectal point, the ICRU-38 bladder point, the vaginal surface, and the pelvic sidewall. Generalized estimating equations were used to determine the significance of changes in OAR to point A dose ratios with differences in brachytherapy technique or patient characteristics. Patients underwent a median of 5 brachytherapy procedures (range, 3 to 5), with a total of 179 procedures for 31 patients. For all brachytherapy treatments, the average ratios between the doses for the rectal, bladder, vaginal surface, and pelvic sidewall reference points to those at point A were 0.49, 0.59, 1.15, and 0.17, respectively. In general, decreased OAR dose was associated with a lower stage, younger age, increased ovoid size, increased tandem length, and earlier implant number. Increased tandem curvature significantly increased bladder dose and decreased rectal dose. Intravenous anesthesia usage was not correlated with improved dosimetry. This study allowed identification of patient and procedure characteristics influencing OAR dosing. Although the advent of 3-dimensional (3D) image-guided brachytherapy will bring new advances in treatment optimization, the actual technique involved at the time of the brachytherapy implant procedure will remain important.

  15. Vaginal cuff dehiscence after vaginal cuff brachytherapy for uterine cancer. A case report

    OpenAIRE

    Cattaneo, Richard; Bellon, Maria; Elshaikh, Mohamed A.

    2013-01-01

    Vaginal cuff dehiscence is a rare, but potentially serious complication after total hysterectomy. We report a case of vaginal cuff dehiscence after vaginal cuff brachytherapy. A 62 year old female underwent a robotic-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy, and was found to have International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB endometrioid adenocarcinoma of the uterus. The patient was referred for adjuvant vaginal cuff brachytherapy. D...

  16. Microfocus X-ray imaging of the internal geometry of brachytherapy seeds.

    Science.gov (United States)

    Hasegawa, Tomoyuki; Hanada, Takashi; Yorozu, Atsunori; Ito, Hidetaka; Masuda, Shinji; Kawahara, Maki; Yogo, Katsunori; Hayakawa, Kazushige

    2014-04-01

    Precise and reliable geometrical data on the internal structure of seeds are indispensable for dosimetric calculation in brachytherapy. We used a novel microfocus X-ray imaging technique for observing the internal structure of brachytherapy seeds. Two popular (125)I seed models were evaluated. Obtained high precision images enabled us to observe the internal structure of seeds qualitatively. Geometrical size parameters were evaluated quantitatively with uncertainty of 0.01-0.04 mm (k=2). Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Proceedings of the Second Congress of Radiochemotherapy and Brachytherapy and the Fifth Meeting of Medical Physics

    International Nuclear Information System (INIS)

    Zunino, Silvia; Venencia, Daniel; Martinez, Monica; Garrigo, Edgardo

    2009-01-01

    The Marie Curie Foundation in the city of Cordoba in Argentina, has organized the Second Congress of radiochemotherapy and brachytherapy and the Fifth Meeting of Medical Physics in order to collaborate with the scientific growth of radiation oncology and medical physics. The main topics covered were: patient's radioprotection, brachytherapy with iodine, radiation protection regulatory issues in Argentina, risk analysis in radiotherapy, medical radiation therapy, EPID dosimetry (Electronic Portal Image Device), accidents in radiotherapy, among others. [es

  18. National breast cancer brachytherapy survey in France: Results and perspectives in 2009

    International Nuclear Information System (INIS)

    Hannoun-Levi, J.M.; Hennequin, C.; Pommier, P.; Izar, F.; Thomas, L.; Le Scodan, R.; Lesaunier, F.; Nguyen, T.; Heymann, S.; Truc, G.; Peiffert, D.

    2010-01-01

    Purpose To present the national survey patterns in France for breast cancer brachytherapy in 2009. Material and method A written questionnaire was sent to the academic and general hospitals and the anticancer centres. The different items were type of institution; breast cancer clinical trial participation; number of breast brachytherapy per year; its indications; material and dose rate used. Results Among the 76 sent questionnaires, 35 (46 %) answers were available: 9 % of academic hospitals and 50 % of cancer centres performed breast brachytherapy. The number of breast brachytherapy per year ranged between 300 and 350. The indications were boost (100 %), partial breast irradiation (20 %) and second conservative treatment for local recurrence (53 %). The implanted material consisted in needles (27 %) and plastic tubes (73 %). The dose rate was low (50 %), pulsed (25 %) and high (25 %). Conclusion Breast brachytherapy appears as a validated technique in case of boost but remains under investigation for partial breast irradiation and second conservative treatments. Good clinical practice rules as well as technical and dosimetric guidelines are needed. A cost-effective analysis of breast brachytherapy is warranted. (authors)

  19. Brachytherapy in childhood rhabdomyosarcoma treatment; Braquiterapia no tratamento do rabdomiossarcoma da infancia

    Energy Technology Data Exchange (ETDEWEB)

    Novaes, Paulo Eduardo Ribeiro dos Santos

    1995-07-01

    A retrospective study of 21 children with rhabdomyosarcoma treated by brachytherapy to the primary site of the tumor at the Radiotherapy Department of the A.C.Camargo Hospital between january/1980 to june/1993 was undertaken. The main objectives were to comprove the utility of brachytherapy in childhood rhabdomyosarcoma, to evaluate the local control and survival, in association with chemotherapy, to analyze the late effects of the treatment and to determinate the preferential technique to each clinical situation. All patients received brachytherapy to the tumor site. The radioactive isotopes employed were Gold{sup 198}, Cesium{sup 137} and Iridium{sup 192}. The brachytherapy techniques depended on the tumor site, period of treatment, availability of the radioactive material and stage of the disease. Patients treated exclusively by brachytherapy received 40 Gy to 60 Gy. When brachytherapy was associated with external radiotherapy the dose ranged from 20 Gy to 40 Gy. Local control was achieved in 18 of 20 patients (90%). The global survival and local control survival rates were 61.9% (13/21 patients) and 72,2% (13/18 patients) respectively. (author)

  20. Quality control of brachytherapy equipment in the Netherlands and Belgium: current practice and minimum requirements

    International Nuclear Information System (INIS)

    Elfrink, Robert J.M.; Kolkman-Deurloo, Inger-Karine K.; Kleffens, Herman J. van; Rijnders, Alex; Schaeken, Bob; Aalbers, Tony H.L.; Dries, Wim J.F.; Venselaar, Jack L.M.

    2002-01-01

    Background and purpose: Brachytherapy is applied in 39 radiotherapy institutions in The Netherlands and Belgium. Each institution has its own quality control (QC) programme to ensure safe and accurate dose delivery to the patient. The main goal of this work is to gain insight into the current practice of QC of brachytherapy in The Netherlands and Belgium and to reduce possible variations in test frequencies and tolerances by formulating a set of minimum QC-requirements. Materials and methods: An extensive questionnaire about QC of brachytherapy was distributed to and completed by the 39 radiotherapy institutions. A separate smaller questionnaire was sent to nine institutions performing intracoronary brachytherapy. The questions were related to safety systems, physical irradiation parameters and total time spent on QC. The results of the questionnaires were compared with recommendations given in international brachytherapy QC reports. Results: The answers to the questionnaires showed large variations in test frequencies and test methods. Furthermore, large variations in time spent on QC exist, which is mainly due to differences in QC-philosophy and differences in the available resources. Conclusions: Based on the results of the questionnaires and the comparison with the international recommendations, a set of minimum requirements for QC of brachytherapy has been formulated. These guidelines will be implemented in the radiotherapy institutions in The Netherlands and Belgium

  1. High dose rate endobronchial brachytherapy effectively palliates symptoms due to inoperable lung cancer

    International Nuclear Information System (INIS)

    Celebioglu, B.; Gurkan, O.U.; Savas, I.; Kose, K.; Kurtman, C.; Gonullu, U.; Erdogan, S.

    2002-01-01

    Intraluminal brachytherapy has become an established treatment for major airway occlusion by relapsed or persistent inoperable endobronchial tumors. The aim of this study was to compare the palliation improvement pre- and post-radiotherapy. The study group was 95 patients with the diagnosis of inoperable lung cancer who were eligible for high dose rate (HDR) brachytherapy. Fiber-optic bronchoscopy was performed and the level and degree of endobronchial obstruction were estimated in terms of bronchial obstruction index. Endobronchial irradiation was delivered using remote HDR afterloading brachytherapy with iridium-192. Brachytherapy was delivered at weeks 1, 2 and 3 at 7.5 Gy per fraction or at weeks 1 and 2 at 10 Gy per fraction. All patients were evaluated at the beginning and at the third month of therapy. Using Speiser's symptomatic scoring criteria, the severity of symptoms (dyspnea, cough, hemoptysis and postobstructive pneumonia) was weighted. Bronchoscopic findings at the initial evaluation and at the third month were also scored. Surviving patients were followed up for a minimum of 3 months with a mean of 7.5±5.35 months (median: 6 months). All the symptoms and bronchial obstruction improved significantly after brachytherapy (P 0.05). All the symptoms and bronchial obstruction index seemed to improve after brachytherapy. However, it is difficult to predict the response before the therapy. (author)

  2. Adherence to Vaginal Dilation Following High Dose Rate Brachytherapy for Endometrial Cancer

    International Nuclear Information System (INIS)

    Friedman, Lois C.; Abdallah, Rita; Schluchter, Mark; Panneerselvam, Ashok; Kunos, Charles A.

    2011-01-01

    Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer. Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs. Results: Seventy-eight of 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy. Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study.

  3. Characterization of a saphenous vein graft aneurysm by intravascular ultrasound and computerized three-dimensional reconstruction.

    Science.gov (United States)

    Ennis, B M; Zientek, D M; Ruggie, N T; Billhardt, R A; Klein, L W

    1993-04-01

    Aneurysmal dilatations in saphenous vein grafts are rare complications of coronary artery bypass surgery that mostly represent thin-wall pseudoaneurysms at anastomotic sites. We describe a case of an enlarging distal saphenous vein graft aneurysm in which intravascular ultrasound (IVUS) and computerized three-dimensional reconstruction (3DR) of the IVUS images was performed to conclusively demonstrate true aneurysm morphology. Although both atherosclerotic and nonatherosclerotic mechanisms for vein graft aneurysm formation have been previously suggested, IVUS images and 3DR of the aneurysm in this case did not reveal any of the features typical for atherosclerotic lesions. Further, the IVUS images and 3DR suggest that progressive atherosclerosis is not the likely cause of aneurysm formation in this case. This application of IVUS and 3DR provides detailed information about saphenous vein graft aneurysm structure, clues to aneurysm formation, and suggests a natural history that may differ from that of pseudoaneurysms.

  4. Histopathological approach for diagnosis of intravascular leiomyosarcoma of the femoral vein

    Directory of Open Access Journals (Sweden)

    Gaurav Singal

    2016-04-01

    Full Text Available Malignant tumors arising from venous walls in the lower extremities are uncommon and intravascular leiomyosarcoma represents only a small proportion and rare of soft tissue leiomyosarcoma. All publications in the literature are of small clinical series or case reports. We present a case of primary leiomyosarcoma of the femoral vein in a 40 year old man; which is a rare lesion with less than 40 cases reported. The patient presented with swelling and localized leg pain. The diagnosis was made histopathologically, the tumor was resected, vascular reconstruction was performed, and for postoperative radiation therapy and chemotherapy patient was referred to the oncologist. Primary leiomyosarcoma of a major peripheral artery is extremely rare, and this report share the clinical presentation, histopathological findings, treatment, and prognosis in these patients

  5. Specific features of red blood cell morphology in hemolytic disease neonates undergoing intrauterine intravascular blood transfusion

    Directory of Open Access Journals (Sweden)

    A. V. Ivanova

    2016-01-01

    Full Text Available The paper presents data on the characteristics of red blood cell morphology in infants who have undergone intrauterine intravascular blood transfusion for hemolytic disease of the fetus. The infants are shown to have a reduction in the mean volume of red blood cells and in their mean level of hemoglobin, a decrease in the fraction of fetal hemoglobin and an increase in oxygen tension at half saturation. The above morphological characteristics of red blood cells remain decreased during the neonatal period after exchange transfusion or others, as clinically indicated, which seems to suggest that the compensatory-adaptive mechanisms to regulate hematopoiesis are exhausted and a donor’s red blood cells continue to be predominant.

  6. Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor) of the Radial Artery: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Stark, Christopher, E-mail: Christopher.stark@uvmhealth.org [University of Vermont Medical Center, Department of Radiology (United States); Olsen, Daniel [Mayo Clinic, Department of Pathology (United States); Morris, Christopher [University of Vermont Medical Center, Department of Radiology (United States); Bertges, Daniel [University of Vermont Medical Center, Department of Surgery (United States); Najarian, Kenneth [University of Vermont Medical Center, Department of Radiology (United States)

    2016-11-15

    Intravascular papillary endothelial hyperplasia (IPEH), often referred to as Masson’s tumor, is a benign non-neoplastic vascular lesion of the skin and subcutaneous tissues. Although it is rare, knowledge of the existence of IPEH is important as it can mimic other benign and malignant tumors, most notably angiosarcoma. IPEH remains an incompletely understood entity; however, most consider it to be the result of reactive endothelial proliferation following thrombus formation within a vessel, vascular malformation, or adjacent to a vessel. In this article, we report a case of IPEH arising within an arteriovenous malformation of the radial artery and present accompanying multimodality imaging and pathology figures. We will also describe the clinical presentation, pathophysiology, histology, imaging features, and management of IPEH.

  7. Intravascular Large B-Cell Lymphoma Presenting as Interstitial Lung Disease

    Directory of Open Access Journals (Sweden)

    Elham Vali Khojeini

    2014-01-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBL is a rare subtype of diffuse large B-cell lymphoma that resides in the lumen of blood vessels. Patients typically present with nonspecific findings, particularly bizarre neurologic symptoms, fever, and skin lesions. A woman presented with shortness of breath and a chest CT scan showed diffuse interstitial thickening and ground glass opacities suggestive of an interstitial lung disease. On physical exam she was noted to have splenomegaly. The patient died and at autopsy was found to have an IVLBL in her lungs as well as nearly all her organs that were sampled. Although rare, IVLBL should be included in the differential diagnosis of interstitial lung disease and this case underscores the importance of the continuation of autopsies.

  8. Neuroendocrine and renal effects of intravascular volume expansion in compensated heart failure

    DEFF Research Database (Denmark)

    Gabrielsen, A; Bie, P; Holstein-Rathlou, N H

    2001-01-01

    To examine if the neuroendocrine link between volume sensing and renal function is preserved in compensated chronic heart failure [HF, ejection fraction 0.29 +/- 0.03 (mean +/- SE)] we tested the hypothesis that intravascular and central blood volume expansion by 3 h of water immersion (WI) elicits...... sustained angiotensin-converting enzyme inhibitor therapy, n = 9) absolute and fractional sodium excretion increased (P Renal free water clearance increased during WI in control subjects but not in HF......, albeit plasma vasopressin concentrations were similar in the two groups. In conclusion, the neuroendocrine link between volume sensing and renal sodium excretion is preserved in compensated HF. The natriuresis of WI is, however, modulated by the prevailing ANG II and Aldo concentrations. In contrast...

  9. Quantification of iliac artery stenoses: a methodological comparative study between intravascular ultrasound, arteriography and duplex scanning

    DEFF Research Database (Denmark)

    Vogt, K C; Rasmussen, John Bøje Grønvall; Skovgaard, Lene T

    1998-01-01

    Two morphological methods for quantifying the degree of stenoses in the iliac arteries, intravascular ultrasound (IVUS) and arteriography, were compared with duplex scanning, a method of evaluating the haemodynamic importance of the stenosis. A total of 38 patients, 20 women and 18 men, median age...... 66 y, admitted for either PTA (n=18) or femoro-femoral crossover bypass surgery (n=20), were examined by IVUS, single plane arteriography and duplex scanning. The predictive value, sensitivity, specificity and kappa value of IVUS were higher than the corresponding values for arteriography. Logistic...... regression analysis found that IVUS had a predictive value (p=0.0003) for diagnosing significant stenosis as defined by duplex scanning, but arteriography did not (p=0.1). However, this difference in usefulness as predictors did not reach significance. The agreement between arteriography and IVUS...

  10. The use of intravascular ultrasound for intraoperative assessment during semiclosed thromboendarterectomy

    DEFF Research Database (Denmark)

    Vogt, K C; Sillesen, H; Schroeder, T V

    1998-01-01

    To evaluate the application of intravascular ultrasound (IVUS) for intraoperative assessment of semiclosed thromboendarterectomy (TEA), IVUS images of the iliofemoral segment in 20 patients were obtained. The configuration and size of residual atherosclerotic material were evaluated. Stenoses...... was detected in the artery by IVUS. The material was removed in five cases. The part of the iliac artery proximal to the endarterectomized segment was visualized in 14 cases and showed minor stenoses in 10 cases. After follow-up at a median of 8 months (range 1-24), occlusion had occurred in one of 20 patients...... and restenosis (> 50%) had developed in two (10%). At this point, patency cannot be related to IVUS findings. We conclude that IVUS is a feasible method for intraoperative assessment of semiclosed TEA. The rate of early failures due to residual material might be reduced by this new application of IVUS....

  11. [Disseminated intravascular coagulation, 113 cases, including 17 children with fulminant purpura].

    Science.gov (United States)

    Briones, L R; Dorantes, S

    1976-01-01

    Between 1964 and 1971, 113 children with the syndrome of disseminated intravascular coagulation were studied at the Hospital Infantil de México, including 17 cases with the diagnosis of fulminant purpura. Comparison was established with reports from foreign institutions. The following conclusions are offered: Fulminant purpura appears after a period of latency following the causal disease. It is not caused by septicemia; shows a clear picture in infants, preschool and school children, with letality index of 17.7%. In Mexico, DIC was caused by infection in 88% of the cases and in 68% of them, the infection started in the digestive tract. The diagnosis of fulminant purpura is based on the clinical picture, while in DIC, the diagnosis must also be based on laboratory tests unless one half of the diagnoses be missed.

  12. Lipid modulation of intravascular and cellular sodium handling: mechanistic insights and potential clinical implications.

    Science.gov (United States)

    Amaral, Andre C K B; Sposito, Andrei C

    2006-10-01

    Lipid metabolism can modulate structural and functional characteristics of the vascular system. Recent studies suggested that dyslipidemia may also affect the hemodynamic response to salt intake through the impairment of intravascular volume regulation and cellular sodium handling. Indeed, dyslipidemia may affect sodium homeostasis through several pathways, including defective nitric oxide and eicosanoid production, enhanced renin-angiotensin system activity and increased sympathetic response. Moreover, dyslipidemia directly affects cellular membrane viscosity and modifies membrane ion transport activity. In line with this evidence, attenuation of the above mentioned mechanisms has been demonstrated after lipid-lowering treatment. From the clinical point of view, such interaction between plasma lipids and sodium homeostasis may adversely affect the clinical presentation of diseases such as salt-sensitive hypertension, congestive heart failure, renal diseases with proteinuria or sodium retention. This review considers the interplay between plasma lipids and sodium homeostasis and its potential clinical implication.

  13. The role of Intravascular Ultrasound in the management of spontaneous coronary artery dissection

    Directory of Open Access Journals (Sweden)

    Karamitsos Theodoros D

    2008-05-01

    Full Text Available Abstract Primary or spontaneous coronary artery dissection (SCAD is an unusual but increasingly recognized cause of acute myocardial ischemia and sudden cardiac death. Typically, SCAD presents in younger patients without conventional risk factors for coronary artery disease. It occurs more commonly in women than in men, and frequently during pregnancy or the postpartum period. Its pathophysiology is poorly understood, and there is considerable controversy regarding the optimal management of patients with SCAD-related myocardial ischemia. Therapeutic approaches include conservative medical therapy, coronary artery bypass graft surgery and percutaneous coronary intervention (PCI. We present four cases of SCAD to illustrate specific aspects of the presentation and management of this condition, with particular reference to the importance of intravascular ultrasound (IVUS to aid diagnosis and guide subsequent PCI.

  14. Early Blood Transfusion and Resolution of Disseminated Intravascular Coagulation Associated with Massive Subgaleal Hemorrhage.

    Science.gov (United States)

    Modanlou, Houchang; Hutson, Shandee; Merritt, Allan Thurman

    2016-01-01

    A male infant delivered to a primipara woman following vacuum applications. He was vigorous at birth, with small caput and scalp bruising. His head was enlarging; he became pale with respiratory distress. Subgaleal hemorrhage (SGH) was suspected. His hematocrit was noted to be 26.2 percent prior to transfusion of O, Rh-negative blood (40 mL/kg). Moderate disseminated intravascular coagulation (DIC) was noted at 12 hours of age. Posttransfusion of fresh frozen plasma (FFP), his condition became stable, and DIC gradually resolved. Head magnetic resonance imaging did not show intracranial hemorrhage. Although one episode of seizures was noted, electroencephalogram was normal. With the application of obstetric vacuum, we recommend that the neonatal health care professionals frequently evaluate the infant's condition. In light of developing fluctuant subgaleal fluid associated with pallor, anemia, metabolic acidosis, and respiratory distress, immediate blood transfusion is warranted. In the presence of DIC, transfusion of FFP is beneficial.

  15. Comparison of angiography and intravascular ultrasound before and after balloon angioplasty of the femoropopliteal artery

    International Nuclear Information System (INIS)

    Lankeren, Winnifred van; Gussenhoven, Elma J.; Pieterman, Herman; Sambeek, Marc R. H. M. van; Lugt, Aad van der

    1998-01-01

    Purpose: To compare angiographic and intravascular ultrasound (IVUS) data before and after balloon angioplasty (PTA) of the femoropopliteal artery.Methods: Qualitative and quantitative analyses were performed on corresponding angiographic and IVUS levels obtained from 135 patients.Results: IVUS detected more lesions, calcified lesions, and vascular damage than angiography. Sensitivity of angiography was good for the presence of a lesion (84%), moderate for eccentric lesions (53%) and for vascular damage (52%), and poor for calcified lesions (30%). The increase in angiographic diameter stenosis was associated with a decrease in lumen area and increase in percentage area stenosis on IVUS.Conclusions: Angiography is less sensitive than IVUS for detecting lesion eccentricity, calcified lesions, and vascular damage. Presence of a lesion and amount of plaque were underestimated angiographically. Only before PTA was good agreement found between angiographic diameter stenosis and lumen size on IVUS.

  16. Mechanical behavior of deformed intravascular NiTi stents differing in design. Numerical simulation

    Science.gov (United States)

    Eremina, Galina M.; Smolin, Alexey Yu.; Krukovskii, Konstantin V.; Lotkov, Aleksandr I.; Kashin, Oleg A.; Kudryashov, Andrey N.

    2017-12-01

    Self-expanding intravascular NiTi stents serve to recover the lumen of vessels suffered from atherosclerotic stenosis. During their manufacturing or functioning in blood vessels, the stents experience different strains and local stresses that may result in dangerous defects or fracture. Here, using the method of movable cellular automata, we analyze how the design of a stent influences its stress state during shaping to a desired diameter on a mandrel. We consider repeated segments of different stents under two loads: uniform diametric expansion of their crown and expansion with relative displacements. The simulation data agree well with experiments, revealing critical strain, stress, and their localization sites at the shaping stage, and provide the way toward optimum stent designs to minimize the critical stress during shaping.

  17. Perspectives on Imaging the Left Main Coronary Artery Using Intravascular Ultrasound and Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Harry C Lowe

    2015-01-01

    Full Text Available Percutaneous Coronary Intervention (PCI for significant left main coronary artery (LMCA stenosis is increasingly being viewed as a viable alternative to Coronary Artery Bypass Grafting (CABG (1. This is leading to an expectation of increasing numbers of such procedures, with a consequent focus on both the ability to image both lesion severity, and assess more accurately the results of PCI. While there have been advances in physiologic assessment of left main severity using fractional flow reserve (FFR, imaging of the LMCA using Intravascular Ultrasound (IVUS and more recently Optical Coherence Tomography (OCT has the specific advantage of being able to provide detailed anatomical information both pre and post PCI, such that it is timely to review briefly the current status of these two imaging technologies in the context of LMCA intervention.

  18. Intravascular photoacoustic detection of vulnerable plaque based on constituent selected imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jian; Xing Da, E-mail: xingda@scnu.edu.cn [MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631 (China)

    2011-01-01

    Atherosclerosis, a disease of the large arteries, is the primary cause of heart disease and stroke. Over decades, atherosclerosis is characterized by thickening of the walls of the arteries, only advanced atherosclerotic disease could be observed. Photoacoustic imaging is a hybrid imaging technique that combines the advantages of high spatial resolution of ultrasound with contrast of optical absorption. In this paper, we present an intravascular photoacoustic (IVPA) imaging system to characterize vulnerable plaques by using the optical absorption contrast between different constituents. Epidemiological studies have revealed several important plaque constituents associated with early atherosclerosis, such as macrophage, cholesterol, lipid, calcification, and so on. We chose a section of lipid rich atherosclerosis artery and a section of normal artery as the phantom. Two IVPA images of them are given to show the difference between sick and normal. As a new method of detecting vulnerable plaque, IVPA constituents imaging will provide more details for diagnosis that offer an enticing prospect in early detecting of atherosclerosis.

  19. The cerebral intravascular enhancement sign is not specific: a contrast-enhanced MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Bakshi, R.; Kinkel, W.R.; Bates, V.E.; Mechtler, L.L.; Kinkel, P.R. [Lucy Dent Imaging Center, University at Buffalo, NY (United States)

    1999-02-01

    The intravascular enhancement (IVE) sign, also known as the ``arterial enhancement sign``, is an abnormal finding in the brain on contrast-enhanced MRI studies. IVE has been described in arterial cerebrovascular disorders, most commonly in acute or subacute arterial ischemic infarcts. However, the specificity of this sign has not been established. We describe four patients with disorders other than arterial strokes in whom gadolinium-enhanced high-field (1.5 T) MRI suggested IVE. The conditions were herpes simplex viral encephalitis, idiopathic cerebellitis, pneumococcal meningitis, and superior sagittal sinus thrombosis with venous infarction. IVE in these cases may be due to multiple factors, including arterial, venous, perivascular, and leptomeningeal or sulcal contrast medium accumulation. Our observations suggest that arterial ischemia, previously described as the cardinal cause of IVE, probably does not explain all instances, and urge caution in interpreting this sign as a specific MRI manifestation of acute arterial infarction or ischemia. (orig.) With 4 figs., 1 tab., 44 refs.

  20. Intravascular papillary endothelial hyperplasia of the extremities: MR imaging findings with pathologic correlation

    International Nuclear Information System (INIS)

    Lee, Sang Hoon; Suh, Jin-Suck; Lim, Byung Il; Yang, Woo Ick; Shin, Kyoo-Ho

    2004-01-01

    We report the MRI findings of three cases of intravascular papillary endothelial hyperplasia (IPEH) of the extremities with correlation of the pathologic findings. The IPEH is a non-neoplastic reactive lesion within the vessels and is commonly associated with thrombi. Signal intensity of the IPEH is complex due to the thrombi and the PEH itself. The thrombi are characterized by a slightly hyperintense signal on T1- and T2-weighted images compared with that of muscle when it comes at the medium stage of hemorrhage. Papillary endothelial hyperplastic tissue appears either as iso- or hyperintense to the muscle on T2- and T1-weighted images and shows variable enhancement on Gd-DTPA-enhanced images. (orig.)

  1. Optimum plastic scintillator and optical fiber combination for brachytherapy dosimetry

    International Nuclear Information System (INIS)

    Arnfield, Mark R.; Gaballa, Hani E.; Zwicker, Robert D.; Islam, Quazi; Schmidt-Ullrich, Rupert

    1995-01-01

    Purpose/Objective: There have been several recent reports using plastic scintillators to measure dose in photon and electron beams. External beam measurements agreed well with standard ion chamber dosimetry. This was implemented by using two identical, parallel optical fibers with a small piece of plastic scintillator attached to one. We have constructed a similar device for application to brachytherapy. Brachytherapy dosimetry is a more difficult problem than external beam because of high dose gradients and widely ranging photon energies. Based on detailed spectral measurements, we have designed a dosimeter specifically to meet the unique, stringent needs of brachytherapy. Materials and Methods: The work consisted of two stages. In the first stage, we measured the optical spectra emitted by commercial plastic scintillators and silica core optical fibers in the presence of a 10 Curie iridium 192 HDR source. In the second stage, the spectral information was used to select an optimum combination of scintillator and fiber which were incorporated in the dosimeter. Equipment for the spectral measurements included a 0.1 meter monochromator with a sensitive photomultiplier (PMT) with flat response across the visible. The resolution of spectral scans was 4 nm. The dosimeter was constructed with a 1mm x 3mm piece of plastic scintillator bonded with optical cement to a 0.6 mm diameter silica core optical fiber. A second, identical optical fiber running alongside the first, with no scintillator attached, was used for background subtraction. Two PMTs with high sensitivity in the visible were used at the fiber distal ends. There was a space for an optical filter between the fiber and the PMTs, whose purpose is described below. The PMTs were connected to a differential pair whose output was transferred to a current source for measurement by a standard electrometer. Results: The scintillation spectra of six different types of silica core optical fibers in the presence of the

  2. Immediate and delayed hypersensitivity reactions to intravascular iodine based radiocontrast media -- an update.

    Science.gov (United States)

    Bumbăcea, Roxana Silvia; Petruţescu, Brînduşa; Bumbăcea, Dragoş; Strâmbu, Irina

    2013-01-01

    Used since 1929 in medical practice, nowadays four chemical varieties of intravascular iodine based radiocontrast media (I-RCM) are available: ionic monomers with high osmolarity, ionic dimers with low osmolarity, non-ionic monomers with low osmolarity and non-ionic iso-osmolar dimers. Increasing prescription of l-RCMs augments the number of reported hypersensitivity reactions. I-RCM induced hypersensitivity reactions can be dclasified in two types: immediate hypersensitivity reactions (IHRs - occurring within the first hour) and delayed hypersensitivity reactions (DHRs - occurring between 1 hour and 7 days). IHRs usually present as urticaria and angioedema but may associate severe respiratory and cardiovascular symptoms. Risk factors for an IHRs include a prior immediate reaction, personal history of atopic diseases (mainly asthma) and treatment with beta blocking agents. Diagnostic tests for IHRs include blood tests (serum tryptase) and skin tests (prick and intradermal) performed 2 to 6 months after IHR. High osmolarity of the I-RCM is the factor most strongly associated with IHRs. Primary prevention of IHRs involves the use of non-ionic low-osmolar or iso-osmolar agents for all intravascular procedures. DHRs are usually mild to moderate in severity, transient and self-limiting, presenting as maculopapular rash in more than 50% of cases. As with IHRs, the most important risk factor for DHRs is a previous reaction to I-RCM. Assessment of DHRs includes skin prick tests, intradermal and patch tests. Due to extensive cross-reactivity between I-RCM, a change of product is no guarantee against a repeated reaction. Current premedication procedures in patients with previous severe reactions can reduce symptoms, but may not prevent recurrent reactions.

  3. Prediction of postpercutaneous coronary intervention myocardial infarction: insights from intravascular imaging, coronary flow, and biomarker evaluation.

    Science.gov (United States)

    Hoole, Stephen P; Hernández-Sánchez, Jules; Brown, Adam J; Giblett, Joel P; Bennett, Martin R; West, Nick E J

    2018-05-01

    Percutaneous coronary intervention-induced myocardial infarction (PMI) has prognostic significance. Identifying patients at high risk for PMI is desirable as it may alter strategy and facilitate early preventative therapy. We therefore sought to establish whether preprocedural demographic, interventional (plaque characteristics and coronary microcirculatory function), and inflammatory, endothelial damage, and platelet-derived biomarker data could predict the risk of PMI. We performed target vessel pressure wire to assess fractional flow reserve, index of microcirculatory resistance (IMR) and coronary flow reserve, plaque characterization by virtual histology intravascular ultrasound, and assayed peripheral biomarkers before uncomplicated PCI in 88 patients. We then analyzed post-PCI cardiac troponin level to adjudicate PMI based on the third universal definition of myocardial infarction. Overall incidence of PMI was 27%. Women [10/15 (66%) vs. 14/73 (19%), PPMI. Preprocedural coronary flow reserve was lower in individuals with a subsequent PMI (1.8±1.2 vs. 2.1±1.3. P=0.03), and patients with higher pre-PCI IMR were more likely to sustain PMI [IMR>22: 10/23 (44%) vs. ≤22: 14/65 (22%), P=0.04], although neither was predictive after multivariate analysis. Plaque characterization by virtual histology intravascular ultrasound did not discriminate those at risk of PMI. However, peripheral venous interleukin (IL)-18 and IL-8 levels were independently negatively and positively associated with PMI, respectively. Women and those with low BMI, particularly when associated with high IL-8 and low IL-18 levels, appear to be at increased risk of PMI.

  4. Intravascular large B-cell lymphoma of the kidney: A case report

    Directory of Open Access Journals (Sweden)

    Jia Nan

    2011-09-01

    Full Text Available Abstract We report a 41-year-old Chinese woman with intravascular large B-cell lymphoma diagnosed by percutaneous renal biopsy. The patient was admitted to Nanfang Hospital of Southern Medical University, Guangzhou, China with complaints of high spiking fever for a month and bilateral lower limb fatigue with difficulty ambulating for the past 5 months. She had renal dysfunction with a total urinary protein of 5.61 g/dL (56.1 g/L, serum albumin of 2.89 g/dL (28.9 g/L, urea nitrogen of 2.24 mg/dL (1.6 mmol/L, and serum creatinine of 0.54 mg/dL (48 μmol/L. Bone marrow biopsy revealed myeloproliferative disorder without abnormal myeloid or lymphocytic proliferation. Positron Emission Tomography-Computed Tomography (PET-CT showed marked bilateral swelling and enlargement of the renal parenchyma with splenic enlargement and involvement of multiple vertebrae. Percutaneous renal biopsy showed island-like accumulations of medium to large lymphoid cells in many areas of the interstitium, with round vesicular nuclei containing distinct basophilic nucleoli. Immunohistochemical analysis together with other supportive investigation confirmed the diagnosis of intravascular large B-cell lymphoma. Ten days later, she was started on chemotherapy with CHOP (cyclophosphamide, doxorubicin, leurocristime and prednisone for a week. Palliative radiotherapy DT 40Gy/20F with other supportive treatment was provided for metastatic foci in the medullary cavity of the sternum, T1-T7. The patient regained muscle strength in both lower limbs and was able to walk again after three weeks. The patient was discharged after hepatic and renal function and proteinuria values had returned to normal. Follow-up data shows the patient to be alive nine months after discharge.

  5. Establishment of virtual three-dimensional model for intravascular interventional devices and its clinical value

    International Nuclear Information System (INIS)

    Wei Xin; Zhong Liming; Xie Xiaodong; Wang Chaohua; You Jian; Hu Hong; Hu Kongqiong; Zhao Xiaowei

    2012-01-01

    Objective: To explore virtual three-dimensional (3D) model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work. Methods: The virtual models including catheter, guide wire, stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization (anterior communicating artery 5, posterior communicating artery 10,middle cerebral artery 3, internal carotid artery 2, and vertebral artery 1), during interventional procedures, the surgeon relied on the simulation results for plastic micro-guide wire, catheter and the release of micro-coils and stents. Results: (1) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours. The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter, molding micro-guide wire tip, and shortened the operating time. For embolization, the simulation results of filling coil and releasing stent were similar to surgical results in 76% of the patients (16/21). (3)For teaching and training, 93% (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. Conclusions: The method of virtual model of intravascular interventional devices was reliable. The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity, and could play a role in promoting researches on interventional virtual operations. (authors)

  6. The effects of serial intravascular transfusions in ascitic/hydropic RhD-alloimmunized fetuses.

    Science.gov (United States)

    Craparo, F J; Bonati, F; Gementi, P; Nicolini, U

    2005-02-01

    To evaluate the effects of serial intravascular transfusions on RhD-alloimmunized fetuses with ascites/hydrops at the time of the first transfusion by measuring multiple hematological/biochemical blood variables. Thirty-one singleton pregnancies were referred for management of RhD alloimmunization. Seven fetuses had hydrops on presentation and were transfused immediately. The remainder underwent weekly ultrasound examinations, and fetal blood sampling and transfusion were performed on development of ascites. In the 104 samples collected overall from the 31 fetuses, glucose, uric acid, urea, creatinine, total protein, total and direct bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase, alkaline phosphatase, lactic dehydrogenase, amylase, pseudocholinesterase (PCHE), creatine kinase, triglycerides and cholesterol were measured and compared with a reference range for non-anemic fetuses. The median gestational age at first transfusion was 26 (range, 18-34) weeks. There were three fetal losses after the first transfusion, two of which were due to procedure-related complications; one further loss occurred. At the first transfusion fetal hematocrit, pO2, total protein, PCHE, creatinine and urea concentrations were significantly decreased compared to reference data, while total and direct bilirubin, AST, ALT, amylase, triglyceride and uric acid concentrations were increased. In all surviving fetuses ascites/hydrops had disappeared by the second transfusion. Fetal pO2, total protein, AST, ALT and PCHE concentrations had normalized by the third transfusion. Correction of fetal anemia did not affect the other variables. RhD-alloimmunized fetuses with ascites/hydrops at the time of the first transfusion had a survival rate of 87%. Alterations of several biochemical fetal blood indices are present at the first sampling/transfusion, but most variables normalize with intravascular transfusions. Copyright 2005 ISUOG.

  7. Low molecular weight heparin attenuates multiple organ failure in a murine model of disseminated intravascular coagulation.

    Science.gov (United States)

    Slofstra, Sjoukje H; van 't Veer, Cornelis; Buurman, Wim A; Reitsma, Pieter H; ten Cate, Hugo; Spek, C Arnold

    2005-06-01

    Bacterial sepsis causes widespread vascular inflammation that frequently leads to disseminated intravascular coagulation (DIC). Although intravascular coagulation contributes to organ failure, it is often debated whether anticoagulant therapy produces any beneficial effects in patients with DIC. The aim of this study was to document potential beneficial effects of low molecular weight heparin (LMWH) in a lipopolysaccharide-induced DIC model. Controlled animal experiment combined with an in vitro laboratory study. Academic research laboratory. C57BL/6 mice subjected to two injections of Serratia Marcescens lipopolysaccharide (LPS) resulting in the generalized Shwartzman's reaction as a model for DIC. LMWH (5 IU of anti-Xa activity) or saline was administered before both LPS injections and 10 hrs after the first exposure to LPS. To test the effect of LMWH on LPS-driven monocyte inflammatory responses, a human monocyte-human umbilical vein endothelial cell co-culture was used to determine E-selectin expression as a marker of monocyte adherence. In our murine DIC model, LMWH had no effect on markers of inflammation. In addition, no effect of LMWH was detected on monocyte adherence in the human monocyte-human umbilical vein endothelial cell co-culture. Organ damage, contrarily, was significantly reduced as determined by hepatic necrosis (p < .05), lung epithelial protein leakage (p < .05), and creatinine release from kidneys into plasma (p < .01). LMWH protection from organ failure resulted in an increase in survival (p = .06) in this model for DIC. These results demonstrate the significance of blood coagulation in the progression of DIC and hint at a beneficial role for LMWH anticoagulation in the management of DIC.

  8. Penetration of an artificial arterial thromboembolism in a live animal using an intravascular therapeutic microrobot system.

    Science.gov (United States)

    Jeong, Semi; Choi, Hyunchul; Go, Gwangjun; Lee, Cheong; Lim, Kyung Seob; Sim, Doo Sun; Jeong, Myung Ho; Ko, Seong Young; Park, Jong-Oh; Park, Sukho

    2016-04-01

    The biomedical applications of wireless robots are an active area of study. In addition to moving to a target lesion, wireless locomotive robots can deliver a therapeutic drug for a specific disease. Thus, they hold great potential as therapeutic devices in blood vessel diseases, such as thrombi and occlusions, and in other diseases, such as cancer and inflammation. During a percutaneous coronary intervention (PCI), surgeons wear a heavy shielding cloth. However, they cannot escape severe radiation exposure owing to unstable shielding. They may also suffer from joint pains because of the weight of the shielding cloth. In addition, the catheters in PCIs are controlled by the surgeon's hand. Thus, they lack steering ability. A new intravascular therapeutic system is needed to address these problems in conventional PCIs. We developed an intravascular therapeutic microrobot system (ITMS) using an electromagnetic actuation (EMA) system with bi-plane X-ray devices that can remotely control a robot in blood vessels. Using this proposed ITMS, we demonstrated the locomotion of the robot in abdominal and iliac arteries of a live pig by the master-slave method. After producing an arterial thromboembolism in a live pig in a partial iliac artery, the robot moved to the target lesion and penetrated by specific motions (twisting and hammering) of the robot using the proposed ITMS. The results reveal that the proposed ITMS can realize stable locomotion (alignment and propulsion) of a robot in abdominal and iliac arteries of a live pig. This can be considered the first preclinical trial of the treatment of an artificial arterial thromboembolism by penetration of a blood clot. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  9. HDR intralumenal brachytherapy in bronchial cancer: review of our experience

    International Nuclear Information System (INIS)

    Muto, P.; Ravo, V.; Muschera, R.

    1996-01-01

    The main indications for brachytherapy in the treatment of endobronchial cancer are dyspnea. postobstructive pneumonia and atelectasis, cough and hemoptysis resulting from broncus obstruction by exophytic intralumenal tumor growth. High Dose Rate intralumenal brachytherapy (HDRBT) may be combined with external beam radiotherapy (EBRT), in particular as almost all tumors are too large for HDRBT alone. From January 1992 to September 1995 we treated 268 patients affected by bronchial cancer, with EBRT combined with HDRBT. All patients were staged as IIIa-IIIb-IV but KPS was >60 and expectancy of life > than 3 months. After bronchoscopy and Tc simulation we found that almost 10% of patients were downstaged. Treatment was always realized delivering 60 Gy to the tumour volume and 50 Gy to the mediastinal structures with EBRT. Brachytherapy was performed during the radiotherapy course. In 38 patients HDRBT was realized just one time, at the beginning of EBRT, with a dose of 10 Gy calculated at 1cm from the central axis of the catheter. In 47 HDRBT was performed twice (at the beginning and at the end of EBRT) with a dose of 7 Gy calculated at 1 cm from the central axis. From 1994 we started a 3 fractions protocol (Timing: days 1.15.30) with a dose of 5 Gy calculated at 0.5 cm from the axis. Of the 183 patients introduced in the protocol 170 received the three fractions of HDRBT and 13 were excluded from the study for personal or clinical reasons. In 97% of cases the application did not need general anesthesia; local anesthesia has been sufficient supplemented by some drug for sedation and coughing. Anyway both bronchoscopy and HDRBT (with anterior-posterior and lateral chest X-ray) are performed in the same shielded room without the necessity of displacing the patient. In almost 60% of treatments we used just one endobronchial applicator. In case of tumor involvement of the carina, two applicators were introduced. By this a larger tumor volume can be treated with adequate

  10. Effectiveness of brachytherapy in treating carcinoma of the vulva

    International Nuclear Information System (INIS)

    Pohar, Surjeet; Hoffstetter, Sylvette; Peiffert, Didier; Luporsi, Elisabeth; Pernot, Monique

    1995-01-01

    Purpose: Radical radiotherapeutic management of vulvar cancer often incorporates brachytherapy as a portion of the treatment regimen. However, few studies using this modality alone to manage vulvar cancer have been published. Methods and Materials: Thirty four patients were treated with iridium-192 ( 192 Ir) brachytherapy for vulvar cancer between 1975 and 1993 at Centre Alexis Vautrin. Twenty-one patients were treated at first presentation when surgery was contraindicated or declined. Of these patients, 12 had International Federation of Gynecology and Obstetrics Classification Stage III or IV disease, 8 were Stage II, 1 was Stage I, and 1 was Stage 0. Thirteen patients were treated for recurrent disease. Paris system rules for implantation and dose prescription were followed. The median reference dose was 60 Gy (range 53 to 88 Gy). At the time of analysis, 10 of 34 patients were alive. Median follow-up in these 10 patients was 31 months (range: 21 months to 107 months). Fourteen of the 24 deaths were from causes other than vulvar cancer. Results: Kaplan-Meier actuarial 5-year local control was 47% (95% confidence interval (CI) = 23 to 73%) and 5-year actuarial loco-regional control was 45% (95% CI = 21 to 70%). Kaplan-Meier actuarial 5-year disease-specific survival was 56% (95% CI = 33 to 76%) and actuarial 5-year survival was 29% (95% CI = 15 to 49%). Median time to death was 14 months. Subset analysis revealed a higher actuarial 5-year local control in patients treated at first presentation than those treated for recurrence (80 vs. 19%, log rank, p = 0.04). Similarly, actuarial 5-year loco-regional control was higher in patients treated at first presentation (80 vs. 16%, log rank, p 0.01). The two groups did not differ significantly in disease-specific or overall survival. The actuarial 5-year disease specific survival of 56% is somewhat less than the expected 5-year disease-specific survival after surgery in a group having a similar proportion of early stage

  11. Critical Organ Preservation in Reirradiation Brachytherapy by Injectable Spacer

    International Nuclear Information System (INIS)

    Kishi, Kazushi; Sonomura, Tetsuo; Shirai, Shintaro; Sato, Morio; Tanaka, Kayo

    2009-01-01

    Purpose: This case series study evaluated the feasibility and effectiveness of an interstitial high-dose rate brachytherapy (HDR-BT) procedure combined with an at-risk organ-sparing procedure. Methods and Materials: Thirty patients who were scheduled for reirradiation treatment for recurrent cancer after receiving a median dose of 60 Gy (range, 44-70 Gy) in 2-Gy fractions of previous external beam treatment were enrolled. Thirteen patients had lesions in the head and neck, and other lesions were located in the axilla, skeleton, breast, pelvis, and abdominal wall. Chief complaints included local masses (for 25) and refractory pain (for 21). After high-dose rate brachytherapy applicator needle implantation, an optimal CT-based three-dimensional brachytherapy plan was created with a virtual at-risk organ shift from the target. According to the plan, hyaluronic acid gel was injected to maintain the shift during irradiation. The prescribed dose was the result of an individualized tradeoff between target dose and at-risk organ dose, to avoid serious complications. A single-fraction dose of 18.0 Gy (median, equivalent to 75.6 Gy at an α/β value of 3; range, 16-20 Gy) was applied to the tumor. Results: The at-risk organ dose decreased from 9.1 ± 0.9 Gy to 4.4 ± 0.4 Gy (mean ± standard deviation, p < 0.01), and the normal tissue complication probability decreased from 60.8% ± 12.6% to 16.1% ± 19.8% (p < 0.01). The shift effect lasted at least 4 hours and disappeared gradually. Distinct tumor shrinkage in 20 of 21 eligible patients, including tumor disappearance in 6 patients, pain reduction in 18 of 21 eligible patients, and no unexpected late toxicity greater than grade 2 were observed during the 19.5-month observation period. Conclusions: This at-risk organ-sparing preservation procedure may provide a safe and efficient reirradiation treatment.

  12. Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns

    Energy Technology Data Exchange (ETDEWEB)

    Cunha, J. A. M.; Hsu, I-C.; Pouliot, J. [University of California, San Francisco, California 94115 (United States)

    2009-01-15

    Purpose: To determine whether alternative high dose rate prostate brachytherapy catheter patterns can result in similar or improved dose distributions while providing better access and reducing trauma. Materials and Methods: Standard prostate cancer high dose rate brachytherapy uses a regular grid of parallel needle positions to guide the catheter insertion. This geometry does not easily allow the physician to avoid piercing the critical structures near the penile bulb nor does it provide position flexibility in the case of pubic arch interference. This study used CT datasets with 3 mm slice spacing from ten previously treated patients and digitized new catheters following three hypothetical catheter patterns: conical, bi-conical, and fireworks. The conical patterns were used to accommodate a robotic delivery using a single entry point. The bi-conical and fireworks patterns were specifically designed to avoid the critical structures near the penile bulb. For each catheter distribution, a plan was optimized with the inverse planning algorithm, IPSA, and compared with the plan used for treatment. Irrelevant of catheter geometry, a plan must fulfill the RTOG-0321 dose criteria for target dose coverage (V{sub 100}{sup Prostate}>90%) and organ-at-risk dose sparing (V{sub 75}{sup Bladder}<1 cc, V{sub 75}{sup Rectum}<1 cc, V{sub 125}{sup Urethra}<<1 cc). Results: The three nonstandard catheter patterns used 16 nonparallel, straight divergent catheters, with entry points in the perineum. Thirty plans from ten patients with prostate sizes ranging from 26 to 89 cc were optimized. All nonstandard patterns fulfilled the RTOG criteria when the clinical plan did. In some cases, the dose distribution was improved by better sparing the organs-at-risk. Conclusion: Alternative catheter patterns can provide the physician with additional ways to treat patients previously considered unsuited for brachytherapy treatment (pubic arch interference) and facilitate robotic guidance of

  13. Commissioning and clinical implementation of HDR brachytherapy in El Salvador

    International Nuclear Information System (INIS)

    Morales Lopez, Jorge Luis; Castillo, Luis Frank; Castillo Bahi, Ramon del

    2009-01-01

    The Gynecologic Cancer is one of the best known malignancies in different countries of the world, with a high incidence in developing countries. In the treatment of this disease have been used multiple treatment arms among which is the high rate brachytherapy (HDR). The IAEA has put much emphasis on supporting all programs to treat this disease and in this context within the project 'Human Resource Development and Nuclear Technology Support', collaborated with the dispatch of experts on mission ELS0006 01 'Assistance to the ICES in HDR brachytherapy initiating Treatments at the Cancer Institute of El Salvador 'Dr. Narciso Diaz Bazan' in San Salvador, El Salvador. The process of commissioning and implementing clinical service Brachytherapy High Dose Rate (HDR BT) is a relatively complex process that begins with the formation of functional and technical service, based on flow patients to be treated, availability of local technological capability to install, and culminates with the preparation and implementation of protocols. Experts involved in the implementation of this service divided this task in stages organized chronologically: 1st. Study of existing infrastructure and level of training of technical personnel available, 2nd. Proposal and application of amendments in order to adapt the facility to the planned patient flow and optimal use of technological infrastructure, 3rd. Establishment of the process of securing the disposable waste materials and not required, 4th. Performance of tests of physical commissioning clinical dosimetry and instrumentation unit, surgical and therapeutic, 5th. Training of technical personnel, 6th. Preparation of clinical protocol and 7th. Initiation and development of treatment for patients. All these steps are carried out with the integration and consensus of the entire multidisciplinary team that makes up the service and with the support of the administration as a prerequisite. Within two weeks the service was modified according to

  14. Outcomes and toxicities in patients with intermediate-risk prostate cancer treated with brachytherapy alone or brachytherapy and supplemental external beam radiation therapy.

    Science.gov (United States)

    Schlussel Markovic, Emily; Buckstein, Michael; Stone, Nelson N; Stock, Richard G

    2018-05-01

    To evaluate the cancer control outcomes and long-term treatment-related morbidity of brachytherapy as well as combination brachytherapy and external beam radiation therapy (EBRT) in patients with intermediate-risk prostate cancer. A retrospective review was conducted in a prospectively collected database of patients with intermediate-risk prostate cancer who were treated either with brachytherapy or brachytherapy and EBRT, with or without androgen deprivation therapy (ADT), in the period 1990-2014. Urinary and erectile dysfunction symptoms were measured using the International Prostate Symptom Score (IPSS), the Mount Sinai erectile function scale and the Sexual Health Inventory for Men (SHIM). Cancer control endpoints included biochemical failure and development of distant metastases. All statistical analyses were carried out using the Statistical Package for Social Science (SPSS). Survival curves were calculated using Kaplan-Meier actuarial methods and compared using log-rank tests. Cox regression multivariate analyses were used to test the effect of multiple variables on treatment outcomes. A total of 902 patients were identified, with a median follow-up of 91 months. Of these, 390 received brachytherapy and 512 received combination therapy with EBRT. In patients with one intermediate-risk factor, the addition of EBRT did not significantly affect freedom from biochemical failure or distant metastases. Among patients with two or three intermediate-risk factors, added EBRT did not improve freedom from biochemical failure. Significant differences in late toxicity between patients treated with brachytherapy vs combination brachytherapy and EBRT were identified including urge incontinence (P actuarial methods showed that patients receiving combination therapy more frequently experienced loss of potency, as measured by the Mount Sinai erectile function scale (P = 0.040). Brachytherapy monotherapy results in equal biochemical and distant control in both patients with

  15. Torque calculation in the induction motor with the finite element method; Calculo del par en el motor de induccion con el metodo del elemento finito

    Energy Technology Data Exchange (ETDEWEB)

    Castillo Diaz, Ramon

    2002-06-15

    In this work the method of the finite element is applied to the bi-dimensional analysis of the induction motor in operation in steady state, excited by sine sources of laminar currents and sine sources of voltage. The analysis is focused mainly in the calculation of the electromagnetic torque. The topics of electromagnetic theory are covered and in an idealized model of the induction motor, analytically and numerically with the method of the finite element, in the variant method of Galerkin, the vectorial potential and the torque are calculated. The results obtained with the analytical and numerical methods are compared. Three formulations are developed to calculate the torque with the method of the finite element, using triangular elements of first order, based in the equation of force of Lorentz, the Maxwell tensor and the principle of the virtual work. Finally, a motor of induction of real characteristics is simulated, assuming it is connected to a three-phase voltage source. In this motor it is analyzed the convergence and the evolution in the results obtained of the torque with different discretions, and the torque-velocity performance curve is calculated. [Spanish] En este trabajo se aplica el metodo del elemento finito al analisis bidimensional del motor de induccion en operacion en estado estable, excitado por fuentes de corriente laminar senoidales y fuentes de voltaje senoidales. El analisis se enfoca principalmente en el calculo del par electromagnetico. Se tratan los topicos de teoria electromagnetica involucrados y en un modelo idealizado del motor de induccion, se calculan analitica y numericamente con el metodo del elemento finito, en la variante metodo de Galerkin, el potencial vectorial y el par. Se comparan resultados obtenidos con los metodos analiticos y numericos. Se desarrollan tres formulaciones para calcular el par con el metodo del elemento finito, utilizando elementos triangulares de primer orden, basadas en la ecuacion de fuerza de

  16. High-dose-rate brachytherapy for uterine cervical cancer: the results of different fractionation regimen

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Won Sup; Kim, Tae Hyun; Yang, Dae Sik; Choi, Myung Sun; Kim, Chul Yong [College of Medicine, Korea University, Seoul (Korea, Republic of)

    2002-09-15

    Although high-dose-rate (HDR) brachytherapy regimens have been practiced with a variety of modalities and various degrees of success, few studies on the subject have been conducted. The purpose of this study was to compare the results of local control and late complication rate according to different HDR brachytherapy fractionation regimens in uterine cervical cancer patients. From November 1992 to March 1998, 224 patients with uterine cervical cancer were treated with external beam irradiation and HDR brachytherapy. In external pelvic radiation therapy, the radiation dose was 45 {approx} 54 Gy (median dose 54 Gy) with daily fraction size 1.8 Gy, five times per week. In HDR brachytherapy, 122 patients (Group A) were treated with three times weekly with 3 Gy to line-A (isodose line of 2 cm radius from source) and 102 patients (Group B) underwent the HDR brachytherapy twice weekly with 4 or 4.5 Gy to line-A after external beam irradiation. Iridium-192 was used as the source of HDR brachytherapy. Late complication was assessed from grade 1 to 5 using the RTOG morbidity grading system. The local control rate (LCR) at 5 years was 80% in group A and 84% in group B ({rho} = 0.4523). In the patients treated with radiation therapy alone, LCR at 5 years was 60.9% in group A and 76.9% in group B ({rho} = 0.2557). In post-operative radiation therapy patients, LCR at 5 years was 92.6% in group A and 91.6% in group B ({rho} 0.8867). The incidence of late complication was 18% (22 patients) and 29.4% (30 patients), of bladder complication was 9.8% (12 patients) and 14.7% (15 patients), and of rectal complication was 9.8% (12 patients) and 21.6% (22 patients), in group A and B, respectively. Lower fraction sized HDR brachytherapy was associated with decrease in late complication ({rho} =0.0405) (rectal complication, {rho} = 0.0147; bladder complication, {rho} =0.115). The same result was observed in postoperative radiation therapy patients ({rho} = 0.0860) and radiation only

  17. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gestaut, Matthew M., E-mail: Matthew.Gestaut@BSWHealth.org [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); Cai, Wendi [Department of Biostatistics, Baylor Scott and White Health, Temple, Texas (United States); Vyas, Shilpa [Department of Radiation Oncology, Swedish Cancer Institute, Seattle, Washington (United States); Patel, Belur J. [Department of Urology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); Hasan, Salman A. [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States); MunozMaldonado, Yolanda [Department of Biostatistics, Baylor Scott and White Health, Temple, Texas (United States); Deb, Niloyjyoti; Swanson, Gregory [Department of Radiation Oncology, Baylor Scott and White Memorial Hospital, Texas A& M University School of Medicine, Temple, Texas (United States)

    2017-05-01

    Purpose: Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Methods and Materials: Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. Results: A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression–free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (P<.0001). The 5-year bPFS rate was 70.0% (LRC), 51.4% (IRC), 89.4% (LRB), and 89.7% (IRB). The bPFS rate was significantly different between brachytherapy and cryotherapy for low- and intermediate-risk groups (P<.05). The mean nadir temperature reached for cryotherapy patients was −35°C (range, −96°C to −6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Conclusions: Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with

  18. Inverse planning in brachytherapy from radium to high rate 192 iridium afterloading

    International Nuclear Information System (INIS)

    Lahanas, M.; Mould, R.F.; Baltas, D.; Karauzakis, K.; Giannouli, S.; Baltas, D.

    2004-01-01

    We consider the inverse planning problem in brachytherapy, i.e. the problem to determine an optimal number of catheters, number of sources for low-dose rate brachytherapy (LDR) and the optimal dwell times for high-dose rate brachytherapy (HDR) necessary to obtain an optimal as possible dose distribution. Starting from the 1930s, inverse planning for LDR brachytherapy used geometrically derived rules to determine the optimal placement of sources in order to achieve a uniform dose distribution of a specific level in planes, spheres and cylinders. Rules and nomograms were derived which still are widely used. With the rapid development of 3D imaging technologies and the rapidly increasing computer power we have now entered the new era of computer-based inverse planning in brachytherapy. The inverse planning is now an optimisation process adapted to the individual geometry of the patient. New inverse planning optimisation algorithms are anatomy-based that consider the real anatomy of the tumour and the organs at risk (OAR). Computer-based inverse planning considers various effects such as stability of solutions for seed misplacements which cannot ever be solved analytically without gross simplifications. In the last few years multiobjective (MO) inverse planning algorithms have been developed which recognise the MO optimisation problem which is inherent in inverse planning in brachytherapy. Previous methods used a trial and error method to obtain a satisfactory solution. MO optimisation replaces this trial and error process by presenting a representative set of dose distributions that can be obtained. With MO optimisation it is possible to obtain information that can be used to obtain the optimum number of catheters, their position and the optimum distribution of dwell times for HDR brachytherapy. For LDR brachytherapy also the stability of solutions due to seed migration can also be improved. A spectrum of alternative solutions is available and the treatment planner

  19. Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Gestaut, Matthew M.; Cai, Wendi; Vyas, Shilpa; Patel, Belur J.; Hasan, Salman A.; MunozMaldonado, Yolanda; Deb, Niloyjyoti; Swanson, Gregory

    2017-01-01

    Purpose: Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy. Methods and Materials: Institutional review board approval was obtained to conduct a retrospective chart review of consecutive patients treated at our institution from 1990 to 2012. For inclusion, patients must have received a prostate cancer diagnosis and have been considered to have low- to intermediate-risk disease according to the National Comprehensive Cancer Network criteria. All patients received brachytherapy or cryotherapy treatment. Disease specifics and failure details were collected for all patients. Failure was defined as prostate-specific antigen nadir +2 ng/mL. Results: A total of 359 patients were analyzed. The groups comprised 50 low-risk cryotherapy (LRC), 92 intermediate-risk cryotherapy (IRC), 133 low-risk brachytherapy (LRB), and 84 intermediate-risk brachytherapy (IRB) patients. The median prostate-specific antigen follow-up periods were 85.6 months (LRC), 59.2 months (IRC), 74.9 months (LRB), and 59.8 months (IRB). The 5-year biochemical progression–free survival (bPFS) rate was 57.9% in the cryotherapy group versus 89.6% in the brachytherapy group (P<.0001). The 5-year bPFS rate was 70.0% (LRC), 51.4% (IRC), 89.4% (LRB), and 89.7% (IRB). The bPFS rate was significantly different between brachytherapy and cryotherapy for low- and intermediate-risk groups (P<.05). The mean nadir temperature reached for cryotherapy patients was −35°C (range, −96°C to −6°C). Cryotherapy used a median of 2 freeze-thaw cycles (range, 2-4 freeze-thaw cycles). Conclusions: Results from this study suggest that cryotherapy is inferior to brachytherapy for patients with

  20. Automation of brachytherapy planning based on RADPLAN system

    International Nuclear Information System (INIS)

    Costa, Helder Rodrigues da; Campos, Tarcisio P.R.

    2000-01-01

    RADPLAN is a software to automate the clinical planning of doses in brachytherapy managing the radionuclide source position and time. It intends to be a important tools to assist cancer treatment in the radiotherapy services. It evaluates the tridimensional isodoses for a set of radioactive sources implanted on tissue or placed inside a body cavity. RADPLAN allows visualization of virtual frames in which isodose curves overlap medical images produced in computerized tomography), X-ray and nuclear magnetic resonance equipment. In this work, the software function is explained and a hypothetic case of medical information management is presented, specifically illustrations of isodoses curves obtained for a spatial distribution of Ir 192 wires implanted in a breast. (author)

  1. A new human eye model for ophthalmic brachytherapy dosimetry

    International Nuclear Information System (INIS)

    Yoriyaz, H.; Sanchez, A.; Dos Santos, A.

    2005-01-01

    The present work proposes a new mathematical eye model for ophthalmic brachytherapy dosimetry. This new model includes detailed description of internal structures that were not treated in previous works, allowing dose determination in different regions of the eye for a more adequate clinical analysis. Dose calculations were determined with the MCNP-4C Monte Carlo particle transport code running n parallel environment using PVM. The Amersham CKA4 ophthalmic applicator has been chosen and the depth dose distribution has been determined and compared to those provide by the manufacturer. The results have shown excellent agreement. Besides, absorbed dose values due to both 125 I seeds and 60 Co plaques were obtained for each one of the different structures which compose the eye model and can give relevant information in eventual clinical analyses. (authors)

  2. A new afterloading applicator for primary brachytherapy of endometrial cancer

    International Nuclear Information System (INIS)

    Bauer, M.; Schulz-Wendtland, R.

    1993-01-01

    The authors describe and have used a new afterloading applicator in six patients for primary radiation therapy of endometrial cancer. The first introduction of the applicator was done under general anaesthesia. Dilating the cervical canal to Heger 9 made insertion easier. Prior to application it is advisable to probe the lumen of the uterine cavity with a tube or curette to estimate how far the applicator must be spread open. For brachytherapy it is advantageous to remove necrotic tumour portions. This requires experienced hands to avoid perforation of the uterus. The new afterloading applicator is easy to use, and permits direct contact between the six tubes and the tumour. In conjunction with careful planning with the help of MRI, it provides an optimal system for the treatment of endometrial cancer. (Author)

  3. Evaluating the cost of therapy for restenosis: considerations for brachytherapy.

    Science.gov (United States)

    Weintraub, W S

    1996-11-01

    Costs have become increasingly important in medicine in recent years as demand for services has outstripped readily available resources. Clinical microeconomics offers an approach to understanding cost and outcomes in an environment of economic scarcity. In this article the types of costs and methods for determining cost are presented. In addition, methods for assessing outcome and outcome in relation to cost are developed. Restenosis after coronary angioplasty is a prime example of a clinical problem requiring economic evaluation. This is because it results in little serious morbidity except for recurrent chest pain, but it has serious economic consequences which occur some time after the original angioplasty. This makes the economic assessment of restenosis complicated. The application of health care microeconomic principles to brachytherapy for restenosis in the coronary arteries is presented.

  4. Choroidal melanoma recurrence after episcleral brachytherapy and transpupillary thermotherapy

    Directory of Open Access Journals (Sweden)

    Yrbani Lantigua-Dorville

    2016-02-01

    Full Text Available ABSTRACT A 68-year-old man diagnosed with choroidal melanoma (CM in the right eye underwent treatment with episcleral brachytherapy (I125 and transpupillary thermotherapy. Ultrasound, computed tomography, and magnetic resonance imaging were performed and revealed ocular recurrence of CM. Treatment with extended enucleation was performed. Macroscopic and microscopic examinations revealed extraocular extension and malignant cells, respectively. Immunohistochemistry demonstrated tumoral Melan-A and HMB-45 expression. No cytogenic abnormalities were detected with fluorescence in situhybridization of tumor cells using probes against chromosomes 3q27 and 8q24. The patient underwent adjuvant external beam radiotherapy for treatment of residual tumor tissue. This case represents the first reported case of recurrent CM with no cytogenetic abnormalities and the absence of metastatic disease, despite a number of the poorest prognostic factors.

  5. The present state of brachytherapy practice in the Czech Republic

    International Nuclear Information System (INIS)

    Zackova, H.; Drabkova, A.

    1995-01-01

    In spite of the fact that radiotherapy departments in the Czech republic have been following the general European and world trends in brachytherapy techniques and that they are installing the new remote AFL systems, the reserves of radium sources are still considerably high and not all professionals carry out their applications of radioactive sources by (at least) manual AFL. In near future the attention should be paid to the diminution of the unnecessary radium reserves at that radiotherapy departments where the small number of applications is executed or where the new remote AFL systems are used. For professionals practically thorough radiation protection is assured when new remote AFL systems are used. But in this case an attention should be paid to the radiation safety of the patient because of the potential exposures when high dose rate systems would failed. The likelihood of this unwanted cases can only be decreased when Quality Assurance programs is introduced into practice

  6. Evaluating the cost of therapy for restenosis: considerations for brachytherapy

    International Nuclear Information System (INIS)

    Weintraub, William S.

    1996-01-01

    Costs have become increasingly important in medicine in recent years as demand for services has outstripped readily available resources. Clinical microeconomics offers an approach to understanding cost and outcomes in an environment of economic scarcity. In this article the types of costs and methods for determining cost are presented. In addition, methods for assessing outcome and outcome in relation to cost are developed. Restenosis after coronary angioplasty is a prime example of a clinical problem requiring economic evaluation. This is because it results in little serious morbidity except for recurrent chest pain, but it has serious economic consequences which occur some time after the original angioplasty. This makes the economic assessment of restenosis complicated. The application of health care microeconomic principles to brachytherapy for restenosis in the coronary arteries is presented

  7. Phantom's construction for dose measurement in brachytherapy

    International Nuclear Information System (INIS)

    Tri Harjanto; Hidayat Joko Puspito; Joko Triyanto

    2009-01-01

    In nuclear medicine, dose rate validation is the key for a successful process in therapy and diagnose of any deases. Therefore, the brachytherapy equipment being designed and constructed is to be validated its dose rate received by the radiated object. A phantom for such validation purpose is designed and constructed as a correct as if on site geometrical position of sources. The design of phantom consists of seven layers of flexi glass plates: 10 mm thick, 105 mm wide, and 280 mm length. All the plates are to be holed according to the size of the applicator to be used. Every surface of the flexi glass layers is grooved 1 mm wide, 1 mm depth, and 10 mm distance between the groove. The applicator inside the phantom is positioned at a certain reference for measurement. Every TLD installed has a fix position toward the reference coordinate and has an index number. By this system of phantom, the isodose system can be plotted. (author)

  8. Computerized planning and dosimetry for brachytherapy in carcinomas cervix

    International Nuclear Information System (INIS)

    Kizilbash, N.A.; Jabeen, K.; Hussain, R.

    1996-01-01

    A project on the use of computerize planning and dosimetry for brachytherapy in carcinoma of cervix was started at NORI (Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad) in september 1990. A total number of 182 patients were included in the study over a period of three years. The treatment of all these patients was done by external radiation as well as the intracavitary therapy. Planning and dosimetry was done according to ICRU 38 recommendations. 70 patients were planned with two computers TP-II (Dr. J. Cunningham's software) and PC based system (Dr. Kallinger's software, BTI system). From the results of the two computers TP-II and PC, it can be seen that the difference in a absorbed dose for all recommended points in not going to harm the patient. The dose to the bladder and the rectum in our studies is quite low because of the low activity in the ovoid sources. (author)

  9. Cs-137 brachytherapy sources calibration with well chamber

    International Nuclear Information System (INIS)

    Brunetto, M.; Sansogne, R.; Arbiser, S.; Duran, M.P.

    2004-01-01

    This work describes the procedures and actions developed for the identification and reference air kerma rate (S k ) verification of Cs-137 sources used in gynecological brachytherapy practices. Following the IAEA TECDOC 1151 recommendations, the first stage consisted in designing the documentation required for the inventory and shipping registry of sources, along with the digital spreadsheets for calculating the decay and S k of the sources at the moment of implantation. As a second stage, the S k of sources was measured, following the low dose rate sources protocol advise, with a Standard Imaging HDR 1000 Plus well chamber calibrated at the University of Wisconsin SSDL. The documentation generated through this procedure allows identify each source clearly and uni-vocally. No significant differences were found between the S k values obtained from the well chamber calibration procedure and those reported by the manufacturer in the corresponding certificates. The highest percent difference found was 2.3%. (author) [es

  10. Optimization in brachytherapy with the implementation of Radiobiology

    International Nuclear Information System (INIS)

    Duran, M.P.; Bourel, V.J.; Rodriguez, I.; Torre, M. de la; Caneva, S.

    1998-01-01

    In the brachytherapy planning treatments with High dose rates (HDR), the optimization algorithms used are based in dosimetric considerations and/or geometric ones, ignoring the radiobiological response of the tissue treated. In this work we wish to show the implementation of radiobiological concepts in the optimization. Assuming that the subtiles differences that result in the dose distribution among the different optimization models which are not visible in an isodose plane, it is studied how is classically make it , the quality implant through natural histograms about dose volumes and the resulting parameters. Also is studied the necrosis probability which may be caused by the choice of some optimization model, allowing with this the choice of the best implant. (Author)

  11. Refining prostate seed brachytherapy: Comparing high-, intermediate-, and low-activity seeds for I-125 permanent seed prostate brachytherapy.

    Science.gov (United States)

    Delouya, Guila; Bahary, Pascal; Carrier, Jean-François; Larouche, Renée-Xavière; Hervieux, Yannick; Béliveau-Nadeau, Dominic; Donath, David; Taussky, Daniel

    2015-01-01

    To analyze the difference in prostate coverage and dose to the rectum in men with prostate carcinoma treated with permanent seed brachytherapy with different seed activities. Forty-nine patients treated with iodine-125 permanent seed prostate brachytherapy with low-activity seeds of 0.30-0.37 mCi were identified. For each of these patients, 2 patients with similar prostate volume (±2 cc) were paired: one treated with intermediate seed activity (0.44-0.46 mCi) and one with high seed activity (0.60-0.66 mCi). The doses to prostate and rectum were compared using CT on Day 30. A total of 147 patients divided into the three seed activity groups were analyzed. Mean prostate volume was 35.7 cc (standard deviation [SD], 11.70). Compared with low-activity seeds, implants with high-activity seeds consisted of an average of 22 seeds and 4.7 needles less. The dose to the prostate (prostate volume receiving 100% of the prescribed dose [V100], prostate volume receiving 150% of the prescribed dose, and minimal dose covering 90% of the prostate volume expressed in Gy) was not higher on Day 30 (p = 0.58-0.97). The mean volume (in cubic centimeters) of rectal wall receiving 100% of the prescribed dose (V100) increased with activity: low activity, 0.34 cc (SD, 0.49), intermediate activity, 0.47 cc (SD, 0.48), and high activity, 0.72 cc (SD, 0.79) (p = 0.009). There was a trend (p = 0.073) toward a higher frequency of clinically unfavorable rectal dosimetry (V100 > 1.3 cc) in patients with high-activity seeds (16.7%) compared with low-activity (6.3%) or intermediate-activity (4.2%) seeds. High-activity seeds do not result in a higher dose to the prostate but in a higher dose to the rectum. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  12. Development of prostate voxel models for brachytherapy treatment

    International Nuclear Information System (INIS)

    Santos, Adriano M.; Reis, Lucas P.; Grynberg, Suely E.

    2011-01-01

    The tools developed recently in the areas of computer graphics and animation movies to computer games allow the creation of new voxel anthropomorphic phantoms with better resolution and thus, more anatomical details. These phantoms can be used in nuclear applications, especially in radiation protection for estimating doses in cases of occupational or accidental radioactive incidents, and in medical and biological applications. For dose estimates, the phantoms are coupled to a Monte Carlo code, which will be responsible for the transport of radiation in this environment. This study aimed to develop a computational tool to estimate the isodose curves in the prostate after brachytherapy seed implants. For this, we have created a model called FANTPROST in the shape of a 48 mm side cube, with a standard prostate inserted in the center of this cube with different distributions of brachytherapy seeds in this volume. The prostate, according to this model, was obtained from the phantom voxels MASH2 developed by Numerical Dosimetry Group, Department of Nuclear Energy - Federal University of Pernambuco. The modeling of the seeds, added to FANTPROST, was done through the use of geometric information of Iodine-125 Amersham 6711 commercial seed. The simulations were performed by the code MCNP5 for spatial distributions containing different amounts of seeds within the FANTPROST. The obtained curves allowed an estimation of the behavior of the maximum dose that decreases with distance, showing that this tool can be used for a more accurate analysis of the effects produced by the presence of such seeds in the prostate and its vicinity. (author)

  13. Deterministic calculations of radiation doses from brachytherapy seeds

    International Nuclear Information System (INIS)

    Reis, Sergio Carneiro dos; Vasconcelos, Vanderley de; Santos, Ana Maria Matildes dos

    2009-01-01

    Brachytherapy is used for treating certain types of cancer by inserting radioactive sources into tumours. CDTN/CNEN is developing brachytherapy seeds to be used mainly in prostate cancer treatment. Dose calculations play a very significant role in the characterization of the developed seeds. The current state-of-the-art of computation dosimetry relies on Monte Carlo methods using, for instance, MCNP codes. However, deterministic calculations have some advantages, as, for example, short computer time to find solutions. This paper presents a software developed to calculate doses in a two-dimensional space surrounding the seed, using a deterministic algorithm. The analysed seeds consist of capsules similar to IMC6711 (OncoSeed), that are commercially available. The exposure rates and absorbed doses are computed using the Sievert integral and the Meisberger third order polynomial, respectively. The software also allows the isodose visualization at the surface plan. The user can choose between four different radionuclides ( 192 Ir, 198 Au, 137 Cs and 60 Co). He also have to enter as input data: the exposure rate constant; the source activity; the active length of the source; the number of segments in which the source will be divided; the total source length; the source diameter; and the actual and effective source thickness. The computed results were benchmarked against results from literature and developed software will be used to support the characterization process of the source that is being developed at CDTN. The software was implemented using Borland Delphi in Windows environment and is an alternative to Monte Carlo based codes. (author)

  14. CT use for nasopharingeal molds realization in endocavitary brachytherapy

    International Nuclear Information System (INIS)

    Lopez, J. Torrecilla; Crispin, V.; Chust, M.; Guinot, J.; Arribas, L.; Mengual, J.; Carrasco, P.; Miragall, E.; Hernandez, A.; Guardino, C.; Carrascosa, M.; Cardenal, R.; Casana, M.; Prats, C.

    1996-01-01

    Purpose: We present the following procedure for the making of individual molds with dental silicone for endocavitary brachytherapy of nasopharingeal cancer aided by CT scan. Procedure: Head immobilization during the realization of nasopharynx CT. Planification of treatment using these CT images, to determine the optimum position of radioactive sources. Printing on paper CT images with the nasopharynx contoured walls and the radioactive sources position. Realization of the mold in plastiline with the aid of the cuts of printer paper cut out with the nasopharynx form. Obtaining of the negative of the mold of plastiline by means of the use of alginate. Placement of two number 20 rectal rigid catheters with metal malleable bars inside them, in order to give them an adequate form in relation to the previous carried out planning. Filling in of alginato negative, where rectal catheters were placed, with Provil MCD Bayer Dental, a silicone based material for precision impression. We recommend to crossing the catheters' end with a number 2 silk thread to secure the catheter. An end of the silk thread is left outside the mold in order to help the extraction at the end of application. We advise to carry out a neuroleptic anaesthesia for its insertion, for the purpose of achieving a soft palate suitable relaxation. It makes the insertion easier. Repeat CT with the mold and phantoms in position to know a definitive dose distribution calculation. Conclusion: This method avoids the necessity of general anaesthesia in the realization of individual molds of nasopharyx for endocavitary brachytherapy and it improves the implant dosimetry

  15. Urethral stricture following high dose rate brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Sullivan, Lisa; Williams, Scott G.; Tai, Keen Hun; Foroudi, Farshad; Cleeve, L.; Duchesne, Gillian M.

    2009-01-01

    Purpose: To evaluate the incidence, timing, nature and outcome of urethral strictures following high dose rate brachytherapy (HDRB) for prostate carcinoma. Methods and materials: Data from 474 patients with clinically localised prostate cancer treated with HDRB were analysed. Ninety percent received HDRB as a boost to external beam radiotherapy (HDRBB) and the remainder as monotherapy (HDRBM). Urethral strictures were graded according to the Common Terminology Criteria for Adverse Events v3.0. Results: At a median follow-up of 41 months, 38 patients (8%) were diagnosed with a urethral stricture (6-year actuarial risk 12%). Stricture location was bulbo-membranous (BM) urethra in 92.1%. The overall actuarial rate of grade 2 or more BM urethral stricture was estimated at 10.8% (95% CI 7.0-14.9%), with a median time to diagnosis of 22 months (range 10-68 months). All strictures were initially managed with either dilatation (n = 15) or optical urethrotomy (n = 20). Second line therapy was required in 17 cases (49%), third line in three cases (9%) and 1 patient open urethroplasty (grade 3 toxicity). Predictive factors on multivariate analysis were prior trans-urethral resection of prostate (hazard ratio (HR) 2.81, 95% CI 1.15-6.85, p = 0.023); hypertension (HR 2.83, 95% CI 1.37-5.85, p = 0.005); and dose per fraction used in HDR (HR for 1 Gy increase per fraction 1.33, 95% CI 1.08-1.64, p = 0.008). Conclusions: BM urethral strictures are the most common late grade 2 or more urinary toxicity following HDR brachytherapy for prostate cancer. Most are manageable with minimally invasive procedures. Both clinical and dosimetric factors appear to influence the risk of stricture formation.

  16. The use of nomograms in LDR-HDR prostate brachytherapy

    Directory of Open Access Journals (Sweden)

    Ma Carmen Pujades

    2011-09-01

    Full Text Available Purpose: The common use of nomograms in Low Dose Rate (LDR permanent prostate brachytherapy (BT allowsto estimate the number of seeds required for an implant. Independent dosimetry verification is recommended for eachclinical dosimetry in BT. Also, nomograms can be useful for dose calculation quality assurance and they could be adaptedto High Dose Rate (HDR. This work sets nomograms for LDR and HDR prostate-BT implants, which are applied tothree different institutions that use different implant techniques. Material and methods: Patients treated throughout 2010 till April 2011 were considered for this study. This examplewas chosen to be the representative of the latest implant techniques and to ensure consistency in the planning. A sufficientnumber of cases for both BT modalities, prescription dose and different work methodology (depending on theinstitution were taken into account. The specific nomograms were built using the correlation between the prostatevo lume and some characteristic parameters of each BT modality, such as the source Air Kerma Strength, numberof implanted seeds in LDR or total radiation time in HDR. Results: For each institution and BT modality, nomograms normalized to the prescribed dose were obtained andfitted to a linear function. The parameters of the adjustment show a good agreement between data and the fitting.It should be noted that for each institution these linear function parameters are different, indicating that each centreshould construct its own nomograms. Conclusions: Nomograms for LDR and HDR prostate brachytherapy are simple quality assurance tools, specific foreach institution. Nevertheless, their use should be complementary to the necessary independent verification.

  17. Vaginal brachytherapy for early-stage carcinosarcoma of the uterus.

    Science.gov (United States)

    Brown, Lindsay C; Petersen, Ivy A; Haddock, Michael G; Bakkum-Gamez, Jamie N; Lee, Larissa J; Cimbak, Nicole C; Berkowitz, Ross S; Viswanathan, Akila N

    2015-01-01

    Uterine carcinosarcoma (CS) is an aggressive malignancy and the optimal adjuvant treatment is not well-established. We report outcomes with vaginal brachytherapy (VB) for women with early-stage CS. A multi-institutional retrospective study of Stage I-II CS treated with hysterectomy, surgical staging, and adjuvant high-dose-rate VB without external-beam pelvic radiotherapy was performed. Rates of vaginal control, pelvic control, locoregional control, disease-free survival, and overall survival were determined using the Kaplan-Meier method. 33 patients were identified. Prescribed VB dose was 21 Gy in three fractions (n = 15 [45%]) or 24 Gy in six fractions (n = 18 [55%]). Eighteen patients (55%) received chemotherapy. Median followup was 2.0 years. Twenty-seven patients (82%) underwent pelvic lymphadenectomy, 5 (15%) had nodal sampling, and 1 (3%) had no lymph node assessment. Relapse occurred in 11 patients (33%), all of whom had lymph node evaluation. Locoregional relapse was a component of failure in 6 patients (18%), of whom 3 (9%) failed in the pelvis alone. Three patients (9%) had simultaneous distant and locoregional relapse (two vaginal, one pelvic). Five additional patients (15%) had distant relapse. Six of the 11 patients (55%) with disease recurrence received chemotherapy. Two-year vaginal control and pelvic control were 94% and 87%. Two-year locoregional control, disease-free survival, and overall survival were 81%, 66%, and 79%. Despite having early-stage disease and treatment with VB, patients in this series had relatively high rates of local and distant relapse. Patients who undergo lymphadenectomy and VB remain at risk for relapse. Novel treatment strategies are needed. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. Development of prostate voxel models for brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Adriano M.; Reis, Lucas P.; Grynberg, Suely E., E-mail: amsantos@cdtn.b [Center for Development of Nuclear Technology (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    The tools developed recently in the areas of computer graphics and animation movies to computer games allow the creation of new voxel anthropomorphic phantoms with better resolution and thus, more anatomical details. These phantoms can be used in nuclear applications, especially in radiation protection for estimating doses in cases of occupational or accidental radioactive incidents, and in medical and biological applications. For dose estimates, the phantoms are coupled to a Monte Carlo code, which will be responsible for the transport of radiation in this environment. This study aimed to develop a computational tool to estimate the isodose curves in the prostate after brachytherapy seed implants. For this, we have created a model called FANTPROST in the shape of a 48 mm side cube, with a standard prostate inserted in the center of this cube with different distributions of brachytherapy seeds in this volume. The prostate, according to this model, was obtained from the phantom voxels MASH2 developed by Numerical Dosimetry Group, Department of Nuclear Energy - Federal University of Pernambuco. The modeling of the seeds, added to FANTPROST, was done through the use of geometric information of Iodine-125 Amersham 6711 commercial seed. The simulations were performed by the code MCNP5 for spatial distributions containing different amounts of seeds within the FANTPROST. The obtained curves allowed an estimation of the behavior of the maximum dose that decreases with distance, showing that this tool can be used for a more accurate analysis of the effects produced by the presence of such seeds in the prostate and its vicinity. (author)

  19. Two years results of electronic brachytherapy for basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Rosa Ballester-Sánchez

    2017-06-01

    Full Text Available Purpose: The use of radiation therapy (RT for non-melanoma skin cancer (NMSC has been changing throughout the last century. Over the last decades, the use of radiotherapy has surged with the development of new techniques, applicators, and devices. In recent years, electronic brachytherapy (eBT devices that use small x-ray sources have been introduced as alternative to radionuclide dependence. Nowadays, several devices have been incorporated, with a few series reported, and with a short follow-up, due to the recent introduction of these systems. The purpose of this work is to describe the clinical results of our series after two years follow-up with a specific eBT system. Material and methods: This is a prospective single-center, non-randomized pilot study, to assess clinical results of electronic brachytherapy in basal cell carcinoma using the Esteya® system. In 2014, 40 patients with 60 lesions were treated. Patient follow-up on a regular basis was performed for a period of two years. Results: Twenty-six patients with 44 lesions achieved two years follow-up. A complete response was documented in 95.5% of cases. Toxicity was mild (G1 or G2 in all cases, caused by erythema, erosion, or alopecia. Cosmesis was excellent in 88.6% of cases, and good in the rest. Change in pigmentation was the most frequent cosmetic alteration. Conclusions : This work is special, since the equipment’s treatment voltage was 69.5 kV, and this is the first prospective study with long term follow-up with Esteya®. These preliminary report show excellent results with less toxicity and excellent cosmesis. While surgery has been the treatment of choice, certain patients might benefit from eBT treatment. These are elderly patients with comorbidities or undergoing anticoagulant treatment as well as those who simply refuse surgery or might have other contraindications.

  20. Brachytherapy as sole treatment modality in initial cervix carcinoma

    International Nuclear Information System (INIS)

    Heredia Z, A.

    1993-01-01

    The aim of this study was to evaluate brachytherapy as the only treatment modality in inoperable early cervix carcinoma patients (carcinoma in situ, IA and IBocc). In a retrospective analysis 36 patients were treated with intracavitary irradiation between 1984 and 1988 in the Radiotherapy Department of the National Institute of Neoplasmic Diseases. Distribution by stage was; carcinoma in situ: one patient (2,47%), IA: six patients (16,6%), IBooc: twenty-nine patients (80,7%). Histology revealed epidermoid carcinoma in all cases. Mean age 55 years (range: 32-78). Treatment consisted in: two intracavitary applications of Radium, for 120 hours each, with a month interval, in 30 patients (carcinoma in situ: one, IA: four, IBocc: twenty-five patients), two applications of 72 hours each, with 15 days interval in four patients (IA: one, IBocc: 3) and one single intracavitary radium application in two patients (IA and IBocc). Local control was complete in all carcinoma in situ and IA patients. Only 1 of 29 patients with IBocc stage failed to respond, in spite of having received two applications, this shows that local response is independent of the number of insertions. Incidence of complications was low, and resolved with medical treatment. One patient had rectal adenocarcinoma 3 years after treatment -it was considered as radio induced neoplasm, since time of appearance was more than two years and localization was within irradiated area. Two patients died form intercurrent diseases, one (IBocc) from persistent diseases. Two patients were lost to follow-up. Three years survival was: 100% for carcinoma in situ and IA 86,2% for IBocc. Five years survival was 80% for IA and IBocc. Brachytherapy as unique modality of treatment is highly effective in initial cervix carcinoma stages. (author). 41 refs., 14 tabs., 2 figs., 1 ill

  1. The role of vaginal cuff brachytherapy in endometrial cancer.

    Science.gov (United States)

    Harkenrider, Matthew M; Block, Alec M; Siddiqui, Zaid A; Small, William

    2015-02-01

    The purpose of this article is to review the data, rationale, and recommendations of vaginal brachytherapy (VBT) in the post-operative treatment of endometrial cancer patients. The authors performed a thorough review of the medical literature regarding the use of adjuvant VBT in the treatment of endometrial cancer. Relevant data are presented in this review. Additionally, personal and institutional practices from the authors are incorporated where relevant. VBT for the adjuvant treatment of early stage endometrial cancer patients results in a low rate of recurrence (0-3.1%) with very low rates of toxicity. PORTEC-2 supports the use of adjuvant VBT versus external beam radiotherapy specifically for high-intermediate risk endometrial cancer patients. VBT has low rates of acute and chronic gastrointestinal and genitourinary toxicity and very low rates of second primary malignancy. The primary toxicity of VBT is vaginal atrophy and stenosis with controversy regarding the use of vaginal dilators for prevention. Data support that patients prefer to be involved in the decision making process for their adjuvant therapy, and patients have a lower minimal desired benefit of adjuvant VBT than do physicians. Guidelines exist from the American Brachytherapy Society and American Society of Radiation Oncology with support from the Society for Gynecologic Oncologists regarding the use of adjuvant VBT. VBT decreases the risk of recurrence with minimal toxicity in the adjuvant treatment of endometrial cancer. Adjuvant therapy should be discussed in a multi-disciplinary setting with detailed counseling of the risks and benefits with the patient so that she ultimately makes an informed decision regarding her adjuvant therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Evaluation of hypothetical (153)Gd source for use in brachytherapy.

    Science.gov (United States)

    Ghorbani, Mahdi; Behmadi, Marziyeh

    2016-01-01

    The purpose of this work is to evaluate the dosimetric parameters of a hypothetical (153)Gd source for use in brachytherapy and comparison of the dosimetric parameters with those of (192)Ir and (125)I sources. Dose rate constant, the radial dose function and the two dimensional (2D) anisotropy function data for the hypothetical (153)Gd source were obtained by simulation of the source using MCNPX code and then were compared with the corresponding data reported by Enger et al. A comprehensive comparison between this hypothetical source and a (192)Ir source with similar geometry and a (125)I source was performed as well. Excellent agreement was shown between the results of the two studies. Dose rate constant values for the hypothetical (153)Gd, (192)Ir, (125)I sources are 1.173 cGyh(-1) U(-1), 1.044 cGyh(-1) U(-1), 0.925 cGyh(-1) U(-1), respectively. Radial dose function for the hypothetical (153)Gd source has an increasing trend, while (192)Ir has more uniform and (125)I has more rapidly falling off radial dose functions. 2D anisotropy functions for these three sources indicate that, except at 0.5 cm distance, (192)Ir and (125)I have more isotropic trends as compared to the (153)Gd source. A more uniform radial dose function, and 2D anisotropy functions with more isotropy, a much higher specific activity are advantages of (192)Ir source over (153)Gd. However, a longer half-life of (153)Gd source compared to the other two sources, and lower energy of the source with respect to (192)Ir are advantages of using (153)Gd in brachytherapy versus (192)Ir source.

  3. Evaluation of (101)Rh as a brachytherapy source.

    Science.gov (United States)

    Pakravan, Delaram; Ghorbani, Mahdi; Meigooni, Ali Soleimani

    2015-04-01

    Recently a number of hypothetical sources have been proposed and evaluated for use in brachytherapy. In the present study, a hypothetical (101)Rh source with mean photon energy of 121.5 keV and half-life of 3.3 years, has been evaluated as an alternative to the existing high-dose-rate (HDR) sources. Dosimetric characteristics of this source model have been determined following the recommendation of the Task Group 43 (TG-43) of the American Association of the Physicist in Medicine (AAPM), and the results are compared with the published data for (57)Co source and Flexisource (192)Ir sources with similar geometries. MCNPX Monte Carlo code was used for simulation of the (101)Rh hypothetical HDR source design. Geometric design of this hypothetical source was considered to be similar to that of Flexisource (192)Ir source. Task group No. 43 dosimetric parameters, including air kerma strength per mCi, dose rate constant, radial dose function, and two dimensional (2D) anisotropy functions were calculated for the (101)Rh source through simulations. Air kerma strength per activity and dose rate constant for the hypothetical (101)Rh source were 1.09 ± 0.01 U/mCi and 1.18 ± 0.08 cGy/(h.U), respectively. At distances beyond 1.0 cm in phantom, radial dose function for the hypothetical (101)Rh source is higher than that of (192)Ir. It has also similar 2D anisotropy functions to the Flexisource (192)Ir source. (101)Rh is proposed as an alternative to the existing HDR sources for use in brachytherapy. This source provides medium energy photons, relatively long half-life, higher dose rate constant and radial dose function, and similar 2D anisotropy function to the Flexisource (192)Ir HDR source design. The longer half-life of the source reduces the frequency of the source exchange for the clinical environment.

  4. Comparison of biochemical failure definitions for permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Kuban, Deborah A.; Levy, Larry B.; Potters, Louis; Beyer, David C.; Blasko, John C.; Moran, Brian J.; Ciezki, Jay P.; Zietman, Anthony L.; Zelefsky, Michael J.; Pisansky, Thomas M.; Elshaikh, Mohamed; Horwitz, Eric M.

    2006-01-01

    Purpose: To assess prostate-specific antigen (PSA) failure definitions for patients with Stage T1-T2 prostate cancer treated by permanent prostate brachytherapy. Methods and Materials: A total of 2,693 patients treated with radioisotopic implant as solitary treatment for T1-T2 prostatic adenocarcinoma were studied. All patients had a pretreatment PSA, were treated at least 5 years before analysis, 1988 to 1998, and did not receive hormonal therapy before recurrence. Multiple PSA failure definitions were tested for their ability to predict clinical failure. Results: Definitions which determined failure by a certain increment of PSA rise above the lowest PSA level to date (nadir + x ng/mL) were more sensitive and specific than failure definitions based on PSA doubling time or a certain number of PSA rises. The sensitivity and specificity for the nadir + 2 definition were 72% and 83%, vs. 51% and 81% for 3 PSA rises. The surgical type definitions (PSA exceeding an absolute value) could match this sensitivity and specificity but only when failure was defined as exceeding a PSA level in the 1-3 ng/mL range and only when patients were allowed adequate time to nadir. When failure definitions were compared by time varying covariate regression analysis, nadir + 2 ng/mL retained the best fit. Conclusions: For patients treated by permanent radioisotopic implant for prostate cancer, the definition nadir + 2 ng/mL provides the best surrogate for failure throughout the entire follow-up period, similar to patients treated by external beam radiotherapy. Therefore, the same PSA failure definition could be used for both modalities. For brachytherapy patients with long-term follow-up, at least 6 years, defining failure as exceeding an absolute PSA level in the 0.5 ng/mL range may be reasonable

  5. Remote afterloading for neutron brachytherapy using californium-252.

    Science.gov (United States)

    Tacev, Taco; Grigorov, Grigor; Papírek, Tomás; Kolarík, Vladimír

    2003-02-01

    Despite a pronounced technical process attained in radiotherapy of malignant neoplasms, no remarkable improvement in the treatment results has been achieved. The reason for this stagnation is the interaction between tumor cell and photon radiation. Tumor resistance against photon bombardment can be broken down by applying high linear energy transfer (LET) radiation-based treatment. The discovery of californium-252 ((252)Cf) nuclide, a source of gamma neutron radiation, established a precondition for using neutrons in tumor brachytherapy. The design of a remote afterloading device using (252)Cf sources remains an unsolved problem. The afterloading device has been designed as a stationary radiator which is composed of three mutually interconnected units: 1. the control and drive unit consisting of a control computer and a motor-driven bowden system carrying the (252)Cf source; 2. the source which is housed in a watertight concrete vessel-storage strong room, situated in the ground at a depth of 25 cm beneath the patient's bed; 3. the afterloading application module installed in the irradiation room. Remote afterloading allows simple, inexpensive and highly efficient radiation protection and work safety for the operating personnel. The sources may be moved arbitrarily during treatment with a position accuracy of 0.5-1.0 mm within a distance of 520 cm from the source storage position in the strong room to the application position. Both afterloading systems' unused indexer outputs are protected electronically and mechanically against any unintentional movement of the source outside the application tubes. The technologic concept of the present automatic afterloading device for neutron brachytherapy represents a possible option from the range of conceivable design variants, which - while minimizing technologic and economic requirements - provides the operating personnel with optimum protection and work safety, thus extending the applicability of high LET radiation

  6. Two years results of electronic brachytherapy for basal cell carcinoma.

    Science.gov (United States)

    Ballester-Sánchez, Rosa; Pons-Llanas, Olga; Candela-Juan, Cristian; de Unamuno-Bustos, Blanca; Celada-Alvarez, Francisco Javier; Tormo-Mico, Alejandro; Perez-Calatayud, Jose; Botella-Estrada, Rafael

    2017-06-01

    The use of radiation therapy (RT) for non-melanoma skin cancer (NMSC) has been changing throughout the last century. Over the last decades, the use of radiotherapy has surged with the development of new techniques, applicators, and devices. In recent years, electronic brachytherapy (eBT) devices that use small x-ray sources have been introduced as alternative to radionuclide dependence. Nowadays, several devices have been incorporated, with a few series reported, and with a short follow-up, due to the recent introduction of these systems. The purpose of this work is to describe the clinical results of our series after two years follow-up with a specific eBT system. This is a prospective single-center, non-randomized pilot study, to assess clinical results of electronic brachytherapy in basal cell carcinoma using the Esteya ® system. In 2014, 40 patients with 60 lesions were treated. Patient follow-up on a regular basis was performed for a period of two years. Twenty-six patients with 44 lesions achieved two years follow-up. A complete response was documented in 95.5% of cases. Toxicity was mild (G1 or G2) in all cases, caused by erythema, erosion, or alopecia. Cosmesis was excellent in 88.6% of cases, and good in the rest. Change in pigmentation was the most frequent cosmetic alteration. This work is special, since the equipment's treatment voltage was 69.5 kV, and this is the first prospective study with long term follow-up with Esteya ® . These preliminary report show excellent results with less toxicity and excellent cosmesis. While surgery has been the treatment of choice, certain patients might benefit from eBT treatment. These are elderly patients with comorbidities or undergoing anticoagulant treatment as well as those who simply refuse surgery or might have other contraindications.

  7. Predictive factors for acute and late urinary toxicity after permanent interstitial brachytherapy in Japanese patients

    International Nuclear Information System (INIS)

    Tanimoto, Ryuta; Bekku, Kensuke; Katayama, Norihisa

    2013-01-01

    The objectives of this study were to describe the frequency of and to determine predictive factors associated with Radiation Therapy Oncology Group urinary toxicity in prostate brachytherapy patients. From January 2004 to April 2011, 466 consecutive Japanese patients underwent permanent iodine-125-seed brachytherapy (median follow up 48 months). International Prostate Symptom Score and Radiation Therapy Oncology Group toxicity data were prospectively collected. Prostate volume, International Prostate Symptom Score before and after brachytherapy, and postimplant analysis were examined for an association with urinary toxicity, defined as Radiation Therapy Oncology Group urinary toxicity of Grade 1 or higher. Logistic regression analysis was used to examine the factors associated with urinary toxicity. The rate of Radiation Therapy Oncology Group urinary toxicity grade 1 or higher at 1, 6, 12, 24, 36 and 48 months was 67%, 40%, 21%, 31%, 27% and 28%, respectively. Grade 2 or higher urinary toxicity was less than 1% at each time-point. International Prostate Symptom Score was highest at 3 months and returned to normal 12 months after brachytherapy. On multivariate analysis, patients with a larger prostate size, greater baseline International Prostate Symptom Score, higher prostate V100, higher prostate V150, higher prostate D90 and a greater number of seeds had more acute urinary toxicities at 1 month and 12 months after brachytherapy. On multivariate analysis, significant predictors for urinary toxicity at 1 month and 12 months were a greater baseline International Prostate Symptom Score and prostate V100. Most urinary symptoms are tolerated and resolved within 12 months after prostate brachytherapy. Acute and late urinary toxicity after brachytherapy is strongly related to the baseline International Prostate Symptom Score and prostate V100. (author)

  8. Brachytherapy of endometrial cancers; Curietherapie des cancers de l'endometre

    Energy Technology Data Exchange (ETDEWEB)

    Peiffert, D.; Hoffstetter, S.; Charra-Brunaud, C. [Centre Alexis-Vautrin, Unite de Curietherapie, 54 - Vandoeuvre-les-Nancy (France)

    2003-04-01

    Endometrial adenocarcinomas rank third as tumoral sites en France. The tumors are confined to the uterus in 80% of the cases. Brachytherapy has a large place in the therapeutic strategy. The gold standard treatment remains extra-fascial hysterectomy with bilateral annexiectomy and bilateral internal iliac lymph node dissection. However, after surgery alone, the rate of locoregional relapses reaches 4-20%, which is reduced to 0-5% after postoperative brachytherapy of the vaginal cuff. This postoperative brachytherapy is delivered as outpatients treatment, by 3 or 4 fractions, at high dose rate. The utero-vaginal preoperative brachytherapy remains well adapted to the tumors which involve the uterine cervix. Patients presenting a localized tumor but not operable for general reasons (< 10%) can be treated with success by exclusive irradiation, which associates a pelvic irradiation followed by an utero-vaginal brachytherapy. A high local control of about 80-90% is obtained, a little lower than surgery, with a higher risk of late complications. Last but not least, local relapses in the vaginal cuff, or in the perimeatic area, can be treated by interstitial salvage brachytherapy, associated if possible with external beam irradiation. The local control is reached in half of the patients, but metastatic dissemination is frequent. We conclude that brachytherapy has a major role in the treatment of endometrial adenocarcinomas, in combination with surgery, or with external beam irradiation for not operable patients or in case of local relapses. It should use new technologies now available including computerized after-loaders and 3D dose calculation. (authors)

  9. GGEMS-Brachy: GPU GEant4-based Monte Carlo simulation for brachytherapy applications

    International Nuclear Information System (INIS)

    Lemaréchal, Yannick; Bert, Julien; Schick, Ulrike; Pradier, Olivier; Garcia, Marie-Paule; Boussion, Nicolas; Visvikis, Dimitris; Falconnet, Claire; Després, Philippe; Valeri, Antoine

    2015-01-01

    In brachytherapy, plans are routinely calculated using the AAPM TG43 formalism which considers the patient as a simple water object. An accurate modeling of the physical processes considering patient heterogeneity using Monte Carlo simulation (MCS) methods is currently too time-consuming and computationally demanding to be routinely used. In this work we implemented and evaluated an accurate and fast MCS on Graphics Processing Units (GPU) for brachytherapy low dose rate (LDR) applications. A previously proposed Geant4 based MCS framework implemented on GPU (GGEMS) was extended to include a hybrid GPU navigator, allowing navigation within voxelized patient specific images and analytically modeled 125 I seeds used in LDR brachytherapy. In addition, dose scoring based on track length estimator including uncertainty calculations was incorporated. The implemented GGEMS-brachy platform was validated using a comparison with Geant4 simulations and reference datasets. Finally, a comparative dosimetry study based on the current clinical standard (TG43) and the proposed platform was performed on twelve prostate cancer patients undergoing LDR brachytherapy. Considering patient 3D CT volumes of 400  × 250  × 65 voxels and an average of 58 implanted seeds, the mean patient dosimetry study run time for a 2% dose uncertainty was 9.35 s (≈500 ms 10 −6 simulated particles) and 2.5 s when using one and four GPUs, respectively. The performance of the proposed GGEMS-brachy platform allows envisaging the use of Monte Carlo simulation based dosimetry studies in brachytherapy compatible with clinical practice. Although the proposed platform was evaluated for prostate cancer, it is equally applicable to other LDR brachytherapy clinical applications. Future extensions will allow its application in high dose rate brachytherapy applications. (paper)

  10. Brachytherapy for carcinoma of the cervix: A Canadian survey of practice patterns in a changing era

    International Nuclear Information System (INIS)

    Pearce, Andrew; Craighead, Peter; Kay, Ian; Traptow, Laurel; Doll, Corinne

    2009-01-01

    Background and purpose: This survey aimed to document practices of Canadian radiation oncologists performing gynecologic brachytherapy for carcinoma of the cervix and to determine what the effect of the phasing-out of LDR after-loading systems from the commercial market is having on practice. Materials and methods: A 26-item questionnaire was developed to survey various aspects of brachytherapy practice to include: number of patients treated, prescription points/volume, dose and fractionation, timing, critical structure delineation, expected changes due to the phasing-out of support for low dose rate systems, and support for the development of national guidelines. A link to a web-based survey collection instrument was emailed to each radiation oncologist in Canada practicing gynecologic brachytherapy. Results: A 67% response rate was achieved in this web-based survey. Radiation oncologists currently using HDR brachytherapy are most commonly delivering 5 fractions of 6 Gy in addition to an EBRT dose of 45 Gy in 25 fractions. The median total dose equivalents to Point A was 82.9 Gy for both early and advanced disease. In response to the announcement by a major vendor that they would be phasing-out service for a popular LDR after-loader, 49% of Canadian radiation oncologists who practice brachytherapy for cervix cancer are changing to an HDR technique with a further 9% changing to a PDR technique. Eighty-six percent of respondents would support the development of national guidelines for cervix brachytherapy in Canada. Conclusions: Variation in practice exists in Canada in brachytherapy for cervix cancer. Many centers are in the process of phasing-out LDR techniques in response to the withdrawal of commercial support for these systems. Support for the development of Canadian national guidelines is high.

  11. Sci-Thur PM – Brachytherapy 06: 3D Printed Surface Applicators for High Dose Rate Brachytherapy

    International Nuclear Information System (INIS)

    Clarke, Scott; Yewondwossen, Mammo; Robar, James

    2016-01-01

    Purpose: The purpose of this work is to develop a new applicator for administering high dose rate (HDR) brachytherapy using 3D printing technology. Primary advantages of using a 3D printed applicator will be to offer a more streamlined approach for therapists and patients while achieving better conformity, reproducibility, and patient specific applicators. Methods: A phantom study was conducted to measure the effectiveness of a 3D printed surface applicator by analyzing tumours on three locations of the body: the foot, nose, and scalp. The applicator was designed using Eclipse and further modified using Blender to create the catheter tunnels before being printed on a Lulzbot Taz 5 3D printer. A radiation plan was made using Oncentra Brachytherapy for a control treatment option using Freiburg Flaps and one with the novel method of a 3D printed applicator. A comparative analysis was made using D90, D100, V100, V150, and V200 Results: The 3D printed applicator showed comparable dose coverage with significant improvements on highly irregular surfaces when analyzed against a plan made using Freiburg Flaps. Although both plans exhibited complete tumour coverage, the 3D applicator showed improvements in D90 and V150 and the 3D applicator had a dose homogeneity index (DHI) of 0.99 compared to a DHI of 0.97 for the control. Therapist prep time also dropped significantly due to the lack of need for a thermoplastic mesh. Conclusions: 3D printed applicators for treatment of superficial sites proved to offer more patient convenience, less prep time, better conformity and tighter margins.

  12. Post-surgical treatment of early-stage breast cancer with electronic brachytherapy: an intersociety, multicenter brachytherapy trial

    Directory of Open Access Journals (Sweden)

    Peter D Beitsch

    2010-10-01

    Full Text Available Peter D Beitsch1, Rakesh R Patel2, John D Lorenzetti3, James C Wurzer4, James C Tucker5, Susan J Laduzinsky6, Morris A Kugler71Dallas Surgical Group, Dallas, TX, USA; 2Valley Medical Oncology Consultants, Pleasanton, CA, USA; 3Breast Specialists, Egg Harbor Township, NJ, USA; 4AtlantiCare Regional Medical Center, Egg Harbor Township, NJ, USA; 5DCH Regional Medical Center – Tuscaloosa, AL, USA; 6Memorial and St Elizabeth’s Cancer Treatment Center, Swansea, IL, USA; 7Southern Illinois Surgical Consultants, Maryville, IL, USAIntroduction: Electronic brachytherapy (EBT was developed to allow accelerated partial breast irradiation to be performed in a patient procedure room with minimal shielding. This observational, nonrandomized, multicenter study evaluated EBT as a post-surgical adjuvant radiation therapy for early stage breast cancer.Methods: This study included women aged 50 years or more with invasive carcinoma or ductal carcinoma in situ, tumor size ≤3 cm, negative lymph node status, and negative surgical margins. The endpoints were skin and subcutaneous toxicities, efficacy outcomes, cosmetic outcomes, and device performance. In this interim report, 1-month, 6-month, and 1-year follow-up data are available on 68, 59, and 37 patients, respectively.Results: The EBT device performed consistently, delivering the prescribed 34 Gy to all 69 patients (10 fractions/patient. Most adverse events were Grade 1 and included firmness, erythema, breast tenderness, hyperpigmentation, pruritis, field contracture, seroma, rash/desquamation, palpable mass, breast edema, hypopigmentation, telangiectasia, and blistering, which were anticipated. Breast infection occurred in 2 (2.9% patients. No tumor recurrences were reported. Cosmetic outcomes were excellent or good in 83.9%–100% of evaluable patients at 1 month, 6 months, and 1 year.Conclusion: This observational, nonrandomized, multicenter study demonstrates that this EBT device was reliable and well

  13. Impact of systematic errors on DVH parameters of different OAR and target volumes in Intracavitary Brachytherapy (ICBT)

    International Nuclear Information System (INIS)

    Mourya, Ankur; Singh, Gaganpreet; Kumar, Vivek; Oinam, Arun S.

    2016-01-01

    Aim of this study is to analyze the impact of systematic errors on DVH parameters of different OAR and Target volumes in intracavitary brachytherapy (ICBT). To quantify the changes in dose-volume histogram parameters due to systematic errors in applicator reconstruction of brachytherapy planning, known errors in catheter reconstructions have to be introduced in applicator coordinate system

  14. Towards real-time 3D ultrasound planning and personalized 3D printing for breast HDR brachytherapy treatment

    International Nuclear Information System (INIS)

    Poulin, Eric; Gardi, Lori; Fenster, Aaron; Pouliot, Jean; Beaulieu, Luc

    2015-01-01

    Two different end-to-end procedures were tested for real-time planning in breast HDR brachytherapy treatment. Both methods are using a 3D ultrasound (3DUS) system and a freehand catheter optimization algorithm. They were found fast and efficient. We demonstrated a proof-of-concept approach for personalized real-time guidance and planning to breast HDR brachytherapy treatments

  15. Single-dose brachytherapy versus metal stent placement for the palliation of dysphagia from oesophageal cancer: multicentre randomised trial

    NARCIS (Netherlands)

    Homs, Marjolein Y. V.; Steyerberg, Ewout W.; Eijkenboom, Wilhelmina M. H.; Tilanus, Hugo W.; Stalpers, Lukas J. A.; Bartelsman, Joep F. W. M.; van Lanschot, Jan J. B.; Wijrdeman, Harm K.; Mulder, Chris J. J.; Reinders, Janny G.; Boot, Henk; Aleman, Berthe M. P.; Kuipers, Ernst J.; Siersema, Peter D.

    2004-01-01

    Background Both single-dose brachytherapy and self-expanding metal stent placement are commonly used for palliation of oesophageal obstruction due to inoperable cancer, but their relative merits are unknown. We under-took a randomised trial to compare the outcomes of brachytherapy and stent

  16. Calculations radiobiological using the quadratic lineal model in the use of the medium dose rate absorbed in brachytherapy. Pt. 3

    International Nuclear Information System (INIS)

    2002-01-01

    Calculations with the quadratic lineal model for medium rate using the equation dose-effect. Several calculations for system of low dose rate brachytherapy plus teletherapy, calculations for brachytherapy with medium dose rate together with teletherapy, dose for fraction and the one numbers of fractions in medium rate

  17. Surgery and postoperative brachytherapy for treatment of small volume uterine cervix cancer: an alternative to the standard association of utero vaginal brachytherapy + surgery

    International Nuclear Information System (INIS)

    Gallocher, O.; Thomas, L.; Pigneux, J.; Stocke, E.; Bussieres, E.; Avril, A.; Floquet, A.

    2002-01-01

    Purpose. -Evaluate the results of the treatment of small uterine cervix cancer with the association of surgery and postoperative vaginal brachytherapy, without unfavourable prognostic factors. Patients and methods. -After radical hysterectomy with lymphadenectomy, 29 women (mean age: 44 years) with carcinoma < 25 mm (26 stage IB1, 3 IIA, mean size: 15 mm) were treated by post-operative prophylactic vaginal brachytherapy using low dose rate. Ovarian transposition was performed at the surgical time in 14 young women (mean age 35 years). Results. - The actuarial specific survival rates at 5 and 10 years were 100% and 90% respectively, with a mean follow-up 75 months. Only one local recurrence was observed. The rate of grade 1 post-operative complication was 7%. The conservation rate of the ovarian function was 85% for young women. Conclusion. -Treatment of small volume uterine cervix cancer using first surgery and post-operative vaginal brachytherapy is a reliable therapeutic option. The results in terms of specific survival and complications are the same with those after standard association of preoperative utero-vaginal brachytherapy and surgery. (authors)

  18. Quality assurance of Vari-source high dose rate (HDR) brachytherapy- remote after loader and cost effectiveness of Vari-source HDR- brachytherapy: NORI, Islamabad experience

    International Nuclear Information System (INIS)

    Ahmad, N.; Mahmood, H.; Jafri, S.R.A.

    2004-01-01

    A quality control of Vari-Source high dose rate (HDR) remote after loading brachytherapy machine was carried out and the cost effectiveness of HDR brachytherapy machine was also evaluated considering the cost of ten Iridium-192 wire sources at Nuclear Medicine, Oncology and Radiotherapy Institute (NORI), Islamabad, Pakistan. A total number of 253 intracavitary insertions were done in 98 patients from October 1996 to May 2001. The results of the quality control tests performed during 1996 to 2001 were within the acceptable limits. The cost effectiveness of Vari-Source HDR brachytherapy machine was also evaluated. The average cost per patient was calculated as US$ 491. Small number of patients was treated as the machine was used for gynecologic malignancies only. The objective was to assess the quality control status of HDR brachytherapy machine on patient treatment day, source exchange day and periodic day (monthly basis). It was found that the cost per patient can be minimized if other type of cancer patients are also treated on Vari-Source HDR machine. (author)

  19. Specific features of a neonatal period in infants following intrauterine intravascular blood transfusion for fetal hemolytic disease

    Directory of Open Access Journals (Sweden)

    A. V. Ivanova

    2015-01-01

    Full Text Available The paper gives data on the characteristics of a neonatal period in infants following intrauterine blood transfusion for Rh-induced fetal hemolytic disease. It is shown that the early diagnosis and detection of the signs of fetal hemolytic disease, and intrauterine intravascular blood transfusion may prolong pregnancy, ensure the birth of a baby with normal anthropometric indicators, optimize his/her neonatal period and prognosis of severe hemolytic disease in the fetus and newborn.

  20. Resolution of spontaneous coronary artery dissection within 3 weeks detected by computed tomography angiography and intravascular ultrasound.

    Science.gov (United States)

    Tsutsui, Hiroshi; Chino, Chiharu; Komatsu, Miho; Sakai, Takahiro; Aizawa, Kazunori; Owa, Mafumi

    2017-01-01

    A 62-year-old woman was admitted with chest pain lasting about 3 h. Spontaneous coronary artery dissection (SCAD) was detected in the left anterior descending artery (LAD) by intravascular ultrasound (IVUS). Sixteen days after onset, follow-up computed tomography angiography was performed and revealed shrinkage of the false lumen of the SCAD. On hospital day 22, IVUS image confirmed that the SCAD in the LAD was completely healed. This case shows the possibility of rapid healing of SCAD.