Chest wall mass in a 15 year old female patient

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Special focus issue on potentially premalignant oral epithelial lesions: introduction and perspective

Publication date: Available online 6 April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Nikolaos G. Nikitakis




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Introduction to the Oral and Maxillofacial Pathology focus issue on “Preneoplastic Oral Epithelial Lesions”

Publication date: Available online 6 April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Paul C. Edwards




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A contemporary analysis of radiotherapy effect in surgically treated retroperitoneal sarcoma

Contemporary data regarding the benefit of radiotherapy in surgically treated retroperitoneal sarcoma are scarce. The aim of the study was to evaluate the effect of radiotherapy on cancer specific mortality in surgically treated patients according to tumor size, histological subtype and grade.

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Physician assessed and patient reported lower limb edema after definitive radio(chemo)therapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: A report from the EMBRACE study

To evaluate the pattern of manifestation and risk factors for lower limb edema (LLE) within the prospective, observational, multi-center EMBRACE study on radiochemotherapy and MRI-guided brachytherapy in locally advanced cervical cancer (LACC).

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Role of adjuvant external beam radiotherapy and chemotherapy in one versus two or more node-positive vulvar cancer: A National Cancer Database study

Inguinal lymph node involvement is considered the most important prognostic risk factor for survival in vulvar cancer. However, controversy exists concerning the optimal adjuvant therapy for node-positive disease. This study sought to identify the optimal adjuvant therapy for each subset of women with node-positive disease.

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A contemporary analysis of radiotherapy effect in surgically treated retroperitoneal sarcoma

Publication date: Available online 6 April 2018
Source:Radiotherapy and Oncology
Author(s): Sebastiano Nazzani, Marco Bandini, Michele Marchioni, Felix Preisser, Zhe Tian, Denis Soulières, Emanuele Montanari, Gloria Motta, Pietro Acquati, Alberto Briganti, Shahrokh F. Shariat, Firas Abdollah, Luca Carmignani, Pierre I. Karakiewicz
Background and purposeContemporary data regarding the benefit of radiotherapy in surgically treated retroperitoneal sarcoma are scarce. The aim of the study was to evaluate the effect of radiotherapy on cancer specific mortality in surgically treated patients according to tumor size, histological subtype and grade.Material and methodsWithin Surveillance, Epidemiology, and End Results database (2004–2014), we identified 1226 patients with non-metastatic retroperitoneal sarcoma. Univariable and multivariable logistic regression models tested for predictors of radiotherapy delivery. Univariable and multivariable Cox regression models tested the effect of radiotherapy on cancer specific mortality in the overall population. Subgroup analyses explored the result of tumor grade and tumor size on radiotherapy effect. All analyses were repeated after adjustment according to inverse probability of treatment. Additionally, all analyses were subjected to 1000 bootstrap resamples for internal validation.ResultsRadiotherapy was delivered in 372 patients (30.3%). In univariable and multivariable logistic regression models high grade (OR: 1.46, CI:1.12–1.90; p = 0.006), and leiomyosarcoma histologic subtype (OR: 2.14, CI: 1.55–2.95; p < 0.001) predicted radiotherapy delivery. In the overall population multivariable Cox regression models showed lower cancer specific mortality (HR: 0.73, CI: 0.55–0.96; p = 0.025) with radiotherapy. In subgroup analyses multivariable Cox regression models showed radiotherapy benefit predominantly in high grade, large tumor size retroperitoneal sarcomas (HR 0.51: C.I.: 0.30–0.86; p = 0.02).ConclusionsIn this retrospective report, delivery of radiotherapy was associated with lower cancer specific mortality in high grade, large tumor size retroperitoneal sarcoma patients. Our findings are predominantly representative of liposarcomas and leiomyosarcomas that accounted for 90% of study population. Further study is needed to evaluate the role of radiotherapy in retroperitoneal sarcoma patients.



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Fatigue, insomnia and hot flashes after definitive radiochemotherapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: An analysis from the EMBRACE study

Publication date: Available online 5 April 2018
Source:Radiotherapy and Oncology
Author(s): Stéphanie Smet, Richard Pötter, Christine Haie-Meder, Jacob C. Lindegaard, Ina Schulz-Juergenliemk, Umesh Mahantshetty, Barbara Segedin, Kjersti Bruheim, Peter Hoskin, Bhavana Rai, Fleur Huang, Rachel Cooper, Erik van Limbergen, Kari Tanderup, Kathrin Kirchheiner
ObjectiveTo evaluate the pattern of manifestation of fatigue, insomnia and hot flashes within the prospective, observational, multi-center EMBRACE study.MethodsMorbidity was prospectively assessed according to CTCAE v.3 and patient-reported outcome with EORTC QLQ-C30/CX24 at baseline and regular follow-up. Analyses of crude incidence, prevalence rates and actuarial estimates were performed.ResultsA total of 1176 patients were analyzed with a median follow-up of 27 months. At baseline, CTCAE G1/G2 prevalence rates for fatigue were 29%/6.2%, for insomnia 18%/3.1% and for hot flashes 7.9%/1.6% with respective 3-year prevalence rates of 29%/6.8%, 17%/4.4% and 19%/5.9%. Similar patterns of manifestation were seen in patient-reported EORTC outcomes. The 3-year actuarial estimates for G ≥ 3 CTCAE fatigue, insomnia and hot flashes were 5.5%, 4.7% and 1.9%. Younger age was associated with significantly higher risk for fatigue, insomnia and hot flashes.ConclusionFatigue, insomnia and hot flashes occurred mainly in the mild to moderate range. Fatigue and insomnia were already present before treatment and showed minor fluctuations or recovery during follow-up, whereas hot flashes showed a considerable increase after treatment. More research is needed to evaluate contributing risk factors in order to define intervention strategies.



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Functional-guided radiotherapy using knowledge-based planning

Publication date: Available online 5 April 2018
Source:Radiotherapy and Oncology
Author(s): Austin M. Faught, Lindsey Olsen, Leah Schubert, Chad Rusthoven, Edward Castillo, Richard Castillo, Jingjing Zhang, Thomas Guerrero, Moyed Miften, Yevgeniy Vinogradskiy
Background and purposeThere are two significant challenges when implementing functional-guided radiotherapy using 4DCT-ventilation imaging: (1) lack of knowledge of realistic patient specific dosimetric goals for functional lung and (2) ensuring consistent plan quality across multiple planners. Knowledge-based planning (KBP) is positioned to address both concerns.Material and methodsA KBP model was created from 30 previously planned functional-guided lung patients. Standard organs at risk (OAR) in lung radiotherapy and a ventilation contour delineating areas of high ventilation were included. Model validation compared dose-metrics to standard OARs and functional dose-metrics from 20 independent cases that were planned with and without KBP.ResultsA significant improvement was observed for KBP optimized plans in V20Gy and mean dose to functional lung (p = 0.005 and 0.001, respectively), V20Gy and mean dose to total lung minus GTV (p = 0.002 and 0.01, respectively), and mean doses to esophagus (p = 0.005).ConclusionThe current work developed a KBP model for functional-guided radiotherapy. Modest, but statistically significant, improvements were observed in functional lung and total lung doses.



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Role of adjuvant external beam radiotherapy and chemotherapy in one versus two or more node-positive vulvar cancer: A National Cancer Database study

Publication date: Available online 6 April 2018
Source:Radiotherapy and Oncology
Author(s): Nicholas R. Rydzewski, Margaux J. Kanis, Eric D. Donnelly, John R. Lurain, Jonathan B. Strauss
Background and purposeInguinal lymph node involvement is considered the most important prognostic risk factor for survival in vulvar cancer. However, controversy exists concerning the optimal adjuvant therapy for node-positive disease. This study sought to identify the optimal adjuvant therapy for each subset of women with node-positive disease.Material and methodsThe National Cancer Database (NCDB) was queried to identify women with inguinal node positive vulvar cancer. Survival analysis was performed using log-rank test, the Kaplan–Meier estimates, and Cox proportional hazards to both clarify prognosis and identify the benefit of each treatment modality in individual subsets of women.ResultsA total of 2779 women with inguinal node positive vulvar cancer were identified. On multivariate Cox model hazard ratio, radiotherapy yielded a survival advantage for women with one positive node (HR 0.81, p = 0.027) and two or more positive nodes (HR = 0.59, p < 0.001). The addition of chemotherapy to radiotherapy yielded an incremental improvement in survival for women with 2 or more positive nodes (HR = 0.79, p = 0.022) but not women with 1 positive node (HR = 0.93, p = 0.605).ConclusionsAll patients with node positive disease benefited from radiotherapy. By contrast, only those with 2 or more positive nodes benefited from the addition of chemotherapy to radiotherapy.



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Safe zone for the posterior interosseous nerve with regard to the lateral and posterior approaches to the proximal radius.

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Safe zone for the posterior interosseous nerve with regard to the lateral and posterior approaches to the proximal radius.

Surg Radiol Anat. 2018 Apr 04;:

Authors: Hohenberger GM, Schwarz AM, Maier MJ, Grechenig P, Dauwe J, Grechenig C, Krassnig R, Gänsslen A, Weiglein AH

Abstract
PURPOSE: The posterior interosseous nerve (PIN) is at risk during the posterior and lateral approaches to the proximal radius. We aimed to define a safe zone for these approaches to avoid injury of the PIN and to evaluate their close and changing relationship to the nerve during forearm rotation.
METHODS: The study collective consisted of 50 upper limbs. After performance of the lateral approach, the distance between the tip of the radial head and the PIN's exit point from the supinator (= distance 1) and the shortest interval between the nerve's exit to the radial margin of the ulna (= distance 2) were measured in maximum pronation and supination. Then, the dorsal approach was conducted and again distance 1 and the interval between the distal margin of the anconeus and the nerve's exit point (distance 2) were evaluated (pronation and supination).
RESULTS: There were significantly shorter distances during supination in comparison to pronation. Regarding the lateral approach, distance 1 changed from a mean of 60.3 mm (supination) to 62.7 mm in pronation (p < 0.001). For the dorsal approach, distance 1 decreased significantly (p < 0.001) from 62.9 mm (pronation) to 60.2 mm (supination).
CONCLUSION: Supination during the lateral and dorsal approaches to the proximal radius needs to be avoided to protect the PIN. Furthermore, the nerve appeared at an interval between 45 and 84.1 mm (lateral approach) and 47.5-93.8 mm (dorsal approach), respectively. Therefore, care must be taken at this height during extension of the approaches in a distal direction.

PMID: 29619502 [PubMed - as supplied by publisher]

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PET response assessment in apatinib treated radioactive iodine-refractory thyroid cancer.

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PET response assessment in apatinib treated radioactive iodine-refractory thyroid cancer.

Endocr Relat Cancer. 2018 Apr 04;:

Authors: Wang C, Zhang X, Yang X, Li H, Cui R, Guan W, Li X, Zhu Z, Lin Y

Abstract
This work evaluated the use of the positron emission tomography/computed tomography (PET/CT) technique to assess the early therapeutic response and predict the prognosis of patients with radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) who underwent apatinib therapy. Standardised uptake value (SUV), metabolic tumour volume (MTV) and total lesion glycolysis (TLG), derived from 18FDG PET/CT and SUV from 68Ga-NOTA-PRGD2 PET/CT, were evaluated. Tumour response was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Sixteen of 20 patients achieved partial response (PR) and four of 20 had stable disease (SD) after apatinib therapy. Six progression-free survival (PFS) events occurred. A strong correlation was observed between the best change in the sum of the longest diameters of target lesions (ΔCT%) and 18FDG PET/CT indices after the completion of the first treatment cycle (ΔMTV% [P = 0.0019], ΔTLG% [P = 0.0021] and ΔSUVmax% [P = 0.0443]). A significant difference in PFS was observed between patients with ΔMTV% <-45% and ≥-45% (P = 0.0019) and between patients with ΔTLG% <-80% and ≥-80% (P = 0.0065). Ten of 11 patients presented a decrease in SUVmax on 68Ga-NOTA-PRGD2 PET/CT after two cycles of apatinib therapy and showed PR, whereas one patient presenting an increase in SUVmax only showed SD as the best response. When a cut-off value of the target/background ratio at -20% was used, two PFS curves showed a significant difference (P = 0.0016). Hence, early assessment by 18FDG and 68Ga-NOTA-PRGD2 PET/CT was effective in the prediction and evaluation of RAIR-DTC treated with apatinib.

PMID: 29618578 [PubMed - as supplied by publisher]

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Integrated Video on Vascular Ring : DAMS Unplugged

Presenting an integrated approach to vascular rings with their embryological basis in a series called DAMS  Medicine Unplugged on YouTube and can be looked up for more such videos.

Famous Radiology Blog https://ift.tt/1MM2hKr TeleRad Providers at https://ift.tt/1NgppuI Mail us at sales@teleradproviders.com

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Radiocaesium derived from the TEPCO Fukushima accident in the North Pacific Ocean: Surface transport processes until 2017

Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Michio Aoyama, Yasunori Hamajima, Yayoi Inomata, Yuichiro Kumamoto, Eitarou Oka, Takaki Tsubono, Daisuke Tsumune
We report temporal variations of ¹³⁷Cs activity concentrations in surface waters of six regions of the western and central North Pacific Ocean during 2011–2017 using a combination of 1264 previously published data and 42 new data. In the western and central North Pacific Ocean at latitudes of 30–42°N and longitudes of 140°E to 160°W, eastward transport of radiocaesium was clearly apparent. ¹³⁷Cs activity concentrations in surface water decreased rapidly to ∼2–3 Bq m⁻³ in 2015/2016, still a bit higher than ¹³⁷Cs activity concentrations before the FNPP1 accident (1.5–2 Bq m⁻³). ¹³⁴Cs/¹³⁷Cs activity ratios decay-corrected to 11 March 2011 were ∼0.5–0.8. To the south of 30°N and between 130°E and 160°W in the western and central Pacific Ocean, ¹³⁷Cs activity concentrations were around 1–7 Bq m⁻³ in 2011/2012 but then stabilized at a few Bq m⁻³ up to 2017.¹³⁴Cs activity concentrations were detected at levels of 0.1–0.9 Bq m⁻³, and ¹³⁴Cs/¹³⁷Cs activity ratios decay-corrected to 11 March 2011 were ∼0.3–0.5. Temporal variations of model-simulated ¹³⁷Cs activity concentrations in surface water in the region of interest showed good agreement with observations, except in the southwestern North Pacific Ocean.



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