Determination of rectal muscle, rectal mucosa and rectal wall dimensions: Dosimetric implications in prostate brachytherapy

We report herein a rare case of malignant gastrointestinal stromal tumor (GIST) originated from the rectal wall, which presented as a tumor on the rectovaginal septum.A 54-year-old Japanese woman, gravida 4, para 3, was admitted complaining of anuresis and severe constipation. She had a history of hysterectomy and right salpingo-oophorectomy for uterine leiomyoma 11 years previously. Pelvic examination revealed an 8.5 × 7.5 × 7.5 cm hard mass in the rectovaginal space. The inferior border of the tumor was 2 cm from the vaginal introitus and 2 cm from the anus. Computed tomography and magnetic resonance imaging showed a well-circumscribed soft-tissue mass filling the rectovaginal space. Urinary bladder and rectum were markedly compressed and displaced. Colon fiberscopy revealed invasion of the tumor into the rectal mucosa. An abdominoperineal resection of the rectum with posterior vaginal wall resection and pelvic lymphadenectomy was performed. The resected specimen showed a rectal submucosal tumor that was 8 × 8 × 7 cm in size. The tumor was diagnosed as a malignant GIST. Immunohistochemical analysis confirmed this diagnosis. The patient is now healthy without evidence of recurrence at 13 months after surgery.Gynecologists should be aware of rectal GIST arising in the rectovaginal space as a differential diagnosis of vaginal submucosal tumor.

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Rectal-wall dose dependence on postplan timing after permanent-seed prostate brachytherapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2005.12.024 ◽

2006 ◽

Vol 65 (2) ◽

pp. 358-363 ◽

Cited By ~ 24

Author(s):

Daniel Taussky ◽

Ivan Yeung ◽

Theresa Williams ◽

Shannon Pearson ◽

Michael McLean ◽

...

Keyword(s):

Rectal Wall ◽

Dose Dependence ◽

Prostate Brachytherapy

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Role of Imaging in Rectal Cancer

JMS SKIMS ◽

10.33883/jms.v15i1.102 ◽

2012 ◽

Vol 15 (1) ◽

pp. 4-6

Author(s):

Ajaz Ahmad Malik

Keyword(s):

Rectal Cancer ◽

Rectal Wall ◽

Preoperative Staging ◽

Positron Emission ◽

Adjacent Structures ◽

Tumor Involvement ◽

Magnetic Resonance Imaging Mri ◽

Optimal Treatment Strategy

THIS ARTICLE HAS NO ABSTRACT (FIRST 100 WORDS OF THE ARTICLE ARE DISPLAYED): Staging of rectal cancer is necessary to provide the optimal treatment strategy although proctoscopy or sigmoidoscopy with biopsy are diagnostic. This is achieved by locoregional assessment of the disease by various available radiological investigations. Staging information includes extent of tumor involvement of the rectal wall and adjacent structures, presence or absence of adjacent lymphadenopathy, and determination of distant metastasis. Several modalities exist for the preoperative staging of rectal cancer, like computed tomography (CT); magnetic resonance imaging (MRI) with traditional body, endorectal, or phasedarray coils; endorectal ultrasonography (ERUS) with rigid or flexible probes; and positron emission tomography (PET) with and without. JMS 2012;15(1):4-6.

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Case Report: Role of an Iodinated Rectal Hydrogel Spacer, SpaceOAR Vue™, in the Context of Low-Dose-Rate Prostate Brachytherapy, for Enhanced Post-Operative Contouring to Aid in Accurate Implant Evaluation and Dosimetry

Frontiers in Oncology ◽

10.3389/fonc.2021.810955 ◽

2021 ◽

Vol 11 ◽

Author(s):

Andrew Gross ◽

Jiankui Yuan ◽

Daniel Spratt ◽

Elisha Fredman

Keyword(s):

Dose Rate ◽

Low Dose ◽

Rectal Wall ◽

Case Series ◽

Prostate Brachytherapy ◽

Anterior Rectal Wall ◽

Posterior Aspect ◽

Low Dose Rate ◽

Ldr Brachytherapy ◽

Risk Patients

We present a case series of 13 consecutive patients with prostate cancer treated with low-dose-rate (LDR) brachytherapy, utilizing SpaceOAR Vue™, the recent iodinated iteration of the SpaceOAR™ hydrogel rectal spacer. Low- and favorable intermediate-risk patients receiving monotherapy and unfavorable intermediate- and high-risk patients undergoing a brachytherapy boost were included. Permanent brachytherapy can result in subacute and late rectal toxicity, and precise contouring of the anterior rectal wall and posterior aspect of the prostate is essential for accurate dosimetry to confirm a safe implant. Clearly visible on non-contrast CT imaging, SpaceOAR Vue™ can substantially aid in post-implant contouring and analysis. Not previously described in the literature in the context of LDR brachytherapy, we demonstrate the added clinical benefit of placing a well-visualized rectal spacer.

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PD-0189: US-probe integrated MOSkin detectors for rectal wall in vivo dosimetry in HDR prostate brachytherapy

Radiotherapy and Oncology ◽

10.1016/s0167-8140(15)30294-2 ◽

2014 ◽

Vol 111 ◽

pp. S75

Author(s):

M. Carrara ◽

C. Tenconi ◽

M. Borroni ◽

A. Cerrotta ◽

C. Fallai ◽

...

Keyword(s):

Rectal Wall ◽

In Vivo Dosimetry ◽

Prostate Brachytherapy

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Rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0109 ◽

2017 ◽

Vol 99 (6) ◽

pp. e191-e192 ◽

Cited By ~ 1

Author(s):

FA Meister ◽

I Amygdalos ◽

UP Neumann ◽

G Lurje

Keyword(s):

Foreign Body ◽

Urinary Retention ◽

Traffic Accidents ◽

Rectal Wall ◽

Heavy Traffic ◽

Loop Ileostomy ◽

Rectal Mucosa ◽

Neurological Deficits ◽

Lumbosacral Plexus ◽

Post Traumatic

Rectal foreign body insertion is a common condition in emergency surgery, which often requires surgical intervention. Here we report a clinical case of rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury. A 72-year-old man presented to the emergency department complaining of acute bilateral paraplegia with loss of sensation in both legs, as well as total urinary retention. The patient underwent abdominal computed tomography, which showed a rectal foreign body measuring 13 × 11.5 × 10 cm in the lower abdomen and pelvis. Extraluminal assistance through a median laparotomy was required after unsuccessful attempts at transanal recovery alone. After removal of the foreign body, the rectal wall and anorectal sphincter were massively dilated, with severe bruising of the rectal mucosa on proctoscopy. A protective loop-ileostomy was performed. The sacral plexus is located posteriorly in the pelvis. Physiologically, the nerves are well protected by surrounding anatomical structures. Post-traumatic lumbosacral plexus injuries with paraplegia, urinary retention and anorectal sphincter insufficiency occur quite frequently after heavy traffic accidents. Lumbosacral plexus injury as a result of rectal foreign body insertion is rare. Severe neurological deficits through rectal foreign body insertion are rare but known medical conditions. To the best of our knowledge, this is the first reported case of severe and persistent post-traumatic lumbosacral plexus injury through a rectal foreign body.

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Ultrasonic diagnostics of Hirschsprung’s disease in adults

Kazan medical journal ◽

10.17816/kmj1908 ◽

2013 ◽

Vol 94 (5) ◽

pp. 641-644

Author(s):

A F Shakurov ◽

O Yu Karpukhin ◽

A F Yusupova ◽

N Yu Savushkina

Keyword(s):

Differential Diagnosis ◽

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Rectal Wall ◽

Rectal Mucosa ◽

Correct Choice ◽

Wall Thickening ◽

Slow Transit Constipation ◽

Muscular Layer ◽

Inhibitory Reflex

Aim. To study the possibilities of hydrosonography for the differential diagnosis of Hirschsprung’s disease. Methods. The results of the examination of five patients with histologically confirmed diagnosis of Hirschsprung’s disease, 19 patients with slow transit constipation and 10 healthy volunteers are presented. Rectal ultrasonography was performed after retrograde colon filling with saline. Rectal lumen width, thickness and structure of the rectal mucosa and muscular layer were evaluated. The place of transition of rectal ampoule into the anal canal was thoroughly examined to determine rectal anal inhibitory reflex. Results. The following ultrasonic signs of Hirschsprung’s disease were identified: rectal wall thickening up to 6±0,7 mm due to muscular layer hypertrophy, hyperechoic mucosa, rectal lumen widening up to 60±5 mm. A high predictive value of ultrasonography for diagnosis of rectal anal inhibitory reflex absence in Hirschsprung’s disease (sensitivity 100%, specificity 96.7%, accuracy 97.1%). Advantages of the examination are obviousness and technical simplicity. With no introduction of a balloon, electrodes or ultrasonic detector into the rectal lumen, the results of examination can hardly be biased or miscomprehended. Conclusion. Hydrosonography might be used in diagnosis of Hirschsprung’s disease, this method facilitates the differential diagnosis of Hirschsprung’s disease and other forms of chronic constipation and contributes to the correct choice of treatment strategy.

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