The importance of communication skills required to reduce set-up errors in the radiotherapy planning phase

2019 ◽  
Vol 18 (4) ◽  
pp. 395-396
Author(s):  
A. Merlotti ◽  
A. Reali ◽  
E. Russi

AbstractDuring the planning computed tomography (CT) scan, patients experience the position and any immobilisation technique required for radiotherapy.Patient’s stress and anxiety can cause muscle tension that can introduce systematic set-up errors if not recognised and corrected.We discuss two clinical cases that highlight the importance of time dedicated to communication and revision of the first CT acquisition during a virtual simulation procedure.

2020 ◽  
Vol 3 ◽  
pp. 36-39
Author(s):  
Samson O. Paulinus ◽  
Benjamin E. Udoh ◽  
Bassey E. Archibong ◽  
Akpama E. Egong ◽  
Akwa E. Erim ◽  
...  

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.


2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Priyabrata Adhikari ◽  
Siddalingeshwar I. Neeli ◽  
Shyam Mohan

Abstract Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal disease such as renal cell neoplasm. Such tumors are usually associated with a thrombus in renal vein or spermatic vein. We report a rare presentation of right-sided renal tumor causing right-sided varicocele in the absence of thrombus in renal vein and spermatic vein but due to an anomalous vein draining from the tumor into the spermatic vein as demonstrated by computed tomography angiogram. Case presentation A 54-yr-old hypertensive male presented with unilateral grade 3 right-sided varicocele and no other signs and symptoms. Ultrasound examination of his abdomen showed the presence of a mass lesion in the lower pole of right kidney. Computed tomography confirmed the presence of right renal mass, absence of thrombus in right renal vein or inferior vena cava. The angiographic phase of CT scan showed an anomalous vein from the tumor draining into the pampiniform plexus causing varicocele. Conclusion The presence of right-sided varicocele should raise a suspicion hidden serious pathological retroperitoneal condition, renal malignancy in particular, and should prompt the treating physician to carry out imaging studies of the retroperitoneum and careful study of the angiographic phase of the CT scan can ascertain the pathogenesis of the varicocele.


Author(s):  
Majid Anwer ◽  
Atique Ur Rehman ◽  
Farheen Ahmed ◽  
Satyendra Kumar ◽  
Md Masleh Uddin

Abstract Introduction Traumatic head injury with extradural hematoma (EDH) is seen in 2% of patients. Development of EDH on the contralateral side is an uncommon complication that has been reported in various case reports. Case Report We report here a case of an 18-year-old male who had a road traffic injury. He was diagnosed as a case of left-sided large frontotemporoparietal acute extradural bleed with a mass effect toward the right side. He was managed with urgent craniotomy and evacuation of hematoma. A noncontrast computed tomography (NCCT) scan performed 8 hours after postoperative period showed a large frontotemporoparietal bleed on the right side with a mass effect toward the left side. He was again taken to the operating room and right-sided craniotomy and evacuation of hematoma were performed. A postoperative NCCT scan revealed a resolved hematoma. The patient made a complete recovery in the postoperative period and is doing well. Conclusion Delayed onset epidural hematoma is diagnosed when the initial computed tomography (CT) scan is negative or is performed early and when late CT scan performed to assess clinical or ICP deterioration shows an EDH. The diagnosis of such a condition requires a high index of suspicion based on the mechanism of injury along with fracture patterns. Additionally, change in pupillary size, raised intracranial pressure, and bulging of the brain intraoperatively are additional clues for contralateral bleeding. Neurologic deterioration may or may not be associated with delayed EDH presentation. An early postoperative NCCT scan within 24 hours is recommended to detect this complication with or without any neurologic deterioration.


Mathematics ◽  
2021 ◽  
Vol 9 (13) ◽  
pp. 1457
Author(s):  
Muazzam Maqsood ◽  
Sadaf Yasmin ◽  
Irfan Mehmood ◽  
Maryam Bukhari ◽  
Mucheol Kim

A typical growth of cells inside tissue is normally known as a nodular entity. Lung nodule segmentation from computed tomography (CT) images becomes crucial for early lung cancer diagnosis. An issue that pertains to the segmentation of lung nodules is homogenous modular variants. The resemblance among nodules as well as among neighboring regions is very challenging to deal with. Here, we propose an end-to-end U-Net-based segmentation framework named DA-Net for efficient lung nodule segmentation. This method extracts rich features by integrating compactly and densely linked rich convolutional blocks merged with Atrous convolutions blocks to broaden the view of filters without dropping loss and coverage data. We first extract the lung’s ROI images from the whole CT scan slices using standard image processing operations and k-means clustering. This reduces the search space of the model to only lungs where the nodules are present instead of the whole CT scan slice. The evaluation of the suggested model was performed through utilizing the LIDC-IDRI dataset. According to the results, we found that DA-Net showed good performance, achieving an 81% Dice score value and 71.6% IOU score.


Author(s):  
Farnoosh Larti ◽  
Mohammad Amin Khadembashiri ◽  
Mehrshad Abbasi ◽  
Alborz Sherafati

Abstract Background Diagnosis of aortic graft infection is challenging, and delayed diagnosis is associated with poor prognosis. Positron emission tomography/computed tomography (PET/CT) has improved diagnostic accuracy. Case summary A patient with a history of congenital heart disease was admitted due to fever. He had a history of four cardiac surgeries, including the Bentall procedure for endocarditis. Blood cultures were negative. A semi-mobile mass was detected in the distal portion of the aortic tube graft in echocardiography. PET/CT scan was used to confirm tube graft infection and to support proceeding to cardiac surgery. Discussion Using multimodality imaging, including PET/CT scan in combination with echocardiography, can improve diagnostic accuracy for the detection of aortic tube graft infection, infection of prosthetic valves, or intra-cardiac devices, especially in high-risk surgical cases.


2019 ◽  
Vol 58 (6) ◽  
pp. 671-676
Author(s):  
Amy M. West ◽  
Pierre A. d’Hemecourt ◽  
Olivia J. Bono ◽  
Lyle J. Micheli ◽  
Dai Sugimoto

The objective of this study was to determine diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) scans in young athletes diagnosed with spondylolysis. A cross-sectional study was used. Twenty-two young athletes (14.7 ± 1.5 years) were diagnosed as spondylolysis based on a single-photon emission CT. Following the diagnosis, participants underwent MRI and CT scan imaging tests on the same day. The sensitivity and false-negative rate of the MRI and CT scans were analyzed. MRI test confirmed 13 (+) and 9 (−) results while CT test showed 17 (+) and 5 (−) results. The sensitivity and false-negative rate of MRI were, respectively, 59.1% (95% confidence interval [CI] = 36.7% to 78.5%) and 40.9% (95% CI = 21.5% to 63.3%). Furthermore, the sensitivity and false-negative rate of CT scan were 77.3% (95% CI = 54.2% to 91.3%) and 22.7% (95% CI = 0.09% to 45.8%). Our results indicated that CT scan is a more accurate imaging modality to diagnose spondylolysis compared with MRI in young athletes.


Neurosurgery ◽  
1982 ◽  
Vol 10 (4) ◽  
pp. 487-489 ◽  
Author(s):  
Z. Harry Rappaport ◽  
Itzchak Shaked ◽  
Rina Tadmor

Abstract A case of delayed visualization of an acute parietal epidural hematoma by computed tomography (CT) in a child is presented. The initial CT 2½ hours after injury was negative. After neurological deterioration, a repeat CT scan 8 hours postinjury demonstrated a parietal epidural hematoma and a small cerebellar hematoma. The case demonstrates the need for a high level of vigilance in head trauma patients even in the face of an initially negative CT scan.


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