scholarly journals Radiopaque drug-eluting embolisation beads as fiducial markers for stereotactic liver radiotherapy

2021 ◽  
Author(s):  
Laura Beaton ◽  
Mairead Daly ◽  
Henry FJ Tregidgo ◽  
Helen Grimes ◽  
Syed Moinuddin ◽  
...  
Keyword(s):  
Cone Beam Ct ◽  
Helical Ct ◽  
Imaging Modalities ◽  
Radiotherapy Planning ◽  
Fiducial Markers ◽  
Liver Tumours ◽  
Image Guided Radiotherapy ◽  
4D Ct ◽  
Drug Eluting

Objective: To determine the feasibility of using radiopaque (RO) beads as direct tumour surrogates for image-guided radiotherapy (IGRT) in patients with liver tumours after transarterial chemoembolisation (TACE). Methods: A novel vandetanib-eluting RO bead was delivered via TACE as part of a first-in-human clinical trial in patients with either hepatocellular carcinoma or liver metastases from colorectal cancer. Following TACE, patients underwent simulated radiotherapy imaging with 4-dimensional computed tomography (4D-CT) and cone-beam CT (CBCT) imaging. RO beads were contoured using automated thresholding, and feasibility of matching between the simulated radiotherapy planning dataset (AVE-IP image from 4D data) and CBCT scans assessed. Additional kV, MV, helical CT and CBCT images of RO beads were obtained using an in-house phantom. Stability of RO bead position was assessed by comparing 4D-CT imaging to CT scans taken 6–20 days following TACE. Results: Eight patients were treated and 4D-CT and CBCT images acquired. RO beads were visible on 4D-CT and CBCT images in all cases and matching successfully performed. Differences in centre of mass of RO beads between CBCT and simulated radiotherapy planning scans (AVE-IP dataset) were: 2.0 mm mediolaterally, 1.7 mm anteroposteriorally, 3.5 mm craniocaudally. RO beads in the phantom were visible on all imaging modalities assessed. RO bead position remained stable up to 29 days post-TACE. Conclusion: RO beads are visible on IGRT imaging modalities, showing minimal artefact. They can be used for on-set matching with CBCT and remain stable over time. Advances in knowledge: The role of RO beads as fiducial markers for stereotactic liver radiotherapy is feasible and warrants further exploration as a combination therapy approach.

scholarly journals Structural and Functional Imaging in Glioma Management

Neurosurgery ◽  
2020 ◽  
Author(s):  
Bledi C Brahimaj ◽  
Ryan B Kochanski ◽  
John J Pearce ◽  
Melike Guryildirim ◽  
Carter S Gerard ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Imaging Modalities ◽  
Hemispheric Dominance ◽  
Tumor Control ◽  
Histopathological Diagnosis ◽  
Glioma Surgery ◽  
Multiple Modalities ◽  
Advantages And Disadvantages ◽  
Multiple Imaging

Abstract The goal of glioma surgery is maximal safe resection in order to provide optimal tumor control and survival benefit to the patient. There are multiple imaging modalities beyond traditional contrast-enhanced magnetic resonance imaging (MRI) that have been incorporated into the preoperative workup of patients presenting with gliomas. The aim of these imaging modalities is to identify cortical and subcortical areas of eloquence, and their relationship to the lesion. In this article, multiple modalities are described with an emphasis on the underlying technology, clinical utilization, advantages, and disadvantages of each. functional MRI and its role in identifying hemispheric dominance and areas of language and motor are discussed. The nuances of magnetoencephalography and transcranial magnetic stimulation in localization of eloquent cortex are examined, as well as the role of diffusion tensor imaging in defining normal white matter tracts in glioma surgery. Lastly, we highlight the role of stimulated Raman spectroscopy in intraoperative histopathological diagnosis of tissue to guide tumor resection. Tumors may shift the normal arrangement of functional anatomy in the brain; thus, utilization of multiple modalities may be helpful in operative planning and patient counseling for successful surgery.

scholarly journals Role of different imaging modalities in the evaluation of normal and diseased thymus

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
S. A. Hussein ◽  
Y. Y. Sabri ◽  
M. A. Fouad ◽  
H. H. Al-Zawam ◽  
N. M. Mohamed
Keyword(s):  
Imaging Modalities

scholarly journals 466 Resection or Enucleation for Extremely Giant Hepatic Haemangiomata? A Case Report and Review of The Literature

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R E Fraser ◽  
G R Layton ◽  
L L Kuan ◽  
A R Dennison
Keyword(s):  
Expectant Management ◽  
Evidence Base ◽  
Primary Treatment ◽  
Cavernous Haemangioma ◽  
Liver Tumours ◽  
Case Presentation ◽  
Best Management ◽  
Anatomical Liver Resection ◽  
Benign Liver

Abstract Background Cavernous hepatic haemangiomas are benign liver tumours and although common when small, giant haemangiomas (usually accepted as being greater than 10cm) are infrequent. Treatment is indicated in patients who are symptomatic or if diagnosis is unclear, although with giant haemangiomas, many support expectant management of asymptomatic lesions due to the risk of major complications. Traditionally hepatic resection has been the primary treatment option for these lesions, but a variety of other techniques, including enucleation, have been described as safe and effective alternatives. There remains equipoise in respect of the best management of giant haemangiomas above 10cm. Cases of such size are rare and so there is a paucity of data available. Case presentation We present a case of a 65-year-old male who underwent successful anatomical liver resection for a 5kg giant cavernous haemangioma of 26cm diameter following its incidental identification during an ultrasound scan. We also discuss and compare the role of resection and enucleation for the treatment of haemangiomata greater than 20cm in diameter. Conclusions This case demonstrates successful resection of an unusually giant haemangioma which, in contrast to the majority of literature, provides a valuable addition to the limited evidence base for management of this condition by anatomical resection.

scholarly journals Not All That Shines on a PET Scan Is Cancer: A Silicone-Induced Granuloma Masquerading as Malignancy

2020 ◽  
Vol 11 (1) ◽  
pp. 8-12
Author(s):  
Krishna Vedala ◽  
Philip Sobash ◽  
Deborah Johnson ◽  
Krishna Kakkera
Keyword(s):  
Pet Scan ◽  
Imaging Modalities ◽  
Ct Scans ◽  
Pet Ct ◽  
Suspicious Lesions

PET/CT scans are frequently used in the initial workup of suspicious lesions but not all that lights up on a PET is cancerous. We wish to discuss a case of silicone-induced granuloma mimicking malignancy and the role of other imaging modalities for further workup.

scholarly journals X-change symposium: status and future of modern radiation oncology—from technology to biology

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Stefanie Corradini ◽  
Maximilian Niyazi ◽  
Dirk Verellen ◽  
Vincenzo Valentini ◽  
Seán Walsh ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Radiation Oncology ◽  
Trial Design ◽  
Rapid Development ◽  
Clinical Trial Design ◽  
Current Status ◽  
Treatment Modalities ◽  
Special Treatment ◽  
Image Guided Radiotherapy

AbstractFuture radiation oncology encompasses a broad spectrum of topics ranging from modern clinical trial design to treatment and imaging technology and biology. In more detail, the application of hybrid MRI devices in modern image-guided radiotherapy; the emerging field of radiomics; the role of molecular imaging using positron emission tomography and its integration into clinical routine; radiation biology with its future perspectives, the role of molecular signatures in prognostic modelling; as well as special treatment modalities such as brachytherapy or proton beam therapy are areas of rapid development. More clinically, radiation oncology will certainly find an important role in the management of oligometastasis. The treatment spectrum will also be widened by the rational integration of modern systemic targeted or immune therapies into multimodal treatment strategies. All these developments will require a concise rethinking of clinical trial design. This article reviews the current status and the potential developments in the field of radiation oncology as discussed by a panel of European and international experts sharing their vision during the “X-Change” symposium, held in July 2019 in Munich (Germany).

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