scholarly journals A comparison of selected dosimetric parameters of two Hodgkin Lymphoma radiotherapy techniques with reference to potential risk of radiation induced heart disease

2018 ◽  
Vol 24 (3) ◽  
pp. 121-126
Author(s):  
Elias Alibeyki ◽  
Saeid Karimkhani ◽  
Sepide Saadatmand ◽  
Parvaneh Shokrani
Keyword(s):  
Heart Disease ◽  
Hodgkin Lymphoma ◽  
Potential Risk ◽  
Dose Distribution ◽  
Early Stage ◽  
Organs At Risk ◽  
Young Patients ◽  
Mean Value ◽  
Radiation Induced ◽  
The Mean

Abstract Purpose: Hodgkin lymphoma (HL) is one of the most frequent malignancies among pediatric patients. One of the common causes of death in HL survivors after radiation therapy (RT), is radiation-induced heart disease (RIHD). The aim of this study was to compare several dosimetric parameters for two methods of early stage Hodgkin lymphoma radiotherapy with reference to potential risk of RIHD. Materials and Methods: Using a series of computed tomography slices of 40 young patients, treatment planning was done in two methods of HL RT, including involved field (IFRT) and involved site (ISRT) in doses of 20, 30, and 35 Gy. Contouring of clinical target volume as well as the organs at risk, including the heart, was performed by a radiation oncologist. The mean and maximum dose of heart (Dheart-mean and Dheart-max), the volume of heart receiving a dose more than 25 Gy (V25), and the standard deviation of dose as a dose homogeneity index in heart, were used to compare the RIHD risk. Results: The mean value for Dheart-mean in ISRT method in all doses was less compare to IFRT. Maximum reduction in mean value of Dheart-mean occurred at moving from 30 Gy IFRT to ISRT by 9.53 Gy (p < 0.001) and minimum was between 35 Gy IFRT and ISRT. The mean value for Dheart-max was fewer in IFRT rather than ISRT and the maximum difference was between 35 Gy IFRT and ISRT (1.35 Gy). The mean of V25 of heart was 26.66% and 23.74% in 35 Gy IFRT and ISRT, respectively, and dose distribution was more homogeneous in IFRT. Conclusions: If Dheart-max and V25 of heart or homogeneity of dose distribution in heart are considered as determining factors in RIHD, then IFRT can be considered optimum, especially in 35 Gy IFRT; while, assuming the Dheart-mean as the most important factor in RIHD, superiority of ISRT over IFRT is observed.

Enhancement of reflection and backscattering components by plane wave imaging for estimation of surface roughness

2021 ◽  
Author(s):  
Kazuhiro Tochigi ◽  
Ryo Nagaoka ◽  
Jens Erik Wilhjelm ◽  
Hideyuki Hasegawa
Keyword(s):  
Surface Roughness ◽  
Plane Wave ◽  
Arterial Wall ◽  
Early Stage ◽  
Mean Value ◽  
Luminal Surface ◽  
Ultrasonic Echo ◽  
Wave Imaging ◽  
The Mean ◽  
Reflection Component

Abstract In the early stage of atherosclerosis, the luminal surface of the arterial wall becomes rough. Methods for distinguishing between the reflected and backscattered components in the ultrasonic echo from the arterial wall has the potential to be used as a method for assessment of the roughness of the arterial wall. In this study, we proposed a method to distinguish between the reflected and backscattered components using a technique based on plane wave compounding. This method was evaluated by experiments using planar phantoms with rough surfaces made of polyurethane rubber. The coefficient of variation calculated from the mean value of the reflection component and the standard deviation of the backscattering component was proportional to the roughness of the rubber phantom. This result shows the potential usefulness of this method for analyzing surface roughness of the arterial wall.

scholarly journals Utility of VSRAD for diagnosing Alzheimer’s disease in patients screened for dementia

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091727 ◽  
Author(s):  
Gaku Oshikubo ◽  
Akihisa Akahane ◽  
Aki Unno ◽  
Yukako Watanabe ◽  
Emi Ikebuchi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Roc Curve ◽  
Early Stage ◽  
Regional Analysis ◽  
Mean Value ◽  
Cognitive Status ◽  
Roc Curve Analysis ◽  
Z Scores ◽  
The Mean

Objective To investigate the utility of the voxel-based specific regional analysis system for Alzheimer’s disease (VSRAD). Methods Clinical data from patients who underwent screening for dementia using VSRAD and the Japanese version of COGNISTAT, the Neurobehavioral Cognitive Status Examination, were retrospectively investigated to specify the domains of cognitive function that correlate with the statistical mean value of positive Z-scores in the target volume-of-interest (VOI). A receiver operating characteristic (ROC) curve was constructed to assess the mean value of positive Z-scores in discriminating patients with AD. Results A total of 72 patients were included (18 male and 54 female; 15 patients with AD). The mean value of positive Z-scores in the target VOI was significantly correlated with standardized COGNISTAT scores for Orientation and Memory in all patients (r = –0.35 and –0.38, respectively). ROC curve analysis revealed that a cut-off of 1.57 for mean value of positive Z-scores in the target VOI provided 69.4% accuracy in discriminating patients with AD, with a sensitivity of 0.80 and specificity of 0.67. Conclusions The results evinced the value of VSRAD in diagnosing AD. The degree of atrophy represented by the target VOI may reflect impairments in Orientation and Memory, which are early stage symptoms observed in AD.

scholarly journals Development and Implementation of Proton Therapy for Hodgkin Lymphoma: Challenges and Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3744
Author(s):  
Pierre Loap ◽  
Ludovic De Marzi ◽  
Alfredo Mirandola ◽  
Remi Dendale ◽  
Alberto Iannalfi ◽  
...  
Keyword(s):  
At Risk ◽  
Radiation Therapy ◽  
Hodgkin Lymphoma ◽  
Proton Therapy ◽  
Early Stage ◽  
Organs At Risk ◽  
Intensity Modulated Radiation Therapy ◽  
Progression Free Survival ◽  
Treatment Techniques ◽  
Increased Risk

Consolidative radiation therapy for early-stage Hodgkin lymphoma (HL) improves progression-free survival. Unfortunately, first-generation techniques, relying on large irradiation fields, were associated with an increased risk of secondary cancers, and of cardiac and lung toxicity. Fortunately, the use of smaller target volumes combined with technological advances in treatment techniques currently allows efficient organs-at-risk sparing without altering tumoral control. Recently, proton therapy has been evaluated for mediastinal HL treatment due to its potential to significantly reduce the dose to organs-at-risk, such as cardiac substructures. This is expected to limit late radiation-induced toxicity and possibly, second-neoplasm risk, compared with last-generation intensity-modulated radiation therapy. However, the democratization of this new technique faces multiple issues. Determination of which patient may benefit the most from proton therapy is subject to intense debate. The development of new effective systemic chemotherapy and organizational, societal, and political considerations might represent impediments to the larger-scale implementation of HL proton therapy. Based on the current literature, this critical review aims to discuss current challenges and controversies that may impede the larger-scale implementation of mediastinal HL proton therapy.

scholarly journals Dose-Volume Comparison of IMRT and PSPT Treatment Plans for Early-Stage Glottic Cancer

2020 ◽  
Vol 7 (2) ◽  
pp. 42-50
Author(s):  
Takahiro Kato ◽  
Nobukazu Fuwa ◽  
Masao Murakami
Keyword(s):  
Spinal Cord ◽  
Dose Distribution ◽  
Early Stage ◽  
Organs At Risk ◽  
Cricoid Cartilage ◽  
Thyroid Cartilage ◽  
Target Volume ◽  
Glottic Cancer ◽  
Volume Comparison ◽  
Prescription Dose

Abstract Purpose To clarify the dose distribution characteristics for early-stage glottic cancer by comparing the dose distribution between intensity-modulated radiation therapy (IMRT) and passive scattering proton therapy (PSPT) and to examine the usefulness of PSPT for early-stage glottic cancer. Materials and Methods Computed tomography datasets of 8 patients with T1-2 glottic cancer who had been treated by PSPT were used to create an IMRT plan in Eclipse with 7 fields and a PSPT plan in XiO-M with 2 fields. Organs at risk (OARs) included the carotid arteries, arytenoids, inferior constrictor muscles, strap muscles, thyroid cartilage, cricoid cartilage, and spinal cord. The prescription dose was 66 GyRBE in 33 fractions to the planning target volume (PTV). All plans were optimized such that 95% of the PTV received 90% of the prescription dose considering that the skin was slightly spared. Results The superiority of the PSPT was confirmed in all OARs. In the PSPT, the dose to the contralateral carotid artery and the spinal cord, which is slightly distant from the PTV, was dramatically reduced while maintaining the dose distribution uniformity of the PTV by comparison with IMRT. Conclusion PSPT for early-stage glottic cancer resulted in good target dose homogeneity and significantly spared the OARs as compared with the IMRT. PSPT is expected to be effective in reducing late effects and particularly useful for young people.

scholarly journals A maradó fogak gyökér-korona aránya egészséges, fiatal magyar, német és japán populációkban

2021 ◽  
Vol 162 (46) ◽  
pp. 1848-1855
Author(s):  
Boglárka Rencz ◽  
Buthina Alhaddad ◽  
Boglárka Remport ◽  
Noémi Katinka Rózsa ◽  
Mitsuo Iinuma ◽  
...  
Keyword(s):  
Young Patients ◽  
Mean Value ◽  
Permanent Teeth ◽  
German Population ◽  
X Rays ◽  
Proper Treatment ◽  
Lower Jaw ◽  
Treatment Plans ◽  
Hungarian Population ◽  
The Mean

Összefoglaló. Bevezetés: A maradó fogak gyökér-korona arányának meghatározása nagy jelentőséggel bír a fogászati kezelési terv kialakításában és későbbi módosításában. Célkitűzés: Egészséges magyar, német és japán fiatalok maradó fogai gyökér-korona arányának meghatározása és összehasonlítása. Módszer: Hölttä módszerét alkalmaztuk. A mérés 95 magyar, 104 japán és 110 német fiatal páciens 2001 és 2006 között készült panorámaröntgen-felvételén történt. Eredmények: A gyökér-korona arány különbsége a nemek között nem szignifikáns, az egymásnak megfelelő antagonista fogak között sok esetben, de nem mindig, szignifikáns. A legnagyobb gyökér-korona arányt mindhárom populációban az alsó szemfogakon és az alsó második praemolaris fogakon mértük; a felső molarisok esetén a legkisebb az arány. A három nemzetet összehasonlítva szignifikáns különbséget (p≤0,001) nem találtunk egyetlen fogtípus esetében sem. A japán és a német populáció között minden fogtípus esetén szignifikáns volt a különbség a gyökér-korona arányokban. A japán és a magyar populáció összehasonlításakor a fogtípusok felénél találtunk szignifikáns különbséget. A magyar és a német populációt összehasonlítva nagyon kevés fogtípusnál találtunk szignifikáns különbséget. Megbeszélés: Az alsó állcsont fogainak gyökér-korona arányértékei nagyobb mértékben térnek el a populációk között, mint a felső állcsont fogainak esetében. A gyökér-korona arány átlagértéke a német populációban a legnagyobb. A második legnagyobb arányértékkel a magyar populáció rendelkezik, utána pedig a japán, néhány fogtípus kivételével: felső kismetszők, felső szemfogak és felső első molarisok. Következtetés: A legnagyobb gyökér-korona arány különbséget a német és a japán populáció között, a legkisebbet a magyar és a német populáció között találtuk. Cikkünk megmutatja az egyes fogtípusok gyökér-korona arányának normálértékét fiatal, egészséges magyar, német és japán populációban. Orv Hetil. 2021; 162(46): 1848–1855. Summary. Introduction: Defining the root-crown ratio of the permanent teeth is important in making or changing proper treatment plans in dentistry. Objective: To define and compare the root-crown ratios of the permanent teeth of healthy, young Hungarian, German, and Japanese populations. Method: We adapted Hölttä’s method. 95 Hungarian, 104 Japanese and 110 German young patients’ panoramic X-rays (made between 2001 and 2006) were involved in the investigation. Results: Difference between the genders was found non-significant; between the corresponding antagonists many times, but not all significant. The highest root-crown ratios were found in all investigated populations by the lower canines and premolars, the lowest by the upper molars. P≤0,001 was not found among the three populations. Significant differences were found between Japanese and German populations by all tooth-types; between Japanese and Hungarian populations by near half of the tooth-types; between Hungarian and German populations by only a few tooth-types. Discussion: More significant differences were found in root-crown ratios in the lower jaw among the populations. The mean value of the root-crown ratios was the highest in the German population; medium in the Hungarian population; and the least in the Japanese population, with a few exceptions: upper lateral incisors, canines and first molars. Conclusion: The biggest differences were found between the German and Japanese populations; the least between the Hungarian and the German populations. Our paper describes the control values of the root-crown ratios of the tooth types in young, healthy Hungarian, German, and Japanese populations. Orv Hetil. 2021; 162(46): 1848–1855.

scholarly journals Clinical Impact of the Maximum Mean Value of Home Blood Pressure on Cardiovascular Outcomes: A Novel Indicator of Home Blood Pressure Variability

Hypertension ◽  
2021 ◽  
Author(s):  
Takeshi Fujiwara ◽  
Satoshi Hoshide ◽  
Hiroshi Kanegae ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cox Regression ◽  
Mean Value ◽  
Home Blood Pressure ◽  
Antihypertensive Medications ◽  
Unique Identifier ◽  
Cox Regression Analysis ◽  
The Mean

We assessed the relationship between maximum mean home blood pressure (HBP) and incident cardiovascular disease risks in the general practice population of the J-HOP study (Japan Morning Surge-Home Blood Pressure), which recruited 4231 patients with cardiovascular risk factors (mean [SD] age: 65 [11] years; 53% women; 79% on antihypertensive medications) who measured their HBP in the morning and evening for 14 days. The first day’s HBPs were excluded. The average of morning and evening (the average of morning and evening value [MEave]) BP was defined as the average of all HBP values. The maximum mean HBP was defined as the highest value of mean HBP on one occasion. The variability independent of the mean of MEave BP was assessed. The MEave BP was 134/76 mm Hg; the maximum mean HBP was 156/88 mm Hg. Over a median 3.9-year follow-up (16 762 person-years), 72 stroke, and 76 coronary heart disease events occurred. A Cox regression analysis showed that the hazard ratios of a 1-SD increase in maximum mean home systolic BP (SBP; 95% CI) for incident stroke events were (1) 1.89 (1.23–2.89) including MEave SBP and (2) 1.68 (1.33–2.14) including the variability independent of the mean of MEave SBP. These significant associations were not observed for coronary heart disease events. Adding the maximum mean home SBP to the stroke prediction model significantly improved the discrimination: (1) MEave SBP: C statistics difference (95% CI), 0.019 (0.002–0.038); and (2) variability independent of the mean of MEave SBP: 0.031 (0.008–0.056). The maximum mean HBP could be a useful marker for evaluating the stroke risk of patients. REGISTRATION: URL: https://upload.umin.ac.jp ; Unique identifier: UMIN000000894

Dose prescription in SBRT for early-stage non-small cell lung cancer: are we all speaking the same language?

2020 ◽  
pp. 030089162092942
Author(s):  
Anna Merlotti ◽  
Pierluigi Bonomo ◽  
Riccardo Ragona ◽  
Marco Trovò ◽  
Filippo Alongi ◽  
...  
Keyword(s):  
Dose Distribution ◽  
Early Stage ◽  
Organs At Risk ◽  
Optimal Dose ◽  
Target Volume ◽  
Local Tumor Control ◽  
Oncologic Outcomes ◽  
Tumor Control ◽  
Distribution Data ◽  
Published Data

Introduction: Stereotactic body radiation therapy is increasingly used in the treatment of early-stage lung cancers. Guidelines provide indications regarding the constraints to the organs at risk (OARs) and the minimum coverage of the planning target volume but do not suggest optimal dose distribution. Data on dose distribution from the different published series are not comparable due to different prescription modalities and reported dose parameters. Methods: We conducted a review of the published data on dose prescription, focusing on the role of homogeneity on local tumor control, and present suggestions on how to specify and report the prescriptions to permit comparisons between studies or between cases from different centers. Conclusions: To identify the dose-prescription modality that better correlates with oncologic outcomes, future studies should guarantee a close uniformity of dose distribution between cases and complete dose parameters reporting for treatment volumes and OARs.

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