A Single-Institute Experience With Radioactive Seed Localization of Breast Lesions—A Retrospective Study

Objectives: To assess the benefits associated with radioactive seed localization (RSL) in comparison to conventional wire localization (WL) for nonpalpable breast lesions. Methods: Radioactive seed localization was initiated at our institution in July 2013. Retrospective review of all WL performed between June 2012 and July 2013 (2013) and all RSL performed during June 2015 and July 2016 (2016). Patients who received neoadjuvant therapy or did not undergo their planned surgeries and WL performed in 2016 were excluded. The following data were collected: final pathology, resection margins for malignant lesions, time to surgery, seed migration, and number of localized lumpectomies performed by each surgeon. Results: A total of 292 WL procedures (288 women) in 2013 and 194 RSL procedures (186 women) in 2016 were eligible for the study. All WLs were inserted the day of surgery. Mean time from RSL insertion to surgery was 4.0 ± 2.8 days (range: 1-17 days). There was no difference in specimen size for malignant lesions (6.8 ± 2.8 cm for WL and 6.9 ± 2.9 cm for RSL; P = .5). Specimen radiographs were obtained in 233 (80%) of 292 WL compared to 194 (100%) of 194 RSL ( P < .001). For malignant lesions, positive margins were present in 34 (17.2%) of 198 with WL compared to 15 (10.3%) of 146 with RSL ( P < .001). Close margins (≤1 mm) were present in 31 (15.6%) of 198 with WL compared to 1 (0.6%) of 146 with RSL ( P < .001). The seed fell out of the specimen during surgery in 6 (3.1%) of 194. No seed loss was recorded. The surgeons (n = 4) who transitioned to RSL increased the number of surgeries per month from a mean of 4.4 ± 2.6 in 2013 to 6.9 ± 3.5 in 2016, equivalent to a 41% increase ( P = .003). Conclusions: The use of RSL, as compared to conventional WL, resulted in a reduction in the number of pathologically involved surgical margins and was associated with an increased number of surgeries. Furthermore, RSL can be performed up to 14 days prior to surgery, which may improve scheduling flexibility in the radiology department.

A cone beam CT-based study on fiducial seed migration and planning target volume margin in prostate radiotherapy

Aim:This study attempts to investigate fiducial marker (FM) migration and calculate the prostate planning target volume (PTV) margin considering the setup errors after translation corrections alone (T) and translation plus rotational corrections (T+R) and anatomy variation with respect to the corrected fiducial position, analysed on cone beam computed tomography (CBCT) images.Methods and materials:CBCT images from 25 patients are analysed for FM movements, setup error and anatomy variation with respect to the seed match positions. Systematic and random components of setup error and prostate movements are used to calculate the PTV margin for CBCT-based FM localisation in two scenarios, translation corrections only and translation plus rotational correction. MTNW887825 soft tissue gold markers (Civco, Orange City, FL, USA) were used with the department-specific immobilisation system and rectal and bladder filling protocols.Results:The average directional inter-marker distance variation is −0·05 ± 0·90 mm. The systematic setup errors for T+R are 0·40, 0·63 and 0·80 mm in right–left (RL), anterior–posterior (AP) and superior–inferior (SI), respectively. The corresponding values for T only are 0·54, 0·69 and 0·90 mm. The systematic prostate movement from T+R corrected FM positions are 0·65, 1·27 and 1·32 mm in the RL, AP and SI directions.Findings:Minimal FM movements are noted from the study. The PTV margins to incorporate the daily T+R corrected setup error and prostate deformation are found to be 2·5, 4·5 and 5·2 mm in the RL, AP and SI directions, respectively. The corresponding margins for T only corrected scenario are found to be 2·8, 4·8 and 5·7 mm.

The zone of temporary flooding of small rivers as an area of increased floristic diversity

During fluctuating water levels in the lower reaches of rivers, large areas of shallow water are exposed, forming a zone of temporary flooding (TFZ). The level regime of the water body determines the conditions for the growth of plants, the period available for vegetation of species and the path of seed migration. The seed bank is an integral part of a riparian biocenosis, experiencing the characteristics of environmental factors which influence its structure. Our study of the vegetation cover was carried out by the method of route survey of ecotopes in the estuaries of the Korozhechna and Ild rivers, tributaries of the Rybinsk Reservoir. Species composition of the flora is given in accordance with APG IV. The cenotic structure is characterized in terms of the Brown-Blanke school. To assess the species composition of the seed bank, a transect was placed along the width of the TFZ, on which cores were selected. Flora of the Korozhechny river is represented by 59 species from 24 families and 45 genera. Most numerous families: Poaceae (12%), Cyperaceae (10%), Polygonaceae (10%), Asteraceae, Ranunculaceae and Brassicaceae (by 7%). Flora of the Ild river is represented by 42 species from 18 families and 29 genera. Most numerous families: Cyperaceae (21%), Ranunculaceae (14%), Poaceae (12%), Plantaginaceae (7%). We found two rare species: Carex bohemica – on the Ild river and Ranunculus reptans – on both rivers. The difference in the species composition is explained by the greater riparian area of the TFZ on the Korozhechna river, characterized by a wide low floodplain. Phytocenosis form multicomponent complexes and are represented by associations Scirpetum lacustris, Phalaroidetum arundinaceae, Caricetum gracilis, Phragmitetum communis – on both rivers, Hippuridetum vulgaris и Batrachietum circinati – in terrestrial form on the Korozhechna river, and Eleocharitetum palustris and Oenantho-Rorippetum on the Ild river. In the seed bank composition of the TFZ of the transition zone of the Korozhechna river receiver 25 species were found, Ild river – 30 species. The ecological structure of the flora of both rivers and the seed bank is dominated by species of waterlogged and humid habitats. Their share (hygrophyte and hygromeso-and mesophyte) accounts for about 50%. With prolonged drying, they can normally develop in the TFZ. In the biomorphological structure, the main part of the flora and seed bank species are perennial grasses, characterized by great environmental plasticity, adapted to extreme conditions of habitat, having wide ecological amplitude with respect to the ground and which can withstand considerable fluctuations in the water level. As a result, our work has confirmed that the seed bank is a hidden component of plant communities and reflects the floristic potential of ecologically unstable territories.