Severe cerebellar hemorrhage following transverse sinus stenting for idiopathic intracranial hypertension.
We report a severe adverse event occurring in the course of a cohort study (ISRCTN13784335) aimed at measuring the efficacy and safety of venous stenting in the treatment of patients with medically refractory idiopathic intracranial hypertension (IIH). The patient was a 41-year-old woman who was not overweight, who presented with severe headache, grade 1 bilateral papilledema and transient tinnitus, refractory to medical treatment. Right transverse sinus stenting was successfully performed. Following surgery, the patient's state of consciousness decreased acutely with rapid and progressive loss of brainstem reflex. CT scan revealed acute cerebellar and intraventricular hemorrhage with obstructive hydrocephalus. Angioscan revealed normal venous sinus patency and cerebral MRI showed acute mesencephalic ischemia. Mechanical impairment of cerebellar venous drainage by the stent or venous perforation with the large guidewire used in this technique are two logical ways to explain the cerebellar hemorrhage seen in our patient. The risk of such a complication could probably be reduced using alternative tools and technique. However, given the low level of evidence around the safety of transverse sinus stenting in IIH, its formal assessment in clinical trials is required. PMID: 28992723 [PubMed - as supplied by publisher]
We present our results in patients with recurrent H&N cancers treated with interstitial HDRBT in terms of survival and toxicity outcomes and also assess the prognostic factors associated with reirradiation with HDR Brachytherapy.
To investigate the interobserver variability of combined transrectal ultrasound (TRUS) / computed tomography (CT) vs. CT only vs. MRI only- based contouring of the high risk clinical target volume (CTVHR) in image guided adaptive brachytherapy (IGABT) for locally advanced cervical cancer (LACC).
We present a new technique of three dimensional (3D) computed tomography (CT) guided interstitial (IS) brachytherapy (BT) and evaluate the dosimetric advantage of the current technique compared with the conventional intracavitary brachytherapy for locally advanced cervical cancer, offering a more advantageous clinical treatment approach.
Locally advanced cervical cancer patients treated on the EMBRACE protocol require blind intraoperative interstitial needle placement under general anaesthesia, a MRI planning scan and overnight hospital stays leading to operating room facility, imaging and ward access limitations. Benefits of an outpatient based procedure would eliminate such access problems and improve the efficiency of the workflow with the added benefit of faster real time optimisation of interstitial needle placement under CT guidance instead of MRI.
We report on a novel peer review method for gynecologic high dose rate (HDR) BT at our high-volume academic center.
There is increasing evidence in oncology that pain management contributes to broad quality-of-life improvement. To maximize patient outcomes, pain management is an essential part of oncologic management. The aim of this study was to investigate the safety and effectiveness of computed tomography (CT)-guided 125I brachytherapy in treating adult cancer pain.
To evaluate the efficacy and safety of percutaneous computed tomography-guided combined bronchoscope-guided permanent iodine-125 implantation brachytherapy to central lung cancer.
To evaluate intermediate-term outcomes after computed tomography (CT)-guided radioactive iodine-125 seed implantation (CTRISI) and to determine prognostic variables associated with outcomes in patients with pulmonary metastases.
To describe a useful technique to decrease rectal dose during HDR prostate brachytherapy given as boost to EBRT or as monotherapy. Prostate brachytherapy has evolved in recent years together with the technological and computer development. It has become popular to use high dose rate (HDR) and 3D volumetric planning, using computed tomography (CT) and/or magnetic resonance imaging (MRI), which has help improving accuracy and conformation of treatment and also the capabilities to dose scaling, due to the real visualization of the target and organs at risk (OARS), the use of tomographic images allows to take actions and optim...
For cervical brachytherapy planning, magnetic resonance imaging (MRI) is preferable to computed tomography (CT) for target delineation. However, due to logistical and financial restrictions, in-room MRI is not routinely available in brachytherapy centers in the United States. Our institution has created a workflow that integrates MRI based target delineation with an in-room CT scanner. After the initial fraction of CT guided brachytherapy is delivered, an MRI is acquired and fused to subsequent planning CT ’s (fractions 2-5) with the aim of improving target coverage and improving conformality.