Colonoscopy examination requires a longer time in patients with acromegaly than in other individuals.
In conclusion, although cecal intubation during colonoscopy was successful in all participants, it required a longer time in patients with acromegaly. Our results underscore the importance of and certain technical difficulties involved in colonoscopy procedures in patients with acromegaly, especially in older patients. PMID: 29081443 [PubMed - as supplied by publisher]
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.
Image-guided high-dose-rate multichannel vaginal cylinder (MCVC) brachytherapy (BT) permits conformal dose delivery to a vaginal tumor while sparing surrounding organs-at-risk. Due to the proximity of the peripheral channels to the tumor and cylinder surface, the adjacent vaginal mucosa is a dose-limiting structure when using MCVC, however, specific dose-volume limitations are not well characterized. We explored vaginal dose-volume parameters in a series of consecutive patients treated with MCVC for gynecologic cancers involving the vagina.
Doppler ultrasound (US) gives real-time information regarding anatomy and blood vessel location to guide needle placement for gynecologic interstitial brachytherapy (BT). We retrospectively assessed Doppler US images for vessel quantity, size, and distribution in cervical cancer patients undergoing high dose rate (HDR) BT at our institution.
To report survival outcomes in women with stage II uterine endometrioid carcinoma who received adjuvant radiation therapy (RT) without chemotherapy (CT) using the National Cancer Database (NCDB).
Image-guided brachytherapy in locally advanced cervical cancer, with MRI regarded as the gold standard, is increasingly recognized as the new paradigm. GEC-ESTRO has recognized the importance of MRI for cervical cancer, and has issued a series of recommendations. MRI has superior soft tissue depiction quality. OARs (bladder, rectum and sigmoid) and the relevant patho-anatomical structures (uterine cervix and corpus, vagina, parametrium) can be appropriately visualized on T2-weighted MR images without contrast media injection.
For 3D-image guided adaptive brachytherapy in cervical cancer, the current standard of ICRU 89 recommends recording numerous dose parameters. Conventionally, dosimetric parameters from a plan are reviewed and then manually entered into a spreadsheet for cumulative dose analysis. This process is error-prone and poses a significant challenging in a routine clinical practice given the large amount of data recommended by ICRU 89. To address these problems, we have developed an Autobrachy system to automatically document ICRU 89 dosimetric parameters.
To report workflow and the required time for each step of the treatment procedure with MR image guided HDR brachytherapy (MR IGBT) for cervical cancer in a high brachytherapy volume center.
MRI-based, image guided adaptive brachytherapy is now the standard of care for cervical cancer. There is increasing interest in the use of hybrid intracavitary/interstitial applicators for dose escalation in bulky tumors (HR-CTV>30 cc) as currently recommended in the EMBRACE II trial. The value of hybrid intracavitary/interstitial applicators for tumors with smaller HR-CTV is less certain. The purpose of this study is to evaluate the organ at risk sparing of hybrid applicators (Hybrid TR) compared to conventional tandem and ring(TR) applicators.
ConclusionThyroid micro-carcinomas are probably over-diagnosed among acromegalic patients. In regard to colon cancer, there is no sufficient data to suggest that colon cancer risk is higher in acromegaly compared to the general population.
Growth hormone (GH) excess in acromegaly is associated with increased precancerous colon polyps and soft tissue adenomas, whereas short-stature humans harboring an inactivating GH receptor mutation do not develop cancer. We show that locally expressed colon GH is abundant in conditions predisposing to colon cancer and in colon adenocarcinoma-associated stromal...