Measurement uncertainty and prostate seed brachytherapy gregory
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This document discusses measurement uncertainty in prostate seed brachytherapy. It begins by providing an overview of the prostate seed implantation procedure. It then discusses how implant quality is currently assessed using the D90 value metric and thresholds for acceptable vs. unacceptable values. However, the document notes the D90 value has a large uncertainty due to factors like seed activity, hardware calibration, seed placement, fusion matching of images, and CT contouring. Specific uncertainties are provided for each factor. The conclusions are that the overall D90 uncertainty could be improved by using MR images rather than CT for contouring, and investing more time in MR imaging and less in seed placement.
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This document discusses technology assessment, outcomes research, and economic analyses in healthcare. It provides background on rising healthcare costs in the US without clear improvements in health outcomes compared to other countries. The rationale for assessing new technologies and their impact is described. Key aspects of technology assessment are outlined, including technical efficacy, diagnostic accuracy, diagnostic impact, therapeutic impact, patient outcomes, and societal outcomes. Challenges with randomized controlled trials in assessing technologies are reviewed. The National Lung Screening Trial is presented as an example. Finally, computed tomography for appendicitis is analyzed as a hypothetical example of how modeling could be used to assess a technology when a randomized trial may not be feasible.
Implementation of an audit and dose reduction program for ct matyagin
This document summarizes an audit and dose reduction program implemented for CT scans. It found that CT radiation exposure has increased significantly in recent decades and now accounts for a large percentage of medical radiation exposure. By modifying scan protocols and settings to optimize dose while maintaining image quality, they were able to reduce CT radiation doses at their hospital below international reference levels for most common CT exams. Areas like brain perfusion CT still require further dose optimization. Recording detailed dose information in imaging records was also implemented.
Basem AL Al Zahrany .docx
Basem AL Al Zahrany
How effective is CT Colonography in detecting colon cancer?
Introduction
The second cause leading to death in the United States is colorectal cancer in the same way colorectal cancer is the third common cancer in women and men. In the United States 135,260 people diagnosed with colorectal cancer in 2011. Colorectal cancer caused for 51,783 people from them the death. The number of colorectal cancer patients is predictable to rise in the future. Built on the present data, cost scenario and survival for colorectal cancer Yabroff et al expected the cost effect in 2020 for the primary $4.05 billion, making a significant cost load on the healthcare system. Colorectal cancer mortality was decreased by 18% to13 % with apply CT Colonography to detect colonic polyps before they developed to colorectal cancer (Trilisky et al, 2015). CT Colonography has been shown to have polyp discovery rates similar to the patient how use colonoscopy. CT Colonography is an exam for colorectal cancer screening which became generally effected for detecting polyps similar to those of colonoscopy. It has the prospective to improve colorectal cancer screening rates because of colorectal is come to be insignificant noninvasive ,faster patient in quantity ,no sedation requirement and potential for reduced cathartic examination . Appropriate program of a CT Colonography screening must implement and needs important announce to several aspects, counting proper patient preparation before the investigation, image acquisition, and post-processing of the developed images. A CT Colonography need workstation with special software and high quality monitors. Special software called Computer-Aided Detection CAD which is manipulate to reduce mistakes of spotting and showing polyps to the radiologist for images interpretation. These essay will discuss technique, advantages , disadvantages of CT Colonography and how CT Colonography can be affect for colorectal cancer .
Exam technique
Currently, patients go through intestine preparation procedure which has the purpose of avoid misdiagnosed of polyps by cleaning the colon. So far there is no agreement on a best program of food adjustment and releasing preparation of flexible period and amount. There is continuing studies aimed to rise patient relaxation and acceptance. To distinguish polyps from other residual the use usually fecal and fluid tagging with bowel laxative. Some time they do it with small quantity of both iodine-based contrast material and barium or one of them to improve the image and to eliminate the artifact of image which could be accrue ,which may rise the sensitivity of polyp detection, Digital subtraction is a post-acquisition processing technique use to improve the image quality(Trilisky,2015).
Advantages of CT Colonography
CT Colonography shows high sensitivit ...
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Barth imt
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AI techniques are being explored to derive real-world evidence from routine medical imaging and reports. Image segmentation algorithms can identify tumors and organs in medical images. Natural language processing of radiology reports containing over 700,000 structured records dating back to 2009 has mapped patterns of metastatic disease and generated real-time survival curves for different cancers using only the uncurated data. Further development aims to uncover true response rates, map cancers of unknown primary back in time, and generate hypotheses for clinical trials to potentially expedite research. Addressing issues around data biases, identity, and social justice will be important to responsibly develop these techniques.
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The document provides an overview of MR Guided Focused Ultrasound (MRgFUS) and its present and future clinical research studies for various applications. It discusses how MRgFUS works using focused ultrasound to ablate tissue only at the focal point with MR guidance and thermometry for precise targeting and treatment monitoring. Current research studies described include pain palliation of bone metastases, breast cancer, and prostate cancer treatments. Preliminary results for bone metastases and breast cancer indicate reduced pain and high tumor necrosis. Future areas of research discussed include brain treatments and expanding applications to other organs.
Astro highlights 2013
This document summarizes highlights from the 2013 ASTRO conference. It provides an overview of the scientific program and abstracts presented. It then summarizes several notable studies presented on prostate cancer, glioblastoma, meningioma, brain metastases, cervical cancer, and breast cancer. A few of the highlighted studies showed improved outcomes with longer neoadjuvant hormone therapy or improved progression-free survival with adding bevacizumab for glioblastoma. The document cautions that the studies presented are not peer-reviewed and conclusions should not form the basis of practice changes.
Apresentação de radiofrequencia
This systematic review analyzed nine studies on the use of radiofrequency ablation (RFA) to treat benign thyroid nodules. The studies included two randomized controlled trials and six prospective observational studies, with a total of 306 RFA treatments. Meta-analysis found statistically significant reductions in nodule size from baseline to follow-up, including in "hot" and "cold" nodule subgroups. Minor adverse events occurred in 12 treatments but none required hospitalization. RFA was concluded to be a safe and effective treatment for symptomatic benign thyroid nodules, though more high-quality studies are needed comparing it to surgery or other nonsurgical options.
Aula de Radiofrequencia em Nódulos Tireoidianos
This systematic review analyzed nine studies on the use of radiofrequency ablation (RFA) to treat benign thyroid nodules. The studies included two randomized controlled trials and six prospective observational studies, with a total of 306 RFA treatments. Meta-analysis found statistically significant reductions in nodule size from baseline to follow-up, including in "hot" and "cold" nodule subgroups. Symptom and cosmetic scores also significantly improved, and patients were able to withdraw from antithyroid medication. Twelve adverse events occurred but none required hospitalization or caused death. The review concluded that RFA is safe and effective for symptomatic benign thyroid nodules, but noted a lack of high-level evidence comparing it to surgery or other
Advances in oncological PET/CT Imaging
This document discusses advances in oncological PET imaging. It begins by outlining limitations of current PET/CT imaging related to false positives, false negatives, and radiation exposure. It then describes several advances in PET imaging including new radiotracers for tumor characterization, instrumentation improvements, software enhancements to reduce radiation dose, and hybrid PET/MRI imaging. The document provides examples of how various new radiotracers beyond FDG can provide clinical benefits for tumor imaging and characterization.
Similar to Measurement uncertainty and prostate seed brachytherapy gregory (20)
Individually Optimized Contrast-Enhanced 4D-CT for Radiotherapy Simulation in...
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Evaluation the Results of 18F-FDG PET/CT Implementation for Cancer Diseases a...
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Technology Assessment, Outcomes Research and Economic Analyses
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Validazione dei cfDNA Test e Controlli di Qualità Esterni e Interni
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General physicians and the adf Heddle
General physicians known as consultant physician/pediatricians (CPPs) have undergone rigorous medical training but their skills vary widely. They are well-trained in diagnosing and managing complex medical conditions. CPPs could serve in several roles for the ADF, including providing consultations for individual service members, advising on health policy, and working in level 2 or 3 medical facilities. A short modular training program could help update CPPs on relevant areas like emergency medicine and tropical diseases to better prepare them for operational roles.
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Endurance, Courage and Care: The 1942 Kokoda Track Campaign of Captain Alan W...
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The Loss of HMAS SYDNEY 2: Medical Aspects- Westphalen
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Recognising early deteriorating signs a project at kapooka health centre pocius
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Innovation in joint health command clinical governance murphy
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Managing expectations can we really call on our big blue brother- busch
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Mobile Field RAP, Regimental Aid Post- Gordon
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Are suicide rates for young australian males really falling the recent contr...
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The Uniformed Services University of the Health Sciences- A Unique Resource- ...
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Comprehensive Soldier Fitness Concept- Baker
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Case report of thoracic spine fractures from ied blast in armoured vehicle Y...
This document summarizes three cases of thoracic spine fractures in soldiers from a vehicle IED strike in Afghanistan. All three soldiers were seated and wearing body armor at the time of the blast. Two soldiers had compression fractures of T12 that were not initially suspected based on examination alone. CT scans revealed the fractures. Both were treated non-operatively. The third soldier had a burst fracture of T12 also seen on CT scan. A literature review found that spine fractures are common in IED strikes and physical exams can miss injuries. CT scans are recommended to evaluate all back pain cases from IED attacks. Future research on seat design, restraints, and protection from flexion injuries from body armor is discussed.
Real world attenuation of foam earplugs- Smith
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Hypothermia and the battle casualty Wishaw
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Gastrointestinal Infections
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- 1. Measurement uncertainty and prostate seed brachytherapy Presented by Kent Gregory Department of Medical Physics Royal Adelaide Hospital Kent Gregory, John E. Pattison, Giovanni Bibbo
- 2. What is a prostate seed implant? c/o NY Times website
- 6. Post-implant: some hours later melbourneprostate.org
- 7. How is implant quality assessed? One indicator is the value of D90…
- 8. How is implant quality assessed? Interpreting D90 values… •>130 Gray = good treatment •110-130 Gray = closer assessment •<110 Gray = may need top-up
- 9. Most implants are assessed using CT images…
- 10. CT contouring
- 11. However RAH ‘Fuses’ Ultrasound contours onto CT images
- 12. Schiffler Cancer Centre (USA) ~1500 implants between 1995 and 2006, 55 biochemical failures to 2008
- 13. The correlation between D90 value and biochemical failure seems poor. Q1. What factors contribute to D90 uncertainty? Q2. What is the uncertainty of D90? Q3. Can we make better use of clinical resources?
- 14. Q1: What factors contribute to D90 uncertainty? • Seed activity • Hardware cal. • Seed placement • Fusion match • CT contouring • 30 mins (1 MP) • 15 mins (2 MPs) • 60 mins (3 medical + 5 staff) • 15 min (1 MP) • 20 min (1 medical, 1 MP)
- 15. Q2: What is the uncertainty of D90? • Seed activity • Hardware cal. • Seed placement • Fusion match • CT contouring • 2% • 2% • 3% • ? % • 10% Han et al., Med Phys, Vol. 30, No. 6, June 2003
- 17. CT contouring & KG fusion 80 90 100 110 120 130 140 150 160 170 180 0 1 2 3 4 5 6 7 8 9 10 Patient D90 (Gray)
- 18. CT contouring & all fusion 80 90 100 110 120 130 140 150 160 170 180 0 1 2 3 4 5 6 7 8 9 10 Patient D90 (Gray)
- 19. Q2: What is the uncertainty of D90? • Seed activity • Hardware cal. • Seed placement • Fusion match • CT contouring • 2% • 2% • 3% • 9% + Oedema • 10% Han et al., Med Phys, Vol. 30, No. 6, June 2003
- 20. Conclusions • Even preliminary analysis of data indicates D90 values have large uncertainties, due mainly to the contouring or fusion step • Lower D90 uncertainty may be achieved if MR images are used • D90 uncertainty may be improved if more time is invested getting MR images, and less time with seed placement
- 21. Thank you! Acknowledgements •A/Prof Loredana Marcu (Senior Medical Physicist, Royal Adelaide Hospital) •Dr Raghu Gowda (Radiation Oncologist , Royal Adelaide Hospital) •And the rest of the Brachytherapy team at RAH