Objective To evaluate the use of ductography.Method A review of 51 patients with presenting complaints of nipple discharge from January 1998 to May 2000 was conducted. Pathology and ductograms were reviewed.Result Ductography had a definite value in the diagnosis of nipple discharge, the sensitiveity was 84.3%.Conclusion Ductography had value to locate and identify leisions, especially multiple leisions and leisions in the periphery of the breast, but it did not exclude pathology.

Objective To evaluate the influence of integrated-CT artifacts on attenuation-corrected (AC) images of SPECT bone imaging. Methods Imaging documents of 78 patients who underwent SPECT/CT bone imaging were retrospectively analyzed, and the artifacts on CT images and CT attenuation maps were visually studied. Compared with the non-attenuation corrected (NC) images, the coefficient of variation (CV) and percentage difference (PD) of radioactive count of regional bone influenced by CT artifacts were calculated and statistically analyzed to estimate the influence of CT artifacts on AC images of SPECT bone imaging. Results The integrated-CT artifacts were found in 38 patients of 78, and appeared the same image findings as those on CT attenuation maps respectively, including truncation artifact, thoraco-abdominal gas artifact, photon starvation artifact, etc. On all the AC images with integrated-CT artifacts, regional bones were influenced not only on uniformity (CVAC 17.62%±4.13%, CVNC 11.19%±3.81%;t=2.13, P<0.05), but also by the distribution (PDAC 16.98%±3.31%, PDNC 9.84%±1.62%;t=2.46, P<0.05) of radioactive count. Conclusion Artifacts on integrated-CT images can induce false AC information on CT attenuation maps, therefore, a comparative analysis with NC images is recommended if necessary.

Objective To investigate the setup errors of head and neck tumor patients with head mask-ing by TomoTherapy with megavoltage CT (MVCT),and to measure the CTV -PTV margins.Methods There were 34 patients with head and neck tumor .All patients had received MVCT scanning before radiation was deliv-ered.The MVCT images were registered with the kilovoltage CT (kVCT)images,the setup errors of the left -right (x),anterior-posterior(y),superior-inferior(z)and transverse profile rotation(Roll)were obtained by matc-hing MVCT with kVCT,followed by calculating the reasonable CTV -PTV margins with the formula M=2.5∑+0.7σ.Results Six hundred and forty MVCT images in total were received for the patients ,the systemic ±random errors in x,y,z and Roll directions were ( -0.15 ±0.55) mm,(0.30 ±0.56) mm,(0.35 ±0.71) mm and (-0.07 ±0.52)°,the CTV-PTV margin in x,y and z directions were 3.31 mm,5.32 mm and 3.35 mm.Con-clusion we demonstrate a theoretic foundation for our CTV -PTV margins in head and neck tumor patients by analyzing the setup errors ,and it also can provide necessary quality assurance for precise radiation .

Tomotherapy plans were produced using a combination of field widths (1 cm, 2.5 cm and 5 cm) and pitches (0.15, 0.30, and 0.45) for seven patients with brain metastases from lung cancer, the plans were compared with dosimetric parameters, protection of organs at risk (OAR) dose and treatment times. All plans were defined that CTV with 30Gy and GTV 50 Gy by ten fraction synchronously. The results showed that the mean dose and CI for GTV was statistical difference (P = 0.002 1, P = 0.012 8), OARs were within the normal range, the treatment time increased inversely proportional to the jaw width, but had lesser impact on the pitch. This study showed plans produced with 5 cm jaw was an effective method for patients with brain metastases from lung cancer.
Aged ; Brain Neoplasms ; diagnostic imaging ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Spiral Computed

Objective To seek a optimization method for lung cancer planning with Helical TomoTherapy for reducing the low dose area of total lung.Methods CT images of thirty patients with unilateral lung cancer were selected.Seven plans (Groups A,B,C,D,E,F and G) were generated for each patient using an identical optimization procedure with the conditions that implemented contralateral lung with unblocked (control group),1/4 directional block,1/2 directional block,directional block,1/4 complete block,1/2 complete block and complete block,respectively.The benefits in different schemes of reducing the low dose area of normal lung tissue were estimated,in order to provide a reference treatment plan scheme in clinical.Results Groups B,C,D and E had less influence on the target than that of group A.And there were no statistical difference between the target dosimetric parameters.The median dose and average dose of group F were increased within 0.5 Gy.The conformal index of group G had great influence on the target.The low dose area of total lung were reduced effectively in Groups C,D,E,F and G,the average decrease of V5 and V10 was 8.06％-45.26％ and 6.21％-33.95％,respectively.The V20 decreased by 1.71％-3.78％ in directional block group,while V20 increased in complete block group (2.07％-5.07％).The single treatment time was increased by 8.51％-79.22％.Conclusions The results showed that the low dose area of total lung was higher for the plan without any block limitation.It could reduce the low dose area of total lung with directional block.We should lengthen the blocking arc of contralateral lung with directional block based on the fractional treatment time and the patient's physical condition.A certain arc of contralateral lung with complete block could effectively reduce low dose area.When complete block was used,it is suggested that the arc was no more than half of the contralateral lung.

Objective To study the dose characteristics of Body γ Knife and Tomotherapy treatment plans for hepatocellular carcinoma,and compare their differences between organs at risk (OAR) dose and the range of low dose.Methods CT simulation images of twelve patients with hepatocellular carcinoma were selected,the target volume and OAR were drew by doctor.Body γ Knife and Tomotherapy treatment plans were optimized with their own planning station.The dosimetric characteristics were evaluated by dose volume histograms and were compared.To analyze the difference between the two techniques,the paired t-test was applied.Results The Dmax and Dmean of target with Body γ Knife were higher than Tomotherapy (P =0.002,0.000),but the conformal index of PTV of Tomotherapy was superior to the Body γ Knife (P =0.001).The Dmax of spinal cord and left kidney with Body γ Knife was lower than Tomotherapy (P =0.013,0.012),and it was also in the Dean of stomach and left kidney (P =0.010,0.023).In the volume dose comparison,the V40,V35,V30,V25 and V20 of normal tissue (all Body-PTV) and liver (all liver-GTV) with Body γ Knife were higher than Tomotherapy (P =0.001,0.001,0.001,0.007,0.029),but the V10 and V5 were lower (P =0.019,0.031),the Dmax of stomach,Dmean of right kidney and liver were no statistical difference (P =0.247,0.308,0.401).Conclusions Both treatment plans could meet the clinical dosimetric need,by the same prescription dose,Dmax and Dmean of target of Body γ Knife were higher than Tomotherapy.Tomotherapy had excellent dose-target conformal and could reduce the range of V25-V40 of OAR and normal tissue,but the range of V5-V10 was increased obviously.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; urine ; Prognosis ; Young Adult

Objective To analyze the setup errors of bone metastases patients by tomotherapy with megavoltage CT (MVCT) and calculate the CTV-PTV margins.Methods 30 patients with bone metastases were enrolled.All patients received tomotherapy,fixed with body net and received MVCT scanning before radiation.The MVCT images were registered with the kilovoltage CT (kVCT) images,the setup errors of X (lateral),Y (vertical),Z (longitudina) and Roll (transverse profile rotation) were obtained according to the formula M =2.5Σ+0.7σ calculated CTV-PTV margin.Results 30 patients were received 494 MVCT images.The errors of systemic±random were (2.85±0.77) mm,(3.11±0.95) mm,(2.21±0.55) mm,and (0,55±0.24)° on X,Y,Z and Roll directions,respectively.The CTV-PTV margins were 3.64 mm,4.17 mm,and 2.86 mm on X,Y,Z directions,respectively.Conclusion The application of image-guided technology for bone metastases can correct positioning in time,which greatly reduces setup errors of the fractionated treatment,further improves the treat accuracy and has a positive value in guiding clinical radiotherapy.

Objective To investigate the correlation of right ventricular wall fatty infiltration or fibrosis degree and function and volume of right ventricle in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).Methods Twenty ARVC patients were enrolled.Multi-sequences of MR scanning were performed,and the transverse diameter of outflow tract of right and left ventricle,end-diastolic dimension (EDD),ejection fraction (EF),end-diastolic volume index (EDVI),end-systolic volume index (ESVI),cardiac output index (CI),as well as right ventricular myocardial mass index (MASSI) and fat and fibrosis tissue characteristics were quantitatively evaluated.The correlation between right ventricular wall fatty infiltration or fibrosis and right ventricular function and volume were analyzed.Results The right ventricular outflow tract transverse diameter was (52.42±11.80)mm,and right ventricular EDD,EF,EDVI,ESVI,CI and MASSI was(50.13 ± 8.71) mm,(18.13± 6.71)％,(169.13 ± 72.11) ml/m2,(117.01 ± 67.31) ml/m2,(1.81±0.20) L/(min · m2) and (17.62 ±1.80)ml/m2,respectively.The right ventricular free wall/anterior wall involvement was observed in all 20 cases,while inferior wall involvement,apical involvement and right ventricular outflow tract involvement was noticed in 10,14 and 15 cases,respectively.The right ventricular wall fat infiltration or fibrosis index was (70.00±22.33) ％,correlated with right ventricular EF (r=-0.627,P =0.003),EDVI (r=0.695,P=0.001)) and ESVI (r=0.676,P=0.001).Conclusion The correlation of right ventricular wall fatty infiltration or fibrosis degree and function and volume of right ventricle may reflect changes of cardiac function in ARVC patients.