Journal of Medical Imaging and Radiation Oncology最新文献

{"title":"Ensuring a fit-for-purpose resource for consumers, clinicians and health services: The updated Osteoarthritis of the Knee Clinical Care Standard","authors":"Ilana N Ackerman, Fiona Doukas, Rachelle Buchbinder, Sally Dooley, Wendy Favorito, Phoebe Holdenson Kimura, David J Hunter, James Linklater, John B North, Louise Elvin-Walsh, Christopher Vertullo, Alice L Bhasale, Samantha Bunzli","doi":"10.1111/1754-9485.13732","DOIUrl":"10.1111/1754-9485.13732","url":null,"abstract":"<p>Knee osteoarthritis is a prevalent and disabling condition that impacts activities of daily living, participation in work and family roles and overall quality of life. With population growth and ageing, an increasing number of Australians are living with knee osteoarthritis (over 1.9 million people in 2019, representing 126% growth relative to 1990 numbers).<span><sup>1</sup></span> National estimates indicate that knee osteoarthritis is associated with over 59,000 years lived with disability annually, exceeding the disability burden of dementia, stroke or ischaemic heart disease.<span><sup>1</sup></span> Knee osteoarthritis also has a major economic impact in Australia, with over $3.5 billion spent annually on osteoarthritis-related hospital admissions<span><sup>2</sup></span> and an estimated productivity loss of $424 billion.<span><sup>3</sup></span> International clinical guidelines consistently recommend non-surgical modalities as the mainstay of knee osteoarthritis management, with referral for consideration of joint replacement surgery reserved for people with late-stage disease.<span><sup>4-6</sup></span> Concerningly, low value care (care that is wasteful, ineffective and/or harmful) persists across the knee osteoarthritis journey. This is often fuelled by misconceptions about osteoarthritis, including inaccurate beliefs around diagnosis and management, that are amenable to change through education and effective communication.<span><sup>7</sup></span></p><p>The Australian Commission on Safety and Quality in Health Care has developed a range of Clinical Care Standards. These aim to: (i) support the delivery of evidence-based clinical care for a health condition or procedure; (ii) reduce variation in clinical care across Australia; and (iii) promote shared decision making between health professionals and consumers. Unlike clinical guidelines, Clinical Care Standards do not describe all the components of care. Instead, they encompass a limited set of quality statements that describe the expected care for a health condition or procedure and highlight priorities for quality improvement.</p><p>Evidence of low value osteoarthritis care (specifically, high rates of knee arthroscopy among older Australians, with substantial geographic variation)<span><sup>8</sup></span> pointed to the need for the first Clinical Care Standard targeting knee osteoarthritis. In 2017, the Osteoarthritis of the Knee Clinical Care Standard was launched following a comprehensive development process that involved topic experts and consumers, wider stakeholder consultation and national peak body endorsement. Seven years on, we introduce the updated Osteoarthritis of the Knee Clinical Care Standard and indicator set (available at www.safetyandquality.gov.au/oak-ccs),<span><sup>9</sup></span> which have been carefully revised to ensure alignment with new evidence, contemporary international guidelines and advances in person-centred care. The updates also target current ","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"774-780"},"PeriodicalIF":2.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The trainee research curriculum: Time to ENHANCE it?","authors":"Daniel E Roos, Paulina Stehlik, Paul M Parizel","doi":"10.1111/1754-9485.13735","DOIUrl":"10.1111/1754-9485.13735","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"771-773"},"PeriodicalIF":2.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application of convolutional neural network lung nodule detection software: An Australian quaternary hospital experience","authors":"Peter Mark,&nbsp;Isabella Papalia,&nbsp;Jeffrey KC Lai,&nbsp;Diane M Pascoe","doi":"10.1111/1754-9485.13734","DOIUrl":"10.1111/1754-9485.13734","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Early-stage lung cancer diagnosis through detection of nodules on computed tomography (CT) remains integral to patient survivorship, promoting national screening programmes and diagnostic tools using artificial intelligence (AI) convolutional neural networks (CNN); the software of AI-Rad Companion™ (AIRC), capable of self-optimising feature recognition. This study aims to demonstrate the practical value of AI-based lung nodule detection in a clinical setting; a limited body of research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and eighty-three non-contrast CT chest studies from a single centre were assessed for AIRC software analysis. Prospectively collected data from AIRC detection and characterisation of lung nodules (size: ≥3 mm) were assessed against the reference standard; reported findings of a blinded consultant radiologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and sixty-seven CT chest studies were included; 52% indicated for nodule or lung cancer surveillance. Of 289 lung nodules, 219 (75.8%) nodules (mean size: 10.1 mm) were detected by both modalities, 28 (9.7%) were detected by AIRC alone and 42 (14.5%) by radiologist alone. Solid nodules missed by AIRC were larger than those missed by radiologist (11.5 mm vs 4.7 mm, <i>P</i> &lt; 0.001). AIRC software sensitivity was 87.3%, with significant false positive and negative rates demonstrating 12.5% specificity (PPV 0.6, NPV 0.4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a population of high nodule prevalence, AIRC lung nodule detection software demonstrates sensitivity comparable to that of consultant radiologist. The clinical significance of larger sized nodules missed by AIRC software presents a barrier to current integration in practice. We consider this research highly relevant in providing focus for ongoing software development, potentiating the future success of AI-based tools within diagnostic radiology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"659-666"},"PeriodicalIF":2.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy protocol compliance in routine clinical practice for patients with stages I–III non-small-cell lung cancer","authors":"Xiaoshui Huang,&nbsp;Matthew Field,&nbsp;Shalini Vinod,&nbsp;Helen Ball,&nbsp;Vikneswary Batumalai,&nbsp;Paul Keall,&nbsp;Lois Holloway","doi":"10.1111/1754-9485.13727","DOIUrl":"10.1111/1754-9485.13727","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite the availability of radiotherapy treatment protocols for lung cancer, considerable treatment variation occurs in clinical practice. This study assessed compliance with a radiotherapy protocol for the treatment of patients with stages I–III non-small-cell lung cancer (NSCLC) in routine clinical practice and to identify factors that were associated with compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Cancer Institute New South Wales eviQ treatment protocol for external beam radiotherapy of stages I–III NSCLC was taken as the reference to measure compliance. All inoperable patients with stages I–III NSCLC and documented ECOG performance status treated with radiotherapy between 2007 and 2019 at two radiotherapy facilities were available for analysis. Protocol compliance rates were calculated. Univariate and multivariate logistic regression models with 23 input factors were used to determine factors significantly associated with compliance. Survival analysis was conducted for both compliant and non-compliant treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 656 patients met the inclusion criteria. Protocol compliance was 16%. Alternative dose/fractionation was responsible for 49% of non-compliant treatments with 30% receiving an alternative curative fractionation. Five of 23 factors (age at the start of radiotherapy, stage group, ECOG performance status, tumour location and alcoholism history) showed significant associations with protocol compliance on multivariate analysis. There was no significant difference in median survival between patients receiving protocol compliant treatment (15.1 months) and non-compliant treatment (15.6 months).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adherence to the eviQ curative radiotherapy protocol for stages I–III NSCLC was low. Alternative dose/fractionation schemes were the main reason for non-compliance. Protocol compliance was not associated with outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"729-739"},"PeriodicalIF":2.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is ultrasound sufficient in detecting adenomyosis as pre-procedure work-up for uterine artery embolisation? An audit in the community setting","authors":"Eisen Liang,&nbsp;Razeen Parvez,&nbsp;Sylvia Ng,&nbsp;Bevan Brown","doi":"10.1111/1754-9485.13739","DOIUrl":"10.1111/1754-9485.13739","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"699-704"},"PeriodicalIF":2.2,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of radiation-induced epilation and interventional neuroradiology procedures","authors":"Deborah Carrick,&nbsp;Vinicius Carraro do Nascimento,&nbsp;Laetitia de Villiers,&nbsp;Henry Rice","doi":"10.1111/1754-9485.13730","DOIUrl":"10.1111/1754-9485.13730","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The aim of this study is to quantify the association of temporary epilation following interventional neuroradiology (INR) procedures and compare the peak skin dose (<i>D</i>_skin,max) threshold to published values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Gold Coast University Hospital (GCUH) is a major centre for INR with over 500 primarily interventional procedures performed every year. <i>D</i>_skin,max is calculated when the reference air kerma (<i>K</i>_a,r) exceeds 3 Gy. If the <i>D</i>_skin,max exceeds 3 Gy, the patient is followed up for any skin effects. An audit was undertaken of these results over a 2-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From January 2020 to December 2021, 140 patients who underwent INR procedures had a <i>K</i>_a,r &gt; 3 Gy, 66 resulted in a calculated <i>D</i>_skin,max &gt;3 Gy, and 45 were successfully followed up. Twenty patients (44%) reported no skin effects and 25 (56%) reported skin effects, which were almost exclusively epilation. The mean (range) <i>D</i>_skin,max for patients with no reported skin effects and those with observed skin effects was 4.6 Gy (3.0–11.1 Gy) and 4.2 Gy (3.0–7.0 Gy), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results demonstrate that temporary epilation was observed in 56% of patients, in a cohort of 45 patients who underwent an INR procedure with calculated <i>D</i>_skin,max &gt;3 Gy and successful follow-up. The results support evidence in the literature that suggests the approximate threshold for temporary epilation reported by the International Commission on Radiological Protection (ICRP) may be too high for incidence of this effect, specifically on the scalp, when <i>D</i>_skin,max is calculated from <i>K</i>_a,r (using commonly used corrections and assumptions in the calculation).</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 7","pages":"787-795"},"PeriodicalIF":2.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term clinical outcomes of male breast cancer patients treated with curative intent by trimodality therapy at an academic university hospital in India","authors":"Deep Chakrabarti,&nbsp;Arunima Ghosh,&nbsp;Sumaira Qayoom,&nbsp;Shreyamsa Manjunath,&nbsp;Bushra Khalid,&nbsp;Shiv Rajan,&nbsp;Naseem Akhtar,&nbsp;Pooja Ramakant,&nbsp;Mranalini Verma,&nbsp;Kirti Srivastava,&nbsp;Vijay Kumar,&nbsp;Rajeev Gupta,&nbsp;Anand Kumar Mishra,&nbsp;Madan Lal Brahma Bhatt","doi":"10.1111/1754-9485.13733","DOIUrl":"10.1111/1754-9485.13733","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Male breast cancer is rare and accounts for less than 1% of all breast cancer cases worldwide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included all patients of invasive male breast cancer treated with curative intent by a trimodality approach via a multidisciplinary team at an academic university hospital in India between 2009 and 2023. Records were identified from a prospectively maintained database. Clinicopathological parameters, treatment details and survival were recorded and analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four patients were included. The median (IQR) age was 55(44–63) years. Most patients were overall stage III (74%) and node positive (79%) with Scarff-Bloom-Richardson grade II (50%). Twenty-five patients (73%) were oestrogen receptor (ER) positive. Lymphovascular space invasion (LVSI) and perineural invasion (PNI) were present in 62% and 21% of patients, respectively. The most common chemotherapy timing was adjuvant (53%) followed by neoadjuvant (41%), and the most commonly used regimen consisted of a combination of doxorubicin-cyclophosphamide followed by a taxane (53%). Most (85%) patients underwent a mastectomy, five patients underwent breast conservation. All patients received radiotherapy to a dose of 42.6 Gy in 16 fractions, followed by a tumour bed boost for those undergoing breast conservation. At a median follow-up of 70 months (range 10–159 months), the five and ten-year overall survival was 91% and 58%, and the five-year disease-free survival (DFS) was 67%. The median DFS was 72 months. On univariate analysis, the tumour sub-type (Luminal versus TNBC) significantly predicted DFS (<i>P</i> = 0.03 log-rank).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Breast cancer in males has a high incidence of node positivity, ER positivity and LVSI. Even with advanced stages at presentation, trimodality therapy in a multidisciplinary setting offers good long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 5","pages":"604-609"},"PeriodicalIF":2.2,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality assurance and other challenges in paediatric radiotherapy: Accurate delivery of craniospinal radiotherapy.","authors":"Alison L Salkeld, Jonathan Sykes, John Fernandez, Laura Murphy, Jennifer Chard, David I Thwaites","doi":"10.1111/1754-9485.13721","DOIUrl":"https://doi.org/10.1111/1754-9485.13721","url":null,"abstract":"<p><strong>Introduction: </strong>Cranio-spinal radiotherapy (CSI) is used to treat central nervous system malignancies in paediatric, adolescent/young adult (AYA), and adult patients. Its delivery in the paediatric/AYA population is particularly challenging across different age groups. This study aims to assess the setup variations and dosimetric impact of CSI in paediatric and AYA patients.</p><p><strong>Methods: </strong>This retrospective analysis included, 10 paediatric and AYA patients (aged 4-25) who underwent volumetric modulated arc therapy (VMAT) CSI between 2016 and 2022. Patient characteristics, diagnoses, prescribed CSI doses, and fractionation details were assessed. CT simulation and treatment planning followed standard protocols with setup errors were quantified by comparing daily treatment setup images with the planned position. The study evaluated the dosimetric impact on target volumes and organs at risk (OARs).</p><p><strong>Results: </strong>The setup errors were identified, ranging from 0.5 to 6.2 mm in different directions, especially in the cranio-caudal direction. Despite these variations, there was minimal impact observed on the coverage of clinical target volumes (CTV) and doses to OARs (<1% relative change).</p><p><strong>Conclusion: </strong>Ensuring precise setup in paediatric and AYA patients undergoing CSI is essential to maintain adequate CTV coverage. Although occasional substantial setup variations occurred during treatment, they had a limited impact on CTV coverage and OAR doses when infrequent. Appropriate planning target volume (PTV) margins can effectively compensate for occasional shifts. However, systematic errors could compromise treatment quality if undetected. Regular off-line review of patient set-up trends is recommended.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study comparing the cost-effectiveness of conventional and drug-eluting transarterial chemoembolisation (cTACE and DEB-TACE) for the treatment of hepatocellular carcinoma in an Australian public hospital","authors":"Warren Clements,&nbsp;Abigail Chenoweth,&nbsp;Benjamin Phipps,&nbsp;Lowella Mozo,&nbsp;Mark Bolger,&nbsp;Laura Morphett,&nbsp;Tuan Phan,&nbsp;Jim Koukounaras,&nbsp;Matthew W Lukies","doi":"10.1111/1754-9485.13731","DOIUrl":"10.1111/1754-9485.13731","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality and transarterial chemoembolisation (TACE) is an established technique to treat patients with intermediate-stage HCC. The aim of this study was to generate accurate costing data on cTACE and DEB-TACE in an Australian setting and assess whether one of the procedures offers favourable cost-effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Costing study using data from all TACE procedures performed at a single centre between January 2018 and December 2022. Data were included from all direct and indirect costs including operative costs, wages, overheads, ward costs, transfusion, pathology, pharmacy and ward support. Cost-effectiveness was assessed by dividing local costs by existing high-quality data on quality-adjusted life years (QALYs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>64 TACE treatments were performed on 44 patients. Mean age was 66.5 years and 91% were male. Overall median total cost per patient for the entire TACE treatment regime was AUD$7380 (range AUD$3719–$20,258). However, 39% of patients received more than one treatment, and the median cost per individual treatment was AUD$5270 (range AUD$3533–$15,818). The difference in median cost between cTACE (AUD$4978) and DEB-TACE (AUD$9202) was significant, <i>P</i> &lt; 0.001. In calculating cost-effectiveness, each cTACE treatment cost AUD$2489 per QALY gained, while each DEB-TACE cost AUD$3834 per QALY gained. The incremental cost-effectiveness ratio (ICER) for DEB-TACE over cTACE was AUD$10,560 per QALY gained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both cTACE and DEB-TACE are low-cost treatments in Australia. However, DEB-TACE offers a solution with an ICER of AUD$10,560 per QALY gained which is below the Australian government willingness to pay threshold and thus is a more cost-effective treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"714-720"},"PeriodicalIF":2.2,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A roadmap for modelling radiation-induced cardiac disease","authors":"Samuel C Zhang,&nbsp;Andriana P Nikolova,&nbsp;Mitchell Kamrava,&nbsp;Raymond H Mak,&nbsp;Katelyn M Atkins","doi":"10.1111/1754-9485.13716","DOIUrl":"10.1111/1754-9485.13716","url":null,"abstract":"<p>Cardiac risk mitigation is a major priority in improving outcomes for cancer survivors as advances in cancer screening and treatments continue to decrease cancer mortality. More than half of adult cancer patients will be treated with radiotherapy (RT); therefore it is crucial to develop a framework for how to assess and predict radiation-induced cardiac disease (RICD). Historically, RICD was modelled solely using whole heart metrics such as mean heart dose. However, data over the past decade has identified cardiac substructures which outperform whole heart metrics in predicting for significant cardiac events. Additionally, non-RT factors such as pre-existing cardiovascular risk factors and toxicity from other therapies contribute to risk of future cardiac events. In this review, we aim to discuss the current evidence and knowledge gaps in predicting RICD and provide a roadmap for the development of comprehensive models based on three interrelated components, (1) baseline CV risk assessment, (2) cardiac substructure radiation dosimetry linked with cardiac-specific outcomes and (3) novel biomarker development.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 8","pages":"950-961"},"PeriodicalIF":2.2,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}