Journal of Medical Imaging and Radiation Oncology最新文献

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Stereotactic body radiotherapy alone versus stereotactic body radiotherapy after incomplete transarterial therapy for hepatocellular carcinoma. 肝细胞癌经动脉治疗不彻底后单纯立体定向体放射治疗与立体定向体放射治疗的比较。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-20 DOI: 10.1111/1754-9485.13794
Youngju Song, Jinhong Jung, Jin-Hong Park, So Yeon Kim, Jonggi Choi, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Sang Min Yoon
{"title":"Stereotactic body radiotherapy alone versus stereotactic body radiotherapy after incomplete transarterial therapy for hepatocellular carcinoma.","authors":"Youngju Song, Jinhong Jung, Jin-Hong Park, So Yeon Kim, Jonggi Choi, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Sang Min Yoon","doi":"10.1111/1754-9485.13794","DOIUrl":"https://doi.org/10.1111/1754-9485.13794","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the clinical outcomes of stereotactic body radiation therapy (SBRT) alone versus SBRT after incomplete transarterial chemoembolization (TACE) for a single recurrent hepatocellular carcinoma (HCC) smaller than 5 cm.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients who underwent SBRT for a single recurrent HCC ≤5 cm, without vascular invasion or extrahepatic metastasis. Patients were divided into the SBRT-alone group and the TACE-SBRT group. The primary outcome was the local control (LC) rate, and secondary outcomes were survivals and treatment-related toxicities. We additionally conducted a propensity score matching (PSM) analysis.</p><p><strong>Results: </strong>A total of 477 patients were available for analysis. Among them, 54 patients received SBRT without prior treatment to the target lesion (SBRT-alone group), whereas 423 patients received SBRT for viable HCC after TACE (TACE-SBRT group). The 3-year LC rates did not differ between the two groups (SBRT-alone group, 88.6% vs. TACE-SBRT group, 89.6%, P = 0.918). The 3-year rates of overall survival, out-of-field intrahepatic recurrence-free survival and recurrence-free survival were also not significantly different (P = 0.479, 0.290 and 0.273, respectively). Even after PSM, LC and survival rates at 3 years were not significantly different.</p><p><strong>Conclusion: </strong>SBRT alone demonstrated comparable local control and survival outcomes to SBRT following incomplete TACE. SBRT alone may be considered an alternative treatment option for a single recurrent HCC smaller than 5 cm when curative treatments or TACE are not feasible.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467674","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}
引用次数: 0
Amputation and limb-sparing surgery in childhood sarcoma: Post-operative imaging appearances and complications. 儿童肉瘤的截肢和保肢手术:术后影像学表现和并发症。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-20 DOI: 10.1111/1754-9485.13790
Joel Earley, Derek Roebuck
{"title":"Amputation and limb-sparing surgery in childhood sarcoma: Post-operative imaging appearances and complications.","authors":"Joel Earley, Derek Roebuck","doi":"10.1111/1754-9485.13790","DOIUrl":"https://doi.org/10.1111/1754-9485.13790","url":null,"abstract":"<p><p>Limb-sparing surgery and amputation are common surgical techniques used to achieve local tumour control in childhood primary bone and soft tissue malignancy of the limbs. The interpretation of post-operative limb imaging in these frequently complex cases is assisted by knowledge of the surgical techniques employed. This review discusses the rationale underpinning the most common surgical techniques used for these patients as well as their expected post-operative imaging appearance and complications. Amputation, long bone resection, endoprosthetic reconstruction, allograft reconstruction, the use of fibular autografts, allograft-prosthetic composite reconstruction and arthrodesis are discussed.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467660","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}
引用次数: 0
A keep-it-simple embolisation approach to treat pelvic congestion syndrome without compromising clinical effectiveness. 治疗盆腔充血综合征的简便栓塞法不会影响临床疗效。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-20 DOI: 10.1111/1754-9485.13795
Eisen Liang, Wai Yan Timothy Wong, Razeen Parvez, Michael Chan, Bevan Brown
{"title":"A keep-it-simple embolisation approach to treat pelvic congestion syndrome without compromising clinical effectiveness.","authors":"Eisen Liang, Wai Yan Timothy Wong, Razeen Parvez, Michael Chan, Bevan Brown","doi":"10.1111/1754-9485.13795","DOIUrl":"https://doi.org/10.1111/1754-9485.13795","url":null,"abstract":"<p><strong>Introduction: </strong>There are two approaches to treating pelvic congestion syndrome (PCS): (i) the keep-it-simple (KIS) approach, which involves embolising only the refluxing vein(s), typically the left ovarian vein (LOV) unless the right ovarian vein (ROV) or left/right internal iliac vein (IIV) tributaries are also refluxing; and (ii) the extensive (EXT) approach, which empirically embolises almost all of the LOV, ROV, and left and right IIV tributaries. The aim of this study is to determine whether the KIS approach can effectively treat PCS while minimising the number of treated veins and coils used, without the need for injecting sclerosing agents into pelvic veins or the use of occlusion balloons.</p><p><strong>Methods: </strong>This is a single-institution retrospective cohort study. Our records identified 154 women who underwent venograms for possible PCS, with the intent to proceed with embolisation. Refluxing veins were treated using the KIS approach, deploying minimal number of coils, 'sandwiching' sclerosing foam. Short-term follow-up was conducted at 6 weeks; long-term follow-ups (between 12 and 60 months) were conducted via an electronic survey consisting of 19 questions assessing pelvic pain/pressure, leg and back pain, fatigue, and bladder and menstrual symptoms.</p><p><strong>Results: </strong>Fifteen women had negative venogram; 139 women had one or more refluxing veins on venogram. Most women (73%) required unilateral ovarian vein (OV) embolisation, 14% required bilateral OV embolisation, and 12% underwent pelvic vein embolisation. Most cases required only four pushable coils. Clinical success was 89% at 6 weeks and 84% at 1-5 years. A visual analogue scale reduction of 5.2 points (from 7.8 to 2.7) was achieved. There were no instances of coil dislodgement or other complications.</p><p><strong>Conclusion: </strong>The keep-it-simple approach, embolising only the refluxing ovarian and/or iliac veins, can achieve a successful clinical outcome for pelvic congestion syndrome. The extensive approach of empirically embolising all ovarian veins and internal iliac veins may not be necessary. This carries implications for potential savings in procedure time, cost and radiation dose.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467659","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}
引用次数: 0
Comparative analysis of clinical treatment outcomes: Breath-hold vs. free-breathing techniques in liver stereotactic body radiotherapy. 临床治疗效果对比分析:肝脏立体定向体放射治疗中的屏气与自由呼吸技术。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-20 DOI: 10.1111/1754-9485.13793
Kosuke Morishima, Hideomi Yamashita, Tomoyuki Noyama, Atsuto Katano
{"title":"Comparative analysis of clinical treatment outcomes: Breath-hold vs. free-breathing techniques in liver stereotactic body radiotherapy.","authors":"Kosuke Morishima, Hideomi Yamashita, Tomoyuki Noyama, Atsuto Katano","doi":"10.1111/1754-9485.13793","DOIUrl":"https://doi.org/10.1111/1754-9485.13793","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to clarify the safety and efficacy of breath-hold irradiation in liver stereotactic body radiotherapy (SBRT).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 57 consecutive patients who received SBRT for hepatocellular carcinoma or liver metastases between 2013 and 2021. Breath-hold irradiation was implemented for patients treated after April 2020.</p><p><strong>Results: </strong>The median follow-up period for all patients was 16.4 months (IQR: 7.36-20.9). The 2-year overall survival rate was 64.4% (95% CI: 47.4-77.2), and the local control rate was 84.3% (95% CI: 69.7-92.3) for all patients. The 1-year overall survival was 80.0% (95% CI: 60.8-90.5) versus 82.0% (95% CI: 53.5-93.9) in the free-respiratory (FR) group versus the breath-hold (BH) group, respectively (P = 0.60). The 1-year local control rates were 78.1% (95% CI: 57.5-89.5) in the FR group and 95.7% (95% CI: 72.9-99.4) in the BH group, respectively (P = 0.16). Radiation-induced liver injury, defined by an escalation of ≥2 in Child-Pugh score, was observed in four patients within each group (FR 13% vs. BH 15%). There were no gastrointestinal adverse events of Grade 3 or higher.</p><p><strong>Conclusion: </strong>Breath-hold irradiation can be safely administered and has demonstrated clinical potential in improving local control. Further research into dose escalation using breath-hold techniques is warranted.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467670","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}
引用次数: 0
Systematic review of extrahepatic hepatic artery pseudoaneurysm following adult liver transplantation: Risk factors and treatment modalities. 成人肝移植术后肝外动脉假性动脉瘤的系统回顾:风险因素和治疗方法。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-20 DOI: 10.1111/1754-9485.13745
Ryan Pereira, Benjamin J Pearch, Gilbert Pavilion, Kheman Rajkomar
{"title":"Systematic review of extrahepatic hepatic artery pseudoaneurysm following adult liver transplantation: Risk factors and treatment modalities.","authors":"Ryan Pereira, Benjamin J Pearch, Gilbert Pavilion, Kheman Rajkomar","doi":"10.1111/1754-9485.13745","DOIUrl":"https://doi.org/10.1111/1754-9485.13745","url":null,"abstract":"<p><p>Hepatic artery pseudoaneurysm (HAP) is a rare vascular complication following liver transplantation (LTx) with treatment choice frequently driven by institutional experience. Approximately, 10% of hepatic grafts are lost from this complication, requiring re-transplantation and placing further demand on the already present organ shortage. Secondly, patients with HAP can present with catastrophic bleeding, with reported mortality of up to 78%. We aim to identify risk factors associated with HAP and assess the survival benefit of different treatment modalities used (endovascular and open surgical techniques). Early detection may facilitate semi-elective management of this condition. A systematic search was performed in PubMed, Medline and Embase up to 1 October 2023. Case series with ≥5 patients focusing on adult patients who developed extrahepatic pseudoaneurysm following LTx were included. A total of 11 studies were pooled, comprising of 118 patients with survival data available in 61 patients. The most common presentation was haemorrhagic shock or luminal haemorrhage (75.5%). Bile leak was documented in 66.7% (28/42), 15.2% (18/118) associated foregut pathologies and 28.6% (14/49) of microbiology cultures grew a fungal organism. Flow preserving strategies (stenting, revascularization) trended towards better survival at 120 months compared to non-flow preserving strategies (embolization, HAL); however, this was not statistically significant following log rank (Mantel-Cox) analysis (P 0.169). Any patient following LTx presenting with haemorrhagic shock or luminal bleeding needs HAP excluded urgently. HAP management is complex, requiring careful consideration of patient specific presentation, anatomic factors and associated pathologies.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467675","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}
引用次数: 0
Optimising PTV margins in oesophageal cancer radiotherapy: A modern radiotherapy planning, treatment delivery and verification approach – A single institutional analysis 优化食道癌放疗的 PTV 边界:现代放射治疗计划、治疗实施和验证方法--单一机构分析。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-18 DOI: 10.1111/1754-9485.13738
Jack Mitchell, Amelia Campbell, Ming Zhao, Jennifer Harvey, Gang Tao Mai, Yoo Young Lee
{"title":"Optimising PTV margins in oesophageal cancer radiotherapy: A modern radiotherapy planning, treatment delivery and verification approach – A single institutional analysis","authors":"Jack Mitchell,&nbsp;Amelia Campbell,&nbsp;Ming Zhao,&nbsp;Jennifer Harvey,&nbsp;Gang Tao Mai,&nbsp;Yoo Young Lee","doi":"10.1111/1754-9485.13738","DOIUrl":"10.1111/1754-9485.13738","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Radiotherapy plays a key role in the multidisciplinary management of oesophageal cancers across neoadjuvant, definitive and palliative settings. Improved precision in radiotherapy planning and delivery techniques have allowed treating disease with tighter margins reducing toxicity. In this study, we examine the appropriateness of current practice in defining the planning target volume (PTV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single institutional retrospective study of patients who received radiotherapy for oesophageal cancers using volumetric modulated arc therapy (VMAT) during 2020. All cone-beam computerised tomography (CBCT) scans were reviewed to assess whether PTV expansions appropriately accounted for tumour motion and interfractional variation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 27 patients, 2 (7%), 5 (19%) and 20 (74%) had cervical, thoracic and distal/gastro-oesophageal junction (GOJ) disease, respectively. 16 (59%) had adenocarcinoma and 9 (33%) had squamous cell carcinoma. 9 of 20 distal/GOJ patients were planned and treated according to the institutional stomach filling protocol. 521/528 (98.7%) CBCTs demonstrated adequate target coverage. Cervical, thoracic and GOJ regions demonstrated adequate target coverage in 57/58, 96/97 and 368/373 CBCTs with median PTV expansions of 5, 7 and 7 mm, respectively. In four patients with GOJ disease, CBCT review identified five episodes where the target volume was insufficiently covered during the treatment course.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this single institutional retrospective study, for the vast majority of patients, our institutional practice of defining PTV margins achieved satisfactory target treatment. The interfractional variations observed in patients with GOJ tumours due to target motion and variable gastric volume, highlights the role of further refinements to motion management techniques in this cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 7","pages":"853-861"},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467671","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}
引用次数: 0
Reflections on Australian radiology education: How can we innovate and improve? 对澳大利亚放射学教育的思考:如何创新和改进?
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-18 DOI: 10.1111/1754-9485.13786
Sally L Ayesa
{"title":"Reflections on Australian radiology education: How can we innovate and improve?","authors":"Sally L Ayesa","doi":"10.1111/1754-9485.13786","DOIUrl":"https://doi.org/10.1111/1754-9485.13786","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467673","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}
引用次数: 0
Thoracic hernias: What the radiologist should know. 胸椎疝气:放射科医生须知。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-18 DOI: 10.1111/1754-9485.13792
Felipe Aluja-Jaramillo, Omar Andrés Pantoja Burbano, Fernando R Gutiérrez, Carlos Previgliano, Sanjeev Bhalla
{"title":"Thoracic hernias: What the radiologist should know.","authors":"Felipe Aluja-Jaramillo, Omar Andrés Pantoja Burbano, Fernando R Gutiérrez, Carlos Previgliano, Sanjeev Bhalla","doi":"10.1111/1754-9485.13792","DOIUrl":"https://doi.org/10.1111/1754-9485.13792","url":null,"abstract":"<p><p>Thoracic hernias encompass the protrusion of thoracic contents through the thorax or intra-abdominal tissue into the thorax. They can be classified as diaphragmatic hernias - either congenital or acquired; pulmonary hernias - involving tissue protrusion through cervical fascia or intercostal spaces; and mediastinal hernias - including cardiac, intrapericardial and hiatal hernias. Prompt identification and classification of thoracic hernias rely on diagnostic imaging, primarily through computed tomography and magnetic resonance, to identify associated complications. This article comprehensively reviews thoracic hernias and their key imaging features.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467676","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}
引用次数: 0
Prognostic value of PSMA PET in predicting long-term biochemical control following curative intent treatment for prostate cancer. PSMA PET 在预测前列腺癌根治性治疗后长期生化控制方面的预后价值。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-11 DOI: 10.1111/1754-9485.13787
Angus Ades, Tanya Holt, Handoo Rhee, Myles Webb, Ahmed M Mehdi, Gishan Ratnayake
{"title":"Prognostic value of PSMA PET in predicting long-term biochemical control following curative intent treatment for prostate cancer.","authors":"Angus Ades, Tanya Holt, Handoo Rhee, Myles Webb, Ahmed M Mehdi, Gishan Ratnayake","doi":"10.1111/1754-9485.13787","DOIUrl":"https://doi.org/10.1111/1754-9485.13787","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to investigate the prognostic value of <sup>68</sup>Ga-labelled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) metrics in predicting long-term biochemical failure-free survival (BFFS) following curative intent treatment for prostate cancer.</p><p><strong>Methods: </strong>We completed a prospective study that followed men who had PSMA PET for staging of newly diagnosed prostate cancer between 2015 and 2017 who went on to have curative intent treatment with radiotherapy (RT) or radical prostatectomy (RP). PSMA PET CT imaging was reported and the intraprostatic maximum standardised uptake value (SUV<sub>max</sub>) was recorded. The primary outcome was BFFS. Statistical analysis included descriptive statistics, Cox proportional hazards (PH) models, Kaplan-Meier survival analysis and a regression tree structured method.</p><p><strong>Results: </strong>A total of 183 men were included in the analysis with a median age of 66 years and the majority of patients (55.2%) had ISUP grade 1-3 disease. All patients had PSMA PET staging prior to curative intent treatment with RP (66.1%) or external beam radiotherapy (33.9%). PSMA-avid pelvic nodes were present in 26 patients but were not associated with worse biochemical control. A PSMA SUV<sub>max</sub> of the prostate primary greater than the median (>5.6) was associated with a lower BFFS (HR: 4.4, 95% CI 1.42-3.72, P = 0.01). A multivariate Cox model incorporating initial biopsy grade, age and PSMA SUV<sub>max</sub> showed that PSMA SUV<sub>max</sub> was an independent predictor of BFFS. The RT-structured method identified an optimal threshold of 6.8 for PSMA SUV<sub>max</sub>, above which patients with ISUP 1-3 disease had a significantly worse BFFS.</p><p><strong>Conclusion: </strong>PSMA SUV<sub>max</sub> is a strong predictor of BFFS in patients with non-metastatic prostate cancer who underwent curative intent treatment. Patients with low-risk disease on biopsy (ISUP 1-3) but high PSMA SUV<sub>max</sub> may have biochemical failure risk analogous to higher-risk disease (ISUP 4-5). These findings allow for further risk stratification and prognosis of patients with newly diagnosed prostate cancer planned for definitive treatment.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467672","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}
引用次数: 0
A cost-effectiveness analysis of stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the management of stage 1 non-small-cell lung cancer: Results from the TROG 09.02 CHISEL study 立体定向消融放疗与传统分次放疗在非小细胞肺癌一期治疗中的成本效益分析:TROG 09.02 CHISEL研究结果。
IF 2.2 4区 医学
Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-09 DOI: 10.1111/1754-9485.13755
Adam Byrne, Richard De Abreu Lourenco, Ramkumar Govindaraj, David Ball, Hien Le
{"title":"A cost-effectiveness analysis of stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the management of stage 1 non-small-cell lung cancer: Results from the TROG 09.02 CHISEL study","authors":"Adam Byrne,&nbsp;Richard De Abreu Lourenco,&nbsp;Ramkumar Govindaraj,&nbsp;David Ball,&nbsp;Hien Le","doi":"10.1111/1754-9485.13755","DOIUrl":"10.1111/1754-9485.13755","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Stereotactic ablative radiotherapy (SABR) is a standard of care treatment for medically inoperable early-stage non-small-cell lung cancer (NSCLC). The CHISEL trial was a phase 3 randomised controlled trial that compared SABR to conventional radiation therapy (CRT). Using patient-level data, we compared the cost-effectiveness of SABR and CRT for early-stage NSCLC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on treatment exposure, outcomes (recurrence, survival) and quality of life (QoL; EORTC QLQ-C30) were sourced from the trial. Quality-adjusted life years (QALYs) were estimated for the trial period using Australian utility weights for the EORTC QLQ-C30-derived QLU-C10D. Costs related to simulation, planning, delivery, verification and post-treatment monitoring were estimated by applying Australian Medicare Benefits Schedule fees. The costs of post-progression therapy and grade ≥3 toxicity were estimated using trial data and relevant literature sources. Cost-effectiveness was investigated as the incremental cost per QALY gained for SABR compared to CRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Complete QoL data were available for 21 patients: 14 in the SABR arm and 7 in the CRT arm. Mean QALYs discounted at 5% per annum were similar between arms: 12.68 months for SABR and 12.12 months for CRT. The mean costs of delivering SABR and CRT were $4763 and $6817, respectively. The costs of monitoring were similar in both arms, $4856 and $4853 for SABR and CRT. The mean costs of post-progression therapy were $24,572 for SABR and $42,801 for CRT. The mean costs of grade ≥3 toxicity were $809 in the SABR arm and $132 in the CRT arm. Therefore, the total mean cost for SABR over the period of interest was lower for SABR than CRT. Given lower mean costs and numerically higher QALYs for SABR compared with CRT, an incremental cost-effectiveness ratio was not calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to CRT, SABR is a cost-effective treatment for early-stage NSCLC as the estimated upfront treatment cost and the cost of subsequent care are lower for SABR for comparable mean QALYs. Assessment of the lifetime QALYs and projections of cost estimation will provide a better indication of the long-term cost-effectiveness of SABR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 7","pages":"843-850"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391109","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}
引用次数: 0
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