Journal of Medical Imaging and Radiation Oncology最新文献

{"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, Razeen Parvez, Sylvia Ng, 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 roadmap for modelling radiation-induced cardiac disease.","authors":"Samuel C Zhang, Andriana P Nikolova, Mitchell Kamrava, Raymond H Mak, Katelyn M Atkins","doi":"10.1111/1754-9485.13716","DOIUrl":"https://doi.org/10.1111/1754-9485.13716","url":null,"abstract":"<p><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":" ","pages":""},"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}

{"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":"Medical imaging in melioidosis – 20-year experience in a non-endemic Australian city","authors":"Joel Earley MBBS,&nbsp;Richard Warne MBBS","doi":"10.1111/1754-9485.13729","DOIUrl":"10.1111/1754-9485.13729","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Melioidosis may occasionally be encountered in non-endemic areas and medical imaging is frequently used to identify and characterise sites of disease. The purpose of this study is to describe the spectrum of imaging findings encountered in melioidosis patients treated in the tertiary public hospitals of Perth, Western Australia, between 2002 and 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A database search and electronic medical record review was used to identify cases. Cases were included if they had <i>Burkholderia pseudomallei</i> isolated on culture and if they had at least one diagnostic imaging study performed at a Perth public tertiary hospital. The relevant imaging studies were reviewed, and imaging findings were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six cases were identified. The most common disease manifestation was bacteraemia (72%, 26 cases), followed by pulmonary infection (58%, 21 cases), skin and soft tissue infection (22%, eight cases), prostate abscess (14%, five cases) and septic arthritis (6%, two cases). A previously unreported case of isolated melioid pleural effusion was identified, as was a case of reactivated chronic latent pulmonary melioidosis with an apparent delay of over 20 years between the onset of symptoms and the time of infection. In cases with pulmonary melioidosis, the major lung abnormalities on CT chest could be categorised into one of two distinct patterns: nodular-predominant (78%) or consolidation-predominant (22%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Further research is required to assess the utility of the pattern-based categorisation of lung abnormalities on CT chest seen in the pulmonary melioidosis cases of this series.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"651-658"},"PeriodicalIF":2.2,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579995","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 multi-centre retrospective study of long-term outcomes of spinal re-irradiation with SABR","authors":"Edward Chmiel,&nbsp;Sashendra Senthi,&nbsp;Shankar Siva,&nbsp;Nicholas Hardcastle,&nbsp;Vanessa Panettieri,&nbsp;Catherine Russell,&nbsp;Mark Tacey,&nbsp;Nigel Anderson,&nbsp;Farshad Foroudi","doi":"10.1111/1754-9485.13723","DOIUrl":"10.1111/1754-9485.13723","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Stereotactic ablative body radiotherapy (SABR) is a highly conformal technique utilising a high dose per fraction commonly employed in the re-treatment of spinal metastases. This study sought to determine the safety and efficacy of re-irradiation with SABR to previously treated spinal metastases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective analysis of patients at three Australian centres who have undergone spinal SABR after previous spinal radiotherapy to the same or immediately adjacent vertebral level. Efficacy was determined in terms of rates of local control, while safety was characterised by rates of serious complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-three spinal segments were evaluated from 32 patients. Median follow-up for all patients was 2.6 years, and median overall survival was 4.3 years. Eleven of 33 (33.3%) treated spinal segments had local progression, with a local control rate at 12 months of 71.4% (95% C.I. 55.2%–92.4%). Four patients (16.7%) went on to develop cauda equina or spinal cord compression. Thirteen out of 32 patients (40.6%) experienced acute toxicity, of which 12 were grade 2 or less. Five out of 30 spinal (16.7%) segments with follow-up imaging had a radiation-induced vertebral compression fracture. There was one case of radiation myelitis which occurred in a patient who had mediastinal radiotherapy with a treatment field which overlapped their prior spinal radiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The patients in this study experienced long median survival, durable tumour control and high rates of freedom from long-term sequelae of treatment. These results support the use of SABR in patients who progress in the spine despite previous radiotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 5","pages":"595-603"},"PeriodicalIF":2.2,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579992","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":"Utility of FDG PET-CT in CT Stage IA non-small cell lung cancer: The New Zealand Te Whatu Ora Northern region experience","authors":"Richard J Kelly,&nbsp;Graeme D Anderson,&nbsp;Budresh S Joshi,&nbsp;Jennifer J Donald","doi":"10.1111/1754-9485.13720","DOIUrl":"10.1111/1754-9485.13720","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Our objective was to investigate the utility of fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) in assessing CT Stage 1A non-small cell lung cancer (NSCLC) in patients under consideration for curative treatment. Performing FDG PET-CT in these patients may lead to unnecessary delays in treatment if it can be shown to provide no added value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 735 lesions in 653 patients from the New Zealand Te Whatu Ora Northern region lung cancer database with suspected or pathologically proven Stage 1A NSCLC on CT scan who also underwent FDG PET-CT imaging. We determined how often FDG PET-CT findings upstaged patients and then compared to pathological staging where available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>FDG PET-CT provided an overall upstaging rate of 9.7%. Category-specific rates were 0% in Tis, 0.9% in T1mi, 7.4% in T1a, 10% in T1b and 12% in T1c groups. The percentage of lesions upstaged on FDG PET-CT that remained Stage 1A was 100% in T1mi, 100% in T1a, 47.1% in T1b and 40.7% in T1c groups. The <i>P</i> value was statistically significant at 0.004, indicating upstaging beyond Stage 1A was dependent on T category.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our data suggests that FDG PET-CT is indicated for T1b and T1c lesions but is of limited utility in Tis, T1mi and T1a lesions. Adopting a more targeted approach and omitting FDG PET-CT in patients with Tis, T1mi, and T1a lesions may benefit all patients with lung cancer by improving accessibility and treatment timelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"645-650"},"PeriodicalIF":2.2,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468638","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":"MethOxyfluraNe in InTerventiOnal Radiology (MONITOR): A randomised controlled trial","authors":"Ross Copping,&nbsp;Paul Balamon,&nbsp;Marcus Lau,&nbsp;Jules Catt,&nbsp;Glen Schlaphoff","doi":"10.1111/1754-9485.13726","DOIUrl":"10.1111/1754-9485.13726","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Procedural sedation and pain management in interventional radiology (IR) are of critical importance to successful outcomes but remain under-researched. Methoxyflurane has been previously used in some minor procedures with several advantages including rapid onset and offset and a good safety profile. The purpose of this study was to evaluate methoxyflurane for procedures in IR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomised, double-blind, placebo-controlled trial was performed between October 2021 and November 2022. Patients presenting for portacath insertion, portacath removal or solid organ biopsy were randomised to either methoxyflurane or placebo. Three hundred and fourteen patients were enrolled in total. Patients were supplied with one Penthrox inhaler containing either 3 mL methoxyflurane or placebo. The primary endpoints of the study were change in pain and anxiety scores compared with baseline, measured on a standardised visual analogue scale (VAS) pre-procedure, at 5-min intervals during the procedure and post-procedure. Baselines scores were controlled for in the statistical analysis. Safety analysis was also performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and sixty-nine patients received methoxyflurane and 145 received placebo. Baseline characteristics were similar between the two groups. The methoxyflurane group had lower pain and anxiety scores throughout the procedure (<i>P</i> &lt; 0.001) with 2.5 times less pain (VAS 1.08/10) and 1.6 times less anxiety (VAS 0.97/10) on average. Lower post-procedure pain (mean 0.72 vs 1.44; <i>P</i> &lt; 0.001) and anxiety (mean 0.55 vs 1.13; <i>P</i> = 0.008) were also observed with methoxyflurane. There were no drug or major procedure-related adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this study suggest that methoxyflurane provides safe and effective analgesia and anxiolysis for some procedures in IR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"705-713"},"PeriodicalIF":2.2,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13726","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457413","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}