The British journal of radiology最新文献

{"title":"Interventional Radiology training: A comparison of 5 English-speaking countries.","authors":"Indrajeet Mandal, A. Minocha, J. Yeung, S. Bandula, Jeremy Rabouhans","doi":"10.1259/bjr.20190340","DOIUrl":"https://doi.org/10.1259/bjr.20190340","url":null,"abstract":"OBJECTIVES\u0000To compare key characteristics of Interventional Radiology (IR) training in the UK with four other English-speaking countries (USA, Canada, Australia and New Zealand) and summarise requirements for training.\u0000\u0000\u0000METHODS\u0000Main features examined were career pathway and requirements, examinations required, specific competition for IR and the process of applying for training as an international medical graduate (IMG). Data was collected from official governing body publications, literature and personal experience.\u0000\u0000\u0000RESULTS\u0000Several differences were highlighted, including length of training (ranging from 6 to 9 years after medical school), length of IR specific training (ranging from 1 to 3 years) and examinations required (USA and Canada have additional IR-specific examinations). The level of competition is generally high, in all countries.\u0000\u0000\u0000CONCLUSIONS\u0000With the demand for IR services set to increase over the next few years, it is crucial that more IR specialists are trained to meet this demand. Awareness of training structures in other countries can highlight opportunity and pitfalls, and help ensure the number of highly trained interventional radiologists in the UK continues to grow.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"350 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124320848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging (MRI) versus single photon emission computed tomography (SPECT/CT) in painful total hip arthroplasty: a comparative multiinstitutional analysis.","authors":"Henrik Bäcker, Isabelle Steurer-Dober, M. Beck, C. Agten, J. Decking, R. Herzog, J. Geller, U. Bhure, J. Roos, K. Strobel","doi":"10.1259/bjr.20190738","DOIUrl":"https://doi.org/10.1259/bjr.20190738","url":null,"abstract":"OBJECTIVE\u0000To investigate the value of MRI in comparison to single photon emission computed tomography (SPECT)/CT in patients with painful hip arthroplasties.\u0000\u0000\u0000METHODS\u0000A prospective, multi-institutional study was performed. Therefore, 35 consecutive patients (21 female, 14 male, mean age 61.8 ± 13.3 years) with 37-painful hip arthroplasties were included. A hip surgeon noted the most likely diagnosis based on clinical examination and hip radiographs. Then, MRI and SPECT/CT of the painful hips were acquired. MRI and SPECT/CT were assessed for loosening, infection, fracture, tendon pathology and other abnormalities. Final diagnosis and therapy was established by the hip surgeon after integration of MRI and SPECT/CT results. The value of MRI and SPECT/CT for diagnosis was assessed with a 3-point scale (1 = unimportant, 2 = helpful, 3 = essential).\u0000\u0000\u0000RESULTS\u0000Loosening was observed in 13/37 arthroplasties (6 shaft only, 6 cup only, 1 combined). Sensitivity, specificity, positive predictive value and negative predictive value for loosening of MRI were 86%/88%/60%/100% and of SPECT/CT 93%/97%/905/100%, respectively. MRI and SPECT/CT diagnosed infection correctly in two of three patients and fractures in two patients, which were missed by X-ray. MRI detected soft tissue abnormalities in 21 patients (6 bursitis, 14 tendon lesions, 1 pseudotumor), of which only 1 tendon abnormality was accurately detected with SPECT/CT. All 5 arthroplasties with polyethylene wear were correctly diagnosed clinically and with both imaging modalities. MRI and SPECT/CT were judged as not helpful in 0/0%, as helpful in 16%/49% and essential in 84%/51%.\u0000\u0000\u0000CONCLUSION\u0000In patients with painful hip arthroplasty SPECT/CT is slightly superior to MR in the assessment of loosening. MRI is far superior in the detection of soft tissue, especially tendon pathologies.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000To our knowledge this is the first prospective, multiinstitutional study which compares MRI with SPECT/CT in painful hip arthroplasties. We found that MRI is far superior in the detection of soft tissue pathologies, whereas in painful hip arthroplasties the SPECT/CT remains slightly superior. In future, new MR sequences may allow detecting arthroplasty loosening or infection with high accuracy.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"153 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131313367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-guided stereotactic ablative radiation therapy of spinal bone metastases: A preliminary experience.","authors":"R. Llorente, B. Spieler, J. Victoria, C. Takita, R. Yechieli, J. Ford, K. Brown, M. Samuels, E. Mellon","doi":"10.1259/bjr.20190655","DOIUrl":"https://doi.org/10.1259/bjr.20190655","url":null,"abstract":"OBJECTIVES\u0000MRI provides clear visualization of spinal cord, tumor, and bone for patient positioning and verification during MRI-guided radiotherapy (MRI-RT). Therefore, we wished to evaluate spine stereotactic ablative radiotherapy (SABR) feasibility with MRI-RT. Given dosimetric limitations of first generation Co-60 MRI-RT, we then evaluated improvements by newer linear accelerator (linac) MRI-RT.\u0000\u0000\u0000METHODS\u0000Nine spinal metastases were treated with Co-60 MRI-RT. Seven received a single 16 Gy fraction, and two received three fractions totaling 24 or 30 Gy. After re-planning with linac MRI-RT software, comparisons of OAR and dose spillage objectives between Co-60 and linac plans were performed.\u0000\u0000\u0000RESULTS\u0000Spinal cord and cauda equina dose constraints were met in all Co-60 cases. Treatments were delivered successfully with real-time imaging during treatment and no treatment-related toxicities. While limits for dose spillage into surrounding soft tissues were not achieved due to the limitations of the Co-60 system, this could be corrected with linac MRI-RT delivery.\u0000\u0000\u0000CONCLUSIONS\u0000MRI-RT SABR of spinal metastases is feasible with Co-60 MRI-RT. Dose delivery is improved by linac MRI-RT.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000This is the first report of MRI-RT for SABR of spinal metastases. The enhanced visualization of anatomy by MRI may facilitate RT dose escalation for spine SABR.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133047249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indicator for local recurrence of hepatocellular carcinoma after proton beam therapy: analysis of attenuation difference between the irradiated tumor and liver parenchyma on contrast enhancement CT.","authors":"Hiroaki Takahashi, Y. Sekino, K. Mori, T. Okumura, K. Nasu, Kuniaki Fukuda, Sota Masuoka, T. Iizumi, Naoyuki Hasegawa, H. Sakurai, M. Minami","doi":"10.1259/bjr.20190375","DOIUrl":"https://doi.org/10.1259/bjr.20190375","url":null,"abstract":"OBJECTIVES\u0000We aimed to identify dynamic computed tomography (CT) features that can be used for prediction of local recurrence of hepatocellular carcinoma (HCC) after PBT.\u0000\u0000\u0000METHODS\u0000We retrospectively retrieved CT scans of patients with PBT-treated HCC, taken between January 2004 and December 2016. Seventeen recurrent lesions and 34 non-recurrent lesions were retrieved. The attenuation difference between irradiated tumor and irradiated parenchyma (ADHCC-IP) was compared in the two groups by using the Mann-Whitney U test. Cut-off value of ADHCC-IP was estimated by using the Youden index.\u0000\u0000\u0000RESULTS\u0000The follow-up time after PBT initiation ranged from 374 to 2402 days (median, 1069 days) in recurrent lesions, and 418 to 2923 days (median, 1091.5 days) in non-recurrent lesions (p = 0.892). The time until appearance of local recurrence after PBT initiation ranged from 189 to 2270 days (median, 497 days). ADHCC-IP of recurrent lesions (mean, -21.8 Hounsfield units (HU); from -95 to -31 HU) was significantly greater than that of non-recurrent lesions (mean, -51.7 HU; from -117 to -12 HU) at 1-2 years in portal venous phase (PVP) (p = 0.039). Five-year local tumor control rates were 0.93 and 0.56 in lesions with ADHCC-IP at 1-2 years in PVP < -55 HU and ≥ -55 HU, respectively.\u0000\u0000\u0000CONCLUSIONS\u0000The attenuation difference between irradiated HCC and irradiated liver parenchyma in PVP at 1-2 years after PBT can predict long-term local recurrence of HCC after treatment.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000We identified a cut-off value for contrast enhancement of HCC after PBT that could predict future local recurrence.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"38 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114039822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic utility of serial 18F-FDG-PET/CT in patients with locally advanced rectal cancer who underwent tri-modality treatment.","authors":"S. Fernando, M. Lin, T. Pham, Shanley Chong, E. Ip, Karen Wong, W. Chua, Weng Ng, P. Lin, S. Lim","doi":"10.1259/bjr.20190455","DOIUrl":"https://doi.org/10.1259/bjr.20190455","url":null,"abstract":"OBJECTIVE\u0000This study explored the value of serial 18-fludeoxyglucose-positron emission tomography (18F-FDG-PET)/CT in predicting disease-free survival (DFS) in locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiation (NCRT) and surgery.\u0000\u0000\u0000METHODS\u0000We prospectively studied 46 patients with LARC who underwent NCRT and surgery. 18F-FDG-PET/CT scans were performed at three time-points before surgery (pre-NCRT-PET1, during NCRT-PET2 and following completion of NCRT-PET3). The following semi-quantitative PET parameters were analysed at each time point: maximum standardizeduptake value, SUVmean, metabolic tumour volume (MTV) and tumour lesion glycolysis (TLG). Absolute and percentage changes in these parameters were analysed between time points. Statistical analysis consisted of median tests, Cox regression and Kaplan-Meier analysis for DFS.\u0000\u0000\u0000RESULTS\u0000The median follow-up time was 24 months. PET parameters showed statistically significant differences for patients with recurrence compared to those without; MTV A % change between PET1 and PET3 (cut-off: 87%, p = 0.023), TLG A % change between PET1 and PET3 (cut-off: 94%, p = 0.02) and MTV absolute change between PET1 and PET2 (cut-off: 10.25, p = 0.001).MTV absolute change between PET1 and PET3 (p=0.013), TLG % change between PET1 and PET2 (p=0.021), maximum standardizeduptake value at PET2 (0.01) and SUVmean change between PET1 and PET3 (0.027) were also prognostic indicators of recurrence.MTV % change between PET1 and PET2 and SUVmean % change between PET1 and PET3 were also trending towards significance (p=0.052, p=0.053 respectively).\u0000\u0000\u0000CONCLUSION\u0000Serial 18F-FDG-PET/CT is a potentially reliable non-invasive method to predict recurrence in patients with LARC. Volumetric parameters were the best predictors. This could be potentially important in risk-stratifying patients who may benefit from conservative management.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000This paper will add to the literature in risk-stratifying, using PET/CT, in patients with LARC based on prognosis. This will potentially improve outcomes with an increasing trend towards conservative management.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114055790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fully automated and comprehensive MRI-based Left-Ventricular contractility analysis in Post-Chemotherapy breast cancer patients.","authors":"Julia Karr, M. Cohen, Cohen V Cohen, Samuel P McQuiston, M. Figarola, C. Malozzi","doi":"10.1259/bjr.20190289","DOIUrl":"https://doi.org/10.1259/bjr.20190289","url":null,"abstract":"OBJECTIVES\u0000This study investigated the occurrence of cardiotoxicity-related left-ventricular (LV) contractile dysfunction in breast cancer patients following treatment with antineoplastic chemotherapy agents (CTA).\u0000\u0000\u0000METHODS\u0000A validated and automated MRI-based LV contractility analysis tool consisting of quantization-based boundary detection, unwrapping of image phases and the meshfree Radial Point Interpolation Method was used toward measuring LV chamber quantifications (LVCQ), 3D strains and torsions in patients and healthy subjects. Data were acquired with the Displacement Encoding with Stimulated Echoes (DENSE) sequence on 21 female patients and 21 age-matched healthy females. Estimates of patient LVCQs from DENSE acquisitions were validated in comparison to similar Steady State Free Precession (SSFP) measurements and their strain results validated via Bland-Altman interobserver agreements. The occurrence of LV abnormalities was investigated via significant differences in contractility measurements (LVCQs, strains and torsions) between patients and healthy subjects.\u0000\u0000\u0000RESULTS\u0000Repeated measures analysis showed similarities between LVCQ measurements from DENSE and SSFP, including cardiac output (4.7 ± 0.4 L, 4.6 ± 0.4 L, p = 0.8), and LV ejection fractions (LVEF) (59±6%, 58±5%, p = 0.2). Differences found between patients and healthy subjects included enlarged basal diameter (5.0 ± 0.5 cm vs 4.4 ± 0.5 cm, p < 0.01), apical torsion (6.0 ± 1.1° vs 9.7 ± 1.4°, p < 0.001) and global longitudinal strain (-0.15 ± 0.02 vs. -0.21 ± 0.04, p < 0.001), but not LVEF (59±6% vs. 63±6%, p = 0.1).\u0000\u0000\u0000CONCLUSION\u0000The results from the statistical analysis reveal the possibility of LV abnormalities in the post-chemotherapy patients via enlarged basal diameter and reduced longitudinal strain and torsion, in comparison to healthy subjects.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000This study shows that subclinical LV abnormalities in post-chemotherapy breast cancer patients can be detected with an automated technique for the comprehensive analysis of contractile parameters.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122608197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-coplanar VMAT plans for lung SABR to reduce dose to the heart: a planning study.","authors":"Sang-Tae Kim, H. An, Jung-in Kim, Jaeryong Yoo, H. Kim, Jong Min Park","doi":"10.1259/bjr.20190596","DOIUrl":"https://doi.org/10.1259/bjr.20190596","url":null,"abstract":"OBJECTIVE\u0000This study aimed to compare the plan quality of non-coplanar partial arc (NPA) volumetric modulated arc therapy (VMAT) to that of coplanar partial arc (CPA) VMAT for stereotactic ablative radiotherapy (SABR) for lung cancer.\u0000\u0000\u0000METHODS\u0000A total of 20 patients treated for lung cancer with the SABR VMAT technique and whose lung tumors were close to the heart were retrospectively selected for this study. For the CPA VMAT, three coplanar half arcs were used while two coplanar half arcs and one noncoplanar arc rotating 315°-45° with couch rotations of 315° ± 5° were used for the NPA VMAT. For each patient, identical CT image sets and identical structures were used for both the CPA and NPA VMAT plans. Dose-volumetric parameters of each plan were analyzed.\u0000\u0000\u0000RESULTS\u0000For the planning target volume and both lungs, no statistically significant differences between the CPA and NPA VMAT plans were observed in general. For the heart, average values of D0.1cc of the CPA and NPA VMAT plans were 29.42 ± 13.37 and 21.71 ± 9.20 Gy, respectively (p < 0.001). For whole body, the mean dose and the gradient index of the CPA VMAT plans were 1.2 ± 0.5 Gy and 4.356 ± 0.608 while those of the NPA VMAT plans were 1.1 ± 0.5 Gy and 4.111 ± 0.480, respectively (both with p < 0.001).\u0000\u0000\u0000CONCLUSION\u0000The NPA VMAT proposed in this study showed more favorable plan quality than the CPA VMAT plans for lung SABR with tumors located close to the heart.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000For lung SABR, NPA VMAT can reduce doses to the heart as well as whole-body irradiation.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133707708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic and age differences in right-left breast asymmetry in a large population-based screening population.","authors":"S. Hudson, L. Wilkinson, R. Denholm, B. D. De Stavola, I. dos-Santos-Silva","doi":"10.1259/bjr.20190328","DOIUrl":"https://doi.org/10.1259/bjr.20190328","url":null,"abstract":"OBJECTIVES\u0000Exposure to sex hormones is important in the pathogenesis of breast cancer (BC) and inability to tolerate such exposure may be reflected in increased asymmetrical growth of the breasts. This study aims to characterise, for the first time, asymmetry in breast volume (BV) and radio-dense volume (DV) in a large ethnically-diverse population.\u0000\u0000\u0000METHODS\u0000Automated measurements from digital raw mammographic images of 54,591 cancer-free participants (aged 47-73) in a UK breast screening programme were used to calculate absolute (cm3) and relative asymmetry in BV and DV. Logistic regression models were fitted to assess asymmetry associations with age and ethnicity.\u0000\u0000\u0000RESULTS\u0000BV and DV absolute asymmetry were positively correlated with the corresponding volumetric dimension (BV or DV). BV absolute asymmetry increased, whilst DV absolute asymmetry decreased, with increasing age (P-for-linear-trend<0.001 for both). Relative to Whites, Blacks had statistically significantly higher, and Chinese lower, BV and DV absolute asymmetries. However, after adjustment for the corresponding underlying volumetric dimension the age and ethnic differences were greatly attenuated. Median relative (fluctuating) BV and DV asymmetry were 2.34 and 3.28% respectively.\u0000\u0000\u0000CONCLUSIONS\u0000After adjusting for the relevant volumetric dimension (BV or DV), age and ethnic differences in absolute breast asymmetry were largely resolved.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000Previous small studies have reported breast asymmetry - BC associations. Automated measurements of asymmetry allow the conduct of large-scale studies to further investigate these associations.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125411067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer incidence after childhood irradiation for tinea capitis in a portuguese cohort.","authors":"L. Antunes, M. Bento, M. Sobrinho-Simões, P. Soares, P. Boaventura","doi":"10.1259/bjr.20180677","DOIUrl":"https://doi.org/10.1259/bjr.20180677","url":null,"abstract":"OBJECTIVES\u0000Our aim was to compare cancer incidence in a cohort exposed in childhood (1950-63) to a therapeutic dose of radiation in the North of Portugal and followed-up until the end of 2012, with the incidence rates for the same age- and sex in the general population.\u0000\u0000\u0000METHODS\u0000A population-based North Region cancer registry (RORENO) was used to assess which members of the cohort developed cancer. The association between radiation exposure and overall and specific cancer sites was evaluated using standardized incidence ratios (SIR).\u0000\u0000\u0000RESULTS\u0000Over the full follow-up period, 3357 individuals of the 5356 original tinea capitis cohort (63%) were retrieved in the RORENO, and 399 new cancer cases were identified, representing an increased risk of 49% when compared with the general population (SIR = 1.49; 95% CI: 1.35-1.64). The risk was slightly higher in males than in females (SIR = 1.65; 95% CI: 1.43-1.89 vs SIR = 1.35; CI = 1.17-1.55). The risk was slightly higher in the individuals exposed to a higher radiation dose (SIR = 1.78; 95% CI: 1.22-2.51 for ≥630 R vs SIR = 1.46; 95% CI: 1.31-1.62 for 325-475 R). In females, there was an excess cancer risk in all cancers with the higher radiation dose (SIR = 2.00; 95% CI: 1.21-3.13 for ≥630 R vs SIR = 1.30; 95% CI: 1.11-1.51 for 325-475 R) which was not observed in males, and for combined dose categories significantly raised SIRs for thyroid and head and neck cancer, suggesting a possible higher radiosensitivity of females. An increase risk was also observed for some cancers located far from the irradiated area.\u0000\u0000\u0000CONCLUSIONS\u0000The results suggest an association between radiation exposure and later increased cancer risk for cancers located near the radiation exposed area, mainly thyroid, and head and neck cancers. Further studies are necessary to disentangle possible non-radiation causes for distant cancers increased risk.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000This paper shows a possible association between childhood X-ray epilation and increased risk of cancer which was not previously investigated in the Portuguese tinea capitis cohort.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"149 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116649896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photons or protons for re-irradiation in (non-)small cell lung cancer? Results of the multicentric ROCOCO in silico study.","authors":"E. Troost, K. Wink, E. Roelofs, C. Simone, S. Makocki, S. Löck, P. V. van Kollenburg, D. Dechambre, A. Minken, J. van der Stoep, S. Avery, N. Jansen, T. Solberg, J. Bussink, D. de Ruysscher","doi":"10.1259/bjr.20190879","DOIUrl":"https://doi.org/10.1259/bjr.20190879","url":null,"abstract":"OBJECTIVE\u0000Locally recurrent disease is of increasing concern in (non-)small cell lung cancer patients [(N)SCLC]. Local re-irradiation with photons or particles may be of benefit to these patients. In this multicentre in silico trial performed within the Radiation Oncology Collaborative Comparison (ROCOCO) consortium, the doses to the target volumes and organs at risk (OARs) were compared when using several photon and proton techniques in patients with recurrent localized lung cancer scheduled to undergo re-irradiation.\u0000\u0000\u0000METHODS\u0000Twenty-four consecutive patients with a second primary (N)SCLC or recurrent disease after curative-intent, standard fractionated radio(chemo)therapy were included in this study. The target volumes and OARs were centrally contoured and distributed to the participating ROCOCO sites. Remaining doses to the OARs were calculated on an individual patient's basis. Treatment planning was performed by the participating site using the clinical treatment planning system and associated beam characteristics.\u0000\u0000\u0000RESULTS\u0000Treatment plans for all modalities (5 photon and two proton plans per patient) were available for 22 patients (N = 154 plans). 3D-conformal photon therapy and double-scattered proton therapy delivered significantly lower doses to the target volumes. The highly conformal techniques, i.e., IMRT, VMAT, CyberKnife, TomoTherapy and IMPT, reached the highest doses in the target volumes. Of these, IMPT was able to statistically significantly decrease the radiation doses to the OARs.\u0000\u0000\u0000CONCLUSION\u0000Highly conformal photon and proton beam techniques enable high-dose re-irradiation of the target volume. They, however, significantly differ in the dose deposited in the OARs. The therapeutic options, i.e., re-irradiation or systemic therapy, need to be carefully weighed and discussed with the patients.\u0000\u0000\u0000ADVANCES IN KNOWLEDGE\u0000Highly conformal photon and proton beam techniques enable high-dose re-irradiation of the target volume. In light of the abilities of the various highly conformal techniques to spare specific organs at risk, the therapeutic options need to be carefully weighed and patients included in the decision making process.","PeriodicalId":226783,"journal":{"name":"The British journal of radiology","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115755319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}