scholarly journals Comparison of implant quality between intraoperatively built custom-linked seeds and loose seeds in permanent prostate brachytherapy using sector analysis

2016 ◽  
Vol 57 (4) ◽  
pp. 393-399 ◽  
Author(s):  
Norihisa Katayama ◽  
Mitsuhiro Takemoto ◽  
Atsushi Takamoto ◽  
Hiroki Ihara ◽  
Kuniaki Katsui ◽  
...  
Keyword(s):  
Dose Calculation ◽  
Operation Time ◽  
Analysis Tool ◽  
Prostate Brachytherapy ◽  
Seed Implantation ◽  
Calculation Technique ◽  
Seed Migration ◽  
Dose Volume ◽  
Group A ◽  
Sector Analysis

Abstract We compared the implant quality of intraoperatively built custom-linked (IBCL) seeds with loose seeds in permanent prostate brachytherapy. Between June 2012 and January 2015, 64 consecutive prostate cancer patients underwent brachytherapy with IBCL seeds ( n = 32) or loose seeds ( n = 32). All the patients were treated with 144 Gy of brachytherapy alone. Brachytherapy was performed using a dynamic dose calculation technique. Computed tomography/magnetic resonance imaging fusion-based dosimetry was performed 1 month after brachytherapy. Post-implant dose–volume histogram (DVH) parameters, prostate sector dosimetry, operation time, seed migration, and toxicities were compared between the IBCL seed group and the loose seed group. A sector analysis tool was used to divide the prostate into six sectors (anterior and posterior sectors at the base, mid-gland, and apex). V100 (95.3% vs 89.7%; P = 0.014) and D90 (169.7 Gy vs 152.6 Gy; P = 0.013) in the anterior base sector were significantly higher in the IBCL seed group than in the loose seed group. The seed migration rate was significantly lower in the IBCL seed group than in the loose seed group (6% vs 66%; P < 0.001). Operation time per seed was significantly longer in the IBCL seed group than in the loose seed group (1.31 min vs 1.13 min; P = 0.003). Other post-implant DVH parameters and toxicities did not differ significantly between the two groups. Our study showed more dose coverage post-operatively in the anterior base prostate sector and less seed migration in IBCL seed implantation compared with loose seed implantation.

Use of sector analysis of I-125 permanent prostate brachytherapy to evaluate and compare pre- and postimplant dosimetry.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 242-242
Author(s):  
Ahamed Badusha Mohamed Yoosuf ◽  
Geraldine Workman ◽  
Monica M O'Toole ◽  
Margaret Straney ◽  
Rejina Verghis ◽  
...  
Keyword(s):  
Rapid Assessment ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
P Value ◽  
Prostate Brachytherapy ◽  
Dose Volume ◽  
Sector Analysis ◽  
Dose Homogeneity ◽  
Dosimetric Analysis

242 Background: To evaluate 12 sector analysis in the assessment and comparison of pre- and post- implant dosimetric parameters during the development of an I-125 prostate brachytherapy (PPB) service. Methods: 50 consecutive men being treated with PPB had dose volume analysis in 12 sectors of their pre implant ultrasound (PIUS) and post implant CT (PICT) data using a Variseed 8.0 treatment planning system. PIUS dosimetry was performed 2 weeks prior to implantation and PICT dosimetry 4 weeks post implant. Individual sectors were created by dividing the cranio-caudal prostate length into 3 equal lengths creating prostate base (PB), midgland (PM) and apex (PA). Each of these volumes was then divided into four axial sectors (right and left anterior, right and left posterior). The planning target volume (PTV), dose to 90% of prostate (D90), prostate volume enclosed by 100% (V100), 150% (V150) and 200% (V200) dose were recorded in each sector on PIUS and PICT. Adjacent sectors on PIUS were assessed for dose-volume homogeneity as were adjacent sectors on PICT. Differences in individual sectors on PIUS and PICT were evaluated. Results: Adjacent sector analysis demonstrated dose homogeneity in all sectors of PIUS and the majority of sectors on PICT. Statistically significant differences between PIUS and PICT were noted in target volume, particularly in PB with PICT >PIUS. When individual sectors on PIUS and PICT were compared, statistically significant differences were noted in the majority of dosimetric parameters. The anterior PB and PM were significantly lower on PICT (p value < 0.001) and significantly higher at the posterior PM and PA (p value < 0.05). These changes were consistent across all analysed parameters. In particular, significant absolute differences in D90 in equivalent sectors on PIUS and PICT were seen. Conclusions: 12 sector analysis allows rapid assessment of PIUS and PICT dose and volume homogeneity. It offers a scientific method of identifying areas of relative over and under dosing on PICT when compared with PIUS providing both clinicians and physicists with a learning tool to refine dosimetric analysis and highlight sectors where implant quality could be improved.

A sector-based postimplant dosimetric comparison of sagittal and axial ultrasound-guided source placement during I-125 permanent prostate brachytherapy.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 262-262
Author(s):  
Ahamed Badusha Mohamed Yoosuf ◽  
Darren M. Mitchell ◽  
Monica M. Byrne ◽  
Margaret A. Flynn ◽  
Eoin Napier ◽  
...  
Keyword(s):  
Prostate Volume ◽  
Prostate Brachytherapy ◽  
Dose Volume ◽  
Sector Analysis ◽  
Seed Deposition ◽  
The Difference ◽  
Group 2 ◽  
Dosimetric Analysis ◽  
Implant Technique ◽  
Group 1

262 Background: To use sector based pre- and postimplant dosimetric analysis to evaluate the effect of changes in implant technique in a developing I-125 permanent prostate brachytherapy program (PPB). Methods: 109 men treated with PPB were divided into two groups by implant technique. The first 50 patients (group 1) had needle-by-needle seed deposition under axial ultrasound (USS) guidance and subsequent 59 patients (group 2) having needle placement row-by-row then seed deposition under sagittal USS guidance. Twelve sector dose volume analysis of pre-implant ultrasound (USpre) and postimplant CT (CTpost) study was performed in all cases. Individual sectors were created by dividing the cranio-caudal prostate into three equal lengths creating prostate base, midgland and apex. Each of these volumes was then divided into four axial sectors (right and left anterior, right and left posterior). The difference in the minimum dose delivered to 90% of prostate volume (D90) and the prostate volume receiving 100%, 150%, and 200% of the prescribed dose (V100, V150, and V200) was compared between both groups. Results: In both groups, the volume of prostate in sectors one through six (entire base and anterior midgland) were significantly larger on CTpost when compared to equivalent sectors in USpre (p < 0.001), conversely the volumes in sectors 11 and 12 (posterior apex) were significantly smaller (p =0.001). When comparing dosimetric parameters of all equivalent sectors in CTpost of both groups, it was found that D90 of sector seven and eight (posterior midgland) in Group 1 received increased dose leading to elevated dose to the rectum but was significantly reduced in Group 2 (p < 0.01), which resulted in achieving the dose as planned in USpre. Prostate implant dosimetry was significantly improved in group 2 with a trend to increased equivalent dose between CTpost and USpre to each sectors and significant decrease in V150 and V200 in majority of the sectors. Conclusions: The row-by-row technique under sagittal USS guidance significantly improved our post implant dosimetric parameters when compared to single needle source placement under axial USS guidance as assessed by 12 sector analysis.

scholarly journals Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

2019 ◽  
Vol 6 (1) ◽  
pp. 8-13
Author(s):  
Birendra Kumar Yadav ◽  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parish Mani Shrestha
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Urine Culture ◽  
Operation Time ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Stone Characteristics ◽  
Negative Urine Culture ◽  
Infective Complications

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture.

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

Social Differentiation in the Use of English Vocabulary

1997 ◽  
Vol 2 (1) ◽  
pp. 133-152 ◽  
Author(s):  
Paul Rayson ◽  
Geoffrey N. Leech ◽  
Mary Hodges
Keyword(s):  
Social Group ◽  
Geographical Region ◽  
Social Differentiation ◽  
Future Research ◽  
Analysis Tool ◽  
Spoken English ◽  
Transcription System ◽  
Group A ◽  
British National Corpus ◽  
National Corpus

In this article, we undertake selective quantitative analyses of the demographi-cally-sampled spoken English component of the British National Corpus (for brevity, referred to here as the ''Conversational Corpus"). This is a subcorpus of c. 4.5 million words, in which speakers and respondents (see I below) are identified by such factors as gender, age, social group, and geographical region. Using a corpus analysis tool developed at Lancaster, we undertake a comparison of the vocabulary of speakers, highlighting those differences which are marked by a very high X2 value of difference between different sectors of the corpus according to gender, age, and social group. A fourth variable, that of geographical region of the United Kingdom, is not investigated in this article, although it remains a promising subject for future research. (As background we also briefly examine differences between spoken and written material in the British National Corpus [BNC].) This study is illustrative of the potentiality of the Conversational Corpus for future corpus-based research on social differentiation in the use of language. There are evident limitations, including (a) the reliance on vocabulary frequency lists and (b) the simplicity of the transcription system employed for the spoken part of the BNC The conclusion of the article considers future advances in the research paradigm illustrated here.

scholarly journals Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Posterior Approach ◽  
Spinal Tuberculosis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Thoracolumbar Junction ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.

scholarly journals Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors: an empirical analysis of 290 patients

2020 ◽  
Author(s):  
Feiya Yang ◽  
Lianjie Mou ◽  
Nianzeng Xing
Keyword(s):  
Partial Nephrectomy ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Intraoperative Ultrasound ◽  
Operation Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Tumors ◽  
Significant Difference ◽  
Group A

Abstract Objective To explore the feasibility of laparoscopic partial nephrectomy(LPN) in the treatment of renal hilar tumors. Methods Clinical data of 290 patients undergoing laparoscopic partial nephrectomy from January 2013 to August 2019 were retrospectively analyzed, including 27 patients with renal hilar tumors and 263 patients with non-hilar renal tumors. Perioperative data and follow-up results were compared between the two groups. Results Tumor size in Group A is smaller(2.97±0.88 vs 3.55±1.46,p<0.05), R.E.N.A.L. nephrometry score of Group A is higher(8.4±1.3 vs 6.5±1.7,p<0.01).The operation time, WIT and intraoperative blood loss in the Group A were slightly higher, but with no statistical difference (p>0.05). There was no significant difference between the two groups in intraoperative ultrasound rate, collection system repair rate, drainage time,postoperative hospital stay, and eGFR changes (p>0.05).The median follow-up period was 40 months. One patient with postoperative pathologic report of angiomyolipoma was found tumor recurrence and was currently undergoing regular reexamination. Conclusion Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors is safe and feasible after detailed preoperative evaluation of the tumor and selection of appropriate surgical strategies.

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