Fetal dose assessment in a pregnant patient with brain tumor: A comparative study of proton PBS and 3DCRT/VMAT radiation therapy techniques.

Purpose: The treatment of brain tumors in pregnant patients poses challenges, as the out-of-field dose exposure to the fetus can potentially be harmful. A pregnant patient with prior radiation treatment was presented with a brain tumor at our clinic. This work reports on our pre-treatment study that compared fetal dose exposure between intensity-modulated proton therapy (IMPT) using pencil beam scanning (PBS) and conventional photon 3D conformal radiation therapy (3DCRT) and volumetric-modulated arc therapy (VMAT), and the subsequent pregnant patient's radiation treatment.

Effect of Cangrelor on Infarct Size in ST-Segment-Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial (The PITRI Trial).

Background: The administration of intravenous cangrelor at reperfusion achieves faster onset of platelet P2Y12 inhibition than oral ticagrelor and has been shown to reduce myocardial infarction (MI) size in the preclinical setting. We hypothesized that the administration of cangrelor at reperfusion will reduce MI size and prevent microvascular obstruction in patients with ST-segment-elevation MI undergoing primary percutaneous coronary intervention.

Methods: This was a phase 2, multicenter, randomized, double-blind, placebo-controlled clinical trial conducted between November 2017 to November 2021 in 6 cardiac centers in Singapore.

Feasibility of patient-specific quality assurance (PSQA) for real-time robotic stereotactic body radiotherapy (SBRT) based on tumor motion traces.

Purpose: To design a patient specific quality assurance (PSQA) process for the CyberKnife Synchrony system and quantify its dosimetric accuracy using a motion platform driven by patient tumor traces with rotation.

Methods: The CyberKnife Synchrony system was evaluated using a motion platform (MODUSQA) and a SRS MapCHECK phantom. The platform was programed to move in the superior-inferior (SI) direction based on tumor traces.

The use of a mini-ridge filter with cyclotron-based pencil beam scanning proton therapy.

Background: Pencil beam scanning (PBS) proton therapy allows for far superior dose conformality compared with passive scattering techniques. However, one drawback of PBS is that the beam delivery time can be long, particularly when treating superficial disease. Minimizing beam delivery time is important for patient comfort and precision of treatment delivery.

Cholangiocarcinoma: Part 1, Pathological and Morphological Subtypes, Spectrum of Imaging Appearances, Prognostic Factors and Staging.

Cholangiocarcinoma (CC) is the most frequent malignant tumor of the biliary tract. The vast majority of cholangiocarcinomas are adenocarcinomas with a high proportion of fibrous stroma. Based on the macroscopic growth pattern, CC is classified as mass-forming, periductal infiltrating, or intraductal, with each type having its own characteristic imaging findings and prognostic outcome.

Cholangiocarcinoma - Part 2, Tumoral and Nontumoral Mimics and Imaging Features Helpful in Differentiation.

Each of the 3 morphological subtypes of cholangiocarcinoma has a different set of imaging differentials. Emulators of mass-forming cholangiocarcinoma include other primary and secondary hepatic malignancies, benign tumors and tumor-like mimics such as abscess, hemangioma and confluent hepatic fibrosis. Benign inflammatory biliary strictures constitute the major differential of periductal-infiltrative type and intraductal calculi are the main consideration for intraductal-growth type.

Adaptability and responsiveness: keys to operational measures in a regional hospital radiology department during the current COVID-19 pandemic.

The rapid and mostly uncontrolled spread of the coronavirus disease 2019 pandemic over the past 4 months has overwhelmed many healthcare systems worldwide. In Singapore, while our public healthcare institutions were considered well prepared due to our prior experience with the SARS outbreak, there was an unexpected surge of infected patients over the recent 2 months to deal with. We describe our radiology department's experience in modifying operational practices and implementing strict infection control measures aimed at minimizing disease transmission and mitigating the potential impact of possible staff infection.

Impact of sequence type and field strength (1.5, 3, and 7T) on 4D flow MRI hemodynamic aortic parameters in healthy volunteers.

Purpose: 4D flow magnetic resonance imaging (4D-MRI) allows time-resolved visualization of blood flow patterns, quantification of volumes, velocities, and advanced parameters, such as wall shear stress (WSS). As 4D-MRI enters the clinical arena, standardization and awareness of confounders are important. Our aim was to evaluate the equivalence of 4D flow-derived aortic hemodynamics in healthy volunteers using different sequences and field strengths.

Tract sealing with normal saline after percutaneous transthoracic lung biopsies.

Introduction: In the present study, we aimed to assess whether normal saline injection for sealing the biopsy track is useful in reducing the incidence of pneumothorax after computed tomography (CT)-guided percutaneous transthoracic lung biopsy (PTLB).

Methods: We retrospectively compared the incidence of pneumothorax in 100 consecutive biopsies (n = 100, group A) that had injection of saline along the track, with historical cohort of same number of consecutive patients who underwent PTLB without injection of saline along the needle track (n = 100, group B). CT-guided biopsies were performed by coaxial technique and 1-3 ml of saline was injected along the tract.

Dual-Source Dual-Energy CT in Submandibular Sialolithiasis: Reliability and Radiation Burden.

This study aims to compare the diagnostic accuracy of virtual unenhanced CT images derived from dual-source dual-energy contrast-enhanced CT with that of standard unenhanced CT images for evaluation of sialolithiasis. All dual-energy CT studies of the neck performed during the preceding 5 years were reviewed for submandibular gland calculi. Only patients who had unenhanced CT and contrast-enhanced CT performed as part of the same evaluation were included in this study.

Sonographic assessment of musculoskeletal causes of calf pain and swelling.

Calf pain or swelling is a common presentation to the emergency department. The differential diagnoses are wide. Deep vein thrombosis (DVT) is often the first diagnosis to be excluded given its potentially fatal complications.

Computer Vision Syndrome: Darkness Under the Shadow of Light.

Radiologists typically spend long hours staring at the computer monitor. This unavoidable nature of our work can lead to detrimental effects on the eyes. Moreover, there is little awareness among radiologists with regards to such potential harm.

Trends and implications of 24/7 interventional radiology in a newly opened acute hospital.

Introduction: We aim to evaluate the frequency of use and changing practices for all out-of-hours interventional radiology (IR) procedures performed in a new hospital.

Methods: This is a 5 year retrospective review of all out-of-hours procedures performed by the Interventional Radiology team from July 2010 to June 2015. Number and category of procedures performed were identified from the RIS database.

Abdominal radiographs in the emergency department: current status and controversies.

This editorial is discussing about the indiscriminate use of abdominal radiographs in the emergency department in general, with focus on value of the erect abdominal radiograph for the diagnosis of mechanical bowel obstruction and paralytic ileus.

Platelet inhibition to target reperfusion injury trial: Rationale and study design.

Background: In ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI), current oral P2Y12 platelet inhibitors do not provide maximal platelet inhibition at the time of reperfusion. Furthermore, administration of cangrelor prior to reperfusion has been shown in pre-clinical studies to reduce myocardial infarct (MI) size. Therefore, we hypothesize that cangrelor administered prior to reperfusion in STEMI patients will reduce the incidence of microvascular obstruction (MVO) and limit MI size in STEMI patients treated with PPCI.