Jet Ventilation Decreases Target Motion and Increases Yield of ENB Especially in Lesions With Negative Bronchus Sign.

Background: Electromagnetic navigational bronchoscopy (ENB) is used to obtain peripheral lung tissue samples for evaluation and staging of central and peripheral lung lesions. Jet ventilation delivers and maintains a sustained airway pressure at high frequency, chest wall and diaphragmatic movement is drastically reduced compared with traditional ventilation. The current study looks to examine the effectiveness of tissue sampling (diagnostic yield) while using jet ventilation on target-lesion movement when compared with traditional ventilation.

Harmonic subtraction for evaluating right ventricle ejection fraction from planar equilibrium radionuclide angiography.

We report an initial investigation of a subtraction-based method to estimate right ventricle ejection fraction (RVEF) from ECG-gated planar equilibrium radionuclide angiography (ERNA) data. Twenty-six consecutive patients referred for scintigraphic evaluation of cardiac function prior to chemotherapy had ECG-gated first-pass (FP) imaging and ERNA imaging performed following the same radiotracer injection. RVEF was computed from FP images (RVEF) and separately from ERNA images (RVEF).

Clinical intervention for quality improvement of gastric-emptying studies.

Unlabelled: Prompted by clinical concerns for false-negative tests, we implemented a clinical intervention consisting of a training session and an image-based verification procedure to document homogeneous radioactivity distribution in the radiolabeled meal (egg substitute per the guideline).

Methods: A technologist training session emphasized the importance of thorough mixing of (99m)Tc-sulfur colloid in the egg meal. For 6 mo after training, an image of the prepared mixed egg was acquired before patient ingestion.

Extravasation of a therapeutic dose of 131I-metaiodobenzylguanidine: prevention, dosimetry, and mitigation.

Unlabelled: After the extravasation of a therapeutic dose of (131)I-metaiodobenzylguanidine that produced a radiation burn to a patient's forearm, we instituted a catheter placement verification protocol.

Methods: Before therapy infusion, proper placement is verified by administering 37 MBq of (99m)Tc-pertechnetate through the catheter, and monitoring activity at the administration site and on the contralateral extremity. A dosimetric model describing both high-rate and low-rate dose components was developed and predicted that the basal epidermal layer received a radiation dose consistent with the observed moist desquamation radiation skin toxicity.

Shortening the 4-hour gastric-emptying protocol.

Purpose: A standardized 4-hour gastric-emptying protocol has been recommended by a consensus panel. However, a study length of 4 hours may be inconvenient. The purpose of this investigation was to determine if the percent emptying at 2 hours could predict abnormal or normal results at 4 hours.

Overcorrection of iodinated contrast attenuation in SPECT-CT: phantom studies.

Purpose: The authors investigated the effects of iodinated contrast agents on the quantification of radioactivity obtained using a combined single photon emission tomography (SPECT) and high resolution 16 slice computed tomography (CT) scanner.

Methods: Two conditions were evaluated: Contrast media mixed with radioisotope and the contrast media, and the radioisotope solution confined in adjacent but distinct volumes. Phantoms containing combinations of 99mTc, 111In, and 131I solutions in normal saline and contrast solutions in normal saline corresponding to the two conditions were prepared and scanned.

Experience with a simplified, standardized 4-hour gastric-emptying protocol.

Unlabelled: Gastric-emptying studies have no accepted standard methodology or reference values. A simplified standardized protocol with a large reference database has been proposed, with imaging obtained at only 0, 1, 2, and 4 h. The rationale for its 4-h length is data suggesting that delayed emptying is detected with higher sensitivity at 4 h than at 2 h.

Setup errors in patients treated with intensity-modulated whole pelvic radiation therapy for gynecological malignancies.

Intensity-modulated whole pelvic radiation therapy (IM-WPRT) has decreased the incidence of gastrointestinal complications by reducing the volume of normal tissue irradiated in gynecologic patients. However, IM-WPRT plans result in steep dose gradients around the target volume, and thus accurate patient setup is essential. To quantify the accuracy of our patient positioning, we examined the weekly portal films of 46 women treated with IM-WPRT at our institution.