Demonstration of real-time positron emission tomography biology-guided radiotherapy delivery to targets.

Background: Biology-guided radiotherapy (BgRT) is a novel technology that uses positron emission tomography (PET) data to direct radiotherapy delivery in real-time. BgRT enables the precise delivery of radiation doses based on the PET signals emanating from PET-avid tumors on the fly. In this way, BgRT uniquely utilizes radiotracer uptake as a biological beacon for controlling and adjusting dose delivery in real-time to account for target motion.

Responding to the rofecoxib withdrawal crisis: a new model for notifying patients at risk and their health care providers.

Background: We decided to inform our patients of the withdrawal of rofecoxib, one of the largest drug withdrawals in United States history, and instruct them to contact their providers for guidance.

Objective: To identify and inform patients and providers affected by the rofecoxib withdrawal.

Design: Descriptive observational study.

Managing technology in a complex healthcare delivery system.

Although clinical management is generally best handled regionally in a large system, e-health is the exception. E-health is managed centrally and not regionally because the patient access is not regional--it is virtual. Also, when patient demand, not business rationalization pressure, is the driver for change, it makes business sense to modify the management form from a regional to a centralized function.