Percutaneous endoscopic gastrostomy vs surgical gastrostomy in infants with congenital heart disease.

Background: Infants with congenital heart disease often require feeding tube placement to supplement oral intake. Gastrostomy tubes may be placed by either surgical or percutaneous endoscopic methods, but there is currently no data comparing outcomes of these procedures in this population.

Aims: The aim of our retrospective study was to investigate the perioperative outcomes between the 2 groups to determine if there are clinically significant differences.

Clarence Borel.

Borel v. Fibreboard Paper Products Corporation is the 1973 landmark case that paved the way for successful litigation against the asbestos industry. Clarence Borel's granddaughter shares recollections of the reluctant man behind the court case.

TG-69: radiographic film for megavoltage beam dosimetry.

TG-69 is a task group report of the AAPM on the use of radiographic film for dosimetry. Radiographic films have been used for radiation dosimetry since the discovery of x-rays and have become an integral part of dose verification for both routine quality assurance and for complex treatments such as soft wedges (dynamic and virtual), intensity modulated radiation therapy (IMRT), image guided radiation therapy (IGRT), and small field dosimetry like stereotactic radiosurgery. Film is convenient to use, spatially accurate, and provides a permanent record of the integrated two dimensional dose distributions.

Clinico-pathologic conference: 12-year-old girl with fatigue, anemia, weight loss, abdominal distention, and occasional nausea and vomiting.

A clinicopathologic case is presented. The patient was a 12-year-old white girl with a history of fatigue and dizziness, occasional nausea and vomiting, and anemia, who showed abdominal distention, especially in the epigastrium. An epigastric mass was palpable.

Comparison of three high-resolution digitizers for radiochromic film dosimetry.

A recently introduced radiographic film scanner from Howtek is evaluated and compared to two other commercially available densitometry systems for its use in radiochromic (RC) film dosimetry in the clinical dose range 0-100 Gy. It has a high-intensity red LED light-source centered at 662 nm (near the major absorption peak for RC film), and is coupled to a CCD linear array detector. This new densitometry system is directly compared to two high-resolution film scanners commonly employed in RC film dosimetry, namely the Lumiscan 75 digitizer (He-Ne laser light source) and the Vidar VXR-16 digitizer (fluorescent light source).

A new geometric and mechanical verification device for medical LINACs.

The goal of quality assurance (QA) for a radiation oncology medical LINAC is to maintain an acceptable level of equipment performance and reliability. The increasing complexity of Radiation Oncology equipment and treatment techniques have led to increased demands on the work load of the medical physicist. Regular testing needs to be as efficient as possible.

Evaluation of an innovative plastic cube phantom designed to improve the efficiency of accelerator QA.

A new cubic phantom was designed to improve the efficiency on the QA measurement of accelerator. It has a variety of applications, such as dose constancy check, depth dose verifications, and symmetry and flatness evaluations. In particular, this new design makes it much easier to perform the check on output constancy vs.

The use of an inexpensive red acetate filter to improve the sensitivity of GAFChromic dosimetry.

The sensitivity of GAFChromic dosimetry using a conventional broad band light source densitometer has significantly been improved twofold using an inexpensive red acetate filter overlay during the densitometric measurements. This thin sheet of red acetate enhances the dosimetric analysis of radiochromic blue image distributions recorded on GAFChromic films. The combination provides higher sensitivity in the optical density measurements than the more expensive He-Ne laser-scanning densitometers.

The thermal characteristics of different diodes on in vivo patient dosimetry.

Diode sensitivity variations with temperature (SVWT) have been reported to vary from small negative values up to 0.6% per degrees C. Thus it is possible for diode calibration factors established at room temperature (approximately 20 degrees C) to yield errors in the range of -1% to +9% when diodes are placed on a patient's skin (approximately 30 degrees C) for in vivo entrance dose measurements.

Calculation of dose distribution near an innovative concentric balloon catheter for endovascular brachytherapy.

Purpose: Using a radioactive solution-filled catheter for intravascular irradiation has the potential problem of chemical and radiological toxicity in the case of a balloon rupture. In order to reduce this risk, an innovative concentric balloon catheter was developed.

Methods And Materials: The concentric balloon was made by inner and outer balloons filled with saline and radioactive solution, respectively.

Calculation of dose distribution near an innovative concentric balloon catheter for endovascular brachytherapy.

Purpose: Using a radioactive solution-filled catheter for intravascular irradiation has the potential problem of chemical and radiological toxicity in the case of a balloon rupture. In order to reduce this risk, an innovative concentric balloon catheter was developed.Methods and Materials: The concentric balloon was made by inner and outer balloons filled with saline and radioactive solution, respectively.

Evaluation of the use of botulinum toxin in children with achalasia.

Background: Achalasia is rare in children. Recently, injection of botulinum toxin into the lower esophageal sphincter has been studied as an alternative to esophageal pneumatic dilatation or surgical myotomy as treatment for achalasia. In the current study, the effects of botulinum toxin were investigated in the largest known series of children with achalasia.

A new genetic algorithm technique in optimization of permanent 125I prostate implants.

Real time optimized treatment planning at the time of the implant is desirable for ultrasound-guided transperineal 125I permanent prostate implants. Currently available optimization algorithms are too slow to be used in the operating room. The goal of this work is to develop a robust optimization algorithm, which is suitable for such application.

A rapid colour stabilization technique for radiochromic film dosimetry.

Various forms of GAFChromic film have been used for several years as radiographic media for measuring dose distributions of brachytherapy sources and small radiation fields. Upon irradiation the film changes colour and darkens with time post-irradiation. The darkening is most rapid in the first 24 h, and it has been suggested that for accurate dosimetry a waiting period of 24 h should occur before any optical density (OD) measurements are taken.

The use of improved radiochromic film for in vivo quality assurance of high dose rate brachytherapy.

GAFChromic film has become increasingly popular for radiation dosimetry. In this study we explore the use of GAFChromic film as an in vivo dosimeter for quality assurance (QA) of fractionated high dose rate 192Ir treatments. Accuracy of dose distribution is explored for the simple vaginal cylinder geometry for which the dose can be easily calculated for comparison.

Desensitization to pancreatic enzyme intolerance in a child with cystic fibrosis.

Objective: Pancreatic enzyme is essential in the treatment of cystic fibrosis (CF), but intolerance to it occasionally occurs. We encountered a child who was intolerant to multiple commercially available preparations of pancreatic enzymes and, hence, desensitization was attempted, with success.

Case Presentation: A 33-month-old girl was diagnosed with CF at 6 months of age.

Evaluation of a new sealed reentrant well chamber for HDR and LDR brachytherapy calibrations.

A new reentrant ionization chamber SNC 1008 has been introduced for low dose rate (LDR) and high dose rate (HDR) brachytherapy source calibrations. There is no air density correction requirement for the chamber since it is hermetically sealed. In this study we evaluate its use for HDR as well as LDR source calibrations.

Predicting optical densitometer response as a function of light source characteristics for radiochromic film dosimetry.

Various forms of GAFChromic (GC) film have been used for several years as radiographic media for measuring dose distributions of brachytherapy sources and small radiation fields. In order to optimize the measurement sensitivity and thus improve precision, we describe a method to calculate the dose response curves (net optical density at a give wavelength or spectrum versus absorbed dose) for different densitometer light sources using measured GC film absorption spectra. Comparison with measurements on the latest version of GC film (model MD-55-2) using four types of densitometers [He-Ne laser, broadband (white light) densitometer, and two LED (red-light) filtered densitometers] confirm the accuracy of this predictive model.

A feasibility study of automated inverse treatment planning for cancer of the prostate.

Purpose: The development of automated "inverse planning," utilizing intensity-modulated radiation therapy (IMRT) raises the question of whether this new technique can provide a practical and efficient means of dose escalation in conformal treatment of cancer of the prostate. The purpose of this feasibility study was to determine a single set of inverse-planning parameters that can be used for a variety of different prostate patient geometries to automatically generate escalated dose (> or = 81 Gy) IMRT plans that satisfy normal tissue constraints for rectal and bladder walls.

Methods: We studied a subset of the 46 patients who were previously treated at Memorial Sloan Kettering Cancer Center (MSKCC) to a total dose of 81 Gy using a 3D conformal approach.