Studies suggest that clinical outcomes are improved in repeat trigeminal neuralgia (TN) Gamma Knife radiosurgery if a different part of the nerve from the previous radiosurgery is treated. The MR images taken in the first and repeat radiosurgery need to be coregistered to map the first radiosurgery volume onto the second treatment planning image. We propose a fully automatic and robust three-dimensional (3-D) mutual information- (MI-) based registration method engineered by a simulated annealing (SA) optimization technique. Commonly, Powell's method and Downhill simplex (DS) method are most popular in optimizing the MI objective function in medical image registration applications. However, due to the nonconvex property of the MI function, robustness of those two methods is questionable, especially for our cases, where only 28 slices of MR T1 images were utilized. Our SA method obtained successful registration results for all the 41 patients recruited in this study. On the other hand, Powell's method and the DS method failed to provide satisfactory registration for 11 patients and 9 patients, respectively. The overlapping volume ratio (OVR) is defined to quantify the degree of the partial volume overlap between the first and second MR scan. Statistical results from a logistic regression procedure demonstrated that the probability of a success of Powell's method tends to decrease as OVR decreases. The rigid registration with Powell's or the DS method is not suitable for the TN radiosurgery application, where OVR is likely to be low. In summary, our experimental results demonstrated that the MI-based registration method with the SA optimization technique is a robust and reliable option when the number of slices in the imaging study is limited.
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http://dx.doi.org/10.1118/1.1944287 | DOI Listing |
Int J Radiat Oncol Biol Phys
January 2025
Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Purpose: Randomized trials have demonstrated similar local tumor control in patients treated with accelerated partial-breast irradiation (APBI) compared with whole-breast irradiation. However, the optimal APBI dose for maximizing tumor control and minimizing toxicity is uncertain.
Methods And Materials: We enrolled patients ≥18 years of age with grade 1 or 2 ductal carcinoma in situ or stage I invasive breast cancer and resection margins ≥2 mm between 2003 and 2011 to a sequential dose-escalation trial using 3-dimensional conformal external beam APBI giving twice daily 4 Gy fractions with total doses of 32 Gy, 36 Gy, and 40 Gy.
BMJ Open Gastroenterol
December 2024
Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
Objective: Non-alcoholic fatty liver disease (NAFLD) is estimated to affect a third of Australian adults, and its prevalence is predicted to rise, increasing the burden on the healthcare system. The LOCal Assessment and Triage Evaluation of Non-Alcoholic Fatty Liver Disease (LOCATE-NAFLD) trialled a community-based fibrosis assessment service using FibroScan to reduce the time to diagnosis of high-risk NAFLD and improve patient outcomes.
Methods: We conducted a 1:1 parallel randomised trial to compare two alternative models of care for NAFLD diagnosis and assessment.
Wound Manag Prev
December 2024
Acute Surgical Wound Service, Department of Surgery, Christiana Care, Newark, DE; Department of Surgery, Christiana Care, Newark, DE.
Background: Traumatic injuries have increased risks for infection and progression to difficult-to-heal wounds. Often, they are inadequately treated with single-purpose dressings. Involving wound care specialists allows for integrating various advanced wound treatments.
View Article and Find Full Text PDFJ Pain Symptom Manage
January 2025
Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
Context: Surrogate decision-makers have expressed the need for better preparation around communication and medical decision-making.
Objectives: This mixed-methods feasibility study aimed to assess the feasibility and usability of an online program to prepare surrogates for their role.
Methods: We developed a 2-part program for surrogates called PREPARE For THEIR Care with a diverse group of Community Advisory Board members and caregivers recruited from the National Patient Advocacy Foundation.
Am J Clin Nutr
January 2025
Department of Family Medicine, University of Virginia, Charlottesville, VA, USA; University of Virginia Comprehensive Cancer Center, University of Virginia, Charlottesville, VA, USA. Electronic address:
Background: An increasing body of evidence has linked fructose intake to colorectal cancer (CRC). African American (AA) adults consume greater quantities of fructose and are more likely to develop right-side colon cancer than European American (EA) adults.
Objective: We examined the hypothesis that fructose consumption leads to epigenomic and transcriptomic differences associated with CRC tumor biology.
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