Background: The use of imaging is indispensable in modern radiation therapy, both for simulation and treatment delivery. For safe and sure utilization, dose delivery from imaging must be evaluated.
Objective: This study aims to investigate the dose to organ at risk (OAR) delivered by imaging during lung stereotactic body radiation therapy (SBRT) and to evaluate its contribution to the treatment total dose.
Material And Methods: In this retrospectively study, imaging total dose to organs at risk (OARs) (spinal cord, esophagus, lungs, and heart) and effective dose were retrospectively evaluated from 100 consecutive patients of a single institution who had lung SBRT. For each patient, dose was estimated using Monte-Carlo convolution for helical computed tomography (helical CT), Four-Dimensional CT (4D-CT), and kilovoltage Cone-Beam CT (kV-CBCT). Helical CT and kV-CBCT dose were evaluated for the entire thorax acquisition, while 4D-CT dose was analyzed on upper lobe (UL) or lower lobe (LL) acquisition. Treatment dose was extracted from treatment planning system and compared to imaging total dose.
Results: Imaging total dose maximum values were 117 mGy to the spinal cord, 127 mGy to the esophagus, 176 mGy to the lungs and 193 mGy to the heart. The maximum effective dose was 19.65 mSv for helical CT, 10.62 mSv for kV-CBCT, 25.95 mSv and 38.45 mSv for 4D-CT in UL and LL regions, respectively. Depending on OAR, treatment total dose was higher from 1.7 to 8.2 times than imaging total dose. Imaging total dose contributed only to 0.3% of treatment total dose.
Conclusion: Imaging dose delivered with 4D-CT to the OARs is higher than those of others modalities. The heart received the highest imaging dose for both UL and LL. Total imaging dose is negligible since it contributed only to 0.3% of treatment total dose.
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http://dx.doi.org/10.31661/jbpe.v0i0.2009-1173 | DOI Listing |
Crit Care
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Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, England.
Background: In severely injured trauma patients, hypofibrinoginaemia is associated with increased mortality. There is no evidence-based consensus for what constitutes optimal fibrinogen therapy, treatment dose or timing of administration. The aim of this systematic review was to evaluate the effects of early fibrinogen replacement, either cryoprecipitate or fibrinogen concentrate (FgC) on mortality, transfusion requirements and deep venous thrombosis (DVT).
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January 2025
Faculty of Environmental and Life Sciences, Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK.
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View Article and Find Full Text PDFClin Genitourin Cancer
January 2025
Department of Urology, Institute of Science Tokyo, Tokyo, Japan.
Introduction: Enfortumab vedotin (EV) currently plays a predominant role in the evolving treatment paradigm of metastatic urothelial carcinoma (mUC). However, large-scale real-world data on EV remain limited. This multicenter retrospective study comprehensively evaluated treatment outcomes and prognostic factors of EV monotherapy for mUC.
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January 2025
Pharmacy Department, Alice Springs Hospital, Alice Springs, Australia; Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Alice Springs, NT, Australia.
Purpose: To determine the incidence of therapeutic target attainment using a three-times per week protocol for vancomycin therapy given during the last hour of intermittent hemodialysis (HD).
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Background: Polyclonal autologous T cells that are epigenetically reprogrammed through mTOR inhibition and IFN-α polarization (RAPA-201) represent a novel approach to the adoptive T cell therapy of cancer. Ex vivo inhibition of mTOR results causes a shift towards T central memory (T) whereas ex vivo IFN-α promotes type I cytokines, with each of these functions known to enhance the adoptive T cell therapy of cancer. Rapamycin-resistant T cells polarized for a type II cytokine phenotype were previously evaluated in the allogeneic transplantation context.
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