Technology in cancer research & treatment
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Positron emission tomography (PET) facilitates the evaluation of molecular aspects and metabolic alterations that are fundamental in detecting of malignancies, characterization of tumor stage and assessment of therapeutical response, and tumor recurrence. The main advantage of PET is its high sensitivity in identifying of areas of cancerous involvement at an early stage. In general, the accelerated radiotracer activity occurs before anatomical structure changes. ⋯ The fusion of PET with MRI can compensate for their disadvantages and therefore offers several advantages in comparison to PET or MRI alone. The combination of these two excellent diagnostic imaging modalities into a single scanner improves the diagnostic accuracy by facilitating the accurate registration of molecular aspects and metabolic alterations of the diseases with exact correlation to anatomical findings and morphological information. Whole-body PET/MRI is a very promising diagnostic modality for oncological imaging and for use in cancer screening in the decades to come due to the considerably lower radiation exposure in contrast to PET/CT and the high soft tissue resolution of MRI.
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Technol. Cancer Res. Treat. · Dec 2004
The role of diffusion tensor imaging in establishing the proximity of tumor borders to functional brain systems: implications for preoperative risk assessments and postoperative outcomes.
Diffusion Tensor Imaging (DTI) is a new MRI imaging technique sensitive to directional movements of water molecules, induced by tissue barriers. This provides a new form of contrast that allows the identification of functional white matter tracts within the brain, and has been proposed as a technique suitable for presurgical planning in brain tumor patients. Resection of primary brain tumors improves survival, functional performance, and the effectiveness of adjuvant therapies, provided that surgically-induced neurological deficits can be avoided. ⋯ Our results show that the combined use of fMRI and DTI can provide a better estimation of the proximity of tumor borders to eloquent brain systems sub-serving language, speech, vision, motor and premotor functions. Additionally, a low regional complication rate (4%) observed in our series suggests that preoperative planning with these combined techniques may improve surgical outcomes compared to that previously reported in the literature. Larger studies specifically designed to establish the accuracy and predictive value of DTI in brain tumor patients are warranted to substantiate our preliminary observations.
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This study reports on the acute and long-term results of cryoablation in patients with supraventricular and ventricular tachycardia. One hundred fifty nine patients with cardiac arrhythmias (147 with supraventricular and 12 with ventricular tachycardia) were consecutively enrolled in our institution to undergo trnasvenous cryoablation with a new cryotechnology system (CryoCor trade mark ). ⋯ The acute and chronic outcomes (after 15 months for patients with supraventricular tachycardia and 9 months for patients with ventricular tachycardia) were comparable to those using radiofrequency energy. From this study we concluded that transvenous cryoablation is a safe and effective therapy for the treatment of cardiac arrhythmias.
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Technol. Cancer Res. Treat. · Feb 2004
Comparative Study Clinical TrialStereotactic radiosurgery versus fractionated stereotactic radiotherapy boost for patients with glioblastoma multiforme.
The aim of this study is to evaluate the efficacy of stereotactic radiotherapy boost (SRB) in patients with glioblastoma multiforme (GBM) by comparing two different regimens, single dose or fractionated treatment. Between December 1994 and January 2000, 24 patients with GBM were treated with SRB in conjunction with external beam radiotherapy (EBRT). Fourteen patients (58%) were treated with stereotactic radiosurgery (SRS) and 10 patients (42%) with fractionated stereotactic radiotherapy (FSRT). ⋯ The addition of SRB appeared to improve the median survival most demonstrably in RTOG RPA class 4 patients. SRS and FSRT are equally effective with similar median survival, but potentially less late complications associated with FSRT. Since this is a nonrandomized study, further investigation is needed to confirm this and to determine an optimal dose/fractionation scheme.
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Technol. Cancer Res. Treat. · Feb 2004
Clinical TrialRepositioning accuracy of a commercially available double-vacuum whole body immobilization system for stereotactic body radiation therapy.
We evaluated the repositioning accuracy of a commercially available stereotactic whole body immobilization system (BodyFIX, Medical Intelligence, Schwabmuenchen, Germany) in 36 patients treated by hypofractionated stereotactic body radiation therapy. CT data were acquired for positional control of patient and tumor before each fraction of the treatment course. Those control CT datasets were compared with the original treatment planning CT simulation and analyzed with respect to positional misalignment of bony patient anatomy, and the respective position of the treated small lung or liver lesions. ⋯ The analyzed BodyFIX whole body immobilization system performed favorably compared with other stereotactic body immobilization systems for which peer-reviewed repositioning data exist. While the measured variability in patient and target setup provided clinically acceptable setup accuracy in the vast majority of cases, larger setup deviations were occasional observed. Such deviations constitute a potential for partial target underdosing warranting, in our opinion, a pre-delivery positional assessment procedure (e.g., pre-treatment control CT scan).