Notes

The Negative Effects regarding Volatile Sulphur Ingredients.
ultidisciplinary team following breast conserving surgery with positive surgical margins on histology, however interpretation is challenging. The value of these studies lie in assessment of the distant breast rather than the surgical resection cavity and can alter patient management guiding the most appropriate next step for definitive treatment.
This paper uses clinical audit to determine the extent and dosimetric impact of additional imaging for patients undergoing ocular proton beam therapy who have no clips visible in the collimated beam.

An audit was conducted on 399 patients treated at The National Centre for Eye Proton Therapy between 3 July 2017 and 14 June 2019. The mean total number of image pairs over the course of treatment for patients with and without clips visible in the collimated beam were compared.

Among 364 evaluable patients, 333 had clips visible in the collimated beam and 31 did not. Baf-A1 There was a statistically significant increase of five image pairs required for patients with no clips visible compared with those with clips visible (mean 14.6
9.6 image pairs, respectively;
= 2.74 × 10
). This equated to an additional 1.5 mGy absorbed dose, representing an increase in secondary cancer induction risk from 0.0004 to 0.0007%.

The small increase in concomitant dose and set-up time for patients with no clips visible in the collimated beam is not clinically significant.

This novel work highlights clinical audit from real on-treatment geometric verification data and frequencies, rather than protocols, for ocular proton beam therapy; something not present in the literature. The simple and straightforward methodology is easily and equally applicable to clinical audits (especially those under Ionising Radiation (Medical Exposure) Regulations) for photon techniques.
This novel work highlights clinical audit from real on-treatment geometric verification data and frequencies, rather than protocols, for ocular proton beam therapy; something not present in the literature. The simple and straightforward methodology is easily and equally applicable to clinical audits (especially those under Ionising Radiation (Medical Exposure) Regulations) for photon techniques.
This study aimed to compare radiotherapy plan quality of coplanar volumetric modulated arc therapy (CO-VMAT) and non-coplanar VMAT (NC-VMAT) for post-operative primary brain tumour.

A total of 16 patients who were treated for primary brain tumours were retrospectively selected for this study. For each patient, identical CT sets with structures were used for both CO-VMAT and NC-VMAT planning. For CO-VMAT, one full arc and two coplanar half arcs were used. For NC-VMAT, one full coplanar and two non-coplanar half arcs with couch rotation of 315° or 45° were used. Dose constraints were adhered to the RTOG 0614, RTOG 0933 and TMH protocol. Dose volumetric parameters were collected for statistical analysis.

.NC-VMAT achieved significant dose reduction in contralateral hippocampus, both temporal lobes and cochleae, and other OARs while the plan qualities remained the same. In particular, NC-VMAT decreased contralateral hippocampus mean dose by 1.67Gy. Similarly, the NC-VMAT decreased temporal lobe mean dose by 6.29Gy and 2.8Gy for ipsilateral and contralateral side respectively. Furthermore, it decreased cochlea mean dose by 5.34Gy and 0.97Gy for ipsilateral and contralateral side respectively. Overall, there was a reduction of 5.4% of normal brain tissue volume receiving low dose irradiation.

The proposed NC-VMAT showed more favourable plan quality than the CO-VMAT for primary brain tumours, in particular to hippocampus, temporal lobes, cochleae and OARs located to the contralateral side of tumours.

For primary brain tumours radiotherapy, NC-VMAT can reduce doses to the hippocampus, both temporal lobes, and cochleae, as well as OARs located to the contralateral side of tumours.
For primary brain tumours radiotherapy, NC-VMAT can reduce doses to the hippocampus, both temporal lobes, and cochleae, as well as OARs located to the contralateral side of tumours.The COVID19 pandemic since its beginning in March 2020, continues to wreak havoc causing great morbidity and mortality with each passing day. link2 Ample literature is now available describing the imaging features of COVID19 infection; however, there is still a paucity of knowledge on the various causes of pulmonary cavitation and cystic lesions which can be associated with the virus albeit uncommonly. Cavitation in a COVID19 positive patient could be a consequence of the infection itself or a manifestation of sinister etiologies like coinfection with bacterial, fungal or mycobacterial pathogens, or incidental malignancy/metastasis. It could also be a result of multiple cavitating pulmonary nodules as a manifestation of septic emboli and infarct, Granulomatosis with polyangiitis or rheumatoid arthritis creating a diagnostic dilemma. Similarly, the causes of cystic air spaces on chest CT in COVID19 patient can be varied, either primarily due to the infection itself or secondary to coexistent cystic bronchiectasis, emphysema, interstitial lung disease or mechanical ventilation-associated barotrauma as well as complicated pulmonary cysts. Through this pictorial review, we aim to highlight these uncommon imaging manifestations of COVID19 and educate the reader regarding the various causes, MDCT features and differentials to be considered while approaching a cavity/cystic lesion amidst this pandemic.
To synthesise existing evidence for the diagnostic accuracy of chest radiographs to detect lung malignancy in symptomatic patients presenting to primary care.

A systematic review was performed and reported in accordance with the PRISMA framework, using a protocol prospectively registered with the PROSPERO database (CRD42020212450). Nine databases were searched for relevant studies. Data were extracted and chest radiograph sensitivity and specificity calculated where possible. Risk of bias was assessed using a validated tool. Random effects meta-analysis was performed.

Ten studies were included. Sensitivity meta-analysis was performed in five studies which were not the high risk of bias, with summary sensitivity of 81% (95% CI 74-87%). Specificity could be calculated in five studies, with summary specificity of 68% (95% CI 49-87%).

The sensitivity of chest radiographs for detecting lung malignancy in primary care is relatively low. Physicians and policymakers must consider strategies to attenuate the possibility of false reassurance with a negative chest radiograph for this significant pathology. Options include widening access to cross-sectional imaging in primary care; however, any intervention would need to take into account the medical and financial costs of possible over-investigation. Prospective trials with long-term follow-up are required to further evaluate the risks and benefits of this strategy.

The chest radiograph has a sensitivity of 81% and specificity of 68% for lung malignancy in a symptomatic primary-care population. A negative chest radiograph does not exclude lung cancer, and physicians should maintain a low threshold to consider specialist referral or cross-sectional imaging.
The chest radiograph has a sensitivity of 81% and specificity of 68% for lung malignancy in a symptomatic primary-care population. A negative chest radiograph does not exclude lung cancer, and physicians should maintain a low threshold to consider specialist referral or cross-sectional imaging.
To survey the diagnostic radiography workforce in the United Kingdom (UK) at an organisational level to ascertain the scope of advanced practice and compliance with Health Education England standards for multiprofessional advanced clinical practice (ACP).

174 diagnostic imaging departments were invited to participate in a cross-sectional electronic survey focused upon advanced level practice and their educational and accreditation expectations (October-December 2019). Breast imaging, computed tomography, fluoroscopy, interventional radiology, lithotripsy, magnetic resonance imaging and projectional radiography were included.

A total of 97 responses were received, of which 79 were eligible for inclusion (45%). Respondents reported advanced-level practice roles across all imaging modalities, which included clinical reporting, procedural-based and combined roles. link3 Radiograph and mammogram reporting were most prevalent (95 and 67% of Trusts), with fluoroscopy the most frequent procedure-only role (25%). Onlyexpected ACP standards.
To evaluate the performance of radiomics features extracted from planning target volume (PTV) and gross tumor volume (GTV) in the prediction of the death prognosis and cancer recurrence rate for head and neck squamous cell carcinoma (HNSCC).

188 HNSCC patients' planning CT images with radiotherapy structures sets were acquired from Cancer Imaging Archive (TCIA). The 3D slicer (v. 4.10.2) with the PyRadiomics extension (Computational Imaging and Bioinformatics Lab, Harvard medical School) was used to extract radiomics features from the radiotherapy planning images. An in-house developed deep learning artificial neural networks (DL-ANN) model was used to predict death prognosis and cancer recurrence rate based on the features extracted from GTV and PTV of the CT images.

The PTV radiomics features with DL-ANN model could achieve 77.7% accuracy with overall AUC equal to 0.934 and 0.932 when predicting HNSCC-related death prognosis and cancer recurrence respectively. Furthermore, the DL-ANN model can achieve an accuracy of 74.3% with AUC equal to 0.947 and 0.956 for the HNSCC-related death prognosis and cancer recurrence respectively using GTV features.

Using both GTV and PTV radiomics features in the DL-ANN model, can aid in predicting HNSCC-related death prognosis and cancer recurrence. Clinicians may find it helpful in formulating different treatment regimens and facilitate personized medicine based on the predicted outcome when performing GTV and PTV delineation.

Radiomics features of GTV and PTV are reliable prognosis and recurrence predicting tools, which may help clinicians in GTV and PTV delineation to facilitate delivery of personalized treatment.
Radiomics features of GTV and PTV are reliable prognosis and recurrence predicting tools, which may help clinicians in GTV and PTV delineation to facilitate delivery of personalized treatment.
To clarify venous phase contrast-enhanced CT findings in early pancreatic adenocarcinomas by retrospectively evaluating CT images of pancreatic adenocarcinomas that developed during follow-up after treatment for non-pancreatic cancers.

The study cohort comprised six patients who developed pancreatic adenocarcinomas between April 2005 and April 2020 during follow-up after treatment for non-pancreatic primary cancers. Two radiologists retrospectively evaluated CT images and reached consensus on previously reported CT findings that were suggestive of small pancreatic adenocarcinomas; namely pancreatic duct interruption and dilatation, pancreatic parenchymal atrophy, focal hypoattenuated areas, and appearance of cystic lesions. Time intervals between the first CT with these suggestive findings and the latest pre-operative CT were recorded. Doubling times were calculated in patients with hypoattenuated areas on initial CT scans.

Small (<10 mm) focal hypoattenuated areas with (
= 2) or without rim enhancement (
= 1) were identified on initial CT images of three patients.
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