AIMS: To evaluate the estimated fetal radiation dose during prophylactic internal iliac arterial occlusion in patients with abnormal placenta and to estimate the risk of radiation induced cancer in child age. METHODS: Prophylactic occlusion of the internal iliac arteries during Caesarean section was performed in 42 patients with placenta praevia and/or placenta accreta spectrum. Fogarty embolectomy catheters were used for prophylactic occlusion of the internal iliac arteries. All procedures were performed in the hybrid operating room using Philips Allura Xper FD 20 X-ray system. Low dose X-ray fluoroscopy (7.5 frames per second) was used. The CODE (Conceptus dose estimation) Software was used to estimate the fetal dose and the risk of radiation induced carcinoma. RESULTS: Fluoroscopy times required for insertion of Fogarty catheters were 0.5-4.2 min (mean: 1.7 min, median: 1.5 min). The estimated radiation dose to the fetus was 0.26-3.36 mGy (mean: 1.49 mGy, median: 1.25 mGy). The risk of radiation induced cancer in child age was 0.01-0.04% (mean 0.02%, median 0.01%). One patient developed thrombosis of a common femoral artery. CONCLUSION: Prophylactic occlusion of the internal iliac arteries is a simple and safe procedure with minimal risk of complications and with a very low estimated radiation dose to the fetus.
- MeSH
- balónková okluze * MeSH
- císařský řez MeSH
- dávka záření MeSH
- dítě MeSH
- krvácení při operaci MeSH
- lidé MeSH
- nádory vyvolané zářením * MeSH
- placentace MeSH
- plod MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The aim of this study was to verify the possibility of summing the dose distributions of combined radiotherapeutic treatment of cervical cancer using the extended Lucas-Kanade algorithm for deformable image registration. MATERIALS AND METHODS: First, a deformable registration of planning computed tomography images for the external radiotherapy and brachytherapy treatment of 10 patients with different parameter settings of the Lucas-Kanade algorithm was performed. By evaluating the registered data using landmarks distance, root mean square error of Hounsfield units and 2D gamma analysis, the optimal parameter values were found. Next, with another group of 10 patients, the accuracy of the dose mapping of the optimized Lucas-Kanade algorithm was assessed and compared with Horn-Schunck and modified Demons algorithms using dose differences at landmarks. RESULTS: The best results of the Lucas-Kanade deformable registration were achieved for two pyramid levels in combination with a window size of 3 voxels. With this registration setting, the average landmarks distance was 2.35 mm, the RMSE was the smallest and the average gamma score reached a value of 86.7%. The mean dose difference at the landmarks after mapping the external radiotherapy and brachytherapy dose distributions was 1.33 Gy. A statistically significant difference was observed on comparing the Lucas-Kanade method with the Horn-Schunck and Demons algorithms, where after the deformable registration, the average difference in dose was 1.60 Gy (P-value: 0.0055) and 1.69 Gy (P-value: 0.0012), respectively. CONCLUSION: Lucas-Kanade deformable registration can lead to a more accurate model of dose accumulation and provide a more realistic idea of the dose distribution.
BACKGROUND: The impact of ECG gating during computed tomography (CT) acquisition of left atrium (LA) model on radiation dose, image quality and ablation event-free survival rate after catheter ablation (CA) of atrial fi brillation (AF) is not well defi ned. METHODS: Sixty-two patients with paroxysmal atrial fi brillation were randomized for two types of LA CT (with vs without ECG gating) before CA. Pulmonary veins isolation was performed in all patients. Patients were followed for 12 months after CA. RESULTS: There was no difference between the groups in CA length (131.61±32.57 vs 119.84±33.18 min; p=0.108), CA fl uoroscopy time (4.48±2.19 vs 3.89±1.83 min; p=0.251), CA fl uoroscopy dose (3.99±2.79 vs 3.91 vs2.91 Gy*cm2; p=0.735), visual data quality (1.77±0.88 vs 2.0±0.63; p=0.102) and registration error (2.42±0.72 vs 2.43±0.46 mm; p=0.612). We found a significant difference in CT Dose index (89.55±5.99 vs 19.19±4.33 mGy; p<0.0001) and Dose Length product (1438.87±147.75 vs 328.21±73.83 mGy*cm; p<0.0001). Twelve months after CA, 25 of 31 patients in the gated group and 24 of 31 patients in the non-gated group were free of AF (80.65 vs 77.42 %; p=0.838). CONCLUSION: ECG gating of computed tomography of LA before AF ablation burdens patients with a four times higher radiation dose while improving neither the quality of CT model or fusion of CT with the electroana-tomic map. As a result, it has no significant impact on arrhythmia recurrence rate after ablation (Tab. 3, Fig. 3, Ref. 25).
- MeSH
- dávka záření MeSH
- dospělí MeSH
- elektrokardiografie MeSH
- fibrilace síní chirurgie MeSH
- hodnocení rizik MeSH
- katetrizační ablace * metody MeSH
- lidé MeSH
- multidetektorová počítačová tomografie metody MeSH
- prospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- randomizované kontrolované studie MeSH
BACKGROUND: The role of ECG-gating in left atrium (LA) computed tomography (MDCT) imaging is not precisely defined. METHODS AND RESULTS: 62 patients were randomized according to ECG gating with prospective evaluation of image quality, Volume CT Dose Index, Dose Length Product, Effective Dose and registration error between anatomical map and MDCT. We found significant difference in all radiation variables, but not in visual quality, registration error, CA duration, CA fluoroscopy time and CA fluoroscopy dose. CONCLUSION: Helical non-gated MDCT achieved a radiation dose more than four times lower with comparable image quality and course of ablation compared to ECG-gated protocol.
- MeSH
- elektrokardiografie * MeSH
- fibrilace síní * diagnostické zobrazování terapie MeSH
- katetrizační ablace MeSH
- lidé středního věku MeSH
- lidé MeSH
- multidetektorová počítačová tomografie * MeSH
- prospektivní studie MeSH
- randomizované kontrolované studie jako téma MeSH
- senioři MeSH
- venae pulmonales diagnostické zobrazování MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Klíčová slova
- volumetric modulated arc therapy, Octavius QA system,
- MeSH
- částice - urychlovače MeSH
- chyby nastavení radioterapie prevence a kontrola MeSH
- filmová dozimetrie přístrojové vybavení MeSH
- lidé MeSH
- nádory hlavy a krku radioterapie MeSH
- nádory prostaty radioterapie MeSH
- plánování radioterapie pomocí počítače * MeSH
- radiometrie normy přístrojové vybavení MeSH
- radioterapie s modulovanou intenzitou * metody normy přístrojové vybavení MeSH
- reprodukovatelnost výsledků MeSH
- řízení kvality * MeSH
- rotace MeSH
- záření gama MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- hodnotící studie MeSH
