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This study evaluated dosimetric parameters for cervical high-dose-rate (HDR) brachytherapy treatment using varying dose prescription methods.
This study includes 125 tandem-based cervical HDR brachytherapy treatment plans of 25 patients who received HDR brachytherapy. Delineation of high-risk clinical target volumes (HR-CTVs) and organ at risk were done on original computed tomographic images. The dose prescription point was defined as per International Commission in Radiation Units and Measurements Report Number 38 (ICRU-38), also redefined using American Brachytherapy Society (ABS) 2011 criteria. The coverage index (V100) for each HR-CTV was calculated using dose volume histogram parameters. A plot between HR-CTV and V100 was plotted using the best-fit linear regression line (least-square fit analysis).
Mean prescribed dose to ICRU-38 Point A was 590·47±28·65 cGy, and to ABS Point A was 593·35±30·42 cGy. There was no statistically significant difference between planned ICRU-38 and calculated ABS Point A doses (p=0·23). The plot between HR-CTV and V100 is well defined by the best-fit linear regression line with a correlation coefficient of 0·9519.
For cervical HDR brachytherapy, dose prescription to an arbitrarily defined point (e.g., Point A) does not provide consistent coverage of HR-CTV. The difference in coverage between two dose prescription approaches increases with increasing CTV. Our ongoing work evaluates the dosimetric consequences of volumetric dose prescription approaches for these patients.
There is now a well-established link between childhood adversity (CA) and schizophrenia. Similar structural abnormalities to those found in schizophrenia including alterations in grey-matter volume have also been shown in those who experience CA.
We examined whether global estimates of cortical thickness or surface area were altered in those familial high-risk subjects who had been referred to a social worker or the Children's Panel compared to those who had not.
We found that the cortical surface area of those who were referred to the Children's Panel was significantly smaller than those who had not been referred, but cortical thickness was not significantly altered. There was also an effect of social work referral on cortical surface area but not on thickness.
Cortical surface area increases post-natally more than cortical thickness. Our findings suggest that CA can influence structural changes in the brain and it is likely to have a greater impact on cortical surface area than on cortical thickness.
Clinical MR Neuroimaging, second edition, provides radiologists, neuroscientists and researchers with a clear understanding of each physiological MR methodology and their applications to the major neurological diseases. Section 1 describes the physical principles underlying each technique and their associated artefacts and pitfalls. Subsequent sections review the application of MRI in a range of clinical disorders: cerebrovascular disease, neoplasia, infection/inflammation/demyelination disorders, seizures, psychiatric/neurodegenerative conditions, and trauma. This new edition includes all recent advances and applications, with greatly increased coverage of permeability imaging, susceptibility imaging, iron imaging, MR spectroscopy and fMRI. All illustrations are completely new, taking advantage of the latest scan capabilities to give images of the highest possible quality. In addition, over 35 new case studies have been included. Editors and contributors are the leading neuroimaging experts worldwide; their unique combination of technical knowledge and clinical expertise makes Clinical MR Neuroimaging the leading text on the subject.
The advent of clinical MR imaging (MRI) in the 1980s heralded a new era in the ability to image the brain in vivo. MRI allows the detailed depiction of brain anatomy and pathology with unprecedented spatial resolution and soft-tissue contrast. It is also relatively safe and completely non-invasive. Nevertheless, the sensitivity and specificity with which structural MRI alone can define the wide range of neurological disease is limited.
The last decade has also seen the development of physiological MR techniques, whereby information concerning tissue function as well as structure is obtained. These techniques include diffusion, perfusion, and MR spectroscopy, which provide information on tissue ultra-structure, blood flow, and biochemistry, respectively. Information of this type supplements and complements that from clinical or structural imaging investigations, often providing important surrogate markers of disease pathophysiology or therapeutic response.