The Experts below are selected from a list of 3309 Experts worldwide ranked by ideXlab platform
Junjie Wang - One of the best experts on this subject based on the ideXlab platform.
-
The feasibility study of low-dose CT scanning in chest tumor with 125I Radioactive Seed implantation
Chinese journal of radiological medicine and protection, 2017Co-Authors: Yan-yan Guo, Bin Huo, Xiaodong Huo, Qiang Cao, Haitao Wang, Shude Chai, Junmin Cheng, Xueli Zhou, Junjie WangAbstract:Objective To investigate the feasibility of reducing CT scanning dose in the process of 125I Radioactive Seed implantation. Methods GEMS phantom and 062 M phantom were scanned using GE Lightspeed RT large hole CT with 120 kV, 100 kV and 80 kV separately, and 150-10 mA (20 mA decreased progressively). The scanning dose, CT value and noise of the region of interest were recorded and the image quality was evaluated. Image signal-to-noise ratio (SNR) and contrast to noise ratio (CNR) values were calculated. Results With the decreasing of tube voltage and current, the SNR values were reduced accorgingly. The values had significant difference with those of standard images except the images acquired with 120 kV, 150-70 mA and 100 kV, 150-90 mA (t=-9.294-3.717, P
-
Dosimetry verification of Radioactive Seed implantation for malignant tumor assisted by 3D-printing coplanar template
Chinese journal of radiological medicine and protection, 2017Co-Authors: Chao Xing, Kai-xian Zhang, Qianqian Yuan, Qirong Man, Sen Yang, Baohu Wang, Junjie WangAbstract:Objective To compare the dose distribution of postoperative plans with preoperative plans for 3D printing coplanar template assisted Radioactive Seed implantation, and to explore the accuracy of the technique in Seed implantation. Methods From November 2015 to December 2016 a total of 32 patients were selected and underwent 3D printing coplanar template assisted Radioactive Seed implantation in Tengzhou Central People′s Hospital of Shandong province. There were 36 implanted lesions, including 10 in the lungs, 5 in neck lymphs, 3 in pelvic cavities, 3 in vertebral body, 2 in pancreas, 2 in abdominal lymph nodes, 2 in portal veins, and 9 in the other parts. All patients were given preoperative planning and guided by the coplanar templates. Compared with the preoperative plan, all levels needles inserted at the same time. According to preoperative planning the implantation surgery was completed accurately. The postoperative dosimetry was evaluated. The preoperative and postoperative dosimetry parameters were compared, including D90, D100, V90, V100, V150, V200 and conformal index(CI), external index(EI), and homogeneity index(HI). The paired t test was used to perform the statistical analysis. Result There was no significant differences in D90, D100, V90, V100, V150, V200, CI, EI and HI between before and after operation(P>0.05). Conclusions The dose parameters in postplan showed no difference compared with preplan in this study. For fixed and moving organ tumors, 3D printing coplanar template assisted Radioactive Seed implantation has good therapeutic accuracy, and may be a standardized surgicalmethod for Seed implantation in the future. Key words: 3D-printing; Coplanar template; Radioactive Seed implantation; Dosimetry; Malignant tumor
-
CT and template-guided Radioactive Seed implantation for inoperable early stage non-small cell lung cancer
Chinese journal of radiological medicine and protection, 2017Co-Authors: Bin Huo, Xiaodong Huo, Lei Wang, Qiang Cao, Jinhuan Wang, Lili Wang, Li Zang, Haitao Wang, Shude Chai, Junjie WangAbstract:Objective To investigate the efficacy and side effects of Radioactive Seed implantation in the treatment of non-surgical early stage non-small cell lung cancer (NSCLC) based on CT guidance combined with template. Methods Twenty-one patients with inoperable T1-2N0M0 NSCLC who underwent CT-guided Radioactive Seed implantation therapy were retrospectively analyzed from December 2010 to October 2016 in the Second Hospital of Tianjin Medical University. All patients were diagnosed by histopathology. All Seeds, with the activity of 18.5-29.6 MBq and prescription dose of 120-160 Gy, were completed in an operation of the Radioactive Seed implantation. The preoperative and postoperative TPS treatment plans and quality verification were corducted. In addition, the local control rate of tumors, overall survival (OS), progression free survival time (PFS), satisfaction rate of dose validation and adverse reactions were evaluated. Results The median follow-up was 25.1 months (range 4.4-72.7 months). The local control rate of primary tumor in 1-, 2- and 3-year was 100%, 95.2% and 95.2%, respectively. Of all patients, the median OS was 48 months with the median PFS 43.4 months. In particular, the 1-, 2- and 3-year survival rate was 100%, 91.7% and 72.9%, respectively. Moreover, the rate of 3-year PFS was 70.2% and the satisfactory rate of postoperative quality verification was 100%. The treatment-related adverse events included pneumothorax, bronchial hemorrhage, pleural effusion, cough, pulmonary fibrosis and Seed shifts. In all, 7 (33.3%) patients had grade 1 adverse events and 4 (19%) patients with grade 2, but no grade 3 adverse event. Conclusions CT and template-guided Radioactive Seed implantation in NSCLC with T1-2N0M0 has a high tumor local control rate and low treatment-related adverse reactions, suggesting that it might provide an alternative way for the treatment of inoperable early stage NSCLC. Key words: Template; CT guided; Brachytherapy; Radioactive Seeds implantation; Non small cell lung cancer(NSCLC)
-
Dosimetry analysis of Radioactive Seed implantation supported by coplanar template for lung cancer patients with mediastinal lymph node metastases 4R
Chinese journal of radiological medicine and protection, 2017Co-Authors: Jinshuang Lyu, Shude Chai, Guangjun Zheng, Shengjie Zhang, Jing-kui Yang, Weiliang Yan, Shuyuan Shi, Zhen Feng, Xiaolei Zhu, Junjie WangAbstract:Objective To compare the planned radiation dose and the actual dose received after 125I Radioactive Seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R, and to evaluate the clinical efficacy. Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014. The mediastinal lymph node metastases were treated by CPT-assisted 125I Radioactive Seed implantation. Digital imaging and communications in medicine(DICOM) data were acquired by chest CT scan before implantation, brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan, and the prescribed dose(PD) was 120 Gy. CPT was used to control the precision of needle penetration and implantation of Radioactive Seeds. Computer tomography (CT) was used to ensure the correct position of needles and Radioactive Seeds. Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test. The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1). Results All patients went through implantation procedure successfully. Dose evaluation after implantation was as followed. The average dose received (231.9±29.6)Gy, the dose received by 90% of the target(D90) (150.8±16.6) Gy, the dose received by 100% of the target(D100) (100.4±12.6)Gy, the volume of 100%PD covering the target(V100) (94.1±2.6)%, the volume of 200%PD covering the target(V200) (33.0±5.7)%, the conformal index(CI) 0.75±0.06, the external index(EI) (22.7±5.8)%, the average dose received by the superior vena cava (19.3±7.2)Gy, and the average dose received by aorta (12.1±5.1)Gy. Efficacy was followed for 6 months after implantation and the effective rate was 84.37%. There was no serious complications (such as Radioactive lung injury, major vascular injury, bleeding, and et al.) occurred in follow-up period. Conclusions CPT assisted CT guided 125I Radioactive Seed implantation in treating mediastinal node metastases 4R can achieve preoperative BTPS, minimize major vascular or organ injury. It is an accurate, effective and safe treatment approach and may be of great value to standardize the procedure of Radioactive Seed implantation in mediastinal metastases. Key words: CT guided; Coplanar template; Radioactive Seeds; Brachytherapy treatment planning system; Mediastinal lymph node metastasis
-
Dosimetry verification of Radioactive Seed implantation for malignant tumors assisted by 3D printing individual templates and CT guidance
Applied radiation and isotopes : including data instrumentation and methods for use in agriculture industry and medicine, 2016Co-Authors: Yuliang Jiang, Haitao Sun, Fuxin Guo, Jinghong Fan, Lujing Zhang, Junjie WangAbstract:Abstract Objective We compared the dose distributions of postoperative plans with preoperative plans for 3D printing template-assisted Radioactive Seed implantations. Methods A total of 14 patients with malignant tumors enrolled in the study. The dose parameters included D90, minimum peripheral dose, V100, V150, and V200. The statistical method was the paired t -test. Results There was no significant difference in P values between the two groups for all parameters except for V100. Conclusions The 3D printing guide template can provide good accuracy for Radioactive Seed implantation.
Richard Gray - One of the best experts on this subject based on the ideXlab platform.
-
operative outcomes of conventional specimen radiography versus in operating room specimen radiography in Radioactive Seed localized segmental mastectomies
American Journal of Surgery, 2018Co-Authors: Daniel Rhee, Barbara A. Pockaj, Nabil Wasif, Chee Chee H Stucky, Victor J Pizzitola, Marina E Giurescu, Bhavika K Patel, Janice Mccarthy, Richard GrayAbstract:Abstract Introduction In-operating room specimen radiography (ORSR) has not been studied among women undergoing Radioactive Seed localization (RSL) for breast cancer surgery and had the potential to decrease operative time and perhaps improve intraoperative margin management. Methods One hundred consecutive RSL segmental mastectomies among 98 patients using ORSR were compared to 100 consecutive segmental mastectomies among 98 patients utilizing conventional radiography (CSR) prior to the initiation of ORSR from December 2013 to January 2015 after Radioactive Seed localization. Final pathologic margins were considered to be 10 mm for all cases of no residual disease after biopsy or neoadjuvant therapy, but such patients were excluded from analyses involving tumor size. All patients' specimens were subjected to intraoperative pathologic consultation in addition to ORSR or CSR. Results The median age of the cohort was 65 years (range 36–97), and the median tumor size was 1 cm. There were no differences between the ORSR and CSR groups in age, tumor size, percentage of cases with only DCIS, and percentage of cases with microcalcifications. The ORSR group had a statistically significant lower BMI. Mean operative time from cut-to-close was not significantly different (ORSR 77 min, SD 24.8 vs CSR 76 min, SD 24.8, p = 0.75). There was no statistical difference in mean closest final pathologic margin (4.99 mm, SD 3.3 vs 4.88 mm, SD 3.5, p = 0.9). The percentage undergoing intraoperative margin re-excision (ORSR 40%, CR 47%, p = 0.31) and the mean total number of margins excised intraoperatively (ORSR 0.9, CR 1.0 p = 0.65) were similar. The rate of any margin Conclusion ORSR for RSL breast surgery, in the setting of routine intraoperative pathology consultation, does not significantly impact operative time, the rate or number of additional intraoperative margins excised, the number of reoperations for margins, or the width of final pathological margins. ORSR was associated with a decrease in the volume of segmental mastectomies relative to the tumor diameter.
-
Radioactive Seed localization for breast conservation surgery low positive margin rate with no learning curve
American Journal of Surgery, 2017Co-Authors: Cristine S Velazco, Barbara A. Pockaj, Nabil Wasif, Richard GrayAbstract:Abstract Background Radioactive Seed localization (RSL) is an alternative to wire localization. We compared the rate of positive margins for evidence of a learning curve in implementing RSL. Methods A retrospective review of RSL by three surgeons at a single institution from 2002 to 2016. Positive margins were defined as ink on tumor. Results Surgeon experience with RSL for ranged from 142 to >500 cases. The positive margin rate among the first 100 of each surgeons' experience (n = 300) was 2.3% and the rate during the most recent up to 100 cases after experience with at least 100 RSL procedures (n = 242) was 4.1% (p = 0.32). Individual surgeon's positive margin rates ranged from 2 to 5% in the early experience and 2–7% in the later experience (p = NS). Conclusions RSL for breast conservation surgery has a low rate of positive margins even early in a surgeon's experience. Implementation of RSL can be done with no evidence of a learning curve.
-
radioguided surgery for non palpable breast lesions i 125 Radioactive Seed localization
2016Co-Authors: Richard Gray, Charles E. Cox, Emilia L DauwayAbstract:Because of several disadvantages, alternatives to wire localization (WL) for surgery of non-palpable breast lesions have been widely pursued. Radioactive Seed localization (RSL) is a technique that has gained acceptance in many practices throughout the world and has been shown to be a safe, effective alternative to WL. RSL allows the localization procedure to be scheduled on a different day from the operative procedure, the operative incision to be planned with no regard for the entry point used for localization, and ongoing feedback as to the location of and distance from the lesion throughout the operation. Herein we describe the procedure, the available evidence of its effectiveness and safety, and the key issues in starting a RSL program.
-
Radioactive Seed localization for excision of non-palpable in-transit metastatic melanoma.
Radiology case reports, 2015Co-Authors: Mark Donald Fleming, Barbara A. Pockaj, Adam J. Hansen, Richard Gray, Maitray D. PatelAbstract:We report the case of a 73-year-old who presented with multiple, small, in-transit melanoma nodules located in her right lower extremity below her knee. Positron emission tomography detected two additional non-palpable subcutaneous lesions posterior and medial to the area of previous wide local excision. A novel approach of Radioactive Seed localization was employed to guide the surgeon to successful surgical resection of all metastatic disease. To our knowledge, the application of Radioactive Seed localization to melanoma has not been previously reported.
-
Starting a Radioactive Seed Localization Program
Annals of Surgical Oncology, 2015Co-Authors: James Jakub, Richard GrayAbstract:Because of disadvantages, such as the need to perform the localization and operation the same day and difficulty maintaining orientation of the center of the localization in relation to the margins of excision, alternatives to wire localization for surgery of nonpalpable breast lesions have been widely pursued. Radioactive Seed localization (RSL) is one technique that has gained acceptance in many practices throughout the world and has been shown to be a safe, effective alternative to wire localization. RSL allows the localization procedure to be scheduled on a different day from the operative procedure, the operative incision to be planned with no regard for the entry point used for localization, and ongoing feedback as to the location of and distance from the lesion throughout the operation. Although RSL is an attractive technique that is intuitive to learn, beginning a new RSL program entails a multidisciplinary effort that includes several challenges. We describe recommendations for how to start a RSL program.
Linnea Langhans - One of the best experts on this subject based on the ideXlab platform.
-
Radioactive Seed localisation of non palpable lymph nodes a feasibility study
Ejso, 2018Co-Authors: C M S Hassing, T F Tvedskov, Niels Kroman, Thomas Levin Klausen, J B Drejoe, J F Tvedskov, T L Lambine, H Kledal, Giedrius Lelkaitis, Linnea LanghansAbstract:Abstract Background Radioactive Seed localisation (RSL) is a preoperative localisation method using a small titanium Seed containing iodine-125. The method is increasingly applied for localising non-palpable lesions in the treatment of breast cancer. We believe that RSL has the potential to be used in various surgical specialties. The aim of this feasibility study was to test RSL as a preoperative localisation of non-palpable lymph nodes. Methods Between November 24, 2015 and October 26, 2016, 15 patients with suspicious lymph nodes on imaging were included in the study. The lymph nodes were located in the axillary region (n = 9), the head and neck region (n = 5) and the inguinal region (n = 1). The Seeds were placed in the centre of the lymph node, in the capsule or just outside the capsule guided by ultrasound. During surgery, incision and localisation of the lymph nodes were performed based on the auditory signal of the gamma probe. After excision, lymph nodes including iodine Seeds were sent for pathologic examination and the Seeds were returned to the Department of Nuclear Medicine. Results The non-palpable lymph nodes were all successfully marked using ultrasound. The lymph nodes were successfully localised and excised during surgery, and the procedure was performed without complications in the majority of the cases. Conclusion Localisation of suspicious non-palpable lymph nodes using RSL is feasible. RSL may ease the surgical procedure, minimise trauma to the surrounding tissue and ultimately benefit the patient. Future prospective studies are necessary to determine the further use of RSL within different surgical specialties.
-
Radioactive Seed localization or wire guided localization of nonpalpable invasive and in situ breast cancer a randomized multicenter open label trial
Annals of Surgery, 2017Co-Authors: Linnea Langhans, Thomas Levin Klausen, Tove Filtenborg Tvedskov, Majbritt Jensen, Majlis Moller Talman, Ilse Vejborg, Cemil Benian, Anne Roslind, Jonas Hermansen, Peter OturaiAbstract:Objective:To compare the rate of positive resection margins between Radioactive Seed localization (RSL) and wire-guided localization (WGL) after breast conserving surgery (BCS).Background:WGL is the current standard for localization of nonpalpable breast lesions in BCS, but there are several difficu
-
Radioactive Seed localization of renal cell carcinoma in a patient with von hippel lindau disease
Clinical Case Reports, 2017Co-Authors: Christina Marie Schiottz Hassing, T F Tvedskov, Niels Kroman, Thomas Levin Klausen, Sissal Djurhuus, Linnea LanghansAbstract:Key Clinical Message This report describes the case of a patient, who had successful Radioactive Seed localization (RSL) performed to improve the identification and excision of a renal cell carcinoma. RSL is a new method of preoperative localization, which can ease the surgical procedure, minimize tissue trauma, and ultimately benefit the patient.
Xiufeng Cao - One of the best experts on this subject based on the ideXlab platform.
-
Dosimetry for 125I Radioactive Seed implantation therapy for hepatocellular carcinoma
Journal of Nanjing Medical University, 2008Co-Authors: Xiufeng CaoAbstract:Abstract Hepatocellular carcinoma (HCC) is an aggressive malignancy. Early lesions respond well to hepatic resection or liver transplantation. However, only a few of HCC patients are suitable for surgical intervention. External beam radiation and chemotherapy is poorly efficacious. In the last 20 years, HCCs belonging to the radiosensitive tumor group has been confirmed. Along with the development of new radiotherapy technology and facilities, the research about brachytherapy(especially 125I Seed implantation therapy) has provoked more interests in the world. Radioactive Seed implantation therapy is a form of interstitial brachytherapy, with the property of local “conformal radiotherapy” and the advantages of minimal invasion, convenience, high performance, and minimal adverse effects. It is a promising therapy for HCC, however the dosimetry hasn' t yet been identified and lacks verification in prospective research. This report aims to further explore the best prescription dose and radioactivity for 125I interstitial implantation brachytherapy for HCC.
Mariejeanne Vrancken T F D Peeters - One of the best experts on this subject based on the ideXlab platform.
-
heading toward Radioactive Seed localization in non palpable breast cancer surgery a meta analysis
Journal of Surgical Oncology, 2015Co-Authors: Bas Pouw, Linda J De Wit Van Der Veen, Marcel P M Stokkel, Claudette E Loo, Mariejeanne Vrancken T F D Peeters, Renato Valdes A OlmosAbstract:Wire-guided localization is the most commonly used technique for intraoperative localization of non-palpable breast cancer. Radioactive Seed localization (RSL) is becoming more popular and seems to be a reliable alternative for intraoperative lesion localization. The purpose of the present meta-analysis was to evaluate the use of RSL. Primary study outcomes were irradicality and re-excision rates. In total 3168 patients were included. The clinical adaptation shows growing confidence in RSL and further growth is expected. J. Surg. Oncol. 2015 111:185–191. © 2014 Wiley Periodicals, Inc.
-
guiding breast conserving surgery in patients after neoadjuvant systemic therapy for breast cancer a comparison of Radioactive Seed localization with the roll technique
Annals of Surgical Oncology, 2013Co-Authors: M Donker, Claudette E Loo, Renato Valdes A Olmos, T Alderliesten, C A Drukker, Emiel Th J Rutgers, Gabe S Sonke, Jelle Wesseling, Mariejeanne Vrancken T F D PeetersAbstract:Background Radioguided occult lesion localization (ROLL) with technetium-99 m colloid (ROLL-99mTc) is commonly used to perform breast-conserving surgery in patients with nonpalpable breast tumors. Radioactive Seed localization is a relatively new technique that localizes the tumor with a Radioactive iodine-125 (125I) Seed. The feasibility and outcome of these techniques after neoadjuvant systemic treatment has not been widely investigated.
-
Radioactive Seed localization of breast lesions an adequate localization method without Seed migration
Breast Journal, 2011Co-Authors: T Alderliesten, Claudette E Loo, Emiel Th J Rutgers, Kenneth E Pengel, Kenneth G A Gilhuijs, Mariejeanne Vrancken T F D PeetersAbstract:: Preoperative localization is important to optimize the surgical treatment of breast lesions, especially in nonpalpable lesions. Radioactive Seed localization (RSL) using iodine-125 is a relatively new approach. To provide accurate guidance to surgery, it is important that the Seeds do not migrate after placement. The aim of this study was to assess short-term and long-term Seed migration after RSL of breast lesions. In 45 patients, 48 RSL procedures were performed under ultrasound or stereotactic guidance. In the first 12 patients, the lesion was localized with two markers: an iodine-125 Seed and a reference marker. In 33 patients, 36 RSL procedures were performed using a single iodine-125 Seed. All patients received control mammograms after Seed placement and prior to surgery. In the patients with two markers, migration was defined as the difference in the largest distance between the markers observed in the mammograms. For single-marked lesions, migration was assessed by comparing distances between anatomical landmarks in the mammograms. RSL was successful in all patients. Seeds were in-situ for 59.5 days on average (3–136 days). The detection rate during surgery was 100%. Overall, an average Seed migration of 0.9 mm (standard deviation 1.0 mm) was observed. Neither differences in lesion type, nor days in situ, type of surgery or radiologic localization method were found to have impact on Seed migration. RSL is an accurate preoperative localization method for breast lesions with negligible Seed migration, independent of time in-situ.