RESUMEN
AIMS: To evaluate the effect of the belly board aperture location on the irradiated small bowel volume in rectal cancer patients treated with preoperative pelvic radiotherapy. MATERIALS AND METHODS: Twenty patients with rectal cancer scheduled to receive preoperative pelvic radiotherapy were evaluated prospectively. Each patient underwent computed tomography with the belly board aperture lower border at three different locations relative to patient anatomy: the lumbosacral junction (location I), the lower end of the sacroiliac joint (location II) and the upper end of the symphysis pubis (location III). The irradiated small bowel volume was calculated for doses between 10 and 100% of the prescribed dose at 10% intervals. For each 10% dose increment, the effect of the belly board aperture at the three different locations on the irradiated small bowel volume was analysed using Wilcoxon signed rank and Wilcoxon rank sum tests. RESULTS: At 10-20% dose levels, the irradiated small bowel volume increased in the order of locations I, II and III, and the differences between each location were significant. At > or = 30% dose levels, the irradiated small bowel volume increased in the order of locations III, II and I, and the differences between locations I and II were significant, but the differences between locations II and III were not significant. CONCLUSION: The belly board aperture location can influence the irradiated small bowel volume differently at each dose level. When considering the use of a belly board in routine clinical practice, we recommend that the clinician take into account the patterns of irradiated small bowel volume according to belly board aperture location.
Asunto(s)
Intestino Delgado/efectos de la radiación , Vértebras Lumbares/efectos de la radiación , Sínfisis Pubiana/efectos de la radiación , Radioterapia Conformacional/métodos , Neoplasias del Recto/radioterapia , Articulación Sacroiliaca/efectos de la radiación , Adulto , Factores de Edad , Anciano , Relación Dosis-Respuesta en la Radiación , Esquema de Medicación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Dosis de Radiación , Traumatismos por Radiación/prevención & control , Radioterapia Conformacional/efectos adversos , Radioterapia Conformacional/instrumentación , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/cirugía , Sensibilidad y Especificidad , Factores Sexuales , Tomografía Computarizada por Rayos X , Resultado del TratamientoAsunto(s)
Osteítis/diagnóstico por imagen , Osteorradionecrosis/diagnóstico por imagen , Osteorradionecrosis/etiología , Huesos Pélvicos/diagnóstico por imagen , Huesos Pélvicos/efectos de la radiación , Radioterapia de Alta Energía/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Osteítis/etiología , Sínfisis Pubiana/diagnóstico por imagen , Sínfisis Pubiana/efectos de la radiación , Radiografía , Cintigrafía , Recuento Corporal TotalRESUMEN
Our study aimed to evaluate the vertebral marrow changes in patients following radiotherapy (RT) by measuring the T2 relaxation times before and during RT. We were mostly interested in evaluating early MR marrow changes during RT. Fifteen patients treated by RT for cervical cancer were submitted to MR examination before and during RT (5-23 days of RT). T2 values were calculated for irradiated and non-irradiated tissues (lumbar and sacral vertebral bone marrow, symphysis pubis marrow, and regional muscle). Fourteen patients presented increased T2 values for irradiated vertebral bone marrow (VBM), and 3 patients showed increased T2 values even for non-irradiated VBM. We found T2 variations for VBM as early as in the fifth day of RT for an absorbed dose as small as 9 Gy. Calculated T2 values in irradiated and also in non-irradiated tissues prove very early tissue alterations.
Asunto(s)
Médula Ósea/patología , Médula Ósea/efectos de la radiación , Vértebras Lumbares/patología , Vértebras Lumbares/efectos de la radiación , Imagen por Resonancia Magnética , Sacro/patología , Sacro/efectos de la radiación , Adulto , Anciano , Edema/diagnóstico , Edema/etiología , Femenino , Humanos , Persona de Mediana Edad , Músculo Esquelético/patología , Músculo Esquelético/efectos de la radiación , Sínfisis Pubiana/diagnóstico por imagen , Sínfisis Pubiana/efectos de la radiación , Radiografía , Dosificación Radioterapéutica , Neoplasias del Cuello Uterino/radioterapiaRESUMEN
A 61-year-old woman was seen with diastasis of the symphysis pubis and insufficiency fractures of the wings of both ilia after irradiation for carcinoma of the cervix. The characteristics and treatment of these fractures are discussed.
Asunto(s)
Fracturas Espontáneas/etiología , Ilion/efectos de la radiación , Luxaciones Articulares/etiología , Sínfisis Pubiana/efectos de la radiación , Carcinoma/radioterapia , Femenino , Estudios de Seguimiento , Curación de Fractura , Fracturas Espontáneas/diagnóstico por imagen , Humanos , Ilion/diagnóstico por imagen , Luxaciones Articulares/diagnóstico por imagen , Persona de Mediana Edad , Osteoporosis/complicaciones , Sínfisis Pubiana/diagnóstico por imagen , Radiografía , Radioterapia/efectos adversos , Neoplasias del Cuello Uterino/radioterapia , Soporte de PesoRESUMEN
We report the clinical and computed tomography (CT) features of seven patients with osteomyelitis of the symphysis pubis following radiotherapy for bladder (n=4) or cervical (n=3) carcinoma. The patients presented with fistulae (n=5), pain (n=1) or small bowel obstruction (n=1) between 6 and 19 years after radiotherapy. The diagnosis was confirmed by surgery with histology or bacteriology of the symphysis pubis and/or associated abscess in all patients. In addition to bone destruction, other features identified on CT included abscesses, bowel loops adherent to the symphysis pubis and/or communicating with an abscess cavity, a soft tissue mass enveloping the residual bone, and fistulae. The combination of clinical and radiological features suggests osteomyelitis and, for patients who have had pelvic radiotherapy, this treatable condition should be included in the differential diagnosis of solitary symphysis pubis destruction.
Asunto(s)
Osteomielitis/diagnóstico por imagen , Sínfisis Pubiana/diagnóstico por imagen , Traumatismos por Radiación/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/radioterapia , Neoplasias del Cuello Uterino/radioterapia , Adulto , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Osteomielitis/etiología , Sínfisis Pubiana/efectos de la radiación , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Tomografía Computarizada por Rayos XRESUMEN
The chest X-ray is the most commonly performed radiological examination in the intensive care unit. We used TLDs to measure the radiation exposure in 30 ICU patients due to portable chest radiography. The mean number of CXR was 3 (range 1-11). The mean surface entry dose at the xiphisternum was 1.8 mGy (range 0.43-5.14 mGy) per patient and 0.63 mGy per CXR. Very small amounts of radiation were detected at the symphysis pubis and in more than half of the patients no radiation was detected at this site. These values are well above accepted norms. Patient exposure may be reduced by ordering fewer X-rays or by changing to a faster screen-film combination.