pinecone/core-2020-05-10-deduplication huggingface dataset:
Progressive brain changes in patients with chronic fatigue syndrome: a longitudinal MRI study

To examine progressive brain changes associated with chronic fatigue syndrome (CFS).We investigated progressive brain changes with longitudinal MRI in 15 CFS and 10 normal controls (NCs) scanned twice 6 years apart on the same 1.5 Tesla (T) scanner. MR images yielded gray matter (GM) volumes, white matter (WM) volumes, and T1- and T2-weighted signal intensities (T1w and T2w). Each participant was characterized with Bell disability scores, and somatic and neurological symptom scores. We tested for differences in longitudinal changes between CFS and NC groups, inter group differences between pooled CFS and pooled NC populations, and correlations between MRI and symptom scores using voxel based morphometry. The analysis methodologies were first optimized using simulated atrophy.We found a significant decrease in WM volumes in the left inferior fronto-occipital fasciculus (IFOF) in CFS while in NCs it was unchanged (family wise error adjusted cluster level P value, PFWE < 0.05). This longitudinal finding was consolidated by the group comparisons which detected significantly decreased regional WM volumes in adjacent regions (PFWE < 0.05) and decreased GM and blood volumes in contralateral regions (PFWE < 0.05). Moreover, the regional GM and WM volumes and T2w in those areas showed significant correlations with CFS symptom scores (PFWE < 0.05).The results suggested that CFS is associated with IFOF WM deficits which continue to deteriorate at an abnormal rate. J. Magn. Reson. Imaging 2016;44:1301-1311.Zack Y. Shan, Richard Kwiatek, Richard Burnet, Peter Del Fante, Donald R. Staines, Sonya M. Marshall-Gradisnik and Leighton R. Barnde
Quantitative assessment of gadolinium deposition in dentate nucleus using quantitative susceptibility mapping

Purpose: Gadolinium deposition in dentate nucleus (DN) has been reported after serial administration of gadolinium-based contrast agents (GBCAs). Gadolinium complexes have paramagnetic properties; therefore, we evaluated susceptibility changes of gadolinium deposition in DN using quantitative susceptibility mapping (QSM) for patients after serial administration of GBCAs. Materials and Methods: In all, 48 patients with brain tumors, who had had serial GBCA administrations (GBCA group), and 48 healthy volunteers without any history of GBCA administrations (non-GBCA group) were enrolled in this study. Susceptibility values in DN on QSM and DN-to-cerebellum signal intensity ratios on unenhanced T1-weighted images (T1 ratios) on 3T were analyzed. The relationship between the number of times of GBCA administrations and susceptibility values or T1 ratios were evaluated in the GBCA group. Results: Susceptibility values at DN in the GBCA group were 0.107±0.029ppm, and significantly higher than those of the non-GBCA group (0.079±0.025ppm) (P < 0.0001). T1 ratios in DN of the GBCA group were 1.059±0.070, and also significantly higher than that of the non-GBCA group (0.993±0.016) (P < 0.0001). Spearman rank correlation coefficients between susceptibility values and the number of times of linear GBCA administration showed a modest significant correlation (ρ=0.45, P=0.0015). There was good correlation between T1 ratios and the number of times of linear GBCA administration, as reported previously (ρ=0.76, P < 0.0001). Conclusion: Susceptibility values on QSM in DN of the GBCA group, after serial administration of GBCAs, were significantly higher than those of the non-GBCA group
Isotropic three-dimensional T-2 mapping of knee cartilage: Development and validation.

1) To implement a higher-resolution isotropic 3D T javax.xml.bind.JAXBElement@6c49fa3f mapping technique that uses sequential T javax.xml.bind.JAXBElement@437b98e8 -prepared segmented gradient-recalled echo (Iso3DGRE) images for knee cartilage evaluation, and 2) to validate it both in vitro and in vivo in healthy volunteers and patients with knee osteoarthritis.
The Iso3DGRE sequence with an isotropic 0.6 mm spatial resolution was developed on a clinical 3T MR scanner. Numerical simulations were performed to optimize the pulse sequence parameters. A phantom study was performed to validate the T javax.xml.bind.JAXBElement@63cf7ddb estimation accuracy. The repeatability of the sequence was assessed in healthy volunteers (n = 7). T javax.xml.bind.JAXBElement@7276377a values were compared with those from a clinical standard 2D multislice multiecho (MSME) T javax.xml.bind.JAXBElement@51cda309 mapping sequence in knees of healthy volunteers (n = 13) and in patients with knee osteoarthritis (OA, n = 5).
The numerical simulations resulted in 100 excitations per segment and an optimal radiofrequency (RF) excitation angle of 15°. The phantom study demonstrated a good correlation of the technique with the reference standard (slope 0.9 ± 0.05, intercept 0.2 ± 1.7 msec, R javax.xml.bind.JAXBElement@4eeecd00 ≥ 0.99). Repeated measurements of cartilage T javax.xml.bind.JAXBElement@565750a3 values in healthy volunteers showed a coefficient of variation of 5.6%. Both Iso3DGRE and MSME techniques found significantly higher cartilage T javax.xml.bind.JAXBElement@155970f4 values (P &lt; 0.03) in OA patients. Iso3DGRE precision was equal to that of the MSME T javax.xml.bind.JAXBElement@29b05cbd mapping in healthy volunteers, and significantly higher in OA (P = 0.01).
This study successfully demonstrated that high-resolution isotropic 3D T javax.xml.bind.JAXBElement@118e0246 mapping for knee cartilage characterization is feasible, accurate, repeatable, and precise. The technique allows for multiplanar reformatting and thus T javax.xml.bind.JAXBElement@7db09a9c quantification in any plane of interest.
1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:362-371
The effect of beam arrangements and the impact of non-coplanar beams on the treatment planning of stereotactic ablative radiation therapy for early stage lung cancer

<b>Introduction</b>\ud
\ud
 - The aim of this study was to compare various coplanar and non-coplanar <i>3-dimensional conformal radiation therapy (3DCRT)</i> beam arrangements for the delivery of <i>stereotactic ablative radiation therapy (SABR)</i> to patients with early stage lung cancer, based on the dosimetric criteria from the <i>Radiation Therapy Oncology Group (RTOG)</i> 1021 protocol.\ud
\ud
<b>Methods</b>\ud
\ud
 - Ten medically inoperable lung cancer patients eligible for SABR were re-planned using three different coplanar and three different non-coplanar beam arrangements. The plans were compared by assessing <i>planning target volume (PTV)</i> coverage, doses to normal tissues, the high-dose conformity (conformity index) and intermediate dose spillage as defined by the D<sub>2cm</sub>, (the dose at any point 2 cm away from the PTV), and the R<sub>50%</sub> (the ratio of the volume of half the prescription dose to the volume of the PTV).\ud
\ud
<b>Results</b>\ud
\ud
 - Sixty plans in total were assessed. Mean PTV coverage with the prescription isodose was similar between coplanar (95.14%) and non-coplanar (95.26%) techniques (P = 0.47). There was significant difference between all coplanar and all non-coplanar fields for the R<sub>50%</sub> (P < 0.0001) but none for the D<sub>2cm</sub> (P = 0.19). The seven and nine field beam arrangements with two non-coplanar fields had less unacceptable protocol deviations (10 and 7) than the seven and nine field plans with only coplanar fields (13 and 8). The 13 field coplanar fields did not improve protocol compliance with eight unacceptable deviations. The 10 field non-coplanar beam arrangement achieved best compliance with the RTOG 1021 dose criteria with only one unacceptable deviation (maximum rib dose).\ud
\ud
<b>Conclusion</b>\ud
\ud
 - A 3DCRT planning technique using 10 fields with ≥6 non-coplanar beams best satisfied high and intermediate dose constraints stipulated in the RTOG 1021 trial. Further investigations are required to determine if minor protocol deviations should be balanced against efficiency with the extended treatment times required to deliver non-coplanar fields and if treatment times can be improved using novel intensity modulated techniques
Practice patterns of radiation therapy technology in Australia: Results of a national audit

This article presents the results of a single-day census of radiation therapy (RT) treatment and technology use in Australia. The primary aim of the study was to ascertain patterns of RT practice and technology in use across Australia. These data were primarily collated to inform curriculum development of academic programs, thereby ensuring that training is matched to workforce patterns of practice. Methods: The study design was a census method with all 59 RT centres in Australia being invited to provide quantitative summary data relating to patient case mix and technology use on a randomly selected but common date. Anonymous and demographic-free data were analysed using descriptive statistics. Results: Overall data were provided across all six Australian States by 29 centres of a possible 59, yielding a response rate of 49% and representing a total of 2743 patients. Findings from this study indicate the increasing use of emerging intensity-modulated radiotherapy (IMRT), image fusion and image-guided radiation therapy (IGRT) technology in Australian RT planning and delivery phases. IMRT in particular was used for 37% of patients, indicating a high uptake of the technology in Australia when compared to other published data. The results also highlight the resource-intensive nature of benign tumour radiotherapy. Conclusions: In the absence of routine national data collection, the single-day census method offers a relatively convenient means of measuring and tracking RT resource utilisation. Wider use of this tool has the potential to not only track trends in technology implementation but also inform evidence-based guidelines for referral and resource planning
Early MRI versus conventional management in the detection of occult scaphoid fractures: what does it really cost? A rural pilot study

INTRODUCTION: To compare the cost-effectiveness and patient impact between acute magnetic resonance imaging (MRI) management and conventional management in the diagnosis of occult scaphoid fractures in a rural setting. METHODS: Consecutive patients presenting to a rural emergency department (ED) with a suspected scaphoid fracture were randomly assigned to either conventional management (6) or acute MRI management (10) (3 patients were excluded from the study analysis). All healthcare costs were compared between the two management groups and potential impacts on the patients\u27 pain, mobility and lifestyle were also measured. RESULTS: There were no significant differences between the two groups at baseline. There was one (10%) scaphoid fracture in the MRI group and none in the conventional group (P&nbsp;=&nbsp;0.42). A larger proportion of other fractures were diagnosed in the MRI group (20% (2) vs. 16.7% (1), P&nbsp;=&nbsp;0.87), as well as less clinic attendances (1 (0-2.25) vs. 4 (2.25-5)) and diagnostic services (1 (1-1.25) vs. 2 (1-3)). Median management costs were $485.05 (AUD) (MRI) and $486.90 (AUD) (conventional). The MRI group had better pain and satisfaction scores as well as less time of immobilisation, treatment and time off work. CONCLUSION: MRI dramatically reduces the amount of unnecessary immobilisation, time of treatment and healthcare usage in a rural setting. The two protocols are suggested to be equivalent financially. When potential societal costs, the amount of unnecessary immobilisation, low prevalence of true fractures and patient satisfaction are considered, acute MRI should be the management technique of choice. Further studies are still required to assess the best method for managing bone bruise within the scaphoid
Ultrasound of paediatric appendicitis and its secondary\ud
sonographic signs: Providing a more meaningful finding

Sonography is an important clinical tool in diagnosing appendicitis in children as it can obviate both exposure to potentially harmful ionising radiation from computed tomography scans and the need for unnecessary appendicectomies. This review examines the diagnostic accuracy of ultrasound in the identification of acute appendicitis, with a particular focus on the the utility of secondary sonographic signs as an adjunct or corollary to traditionally examined criteria. These secondary signs can be important in cases where the appendix cannot be\ud
identified with ultrasound and a more meaningful finding may be made by incorporating the presence or absence of secondary sonographic signs. There is evidence that integrating these secondary signs into the final ultrasound diagnosis can improve the utility of ultrasound in cases where appendicitis is expected, though there remains some conjecture about whether they play a more important role in negative or positive prediction in the absence of an identifiable appendix
A comparison of three different VMAT techniques for the delivery of lung stereotactic ablative radiation therapy

<b>Introduction</b>\ud
\ud
 - The purpose of this study was to investigate coplanar and non-coplanar <i>volumetric modulated arc therapy (VMAT)</i> delivery techniques for <i>stereotactic ablative radiation therapy (SABR)</i> to the lung.\ud
\ud
<b>Methods</b>\ud
\ud
 - For ten patients who had already completed a course of radiation therapy for early stage lung cancer, three new SABR treatment plans were created using (1) a coplanar full arc (FA) technique, (2) a coplanar partial arc technique (PA) and (3) a non-coplanar technique utilising three partial arcs (NCA). These plans were evaluated using planning target volume (PTV) coverage, dose to organs at risk, and high and intermediate dose constraints as incorporated by radiation therapy oncology group (RTOG) 1021.\ud
\ud
<b>Results</b>\ud
\ud
 - When the FA and PA techniques were compared to the NCA technique, on average the PTV coverage (V<sub>54Gy</sub>) was similar (P = 0.15); FA (95.1%), PA (95.11%) and NCA (95.71%). The NCA resulted in a better conformity index (CI) of the prescription dose (0.89) when compared to the FA technique (0.88, P = 0.23) and the PA technique (0.83, P = 0.06). The NCA technique improved the intermediate dose constraints with a statistically significant difference for the D<sub>2cm</sub> and R<sub>50%</sub> when compared with the FA (P < 0.03 and <0.0001) and PA (P < 0.04 and <0.0001) techniques. The NCA technique reduced the maximum spinal cord dose by 2.72 and 4.2 Gy when compared to the PA and FA techniques respectively. Mean lung doses were 4.09, 4.31 and 3.98 Gy for the FA, PA and NCA techniques respectively.\ud
\ud
<b>Conclusion</b>\ud
\ud
 - The NCA VMAT technique provided the highest compliance to RTOG 1021 when compared to coplanar techniques for lung SABR. However, single FA coplanar VMAT was suitable for 70% of patients when minor deviations to both the intermediate dose and organ at risk (OAR) constraints were accepted
International collaboration in medical radiation science

Introduction: International collaboration is recognised for enhancing the ability to approach complex problems from a variety of perspectives, increasing development of a wider range of research skills and techniques and improving publication and acceptance rates. The aim of this paper is to describe the current status of international collaboration in medical radiation science and compare this to other allied health occupations. Methods: This study utilised a content analysis approach where co-authorship of a journal article was used as a proxy for research collaboration and the papers were assigned to countries based on the corporate address given in the by-line of the publication. A convenience sample method was employed and articles published in the professional medical radiation science journals in the countries represented within our research team – Australia, the United Kingdom (UK) and the United States of America (USA) were sampled. Physiotherapy, speech pathology, occupational therapy and nursing were chosen for comparison. Results: Rates of international collaboration in medical radiation science journals from Australia, the UK and the USA have steadily increased over the 3-year period sampled. Medical radiation science demonstrated lower average rates of international collaboration than the other allied health occupations sampled. The average rate of international collaboration in nursing was far below that of the allied health occupations sampled. Overall, the UK had the highest average rate of international collaboration, followed by Australia and the USA, the lowest. Conclusion: Overall, medical radiation science is lagging in international collaboration in comparison to other allied health fields
Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity-modulated and volumetric-modulated arc radiotherapy

Introduction\ud
\ud
This study examines and compares the dosimetric quality of radiotherapy treatment plans for prostate carcinoma across a cohort of 163 patients treated across 5 centres: 83 treated with three-dimensional conformal radiotherapy (3DCRT), 33 treated with intensity-modulated radiotherapy (IMRT) and 47 treated with volumetric-modulated arc therapy (VMAT).\ud
\ud
Methods\ud
\ud
Treatment plan quality was evaluated in terms of target dose homogeneity and organ-at-risk sparing, through the use of a set of dose metrics. These included the mean, maximum and minimum doses; the homogeneity and conformity indices for the target volumes; and a selection of dose coverage values that were relevant to each organ-at-risk. Statistical significance was evaluated using two-tailed Welch’s T-tests. The Monte Carlo DICOM ToolKit software was adapted to permit the evaluation of dose metrics from DICOM data exported from a commercial radiotherapy treatment planning system.\ud
\ud
Results\ud
\ud
The 3DCRT treatment plans offered greater planning target volume dose homogeneity than the other two treatment modalities. The IMRT and VMAT plans offered greater dose reduction in the organs-at-risk: with increased compliance with recommended organ-at-risk dose constraints, compared to conventional 3DCRT treatments. When compared to each other, IMRT and VMAT did not provide significantly different treatment plan quality for like-sized tumour volumes.\ud
\ud
Conclusions\ud
\ud
This study indicates that IMRT and VMAT have provided similar dosimetric quality, which is superior to the dosimetric quality achieved with 3DCRT
Evaluating the dosimetric effect of treatment-induced changed in virally mediated head and neck cancer patients

Introduction\ud
\ud
Patients with virally mediated head and neck cancer (VMHNC) often present with advanced nodal disease that is highly radioresponsive as demonstrated by tumour and nodal regression during treatment.  The resultant changes may impact on the planned dose distribution and so adversely affect the therapeutic ratio.  The aim of this study was to evaluate the dosimetric effect of treatment-induced anatomical changes in VMHNC patients who had undergone a re-plan.\ud
\ud
Methods\ud
\ud
Thirteen patients with virally mediated oropharyngeal or nasopharyngeal cancer who presented for definitive radiotherapy between 2005 and 2010 and who had a re-plan generated were investigated.  The dosimetric effect of anatomical changes, was quantified by comparing dose volume histograms (DVH) of primary and nodal gross target volumes and organs at risk (OAR), including spinal cord and parotid glands, from the original plan and a comparison plan.\ud
\ud
Results\ud
\ud
Eleven 3DCRT and 2 IMRT plans were evaluated.  Dose to the spinal cord and brainstem increased by 4.1% and 2.6%, respectively.  Mean dose to the parotid glands also increased by 3.5%.  In contrast, the dose received by 98% of the primary and nodal gross tumour volumes decreased by 0.15% and 0.3%, respectively when comparing the initial treatment plan to the comparison plan. \ud
	\ud
Conclusion\ud
\ud
In this study, treatment-induced anatomical changes had the greatest impact on OAR dose with negligible effect on the dose to nodal gross tumour volumes. \ud
In the era of intensity modulated radiotherapy (IMRT), accounting for treatment-induced anatomical changes is important as focus is placed on minimising the acute and long-term side effects of treatment
Factors influencing radiation therapy student clinical placement satisfaction

Introduction\ud
\ud
Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement.\ud
\ud
Methods\ud
\ud
This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester.\ud
\ud
Results\ud
\ud
The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures.\ud
\ud
Conclusions\ud
\ud
The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning
Volumetric modulated arc therapy versus step-and-shoot intensity modulated radiation therapy in the treatment of large nerve perineural spread to the skull base: A comparative dosimetric planning study

Introduction Cutaneous squamous cell carcinoma with large nerve perineural (LNPN) infiltration of the base of skull is a radiotherapeutic challenge given the complex target volumes to nearby organs at risk (OAR). A comparative planning study was undertaken to evaluate dosimetric differences between volumetric modulated arc therapy (VMAT) versus intensity modulated radiation therapy (IMRT) in the treatment of LNPN.  Methods Five consecutive patients previously treated with IMRT for LNPN were selected. VMAT plans were generated for each case using the same planning target volumes (PTV), dose prescriptions and OAR constraints as IMRT. Comparative parameters used to assess target volume coverage, conformity and homogeneity included V95 of the PTV (volume encompassed by the 95% isodose), conformity index (CI) and homogeneity index (HI). In addition, OAR maximum point doses, V20, V30, non-target tissue (NTT) point max doses, NTT volume above reference dose, monitor units (MU) were compared.  Results IMRT and VMAT plans generated were comparable for CI (P = 0.12) and HI (P = 0.89). VMAT plans achieved better V95 (P = < 0.001) and reduced V20 and V30 by 652 cubic centimetres (cc) (28.5%) and 425.7 cc (29.1%), respectively. VMAT increased MU delivered by 18% without a corresponding increase in NTT dose.  Conclusion Compared with IMRT plans for LNPN, VMAT achieved comparable HI and CI.Full Tex