ABSTRACT
Aim of the Study: The aim of the study was to study the clinical, radiological, and histopathological correlation of sinonasalmasses.Materials and Methods: This was a descriptive study conducted on 72 patients with sinonasal masses at Government T DMedical College, Alappuzha, over a period of 18 months from January 01, 2014, to June 30, 2015.Results: Age group was from 13 to 85 years with a male to female ratio of 1.3:1. Nasal obstruction was the most commonsymptom followed by nasal discharge and headache. Of the 72 cases, 59 belonged to the non-neoplastic group and 13 to theneoplastic group of sinonasal masses. Clinically, nasal polyp was the most common presentation. Sinonasal polyps (65.3%)formed the majority of the non-neoplastic lesions, vascular lesion (6.9%) was the most common benign neoplastic mass, andmalignancy was seen in 6.9% of cases. After clinical examination and computed tomography scan of the nose and paranasalsinuses, patients underwent surgery. Finally, clinical, radiological, and histopathology correlation of all the sinonasal masseswere done. The clinical diagnosis with computed tomography (CT) scan correlation was the same except in three cases andin one case with histopathology. Histopathology and CT scan result correlated well except in three cases. It was found thatthere was a significant association between the clinical, radiological, and histopathological diagnoses (P < 0.05) and that thesemodalities were complementary to each other. It was also possible to classify the lesions as non-neoplastic, neoplastic benign,and malignant using these modalities. This was important because even though initial presentation of these masses was similar,management of each of them varied significantly.Conclusion: Histopathology still remains the gold standard in the diagnosis of sinonasal masses, while CT scan is indispensablein studying the anatomical variants and providing the route map before and during endoscopic sinus surgeries.
ABSTRACT
Purpose: To assess the potential advantage of intensity-modulated radiotherapy (IMRT) over 3D-conformal radiotherapy (3D-CRT) planning in postoperative adjuvant radiotherapy for patients with gastric carcinoma. Methods and materials: In a retrospective study, for plan comparison, dose distribution was recalculated in 15 patients treated with 3D-CRT on the contoured structures of same CT images using an IMRT technique. 3D-conformal plans with three fields and four-fields were compared with seven-field dynamic IMRT plans. The different plans were compared by analyzing the dose coverage of planning target volume using TV95, Dmean, uniformity index, conformity index and homogeneity index parameters. To assess critical organ sparing, Dmean, Dmax, dose to one-third and two-third volumes of the OARs and percentage of volumes receiving more than their tolerance doses were compared. Results: The average dose coverage values of PTV with 3F-CRT and 4F-CRT plans were comparable, where as IMRT plans achieved better target coverage(p<0.001) with higher conformity index value of 0.81±0.07 compared to both the 3D-CRT plans. The doses to the liver and bowel reduced significantly (p<0.001) with IMRT plans compared to other 3D-CRT plans. For all OARs the percentage of volumes receiving more than their tolerance doses were reduced with the IMRT plans. Conclusion: This study showed that a better target coverage and significant dose reduction to OARs could be achieved with the IMRT plans. The IMRT can be preferred with caution for organ motion. The authors are currently studying organ motion in the upper abdomen to use IMRT for patient treatment.