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1.
PLoS One ; 16(3): e0248589, 2021.
Article in English | MEDLINE | ID: covidwho-1456066

ABSTRACT

PURPOSE: To assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites. METHODS AND MATERIALS: Between January 2014 and March 2019, 102 consecutive percutaneous RFA were performed and retrospectively reviewed. The procedures were performed using a RFA bipolar ablation system (Covidien, exposed tip of 0.7-1cm), under Computed Tomography (CT) guidance or using a navigation system (Masmec) under CT and Cone Beam CT (CBCT) guidance. Patients were followed up over 24 months. Clinical success and recurrences were considered on the base of established criteria. In patients with clinical failure and/or imaging evidence of relapse, retreatment was considered. RESULTS: Administered power per-procedure was ≤8 W (mean temperature, 90°C). The pre-procedure average value of visual analog scale (VAS) was 8.33+/-0.91. Primary and secondary success rate 96.08% (98/102) and100% (102/102), respectively. No major complication was described. Technical success was proved in every patient by CT scan acquisition after needle positioning. Relapse and tumour location were significantly correlated (p-value = 0.0165). The mean dose-length product was 751.55 mGycm2. Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up. CONCLUSION: Imaging-guided percutaneous RFA is a highly effective technique for OO, both in typical and atypical sites. CT or CBCT guidance, navigation systems and operator experience grant the technical success, which is the most crucial parameter affecting outcome.


Subject(s)
Bone Neoplasms/therapy , Cancer Pain/therapy , Neoplasm Recurrence, Local/epidemiology , Osteoma, Osteoid/therapy , Radiofrequency Ablation/methods , Adolescent , Adult , Bone Neoplasms/complications , Bone Neoplasms/diagnosis , Cancer Pain/diagnosis , Cancer Pain/etiology , Cone-Beam Computed Tomography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/prevention & control , Osteoma, Osteoid/complications , Osteoma, Osteoid/diagnosis , Pain Measurement/statistics & numerical data , Radiofrequency Ablation/statistics & numerical data , Retrospective Studies , Treatment Outcome , Young Adult
2.
Pan Afr Med J ; 39: 183, 2021.
Article in English | MEDLINE | ID: covidwho-1395298

ABSTRACT

Mucormycosis is relatively uncommon, fulminant, progressive, life threatening fungal disease which is most often seen in debilitating patients with immunocompromised condition. Mucormycosis cases are seen in patients with the use of systemic steroids in the treatment of severely affected COVID-19 cases and also in the patients with uncontrolled diabetes which causes immunosuppression are being reported with mucormycosis. The main symptoms of this disease include pain on the temporal and the orbital region of the affected side which could be throbbing or lancinating type, mobility of the teeth, jaw pain and often swelling is present which could be extraoral and intraoral both or sometimes only intraorally. The diagnostic approach in such cases is done with the help of clinical diagnosis, histopathology and with advanced imaging like cone beam computed tomography, magnetic resonance imaging and computed tomography. We here used cone beam computed tomography imaging that revealed haziness in the sinuses and breach in cortical bone of the affected area which confirmed the diagnosis of mucormycosis. Early treatment planning like administration of antifungal drugs and surgical debridement will be life saving in such a deadly disease.


Subject(s)
COVID-19/complications , Cone-Beam Computed Tomography/methods , Mucormycosis/diagnostic imaging , Antifungal Agents/administration & dosage , Cortical Bone/diagnostic imaging , Debridement , Humans , Male , Middle Aged , Mucormycosis/therapy , Paranasal Sinus Diseases/diagnostic imaging , Paranasal Sinus Diseases/microbiology , Paranasal Sinus Diseases/therapy
4.
Clin Imaging ; 79: 96-101, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1198667

ABSTRACT

PURPOSE: This study aimed to identify predictive (bio-)markers for COVID-19 severity derived from automated quantitative thin slice low dose volumetric CT analysis, clinical chemistry and lung function testing. METHODS: Seventy-four COVID-19 patients admitted between March 16th and June 3rd 2020 to the Asklepios Lung Clinic Munich-Gauting, Germany, were included in the study. Patients were categorized in a non-severe group including patients hospitalized on general wards only and in a severe group including patients requiring intensive care treatment. Fully automated quantification of CT scans was performed via IMBIO CT Lung Texture analysis™ software. Predictive biomarkers were assessed with receiver-operator-curve and likelihood analysis. RESULTS: Fifty-five patients (44% female) presented with non-severe COVID-19 and 19 patients (32% female) with severe disease. Five fatalities were reported in the severe group. Accurate automated CT analysis was possible with 61 CTs (82%). Disease severity was linked to lower residual normal lung (72.5% vs 87%, p = 0.003), increased ground glass opacities (GGO) (8% vs 5%, p = 0.031) and increased reticular pattern (8% vs 2%, p = 0.025). Disease severity was associated with advanced age (76 vs 59 years, p = 0.001) and elevated serum C-reactive protein (CRP, 92.2 vs 36.3 mg/L, p < 0.001), lactate dehydrogenase (LDH, 485 vs 268 IU/L, p < 0.001) and oxygen supplementation (p < 0.001) upon admission. Predictive risk factors for the development of severe COVID-19 were oxygen supplementation, LDH >313 IU/L, CRP >71 mg/L, <70% normal lung texture, >12.5% GGO and >4.5% reticular pattern. CONCLUSION: Automated low dose CT analysis upon admission might be a useful tool to predict COVID-19 severity in patients.


Subject(s)
COVID-19 , Cone-Beam Computed Tomography , Female , Humans , Lung/diagnostic imaging , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed
5.
Quintessence Int ; 52(2): 154-164, 2021.
Article in English | MEDLINE | ID: covidwho-1024505

ABSTRACT

OBJECTIVE: Nasal airway obstruction affects up to one-third of Americans and is one of the most common complaints by patients to otolaryngologists. Nasal airway obstruction and obstructive sleep apnea syndrome (OSAS) are closely related. The aim of this study was to use the 3D imaging software, ITK-SNAP as a platform to define a gold standard for anatomically accurate boundaries of the nasal airway in 3D CBCT and to create a more reliable and precise 3D CBCT segmentation of the nasal airway for assisting diagnosis, treatment, and monitoring of nasal airway obstruction and OSAS. METHOD AND MATERIALS: After review of the literature to identify established parameters using CBCT and CT technology for the segmentation of the nasal airway, and the existing drawbacks, a gold standard for locating the anatomical boundaries of the nasal airway using CBCT is proposed. This new method aims at standardization of segmentation and quantification, allowing for more reliable comparison between studies. ITK-SNAP software was used to segment three CBCT samples of healthy patients aged 21 to 59 years, who were patients of record, with CBCT obtained for either orthodontic, endodontic, or prosthodontic treatment planning purposes.
Results: The literature search identified 11 studies describing nasal airway parameters utilizing CBCT and CT. A great variation was detected on where the anatomical boundaries for the nasal airway were selected. A new standard in the identification of anatomical boundaries of the nasal airway is proposed for consistent segmentation and quantification using 3D CBCT by using the following landmarks: the inferior ANS-PNS border, the anterior nares border, the posterior sella-PNS border, and superiorly the border in alignment with the base of the skull (excluding the ostia, frontal, ethmoidal, and sphenoidal air cells). The three segmented samples were volumetrically measured, and statistically analyzed. The mean average Hounsfield unit intensity using the CBCT samples in this study was 629 with a standard deviation of 190.
Conclusion: The literature indicates a lack of a gold standard using CBCT technology for the segmentation of the nasal airway. With the proposed standard in this study, it is possible to quantify the nasal airway volume and thereby its reduction. For the general dental practitioner, this is an important aspect during the evaluation of overall airway assessment. This information can be useful in the diagnosis and treatment of airway compromised dental patients. (Quintessence Int 2021;52:154-164; doi: 10.3290/j.qi.a45429).


Subject(s)
Dentists , Spiral Cone-Beam Computed Tomography , Adult , Cone-Beam Computed Tomography , Humans , Imaging, Three-Dimensional , Middle Aged , Professional Role , Young Adult
7.
Technol Cancer Res Treat ; 19: 1533033820974021, 2020.
Article in English | MEDLINE | ID: covidwho-983619

ABSTRACT

PURPOSE: With the widespread prevalence of Corona Virus Disease 2019 (COVID-19), cancer patients are suggested to wear a surgical mask during radiation treatment. In this study, cone beam CT (CBCT) was used to investigate the effect of surgical mask on setup errors in head and neck radiotherapy. METHODS: A total of 91 patients with head and neck tumors were selected. CBCT was performed to localize target volume after patient set up. The images obtained by CBCT before treatment were automatically registered with CT images and manually fine-tuned. The setup errors of patients in 6 directions of Vrt, Lng, Lat, Pitch, Roll and Rotation were recorded. The patients were divided into groups according to whether they wore the surgical mask, the type of immobilization mask used and the location of the isocenter. The setup errors of patients were calculated. A t-test was performed to detect whether it was statistically significant. RESULTS: In the 4 groups, the standard deviation in the directions of Lng and Pitch of the with surgical mask group were all higher than that in the without surgical mask group. In the head-neck-shoulder mask group, the mean in the Lng direction of the with surgical mask group was larger than that of the without surgical mask group. In the lateral isocenter group, the mean in the Lng and Pitch directions of the with surgical mask group were larger than that of the without surgical mask group. The t-test results showed that there was significant difference in the setup error between the 2 groups (p = 0.043 and p = 0.013, respectively) only in the Lng and Pitch directions of the head-neck-shoulder mask group. In addition, the setup error of 6 patients with immobilization open masks exhibited no distinguished difference from that of the patients with regular immobilization masks. CONCLUSION: In the head and neck radiotherapy patients, the setup error was affected by wearing surgical mask. It is recommended that the immobilization open mask should be used when the patient cannot finish the whole treatment with a surgical mask.


Subject(s)
COVID-19/prevention & control , Head and Neck Neoplasms/radiotherapy , Masks , Radiotherapy Setup Errors/statistics & numerical data , Adolescent , Adult , Aged , COVID-19/epidemiology , Case-Control Studies , Cone-Beam Computed Tomography/methods , Female , Head and Neck Neoplasms/epidemiology , Humans , Immobilization/instrumentation , Immobilization/methods , Immobilization/statistics & numerical data , Male , Masks/adverse effects , Masks/statistics & numerical data , Middle Aged , Pandemics , Radiation Oncology/methods , Radiation Oncology/standards , Radiotherapy Planning, Computer-Assisted/adverse effects , Radiotherapy Planning, Computer-Assisted/methods , Radiotherapy Planning, Computer-Assisted/statistics & numerical data , Radiotherapy, Image-Guided/adverse effects , Radiotherapy, Image-Guided/methods , Radiotherapy, Image-Guided/statistics & numerical data , Radiotherapy, Intensity-Modulated/methods , SARS-CoV-2/physiology , Shoulder , Young Adult
9.
Radiol Med ; 126(1): 142-146, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-273535

ABSTRACT

INTRODUCTION: To evaluate stereotactic body radiotherapy (SBRT) in low-risk Prostate Cancer patients as preferred treatment option in emergency health conditions. MATERIALS AND METHODS: From April 2013 to September 2015, 28 patients with low-risk prostate cancer were prospectively enrolled. The SBRT prescribed dose was 36.25 Gy in 5 fractions, twice a week. Primary endpoints were acute and late toxicity. Secondary endpoints were biochemical recurrence free survival (bRFS) and overall survival. RESULTS: Median follow-up was 65.5 months (range 52-81). No acute G3 or G4 toxicity was recorded. Acute G1 or G2 genitourinary (GU) toxicity occurred in 43% and acute G1-G2 gastrointestinal (GI) toxicity in 14%. Late G1 and G3 GU toxicity in 18% and 3.5%, respectively. The G3 toxicity was not directly attributable to radiotherapy. Late G1 GI toxicity occurred in 18%. 5yy bRFS was 96.5% (95% CI 82.3-99.4%). CONCLUSIONS: Stereotactic body radiotherapy for early prostate cancer reported safe toxicity profile and a good clinical outcome at the median follow-up of 5 years. It may be an useful option if radiotherapy is required in emergency medical conditions.


Subject(s)
COVID-19/epidemiology , Prostatic Neoplasms/radiotherapy , Radiosurgery , Aged , Aged, 80 and over , Cone-Beam Computed Tomography , Dose Fractionation, Radiation , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Prospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
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