ABSTRACT
Artifacts are universal across all imaging modalities, varying in their conspicuity and significance. In this report three patients with pathology-proven breast cancer who had densities masquerading as microcalcifications at the resection margins of the lumpectomy specimens, but had negative microscopic margins, will be discussed. It was determined that these pseudocalcifications were the result of ink precipitates from a commonly utilized tissue marking dye. This artifact was further evaluated and reproduced by utilizing a boneless chicken breast as a phantom. © RSNA, 2016.
Subject(s)
Artifacts , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Calcinosis/diagnostic imaging , Image Interpretation, Computer-Assisted/methods , Staining and Labeling/methods , Aged , Breast/diagnostic imaging , Breast/surgery , Coloring Agents , Female , Humans , Ink , Mastectomy, Segmental , Phantoms, Imaging , RadiographyABSTRACT
PURPOSE: With most patients now living long after their breast cancer diagnosis, minimizing long-term side effects of breast cancer treatment, such as reducing late cardiac and pulmonary side effects of radiation therapy (RT), is particularly important. It is now possible to use an electromagnetic tracking system to allow real-time tracking of chest wall (CW) position during the delivery of RT. Here, we report our experience using electromagnetic surface transponders as an added measure of CW position during deep inspiration breath hold (DIBH). METHODS AND MATERIALS: We conducted a single-institution institutional review board-approved retrospective review of 15 female left-sided breast cancer patients treated between July 2012 and June 2013 with conventional whole breast radiation. We compared daily port films with treatment planning digitally reconstructed radiographs to establish daily setup accuracy, then used Calypso tracings to compare the position of the CW during the daily port film with the position of the CW during that day's treatment to determine the reproducibility of the breath hold position. Finally, we created competing treatment plans not using DIBH and used a paired t test to compare mean heart (MH) and left anterior descending (LAD) coronary artery dose between the 2 techniques. RESULTS: Mean total error (inter- and intrafraction) was dominated by interfraction error and was greatest in the longitudinal direction with a mean of 2.13 mm and 2 standard deviations of 8.2 mm. DIBH significantly reduced MH and LAD dose versus free breathing plans (MH, 1.26 Gy vs 2.84 Gy, P ≤ .001; LAD, 5.49 Gy vs 18.15 Gy, P ≤ .001). CONCLUSIONS: This study demonstrates that DIBH with electromagnetic confirmation of CW position is feasible, and allows potential improvement in the accurate delivery of adjuvant RT therapy for breast cancer.
Subject(s)
Chemotherapy, Adjuvant/methods , Adult , Aged , Breast Neoplasms , Breath Holding , Electromagnetic Phenomena , Female , Humans , Inhalation , Middle Aged , Thoracic WallABSTRACT
Superficial siderosis of the central nervous system is a rare neurological disorder caused by deposits of haemosiderin on subplial brain matter. Characterised by a thin dark layer surrounding the brain stem, cerebellum and cortical fissures on the T2-weighted MRI, symptoms include sensorineural hearing loss and progressive gait ataxia. A specific aetiology for the blood in the subarachnoid space is identified in less than 50% of cases. While identification of a specific vascular defect allows for vascular repair, treatment options are limited for idiopathic superficial siderosis. Recently, a pilot safety study demonstrated promising results using an iron chelator, deferiprone. While this approach is promising, we present a potential serious complication of this therapy-the first report of agranulocytosis in the treatment of superficial siderosis following deferiprone therapy.
