Radiotherapy based management during Covid-19 pandemic - A systematic review of presented consensus and guidelines.

Treatment management of cancer patients in the radiation oncology departments during the current COVID-19 pandemic is challenging. A systematic review of published consensus/guidelines on the role of radiotherapy prioritization, suggested treatment protocols, and set up management was undertaken based on the PRISMA protocol and through PubMed/PMC, Scopus, Google Scholar, Web of Science databases until 01/20/2021. One hundred and sixty-eight publications or regional consensus were included. Summary of recommendations contained: (1) using hypo-fractionated (Hypo-F) regimens for therapeutic/palliative indications, (2) delaying radiotherapy for several weeks or until pandemic over, (3) omitting radiotherapy by replacement of alternative therapies or active surveillance, (4) applying safer patients' setup and preparation protocols, (5) developing telemedicine/telehealth service. To conclude, it is essential to carefully weigh the risk of exposure to COVID-19 infection and the benefit of treating cancer patients during the pandemic. Trying to have a global guideline facing this or any other probable crisis is crucial for health care service.

Measurement of ventricular three-dimensional torsion.

BACKGROUND: In this study, three-dimensional torsion angle of myocardium was extracted by two-dimensional images of the left ventricle at three levels of base, mid, and apex of interventricular septum wall. METHODS: Two-dimensional echocardiography images of long- and short-axis views of healthy men were synchronized using an electrocardiogram of each individual and processed. Interventricular septum wall motion at three levels of base, mid, and apex were measured using a motion-detection algorithm throughout three cardiac cycles. Considering position vectors in long and short-axis views, the three-dimensional torsion angle is extracted throughout the cardiac cycle. RESULTS: The average and standard deviation of Φ(M) during three cardiac cycles for interventricular septal wall in healthy individuals in this study are estimated as 16.3 ± 3.0° at base level, 22.8 ± 5.0° at mid level, and 14.6 ± 5.8° at apex level of septum wall, respectively. CONCLUSIONS: This angle suggested for examination of regional and global biomechanical behavior of myocardium in different pathologic conditions.

Estimating the Myocardium's Angle of Three-Dimensional Trajectory, Using the Tracking of Sequential Two-Dimensional Echocardiography Images.

BACKGROUND: In this study, the angle of the myocardium's trajectory in three dimensions (ф) was estimated by simultaneous use of long-axis and short-axis views of left ventricle septum two-dimensional images. Then correlation of three-dimensional trajectory's angle with the rotation angle from the long (χ) and short (θ) axis views was estimated and compared at the three levels of base, mid and apex of the interventricular septum wall. METHODS: Two-dimensional echocardiography images of long- and short-axis views of 19 healthy men were recorded and analyzed. Using an electrocardiogram of each individual, the images of the two views were synchronized. The interventricular septum wall motion at the three levels of base, mid and apex were estimated, using a block matching algorithm throughout three cardiac cycles. Considering the defined system of coordinates and the position vectors in long and short-axis views, the 3-dimensional angle of the trajectory was calculated. RESULTS: Maxima of the ф, θ, and χ angles were extracted at 16.33 ± 3.01, 10.61 ± 3.38, and 15.11 ± 3.30 degrees at base level, 22.77 ± 4.95, 7.78 ± 2.96, and 16.72 ± 2.66 degrees at mid level and 14.60 ± 5.81, 10.37 ± 5.48, and 8.79 ± 3.32 degrees at apex level, respectively, of the septum wall, respectively. This study shows significant correlation between the angle of 3-dimensional trajectory (ф) with the angle in short axis view (θ) of the septum wall at the apex level; and also with the angle in long axis view (χ) of the septum wall at base and mid levels. CONCLUSION: Due to the motion of the wall of the left ventricle in three dimensions, and the non-isotropic structure of myofibers, the angle of 3-dimensional trajectory was estimated using the speckle tracking method of 2-dimentional echocardiography images.