The Impact of Virtual Residency Interviews on the Geographic Distribution of Integrated Interventional and Diagnostic Radiology Residency Matches.

PURPOSE: To characterize how the adoption of virtual residency interviews (2020-2021 cycle) has impacted the geographic distribution of radiology resident matches. METHODS: University-based interventional (IR) and diagnostic radiology (DR) residency programs from 2017 to 2021 were identified using a national residency database (FRIEDA). Public applicant data were obtained from official residency program websites. Medical schools and residency programs were categorized by US census regions. Geographic applicant distribution before and after the initiation of virtual interviews was statistically assessed using Chi-square tests. The effect of virtual interviews on the probability of matching within the same geographic region as one's medical school was evaluated with multivariate logistic regression. RESULTS: 4358 radiology residents (88% diagnostic, 12% interventional) matched at 102 radiology programs during the study period. 71% (n = 3115 residents) had data available for analysis. 56.3% of DR and 49.3% of IR residents matched in the same geographic region as their medical school. The geographic distribution of applicants who matched at Southern IR residency programs significantly changed after implementation of virtual interviews (p < 0.0001). Virtual interviews did not increase the odds of matching in the same region as one's medical school for IR (OR 1.11, p = 0.08) or DR (OR 1.01, p = 0.58) applicants. Top-20 ranked DR programs had lower odds of in-region matches (OR 0.87, p < 0.001). CONCLUSION: With few exceptions, shifting to virtual residency interviews did not significantly affect the geographic distribution of IR or DR residency matches. Top-ranked DR programs match more regionally diverse applicants.

A comparative study between two different dose fractionation schedules of cobalt-60-based HDR intracavitary brachytherapy in carcinoma cervix stages IIB-IIIC1.

INTRODUCTION: High dose rate (HDR) intracavitary brachytherapy (ICBT) is an integral element in the treatment of carcinoma uterine cervix. The main objective of brachytherapy in carcinoma cervix is to deliver a lethal dose to tumor cells without inducing unacceptable damage to the surrounding normal tissue. Because the absorbed dose falls off rapidly, higher doses can be safely delivered to the targeted tissue over a short time. The quest for optimum dose and fractionation schedule in HDR ICBT is still ongoing, and there is no uniform consensus. This study aimed to assess the acute dose-related toxicities of HDR brachytherapy schedule of 7 Gy x 3 fractions over 6 Gy x 4 fractions in the treatment of cervical cancer. OBJECTIVE: The aim of this study was to study the acute treatment-related gastrointestinal (GI) and genitourinary (GU) toxicities between two HDR brachytherapy regimens. MATERIAL AND METHODS: This is a prospective institutional study carried out from May 2018 to September 2018. In this time period, 66 patients of cervical cancers fulfilling our inclusion criteria were treated with concurrent chemoradiation (CCRT) following brachytherapy. During treatment, patients were randomized to arm A-7 Gy per fraction for three fractions and arm B-6 Gy per fraction for four fractions. Acute GI and GU toxicities were assessed using Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03. All patients were kept for follow-up for 3 months in this study. RESULTS: There is no statistically significant difference between the two arms for acute GI and GU toxicities, and the results were comparable. CONCLUSIONS: Considering the increased hospital burden of locally advanced cervical cancer patients in the Indian context, the HDR brachytherapy schedule of 7 Gy per fraction is preferable to 6 Gy per fraction for a lesser fractionation schedule.

Dosimetric comparison of 60Co and 192Ir high dose rate source used in brachytherapy treatment of cervical cancer.

PURPOSE: The study purpose included dosimetric comparison of cobalt 60 (60Co) and iridium 192 (192Ir) high dose rate (HDR) source used in brachytherapy treatment of cervical cancer. MATERIALS AND METHODS: Computed tomography (CT) scans for 15 patients of carcinoma of uterine cervix using 3-mm slice thickness were considered for the study The contouring of high-risk clinical target volume (HRCTV), bladder, and rectum on CT images was done as per the GEC ESTRO guidelines with the help of magnetic resonance imaging images in the treatment planning system. All parameters were kept the same for 60Co (3.5 mm active length, 0.5 mm active dia, Bebig) and 192Ir (3.5 mm active length, 0.6 mm active dia, Bebig) HDR source with 2.5-mm step size and dose prescription to Point A. As per the International Commission on Radiation Unit (ICRU)-89 guidelines, the dose-volume parameters such as D50(Gy), D90(Gy), and D98(Gy) for HRCTV and D0.1cc (Gy), D1cc (Gy), D2cc (Gy), and D5cc (Gy) to the bladder and rectum were calculated for both the HDR sources. RESULTS: The difference in dose-volume histogram parameters such as D50,D90,and D98 of HRCTV was 3.19%, 1.13%, and 0.50%, respectively, for the two radioisotopes. The difference in dose values of D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of bladder was -0.58%, -0.67%, -0.99%, -0.94%, and -1.75%, respectively. On the other hand, dose difference for D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of rectum was 0.67%, 0.26%, 0.56%, 0.63%, and -0.33%, respectively. CONCLUSIONS: The present study results show that all the dose parameters of HRCTV, bladder, and rectum with 60Co were comparable with those of 192Ir HDR source. The isodose distribution is more bulge out for 60Co in cranial-caudal direction compared to that of 192Ir. However, these differences can be reduced by treatment planning optimization techniques. The clinical plan evaluation in each slice and plane is necessary to explore the logistic and financial benefits of miniaturized 60Co source over 192Ir HDR source.

Optimizing computational feature sets for subthalamic nucleus localization in DBS surgery with feature selection.

OBJECTIVE: Microelectrode recording (MER) is used to identify the subthalamic nucleus (STN) during deep brain stimulation (DBS) surgery. Automated STN detection typically involves extracting quantitative features from MERs for classifier training. This study evaluates the ability of feature selection to identify optimal feature combinations for automated STN localization. METHODS: We extracted 13 features from 65 MERs for classifier training. For logistic regression (LR) classification, we compared classifiers identified by feature selection to those containing all possible feature combinations. We used classification error as our metric with hold-one-patient-out cross-validation. We also compared patient-specific vs. independent normalization on classifier performance. RESULTS: Feature selection and patient-specific normalization were superior to non-optimized, patient-independent classifiers. Feature selection, patient-specific normalization, and both produced relative error reductions of 4.95%, 31.36%, and 38.92%, respectively. Three of four feature-selected LR classifiers performed better than 99% of classifiers with all possible feature combinations. Optimal feature combinations were not predictable from individual feature performance. CONCLUSIONS: Feature selection reduces classification error in automated STN localization from MERs. Additional improvement from patient-specific normalization suggests these approaches are necessary for clinically reliable automation of MER interpretation. SIGNIFICANCE: These findings represent an incremental advance in automated functional localization of STN from MER in DBS surgery.