ABSTRACT
BACKGROUND: Virtual Reality (VR) is becoming a popular educational tool in healthcare. This scoping review aimed to (1) determine if VR can be used to reduce the anxiety a patient experiences during an MRI and (2) explore how VR is being used to train MRI technologists. METHODS: PubMed, Web of Science, Cochrane Library, CINAHEL, and PsycINFO internet websites of VR in MRI were evaluated. Two authors independently reviewed the titles and abstracts using the inclusion and exclusion criteria. Articles chosen by both reviewers were automatically included for full text review. Articles chosen by one reviewer were audited by a third independent reviewer to determine inclusion for full text review. Descriptive analyses were conducted. RESULTS: The initial search resulted in 357 articles. A large portion of the articles were excluded because they were either based on fMRI or training-based tools for healthcare professionals, which were not our area of focus. Eight articles were included in the final review for assessing if VR can be a useful tool to aid with patient anxiety in MRI. No articles were found that used VR in MRI technologist training. CONCLUSIONS: This scoping review suggests there are potentially significant uses for VR in reducing anxiety in adults and children as patients. With further research and development of VR application for use with MRI testing may allow for better patient preparation and reduce scan interruptions, increase MRI operational efficiency, and improve patient outcomes.
Subject(s)
Virtual Reality , Adult , Child , Humans , Educational Status , Anxiety , Anxiety Disorders , Health PersonnelABSTRACT
BACKGROUND: Although thoracic hemivertebra can cause neurological signs, they occur commonly in neurologically normal dogs. OBJECTIVES: To evaluate whether computed tomography (CT) findings and factors associated with signalment can be used to differentiate between dogs with and without neurological signs associated with hemivertebra. ANIMALS: One hundred sixty dogs with ≥1 hemivertebrae were retrospectively studied. This group consisted of 40 dogs with clinical signs caused by hemivertebra and 40 French Bulldogs, 40 Pugs, and 40 English Bulldogs that underwent CT for reasons unrelated to neurological disease. METHODS: All dogs underwent CT and affected dogs also underwent magnetic resonance imaging. All CT studies were randomly evaluated by an observer blinded to signalment and clinical status. The following variables were evaluated: presence, number, location, and subtype of hemivertebra; presence of vertebral subluxation; severity of vertebral canal stenosis; presence, location, and severity of kyphosis, and number of vertebrae involved in the kyphotic segment. Statistical modeling was performed to identify factors associated with clinical status. RESULTS: Pug breed (odds ration [OR], 10.8; P = .01), more severe kyphosis (OR, 1.1 per grade increase; P < .001), fewer instead of more observed hemivertebrae (OR, 0.8; P = 0.03), and ventrolateral hypoplasia hemivertebra subtype (OR, 4.0; P = .011) were associated with higher likelihood of neurological disease. A Cobb angle of 34.5 degrees corresponded with the highest combined sensitivity and specificity to differentiate between clinically affected and unaffected dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: The variables identified could aid in differentiating between clinically relevant and irrelevant hemivertebra in small breed brachycephalic dogs.
Subject(s)
Dog Diseases/epidemiology , Dogs/abnormalities , Nervous System Diseases/veterinary , Thoracic Vertebrae/abnormalities , Animals , Cross-Sectional Studies , Dog Diseases/diagnostic imaging , Dog Diseases/genetics , Female , Genetic Predisposition to Disease , Magnetic Resonance Imaging/veterinary , Male , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology , Retrospective Studies , Thoracic Vertebrae/diagnostic imaging , Tomography, X-Ray Computed/veterinaryABSTRACT
This study presents estimation of typical kV fluoroscopic imaging doses for image-guided real-time adaptive radiotherapy. For a cohort of 10 lung SABR patients the estimated imaging dose to ipsi-lateral lung with real-time adaptation is 9.9-15.1cGy, which is less than the extra lung dose from treatment with potentially larger ITV-based PTV approach.
Subject(s)
Dose Fractionation, Radiation , Lung Neoplasms/radiotherapy , Radiography, Interventional/methods , Radiosurgery/methods , Radiotherapy, Image-Guided/methods , Fluoroscopy , Humans , Lung/diagnostic imaging , Phantoms, Imaging , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted/methods , Retrospective StudiesABSTRACT
OBJECTIVES: Liposome (LIP)-like lipid dispersions have emerged as useful detoxification vehicles in vitro. The authors compare resuscitation with tailored LIPs, 20% intravenous lipid emulsion (ILE), and sodium bicarbonate (BIC), in a rabbit model of clomipramine toxicity. METHODS: Sedated, instrumented New Zealand white rabbits underwent clomipramine infusion at 3.2 mg/kg/min to 50% baseline mean arterial pressure (MAP) and then at 1.6 mg/kg/min for 30 minutes. BIC (3 mL/kg 8.4%), ILE (3 mL/kg 20%), or LIP (24 mg/kg) were infused as rescue treatments at toxicity and were repeated at 10 minutes (n = 5 in each group). RESULTS: Thirty-minute MAP was greatest in ILE-treated animals: 61 mm Hg ILE (interquartile range [IQR] = 49 to 64 mm Hg), 43 mm Hg LIP (IQR = 36.5 to 49 mm Hg), and 10 mm Hg BIC (IQR = 10 to 44 mm Hg; all p = 0.02). Two of the five BIC-treated animals survived to 30 minutes, compared with all five of the ILE-treated animals and all five of the LIP-treated animals (p = 0.044). CONCLUSIONS: Both ILE and LIPs improved hemodynamic recovery compared with bicarbonate in clomipramine-induced cardiotoxicity in rabbits. Greater 30-minute MAP was observed in the ILE group.
