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1.
Med Phys ; 48(9): 5531-5539, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34173976

ABSTRACT

PURPOSE: We evaluated the correlation between stomach volume change and interfractional baseline shifts of the diaphragm in image-guided radiotherapy (IGRT) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty-four patients with HCC underwent ten fractions of IGRT, and a total of 240 cone beam computed tomography (CBCT) and on-board imager (OBI) kV image sets were acquired. These image sets were retrospectively analyzed. Baseline shifts of the diaphragm relative to bone and stomach volume change ratios were evaluated using four-dimensional simulation CT, kV image, and CBCT images. Associations between baseline shifts and patient physiologic factors were investigated. RESULTS: The average baseline shift of the diaphragm in the superior-inferior (SI) direction was 1.5 mm (standard deviation 4.6 mm), which was higher than the shift in other directions (0.7, 2.0 mm and 0.9, 2.6 mm in right-left (RL) and anterior-posterior (AP) directions, respectively). Interfractional baseline shifts of the diaphragm in the SI and AP directions were positively correlated with the stomach volume change ratio (Pearson's r: 0.416 and 0.302, p-value: <0.001 and <0.001, respectively). CONCLUSIONS: The interfractional baseline shifts of the diaphragm in the SI and AP directions correlated well with stomach volume changes. Efforts to maintain a constant stomach volume before the simulation and each treatment, such as fasting, may reduce interfractional baseline shifts of liver tumors.


Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Radiotherapy, Image-Guided , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/radiotherapy , Cone-Beam Computed Tomography , Diaphragm/diagnostic imaging , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/radiotherapy , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Retrospective Studies , Stomach/diagnostic imaging
2.
World J Gastroenterol ; 14(27): 4359-64, 2008 Jul 21.
Article in English | MEDLINE | ID: mdl-18666326

ABSTRACT

AIM: To determine the prevalence and risk factors of work-related musculoskeletal disorders in gastrointestinal endoscopists in Korea. METHODS: A survey of musculoskeletal symptoms, using a self-administered questionnaire, was conducted on 55 endoscopists practicing in general hospitals or health promotion centers. RESULTS: Forty-nine (89.1%) endoscopists reported musculoskeletal pain on at least one anatomic location and 37 (67.3%) endoscopists complained of pain at rest. Twenty-six (47.3%) endoscopists had severe musculoskeletal pain defined as a visual analogue score greater than 5.5. Factors related to the development of severe pain were (1) standing position during upper endoscopy, (2) specific posture/habit during endoscopic procedures, and (3) multiple symptomatic areas. Finger pain was more common in beginners, whereas shoulder pain was more common in experienced endoscopists. Sixteen percent of symptomatic endoscopists have modified their practice or reduced the number of endoscopic examinations. Only a few symptomatic endoscopists had sought professional consultation with related specialists. CONCLUSION: The prevalence of musculoskeletal pain in endoscopists is very high. The location of pain was different between beginners and experienced endoscopists. Measures for the prevention and adequate management of endoscopy-related musculoskeletal symptoms are necessary.


Subject(s)
Endoscopes, Gastrointestinal , Musculoskeletal Diseases/etiology , Musculoskeletal Diseases/pathology , Occupational Diseases/diagnosis , Occupational Diseases/etiology , Adult , Back Pain/diagnosis , Back Pain/etiology , Endoscopy/methods , Female , Humans , Korea , Male , Middle Aged , Neck Pain/diagnosis , Neck Pain/etiology , Pain/diagnosis , Pain/etiology , Prevalence
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