A prospective comparison of three systems of patient immobilization for prostate radiotherapy.

PURPOSE: The study compared the setup reliability of 3 patient immobilization systems, a rubber leg cushion, the alpha cradle, and the thermoplastic Hipfix device, in 77 patients with cT1-T3, N0, M0 prostate cancer receiving conformal radiotherapy. METHODS AND MATERIALS: Port films were analyzed and compared to simulation films to estimate the setup errors in the three coordinate axes (anterior-posterior, cranial-caudal, medial-lateral). A total vector error was calculated from these shifts. RESULTS: The Hipfix was found significantly superior to the other two devices in reducing mean setup errors in all axes (p < 0.005). The average field-positioning error with the Hipfix ranged from 1.9 mm to 2.6 mm for all axes, whereas the deviation for the other two systems ranged from 2.7 to 3. 4 mm. Errors greater than 10 mm were virtually eliminated with the Hipfix system. There was a reduction in the mean total vector error in the alpha cradle and Hipfix patient cohorts over time, reflecting improved efficacy as a result of experience. CONCLUSION: There was a significant difference in the performance of each immobilization device. The Hipfix was consistently more reliable in reducing setup errors than the other devices.

Efficacy of retrograde stentograms following cystectomy and diversion.

PURPOSE: The radiological evaluation of ureteroenteric anastomoses following cystectomy and diversion is standard practice at our institution. To our knowledge there are no data that demonstrate the efficacy of retrograde "stentograms" following cystectomy. MATERIALS AND METHODS: A retrospective analysis of the retrograde stentograms of 73 patients who underwent cystectomy and diversion was reviewed. RESULTS: Of 135 ureteroenteric anastomoses 3 (2.2%) demonstrated a leak by retrograde stentogram. No patients had evidence of obstruction. CONCLUSIONS: The 2.2% incidence of ureteroenteric leak in our series does not support the routine use of retrograde stentogram following cystectomy and diversion.

Partial nephrectomy for pediatric renal cell carcinoma: an unusual case presentation.

Nine years after successful treatment of Stage IV neuroblastoma, a 10-year-old white girl was demonstrated to have a complex cystic mass in the upper pole of her solitary right kidney. Partial nephrectomy was performed, disclosing a renal cell carcinoma, predominantly clear cell type. No metastases were detected. Renal cell carcinoma is a rare cause of secondary malignancy. Partial nephrectomy can be used successfully to treat renal cell carcinoma in children.

Renal arteriovenous malformations masquerading as renal cell carcinoma.

Renal arteriovenous malformations may have varied clinical and radiographic appearances. Often, it remains difficult to distinguish these lesions from renal cell carcinomas to tailor the most appropriate diagnostic evaluation and therapy. We have encountered 6 patients with renal arteriovenous malformations that masqueraded as renal cell carcinomas and describe their clinical presentation and management.