The purpose of this research was to employ the audit method to measure performance and identify targets of change, setting a template for future large-scale investigations that may inform decisions involving sonographer role expansion in Canada. The authors conducted an audit of 433 sonographic examinations performed in the ultrasound department of a Canadian hospital. Sonographer reports were contrasted with radiologist final reports, and a degree of agreement (DoA) 1 to 4 was assigned to each exam package. In total, 322 of 429 (75%) exam packages were ranked as DoA 1 (complete agreement between sonographer and radiologist), 86 of 429 (20%) were ranked as DoA 2, 16 of 429 (4%) were ranked as DoA 3, and 5 of 429 (1%) were ranked as DoA 4 (significant discrepancy between sonographer and radiologist). The results revealed a 75% agreement between sonographer and radiologist on imaging findings as they are recorded in technical impression sheets and reports. Discrepancies are usually minor and involve the omission of incidental findings by the radiologist.
11526 Background: Standard treatment of HGMG is surgical resection followed by adjuvant FRT; chemotherapy is under investgation in postoperative setting combined with external FRT. The phase III study of Stupp et al favours the combined TEM and FRT for newly diagnosed HGMG with encouraging results in terms of both survival and disease free survival. We present the experience achieved in our centre with 18 consecutive patients with HGMG treated with FRT and TEM either concomitant or sequential. Methods: In the period January 2004–January 2006 eighteen consecutive adult patients age range 25–72 years, median 55 years, sex ratio M/F 10/8 with histologically proven HGMG have been refferd in our centre for adjuvant treatment. Most of the patients had deep situated tumors that precluded complete resection which has been performed in 6 out of 18 patients. For the remaining patients stereotaxic biopsy was the procedure of diagnosis. A maximum dose of 60 Gy FRT was delivered with dual energy photon (6–15 MV) linear accelerator over six weeks in 30 sessions. TEM was administered concomitant in continuous low daily doses 75 mg/sqm in five patients (all males) followed by maintenance 150–200 mg/sqm for up to six cycles. For three patients TEM was co-administered for two cycles of 200 mg/sqm during the days 1–5 and 29–33 of radiotherapy course and whereas for the remaining patients the TEM was given sequentially after the completion of FRT up to six cycles in 5/28 days schedule. Results: With a median follow-up of 11.5 months the overall survival was 9.7 months and the survival rate of 78.5%. Clinical examination was performed every week during FRT with neurological improvement and a decrease in the need of anticonvulsivants in all patients. According to CTC criteria no grade 3 and 4 grade toxicities were recorded. After the completion of FRT imaging evaluation (CT/MRI) was performed at 6 weeks time period with tumor regression in 75% of the patients and early recurrence in only 2 cases. Conclusions: Concomitant FRT and TEM is a safe and promising treatment in newly diagnosed cases of HGMG. Our preliminary experience confirms the data from literature and we will present updated results by the ASCO meeting time. No significant financial relationships to disclose.
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