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A method of measuring ultrasonic propagation in the os calcis was devised for assessing bone properties in humans. Speed-of-sound (SOS) and broadband ultrasound attenuation (BUA) were measured using broadband acoustic pulses transmitted and received by a pair of focused transducers. The transducers are mounted coaxially in a water tank with the subject's heel in between. Reproducibility of results in an adult male was 10% for the BUA and 1.2% for the SOS. Both SOS and BUA changed when the transmission path through the os calcis was varied. For a population of normal male subjects, SOS and BUA were correlated with densitometry results on the os calcis, but less well correlated to area density at remote sites.

A prospective evaluation of neoadjuvant hormonal downsizing in patients with localized carcinoma of the prostate was undertaken to assess its effect on normal tissue irradiation. Twenty patients with stage T1 or T2 (A, B) carcinoma of the prostate received 3 months of Lupron prior to definitive radiotherapy. The volumes of the prostate, seminal vesicles, bladder, and rectum from both the pre- and posthormone treatment planning CT were entered onto a 3-D treatment-planning system. The treatment planning parameters were standardized to facilitate comparison of the pre- and posthormonal volumes. Following the three monthly injections of Lupron, the average volume of the prostate was reduced by 37%. As a consequence, the volume of the bladder receiving at least 40, 52, and 64 Gy was reduced by an average of 15, 18, and 20%, respectively. In addition, the volume of the rectum receiving at least 40, 52, and 64 Gy was reduced by an average of 13, 20, and 34%, respectively. In conclusion, in patients with localized prostate cancer, downsizing of the prostate resulted in a reduction in the volume of bladder and rectum receiving high radiation doses. This approach may result in an improvement in the therapeutic ratio by reducing the morbidity of treatment.

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Our data suggest that hemithoracic radiotherapy delivered after EPP using EPT may minimize dose to contralateral lung and other structures when compared with IMRT, without compromise of planning target volume coverage.

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