Pitchaya Thongkhao, et al: Effects of Regular Bra-wearing on Acute Skin Toxicity in Breast-conserving RadiotherapyBreast cancer is the most common cancer in Thai women with the annual Age-Standardized Rate (ASR) per 100,000 being 31.4 in 2015 [1]. According to breast cancer treatments, breast conserving therapy is one of the loco-regional treatment options. Radiotherapy after wide local excision reduces the locoregional recurrence rate as well as the risk of breast cancer death [2][3][4]. Conventional radiotherapy regimens, after breast conservation surgery, deliver a total dose of 46-50 Gy in 23-25 daily fractions over 5 weeks [3][4][5][6][7]. A boost to the tumor bed is recommended in patients with a higher risk of recurrences with the typical boost doses being 10-16 Gy in 4-8 fractions [5-7-12].Acute skin toxicity is the most common side effect of Abstract Purpose: To evaluate the effects of regular bra-wearing during radiotherapy on acute skin toxicity (AST) and the Quality of Life (QOL) in women with breast conserving therapy (BCT). Methods: A prospective study of 99 patients with any stage of breast cancer who underwent BCT. Patients were instructed to wear an appropriate bra then they were classified by total hours of wearing a bra during the radiotherapy treatment course into Non-Bra-Wearing (NBW) (0 hr.) and Bra-Wearing (BW) groups (>0 hr.). The AST was assessed weekly and one week after treatment end by CTCAE v 4.03. The QOL was assessed before and one week after treatment end by The Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) Thai version 4. Results: 66 patients were in the BW group and 33 patients were in the NBW group. The rate of ≥ G2 AST was lower in the BW group compared to the NBW group (16.7% vs. 54.5%, p<0.001, respectively). In the multivariate analysis, the statistically significant factors that were associated with increased the risk of ≥ G2 AST were NBW (0 hr.) (p<0.001), high body mass index (p=0.001), and the high percentage of maximum dose (p=0.043). There were no differences in all parts of after treatment FACT-B between the two groups (118.4 vs. 114.7, p=0.256, respectively). Conclusions: Regular BW during radiotherapy is not associated with an increased risk of ≥ G2 acute skin toxicity and does not affect the QOL compared to NBW.
Recently, deep learning with generative adversarial networks (GANs) has been applied in multi-domain image-to-image translation. This study aims to improve the image quality of cone-beam computed tomography (CBCT) by generating synthetic CT (sCT) that maintains the patient’s anatomy as in CBCT, while having the image quality of CT. As CBCT and CT are acquired at different time points, it is challenging to obtain paired images with aligned anatomy for supervised training. To address this limitation, the study incorporated a registration network (RegNet) into GAN during training. RegNet can dynamically estimate the correct labels, allowing supervised learning with noisy labels. The study developed and evaluated the approach using imaging data from 146 patients with head and neck cancer. The results showed that GAN trained with RegNet performed better than those trained without RegNet. Specifically, in the UNIT model trained with RegNet, the mean absolute error (MAE) was reduced from 40.46 to 37.21, the root mean-square error (RMSE) was reduced from 119.45 to 108.86, the peak signal-to-noise ratio (PSNR) was increased from 28.67 to 29.55, and the structural similarity index (SSIM) was increased from 0.8630 to 0.8791. The sCT generated from the model had fewer artifacts and retained the anatomical information as in CBCT.
Objective: Diagnosis of a distal end radius fracture relies on various imaging studies. However, the relative usefulness of these studies is still a matter of some controversy. The aim of this study was to compare the intra-observer and inter-observer reliability of plain radiographs, standard computed tomography (CT) scans and mobile CT scans in the assessment of distal radius fractures as categorized by the Fernandez classification method. The secondary objective was to compare the dosages of radiation between the different imaging modalities. Material and Methods: Sixteen fresh cadaveric wrist bones were used in this experimental study. The desired fractures were created in the bones to mimic Fernandez types I-V fractures and plain radiographs were taken in 4 views. Standard CT and mobile CT scans were also taken with the fractured bones in the same four positions. Interobserver reliability was assessed using Kappa statistics to determine the diagnostic consistency among the nine observers. Inter-observer agreement was assessed based on the Fernandez classification system diagnoses. Results: Overall, the inter-observer agreement was substantial for the Fernandez classifications (Kappa range 0.636 0.727) in all types of imaging. For intra-observer agreement, the analysis found higher agreement for both standard CT scans and mobile CT scans. The standard CT images imparted a higher average dose of radiation than both the mobile CT scans and the plain radiographs.Conclusion: The mobile CT scan can provide an alternative imaging method for precise diagnosis of distal end radius fractures, with the additional benefits of mobility and lower radiation exposure.
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