Purpose: The contribution of in‐vivo dose measurement of organs at risk by TLD and semiconductor detectors during Intensity‐modulated radiotherapy technique in treatment of prostate cancer was studied. Methods: Appropriate prostate cancer patients target and organs at risk contours that managed for IMRT planning were fusion on CT images of Rando phantom. For PTV1 and 2 the equally angel nine fields (within 200°− 160°)IMRT plans were designed using 6MV photon energy with 180cGy per fraction to total dose of 45 and 72Gy respectively. The point dose and two‐dimensional dose measurements for the quality control evaluation of IMRT plans were done and found in appropriate limits. The 3 sub‐slab of Rando phantom were re‐made from paraffin and rectum cavity was created in accordance with the probe for measuring rectal dose. Based on dosimetric method each dosimeter was selected and located on measurement region. Prostate IMRT plans were applied to the phantom. In‐vivo dose measurements were repeated several times by TLD and diode, obtained dose values for rectum and bladder compared with TPS. Results: Both semiconductor and TLD dose measurement values for bladder and rectum is generally in agreement with the TPS. The rectum dose measurement values were differing from TPS up to 30% in intense dose gradient regions. This is because when the coordinates of the reference points are in intense dose gradient regions, +/− 1 mm changes in position create +/− 3–10% difference between the calculated and measured doses. Conclusion: The intracavitary rectum and bladder probes used for brachytherapy dosimetry applications could be applicable in external radiation treatments. In‐vivo dosimetry has an important role in the quality assurance of radiotherapy, especially to preventing errors which may occur in every stage of treatment. In this context,for more complex treatment techniques like IMRT the traditional in‐vivo dosimetric methods using TLD and semiconductor diodes was found to be reliable.
Inflammatory pseudotumor tumors (IPTs) of the spleen are uncommon lesions of uncertain pathogenesis. A definitive clinical diagnosis is challenging because radiological, as well as gross pathologic features may suggest a lymphoma, an inflammatory myofibroblastic tumor (IMT), or an IPT-like follicular dendritic cell tumor (IPT-FDC). Herein, we report a case of an IPT of the spleen in a 48-year-old woman who presented with idiopathic thrombocytopenic purpura (ITP) symptoms. The results of abdominal ultrasonography revealed the presence of a splenic mass that continued to enlarge after the recovery from ITP, leading to the suspicion of lymphoma. A splenectomy was performed for diagnostic and curative purposes. The lesion was a non-encapsulated yellowish mass (largest diameter: 4,4 cm). The presence of spindle cells expressing smooth muscle actin, vimentin, and focal CD68 admixed with polymorphous lymphoid infiltrate supported the IPT diagnosis. The negative expression of CD21, CD23, CD35, and ALK excluded inflammatory myofibroblastic and follicular dendritic cell tumors. Any evidence of the recurrence of either ITP or IPTs was not noted 60 months after the operation. The present case and the review revealed that splenic IPT tends to occur in middle-aged females and diagnosis is challenging due to the absence of specific symptoms or the characteristic hematological or radiological findings. Surgery is the most frequently performed treatment. Although multiple factors have been suggested in the etiology and pathogenesis, previous bleeding may also play a role in the presence of IPTs in patients with ITP. The rare occurrence of splenic IPT and the lack of diagnostic clinical signs and symptoms do not exclude their consideration in the differential diagnosis of spleen tumors, especially in patients with imaging features that cannot rule out malignancy.
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