The supernumerary kidney especially on right side is a rare diagnosis. Only few case reports are documented in literature. We report a case of Right supernumerary kidney with partial fusion of right accessory kidney to upper kidney.
Porcelain gall bladder is a rare entity and a morphological variant of chronic cholecystitis. Dystrophic calcification along with inflammatory scarring of the wall gives the porcelain nature to the gall bladder. Patients are mostly asymptomatic and incidentally diagnosed on X-ray, ultrasound or CT abdomen. In the early stages they can be a surprise as only a histopathological diagnosis. Prophylactic cholecystectomy is recommended in view of high risk of malignancy.
DJ stent is a routine procedure performed by a urologist. DJ stents are forgotten when instructions are not given properly, illiteracy, ignorance, increased patient load in the clinic. Forgotten DJ stent associated with complications i.e., recurrent urinary tract infections, stone formation, fragmentation, migration, obstructive uropathy, hematuria, deterioration in renal function, urosepsis. Management of these forgotten DJ stents depends upon complications. Antibiotics manage encrusted DJ stents, ESWL or PCNL for the upper end, cystolithotripsy or cystolithotripsy, ureteroscopy for lower end. We describe the management of forgotten DJ stents in 3 patients.
Purpose:
For prostate anatomy, previous investigations have shown that simulated CT (sCT) generated from MR images can be used for accurate dose computation. In this study, we demonstrate the feasibility of MR‐only IMRT planning for prostate case.
Methods:
Regular CT (rCT) and MR images of the same patient were acquired for prostate anatomy. Regions‐of‐interest (ROIs) i.e. target and risk structures are delineated on the rCT. A simulated CT (sCT) is generated from the MR image using the method described by Schadewaldt N et al. Their work establishes the clinical acceptability of dose calculation results on the sCT when compared to rCT. rCT and sCT are rigidly registered to ensure proper alignment between the two images. rCT and sCT are overlaid on each other and slice‐wise visual inspection confirms excellent agreement between the two images. ROIs on the rCT are copied over to sCT. Philips AutoPlanning solution is used for generating treatment plans. The same treatment technique protocol (plan parameters and clinical goals) is used to generate AutoPlan‐rCT and AutoPlan‐sCT respectively for rCT and and sCT. DVH comparison on ROIs and slice‐wise evaluation of dose is performed between AutoPlan‐rCT and AutoPlan‐sCT. Delivery parameters i.e. beam and corresponding segments from the AutoPlan‐sCT are copied over to rCT and dose is computed to get AutoPlan‐sCT‐on‐rCT.
Results:
Plan evaluation is done based on Dose Volume Histogram (DVH) of ROIs and manual slice‐wise inspection of dose distribution. Both AutoPlan‐rCT and AutoPlan‐sCT provide a clinically acceptable plan. Also, AutoPlan‐sCT‐on‐rCT shows excellent agreement with AutoPlan‐sCT.
Conclusion:
The study demonstrates that it is feasible to do IMRT planning on the simulated CT image obtained from MR image for prostate anatomy.
The research is supported by Philips India Ltd
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