A technique for the automatic reconstruction of the spatial coordinates of seeds in an interstitial implant has been developed. Seed coordinates from three isocentric radiographs, an anterior-posterior film, and an orthogonal pair of films taken at gantry angles of +/- 45 degrees from the anterior-posterior direction are digitized and recorded in a random sequence. From this, the three-dimensional coordinates of the seeds in the implant are computed by matching the values of common coordinates along the axis of rotation. This rotate and match technique leads to an accurate and consistent identification and reconstruction of seeds with 90% of them within 2 mm of their actual location. These new computer routines have been added to an existing treatment planning system (AECL TP-11 treatment planning system, version 5A). We present our algorithm and technique along with clinical examples.
A rabbit model of hind limb ischemia was designed to demonstrate that new, hemodynamically significant arterial connections will develop between ischemic skeletal muscle and an independently perfused muscle pedicle flap. The right common iliac artery was divided in 15 rabbits. In eight rabbits a muscle flap based on the left deep inferior epigastric artery was transposed to the right thigh (flap group). In seven rabbits a sham operation was performed where the flap was sutured to the abdominal wall (sham group). After 7 days angiography demonstrated arterial connections between the flap and the native limb circulation in all of the flap group animals. The flap increased muscle perfusion in the ischemic limb (2.99 ml/100 gm muscle/minute in the flap group, vs 2.06 ml/100 gm muscle/minute in the sham group, p less than 0.005). Hemodynamically significant vascular connections will develop between a well-perfused muscle flap and an ischemic limb. The augmentation in perfusion provided by these connections can be quantified.
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