PurposeMagnetic resonance imaging-guided radiation therapy (MRgRT) requires patient positioning within the MR bore and prolonged MR imaging during delivery, both of which are new in radiation oncology. Patient tolerance of MRgRT was prospectively evaluated using patient-reported outcome questionnaires (PRO-Q).MethodsOur MRgRT procedure involves daily high-resolution MR scanning, limited re-contouring, daily plan re-optimization, quality assurance (QA), and gated delivery. Patients with claustrophobia are excluded. Mean fraction duration was 45 and 60 minutes for stereotactic treatments during free-breathing and breath-hold, respectively. Patient-controlled video-feedback was used for breath-hold delivery. PRO-Qs collected in the first 150 patients treated included questions on MR-related complaints and also evaluated aspects of active participation.ResultsAlmost one-third of patients (29%) scored at least one PRO-Q item on MR-related complaints as ‘moderate’ or ‘very much’, with noise, feeling cold, and paresthesia being the most frequently scored in this way. Considerable anxiety was reported by 5%, but no medication was required for this in any patient. Patient participation in video feedback for breath-hold delivery was appreciated by the majority of patients, all of whom completed the procedure. Only 5% of patients considered treatment duration to be unacceptably long.ConclusionDespite the lengthy MRgRT procedure, outcomes of PRO-Q indicate that it was well-tolerated by patients.
This paper describes a technique of binocular simultaneous fundus reflectometry in rabbits and man, using a ‘low vacuum’ contact lens with a built-in light source and a cadmium sulphide photo cell. At a high sensitivity level the fundus plethysmogram can be recorded. Fundus reflectometry further enables recording of the decrease of light reflection after intravenous dye injection. In patients with unilateral carotid occlusion even small differences in arm-fundus circulation time between both sides could be measured.
Continuous bilateral simultaneous measurement of the circulation time between arm and ocular fundus and arm and earlobe was performed by fundus reflectometry (FRM). Differences in dye appearance time between the two ocular fundi were larger in cases of angiographically proved stenosis or occlusion of the common or the internal carotid artery. Prolonged dye appearance times in the earlobe were observed in occlusive disease of the common or external carotid artery. The harmless method of FRM seems to be useful in the detection of carotid occlusive disease and helpful in deciding whether carotid angiography should be performed.
The measurement of changes in oxygenation of blood with the aid of fundus reflectometry contact lenses and the effect of elevation of the intraocular pressure on the vascular system of the ocular fundus are described. fundus fluorescence after i.v. fluorescein injection had so far been successful only in animal experiments
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