Detailed and applied anatomy for improved rectal cancer treatment.

Rectal anatomy is one of the most challenging concepts of visceral anatomy, even though currently there are more than 23,000 papers indexed in PubMed regarding this topic. Nonetheless, even though there is a plethora of information meant to assist clinicians to achieve a better practice, there is no universal understanding of its complexity. This in turn increases the morbidity rates due to iatrogenic causes, as mistakes that could be avoided are repeated. For this reason, this review attempts to gather current knowledge regarding the detailed anatomy of the rectum and to organize and present it in a manner that focuses on its clinical implications, not only for the colorectal surgeon, but most importantly for all colorectal cancer-related specialties.

Dose reduction in CT while maintaining diagnostic confidence: diagnostic reference levels at routine head, chest, and abdominal CT--IAEA-coordinated research project.

PURPOSE: To measure radiation doses for computed tomography (CT) of the head, chest, and abdomen and compare them with the diagnostic reference levels, as part of the International Atomic Energy Agency Research coordination project. MATERIALS AND METHODS: The local ethics committees of all participating institutions approved the study protocol. Written informed consent was obtained from all patients. All scanners were helical single-section or multi-detector row CT systems. Six hundred thirty-three patients undergoing head (n = 97), chest (n = 243), or abdominal (n = 293) CT were included. Collected data included patient height, weight, sex, and age; tube voltage and tube current-time product settings; pitch; section thickness; number of sections; weighted or volumetric CT dose index; and dose-length product (DLP). The effective dose was also estimated and served as collective dose estimation data. RESULTS: Mean volumetric CT dose index and DLP values were below the European diagnostic reference levels: 39 mGy and 544 mGy . cm, respectively, at head CT; 9.3 mGy and 348 mGy . cm, respectively, at chest CT; and 10.4 mGy and 549 mGy . cm, respectively, at abdominal CT. Estimated effective doses were 1.2, 5.9, and 8.2 mSv, respectively. CONCLUSION: Comparison of CT results with diagnostic reference levels revealed the need for revisions, partly because the newer scanners have improved technology that facilitates lower patient doses.