High resolution computed tomography findings on the lung of early breast-cancer patients treated by postoperative breast irradiation with a hypofractionated radiotherapy schedule.

CONTEXT: Hypofractionated breast radiotherapy (RT), although convenient for patients and health care systems, could have a negative impact on normal tissues such as lung. AIMS: To evaluate radiation-induced lung toxicity in early breast-cancer patients treated by hypofractionated RT. SETTINGS AND DESIGN: We have been using the 42.5 Gy/16 fractions RT schedule since May 2003. As large fraction size is related to increased normal tissue toxicity we intended to investigate the possible radiation-induced lung toxicity to these patients, by performing high-resolution computed tomography (HRCT) 6 months after the completion of the treatment. METHODS AND MATERIAL: A group of 30 consecutive early breast cancer patients (T1-2N0M0) have been treated by the above-mentioned RT schedule, using a pair of opposing tangential fields. The impact of chemotherapy and hormonotherapy and various breast size-related parameters on HRCT lung changes were investigated. Acute skin and breast tissue reactions were also recorded. STATISTICAL ANALYSIS USED: Correlation of numerical variables was investigated by Pearson correlation coefficient. Logistic regression analysis was used to investigate correlation between HRCT findings (present vs absent) with other variables. RESULTS: Minimal HRCT findings were evident in 15/30 patients. These included small septal lines, linear and subpleural opacities and to a lesser extend, focal-ground glass opacification. The HRCT findings were positively correlated only to field separation (distance between the entrance points of the tangential beams on the breast) (H.R.=1.33, 95% CI: 1.013-1.75). CONCLUSIONS: The short 16-fraction RT schedule for early breast-cancer patients appears to have a minor effect on the underlying lung parenchyma.

Cine-MR in dissection of the thoracic aorta.

Magnetic resonance imaging (MRI) of the thoracic aorta, including cine-MRI, was performed in 25 patients suspected of having dissection of the thoracic aorta. MRI was correlated with echocardiography, CT and angiography. The sensitivity of MRI (100%) was most closely followed by CT and angiography (83% and 77% respectively). The specificity of MRI and angiography was equally good, at 100% each. MRI was able to demonstrate the intimal flap in all 9 cases of aortic dissection, and there were no false-positive results. Differentiation of thrombosis and slow flow was possible on proton density images, gradient echo images permitted detection of the entry and re-entry sites. The nature of the dissection was determinated correctly in 8 out of 9 cases. MRI is capable of providing all the relevant parameters necessary to decide appropriate treatment of dissecting aneurysms of the thoracic aorta.

[Sonography in salivary calculi--indications and status]. / Sonographie bei Speichelsteinen--Indikation und Stellenwert.

In 23 patients with sialolithiasis the value of real time sonography was investigated. The calculi were correctly diagnosed in 91% of the patients. 3 of 4 calculi could be localized in the main duct of the salivary gland. Because of the high accuracy and the possibility to detect non opaque stones, sonography should be performed, if on plain film the localisation of the calculi is questionable, before sialography is done. In sonolithotrypsy, sonography can be used to document the extraglandular localisation of intraductal calculi.

[Value and indications for high-resolution real-time sonography in nontumor salivary gland diseases]. / Stellenwert und Indikation der hochauflösenden Real-time-Sonographie bei nichttumorösen Speicheldrüsenerkrankungen.

308 patients with salivary gland diseases were investigated using real-time sonography. In 142 patients we suspected neoplasms of the salivary glands on the sonograms. In the remaining 166 patients we investigated the following entities: sialolithiasis (74 patients), acute sialadenitis (54 patients), abscess formation (16 patients), chronic sialadenitis or autoimmune disease (53 patients) and cysts of salivary gland (5 patients). The changes in the sonographic morphology of the different diseases will be described. The role of ultrasound in the diagnosis of the different diseases will be discussed and the indications for sonographic investigations are summarised.

Unerupted and displaced teeth in CT-scan.

The results of clinical examination, orthopantomographic examination and computed tomography were compared in 55 patients with impacted teeth. The results of computed tomography and orthopantomograms were equally good. Both methods were superior to clinical examination. With regard to the detection of displacement, contact and resorption, computed tomography was superior to both clinical examination and orthopantomograms.