Scanning and angiography in the diagnosis of pulmonary embolism.

Lung scanning is a safe and simple procedure which, when correlated with chest roentgenograms and clinical picture, is a valuable tool in diagnosing pulmonary embolism. Pulmonary arteriography is a valuable diagnostic procedure and should be employed when serious doubt exists as to the presence or absence of pulmonary emboli. It should also be used whenever surgical treatment is under consideration.

Further progress in CT scanning and computerized radiation therapy treatment planning.

Total body computed tomography has introduced a unique method of obtaining body contours as well as anatomical representations for radiation therapy treatment planning. CT scanning combined with computerized radiation therapy treatment planning has improved accuracy and contributed greatly to the solution of complex treatment problems. CT scans can also be used to evaluate the progress of patients undergoing radiation therapy.

Definitive treatment of carcinoma of the rectum by intracavitary radiation therapy.

A combination of external and contact irradiation treatment has been used successfully in treatment of selected patients with carcinoma of the rectum. The advantages include eliminating a permanent colostomy. If the treatment is unsuccessful in controlling the lesion, electrocoagulation and abdominoperineal resection are still available.

The use of computed tomography for radiation therapy treatment planning.

In this treatment planning method, information from total body scans is fed into a radiation therapy treatment computer, the Artronix PC-12 system with 16K core. By providing an accurate profile of the patients's anatomy, total body computed tomography may contribute greatly to the solution of complex treatment problems involving the head and neck, thorax and abdomen.

Nasopharyngeal carcinoma in the second decade of life.

The clinical findings and treatment results in 27 patients, 11 to 20 years of age, with nasopharyngeal carcinoma were retrospectively reviewed. The histological diagnosis was lymphoepithelioma in 18 patients and undifferentiated carcinoma in nine patients. Seven patients (26%) presented with T4 lesions, 24 patients (89%) with clinically positive cervical nodes, and two patients (7%) with distant metastases. All patients received radiation therapy to the primary site; chemotherapy was employed as an adjuvant in six patients. Overall survival was 64% at five years and 57% at 10 years. Local control of the primary tumor and regional lymph nodes was 85%. Distant metastases were more frequent in patients with advanced primary disease and were associated wtih extremely poor prognoses. A moderate dose of radiotherapy is the recommended treatment for primary tumors and neck nodes. More effective adjuvant chemotherapy is suggested as a possible way to improve therapeutic results.

New dimensions in computed tomography.

Total body CT scanning may be utilized as a means of treatment planning for radiation therapy. Computer reconstruction of coronal and sagittal views from CT cross-sectional slices was accomplished by taking each of the cross-sectional images and placing them together in the specific order in the sequence in which they were scanned to form a cube. Once the cube is built, retrieving in the sagittal and coronal views is readily achieved.

Computed tomography of the pancreas.

Computed tomography (CT) has proven useful in diagnosing inflammatory and neoplastic disease of the pancreas. Neoplasms of the pancreas produce enlargement of the gland and loss of surrounding fat planes. Acute pancreatitis also produces enlargement but correct diagnosis can be made with the clinical correlation. The usefulness of CT in chronic pancreatitis depends upon the state of the disease. Distinction between an inflammatory and a neoplastic mass is not possible on the basis of a CT scan alone. CT is also useful for needle guidance for aspiration biopsy of the pancreas.

Computed tomography of the thorax and abdomen; a preliminary report.

The utility of computed tomography (CT) in the study of the anatomy, physiology, and pathology of the human body has been the subject of considerable interest since the introduction of CT scanning. The advent of a new prototype scanning device has made it possible to examine a variety of abnormalities in the abdomen and thorax in a manner not previously possible. This development permits a remarkable insight into the study of human disease in vivo.

Half and total body radiation for carcinoma of the prostate.

Despite recent advances in the treatment of stage D carcinoma of the prostate many patients become refractory to all therapeutic modalities. Progressive and incapacitating pain is one of the most difficult symptoms to manage. Ten patients with severely symptomatic metastatic adenocarcinoma of the prostate have been treated with either single or sequential doses of half body radiation using 800 rad delivered by a Linac 10 mV linear accelerator. There were 15 courses of half body radiation delivered and a good to excellent response was noted in 11 instances. Results often were immediate and the duration of the response was variable. Treatment was well tolerated with no fatal complications. Half and total body radiation appears to offer significant palliation and its use with other forms of therapy warrants further investigation.