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Article in press
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Role of Low-Level Laser Therapy as an Adjuvant in Functional Rehabilitation of Patients with Joint Stiffness in Post-Burn Contracture
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Abstract [+]
Introduction
Post-burn contracture is a known sequelae of burn injuries involving neck, axilla, elbow, and hand. There are many methods which are used as adjuvant in rehabilitation of post-burn contracture patients. The low-level laser therapy (LLLT) is one of the methods that can be used as an adjuvant in rehabilitation of joint stiffness following burns and but with very few data available from India. In this article we share our experience of using LLLT for functional rehabilitation of a patient with joint stiffness following postburn contracture.
Materials and Methods
This study was conducted in a burns centre in a tertiary care institute in South India. Informed consent and departmental ethical committee clearance were obtained prior to study. The subject was a young boy with no known co-morbidities with stiffness of metacarpophalangeal and interphalangeal joint of index and middle finger of right hand. Patient was treated with contracture release with full thickness skin graft. The patient received low-level laser therapy to induce collagenolysis and to increase the movement of the joints. Each joint received laser therapy for duration of 125-second every time for 15-minutes for 2 sessions in
a span of 4-days.
Result
LLLT has been found to be useful in early rehabilitation of post-burn contracture patients with joint stiffness. No side effects were observed during the study.
Conclusion
The LLLT is an effective, safe, and non-invasive adjuvant in functional rehabilitation of our patient with joint stiffness following post-burn contracture. We suggest further study including multiple subjects and a control group for validation of the result.
Keywords
Low-level laser therapy (LLLT); Post-burn contracture; Joint stiffness; Functional rehabilitation.
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Role of Digital Assessment in Wound Management
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Abstract [+]
Aim
The aim of this study was to assess the role of digital planimetry in accurate measurement of wound size and guide in wound bed preparation in our patient. The calculation of wound surface area was done by using ImageJ software.
Methods
In our study, digital planimetry was used to measure the wound size using ImageJ software.
Results
In our study, digital planimetry helped inaccurate measurement of wound and helped to plan measures to decrease the wound size.
Conclusion
Digital assessment and ImageJ is a simple, easy, cost-effective technique of accurate wound measurement for wound management.
Keywords
Digital planimetry; ImageJ; Wound.
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Current State of Gonadal Shielding in Medical Imaging: A Review
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Abstract [+]
Introduction
In recent times the benefits of using gonadal shielding have been brought into question. Several professional bodies have released positional statements in support of ceasing the use of gonadal shields. However, in Australia the regulatory authority for radiation has not commented to date. This literature review aims to explore the risks and benefits of using lead protection and to establish the current state of the use of gonadal shields in clinical practice.
Methods
A search of the literature was conducted using online databases under the subject “Medical Imaging and Radiation Sciences”. Key terms and phrases included “lead protection”, “plain film imaging”, “lead shielding”, “gonadal shielding”, “X-ray”, “radiography”, “pelvic radiography”,
“radiation protection”, “methods”, “education” and “gonadal shielding”. Articles pertaining to radiation therapy, literature reviews and those not in English were excluded.
Results and Discussion
Gonad shields are often poorly used despite agreement of what constitutes accurate and inaccurate shielding. Inaccurate shielding relates to both inappropriate size and inaccurate positioning of shields. Retrospective studies demonstrated a higher incidence of inaccurate gonadal shield placement in females compared to males. Inaccurate shielding had implications for patients such as obscuration of important anatomy and pathology and increased radiation dose if repeat X-rays were required to correct positioning errors. Shield design innovation was identified as a future area of research that could assist with overcoming these errors. Where gonad shielding was found to be of benefit in patients with conditions that require regular follow-up imaging. This is especially important in conditions affecting children and adolescents who have increased radiosensitivity and longer life expectancy.
Conclusion
Studies have demonstrated high incidence of inaccurately positioned gonad shields for female patients, which leads to repeated X-ray images and increased dose to patients. However, shielding has been shown to be beneficial for patients requiring frequent X-ray examinations to reduce cumulative radiation dose. Establishing a standardised protocol regarding the application of gonadal shields, supported by regulatory agencies, is imperative.
Keywords
Radiography; Gonadal lead protection; Dose; Radiation protection; Regulation.
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Current Issue
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The Emergency Coil Embolization of Iatrogenic Injury to Carotid with Supraclinoid Pseudoaneurysm and Carotid Cavernous Fistula: A Case Report
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Abstract [+]
Carotid cavernous fistulae (CCF) are unique communication between the cavernous segment of the internal carotid artery (ICA) and the cavernous sinus. CCF are rare and result from traumatic skull base fractures (0.2-0.8%). CCF resulting from iatrogenic intradural traumatic aneurysms are not common, and they are hard to treat using a surgical approach. This report presents the case of a female patient with iatrogenic CCF, which resulted from proximal ICA injury. The CCF was successfully treated using the endovascular coil embolization. The patient has reported improvement in her vision, one-year follow-up routine has indicated
no recurrence with this technique.
Keywords
Coil embolization; Traumatic cerebral pseudoaneurysm; Carotid cavernous-fistula.
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The Use of Lead Protection for Staff in Mobile Radiographic Settings: Can Staff Abandon Its Use?
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The use of lead protection in patient contexts has recently come under scrutiny, with organisations moving towards ceasing its use in plain film radiography. The use of lead shielding in protecting staff in low-dose settings, such as plain film and mobile radiography,
is therefore an important aspect of practice to be reviewed. The objective of this review is to evaluate the use of lead shielding in protecting staff in plain film and mobile radiography, while also exploring the evolution of occupational doses and perceptions of lead protection. While literature is limited on the use of lead protection for staff in mobile settings, lead protection has been shown to reduce staff and adjacent patient dose from scatter. Furthermore, despite the increased frequency of medical imaging procedures in contemporary radiography, the occupational doses of medical radiation workers have reduced over time. With literature demonstrating gaps in current understandings of radiobiological mechanisms at low doses, the linear no-threshold model utilised to estimate radiation risk and develop protection standards cannot be rejected. Thus, this review finds the need for further research to be undertaken to improve risk estimates at low doses in larger cohorts of medical radiation workers, for the demonstration of long-term effects from occupational exposure, prior to ceasing staff lead protection.
Keywords
Radiation protection; Occupational dose; Lead protection; Mobile radiography; Radiography; COVID-19 pandemic.
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Study of Analysis the Sensitivity of the Computational Environment for Radiological Research Field Size Based on Two Dimensional Dose Distribution for Water Phantom Cases
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Calculation of Photons Reaction Rate Resulting at 120 kVp X-ray Tube Voltage and 1 mAs as Function to Digital Imaging and Communications in Medicine Pixel Numbers Using Monte Carlo N-Particle Transport and a Voxel Model of a 29-Year-Old Patient
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Radio Histological Treatment of Endometrial Hyperplasia: A Case Report
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Previous Issue
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The Use of Artificial Intelligence in Computed Tomography Image Reconstruction: A Systematic Review
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Abstract [+]
Background
Current image reconstruction techniques in computed tomography (CT) such as filtered back-projection (FBP) and iterative reconstruction (IR) have limited use in low-dose CT imaging due to poor image quality and reconstruction times not fit for clinical implementation. Hence, with the increasing need for radiation dose reductions in CT, the use of artificial intelligence (AI) in image reconstruction has been an area of growing interest.
Aim
The aim of this review is to examine the use of AI in CT image reconstruction and its effectiveness in enabling further dose reductions through improvements in image quality of low-dose CT images.
Method
A review of the literature from 2016 to 2020 was conducted using the databases Scopus, Ovid MEDLINE, and PubMed. A subsequent search of several well-known journals was performed to obtain additional information. After careful assessment, articles were excluded if they were not obtainable from the databases or not available in English.
Results
This review found that deep learning-based algorithms demonstrate promising results in improving the image quality of low-dose images through noise suppression, artefact reduction, and structure preservation in addition to optimising IR methods.
Conclusion
In conclusion, with the two AI-based CT systems currently in clinical use showing favourable benefits, it is expected that AI algorithms will continue to proliferate and enable significant dose reductions in CT imaging.
Keywords
Computed tomography (CT); Artificial Intelligence (AI); Image reconstruction (IN); Machine learning (ML); Deep learning (DL); Dose reduction.
Abbreviations
AI: Artificial intelligence; CT: Computed tomography; ML: Machine learning; DL: Deep learning; FBP: Filtered back-projection; IR: Iterative reconstruction; MBIR: Model-based iterative reconstruction; LDCT: Low-dose computed tomography; FDA: U.S Food and Drug Administration; ANN: Artificial neural network; DNN: Deep neural network; CNN: Convolutional neural network; CNR: Contrast-to-noise ratio; SNR: Signal-to-noise ratio.
Study of Analysis the Sensitivity of the Computational Environment for Radiological Research Field Size Based on Two Dimensional Dose Distribution for Water Phantom Cases
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Abstract [+]
Purpose
This study analysed the sensitivity of the field size from variations in the target volume dimensions, depth, and position. The variations in the target volume analysis were used to determine the width of the field size. Thus, the quality control of the radiation beam can be obtained.
Materials and Methods
The computed tomography (CT) image of the IBA Dose 1 type of water phantom consists of 350 slices. Variations in the dimension of the target volume were modelled in 10×10×10 cm3, 10×12×10 cm3, 10.2×10×10.2 cm3, and 15×15×15 cm3. Beam parameters use one beam of irradiation on the central axis 0°, 6 MV energy, 100 cm source-skin distance (SSD), beamlet delta x, and y set to 0.1 cm. Dose distribution in the form of the XZ isodose curve and dose profile was used to observe the field size.
Results
In this study, the isodose curve was successfully displayed in the XZ isodose curve. The field size’s sensitivity has been successfully reviewed from variations of the target volume, depth, and position. The target X and Z direction analysis is used in determining the width and length of the field size.
Conclusion
The analysis related to the field size sensitivity study was obtained from a relatively valid calculation. The field size was evaluated with variations in depth of 1.5 cm, 5 cm, 10 cm, and variations in positions of 10 cm, 12 cm, 14 cm, 18 cm, and 20 cm. This study will be used as a reference to validate the distribution of computational environment for radiotherapy research (CERR) dose in the future. Thus, the accuracy of the dose calculation can be obtained.
Keywords
2D Dose Distribution; Sensitivity; Quality control; Treatment planning system; Radiation therapy dosimetry.
Calculation of Photons Reaction Rate Resulting at 120 kVp X-ray Tube Voltage and 1 mAs as Function to Digital Imaging and Communications in Medicine Pixel Numbers Using Monte Carlo N-Particle Transport and a Voxel Model of a 29-Year-Old Patient
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Abstract [+]
Purpose
To read the digital imaging and communications in medicine (DICOM) images of brain and extract intensity values and build a three dimensional model for Monte Carlo n-particle transport (MCNP) code input file in purpose to study the average particle flux and deposited energy of X-Ray photons resulting at 120 kVp and 1 mAs (form point source) as function to DICOM pixel numbers in the brain tissues for a 29-year-old female patient using MCNP code and Matlab program to read the DICOM images.
Method
The matrix laboratory (MATLAB) program was used to read the DICOM images and extract the intensity values in each pixel of the DICOM image corresponding to certain slice of the brain. These color levels are characteristic of different tissue, and have been relied upon to create the specific material in each volume element in MCNP input file.
Conclusion
Values of the deposited energy at surface of skin are high, so it is always necessary to be cautious when performing the examination to obtain acceptable images from the first time and without having to repeat the imaging again for the same case unless there are necessities for it.
Keywords
Computed tomography (CT); X-ray; Voxel phantom; MCNP Code; Average particle flux; Matlab.
Radio Histological Treatment of Endometrial Hyperplasia: A Case Report
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Abstract [+]
Endometrial hyperplasia is defined as the pathological condition caused by hyper plastic changes at the level of the glandular and stromal structures of the endometrium that are part of the lining of the endometrial cavity. Atypical endometrial hyperplasia can cause an essential problem because it is considered a precursor of endometrial cancer. The early diagnosis of precancerous endometrial
lesions and the exclusion of pre-existing endometrial carcinomas are necessary for patients’ optimal management. The following is a case of a 50-year-old Guatemalan patient with a three-day history of vaginal bleeding. The transvaginal ultrasound reports endometrial thickening suggestive of endometrial hyperplasia. The diagnosis was confirmed with histology. The treatment offered was surgery without indicating any medication.
Keywords
Endometrium; Endometrial hyperplasia; Biopsy; Histological; Echography; World Health Organization (WHO).
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