Acute presentation of lymphangioma of the retroperitoneum.
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Adult↗
Biomedical subjects
C Loughrey
Publications and source records attributed to C Loughrey.
High precision focused irradiation in the form of fractionated stereotactic conformal radiotherapy (SCRT) for benign meningiomas predominantly in the skull base location.
OBJECTIVE: To present early clinical results of stereotactic conformal radiotherapy (SCRT) in patients with benign predominantly skull base meningiomas. MATERIAL AND METHODS: Between August 1994 and August 1999, 41 patients with benign residual or recurrent meningiomas were treated with SCRT. Thirty-three were histologically verified. All patients were immobilized in a GTC stereotactic relocatable frame, and underwent a post-contrast CT localization scan with additional MRI for fusion in 15 patients. Treatment was delivered on a 6 MV linear accelerator using three (12 patients), or 4 (29 patients) non-coplanar conformal fixed fields to doses of 50-55 Gy in 30-33 daily fractions. Tumours were relatively large with a median gross tumour volume (GTV) of 17.9 cm3 (range 2.5-183 cm3). RESULTS: At a median follow-up of 21 months (range 6-62 months) none of 41 patients have recurred. The current imaging tumour control rate is 100% at 1 and 3 years. The actuarial survival at 2 years is 100% and 91% at 3 and 5 years. Following SCRT tumour decreased in size in 9 patients. SCRT was well tolerated. Five patients had improvement in vision, and six patients improvement in cranial nerve function. Two patients whose planning target volume (PTV) included the sella developed hypopituitarism during and at 18 months after SCRT. One patient with pre-existing hydrocephalus due to pineal region meningioma developed cognitive impairment 7 months after treatment. One patient with involvement of the optic nerve had visual deterioration at 18 months. CONCLUSIONS: SCRT is a feasible high precision irradiation technique for residual and recurrent skull base meningiomas including both small and larger tumours with excellent early tumour control and low toxicity. Longer follow-up is necessary to demonstrate sustained tumour control and low morbidity of such high precision localized method of fractionated irradiation.
Adult↗
Teleradiology.
Advances in telecommunications and computer software have led to the development of radiology image transfer systems. Radiologists may now report radiographs at a site distant from that of the examination, in some cases almost instantaneously. Computed tomography, magnetic resonance imaging, and ultrasonography may also be supervised from afar. Developments over the past few decades are reviewed, allowing an understanding of the systems currently available. These include systems that transmit static images and real time video systems that enable interactive supervision from a radiologist at a distant site. The implications for the practice of radiology are discussed and the main areas of development over the next few years explored.
Computer Communication Networks↗
Initial experience with a electronic CT image transfer system.
An electronic image transfer system for computed tomographic images links the CT scanner in Altnagelvin Hospital, Londonderry with the regional neuroradiology department in the Royal Victoria Hospital, Belfast. In the first 13 months of operation, scans of 100 patients were transferred; 49 scans were taken in acute neurosurgical emergencies, and 51 were non-acute sent for a specialist neuroradiological opinion. Potentially hazardous inter-hospital transfer was avoided in 21 cases of acute neurosurgical emergency, and more efficient and appropriate referral was achieved in the cases whose scans had been sent for sent for radiological second opinion. We believe that the system has substantially improved the diagnosis and management of patients with neurosurgical problems in both hospitals.
Adolescent↗