Abdominopelvic Region Research Articles

Second Recurrence of Aggressive Angiomyxoma of Labia Majora in a 34-Year-Old Woman: A Case Report and Review of Literature

AbstractAggressive angiomyxoma (AAM) is a rare, slow-growing, benign neoplasm with high recurrence and local invasion. It is usually asymptomatic and frequently presents as a mass affecting the perineal and pelvic regions of women in reproductive age group. We present a rare case of a 34-year-old woman with second recurrence of a giant AAM arising from labia majora. The patient presented with a slow-growing pedunculated mass (around 20 × 12 cm) over the right labia majora for the past 1 year. In the last 10 years, she was operated on two different occasions (2013 and 2015) for similar lesion and was a confirmed case of AAM. Ultrasound of the lesion and magnetic resonance imaging of the abdominopelvic region was suggestive of recurrent AAM. The patient underwent en bloc dissection of the tumor with negative margin. Histopathological examination confirmed the diagnosis of recurrent AAM. En bloc dissection with negative margin leads to complete removal of tumor mass. However, long-term follow-up with annual magnetic resonance imaging is advised.

Using computed tomography to evaluate anatomic landmarks in taiwanese trauma patients for insertion of resuscitative endovascular balloon occlusion of the aorta: A retrospective cohort study.

Hemorrhage, particularly from non-compressible torso hemorrhage (NCTH) in the abdominopelvic region, is a leading cause of preventable trauma deaths. Resuscitative endovascular balloon occlusion of the aorta (REBOA), designed for aortic occlusion, has emerged as a tool for temporary hemorrhage control in recent years. However, attaining optimal REBOA placement in diverse demographic groups, such as Asian populations, may pose challenges owing to unique anatomical and physiological differences. This retrospective study analyzed trauma patients who underwent torso computed tomography (CT) at tertiary hospitals in Taiwan from January 2014 to January 2017. The OsiriX software was used to measure the endovascular lengths in the CT images. Among the 223 patients, the median vascular lengths and body measurements were higher in males. The optimal fixed insertion length was identified as 47.5cm for zone 1 with 99.43% accuracy and 25.5cm with 82.1% accuracy for zone 3. The landmark-guided method showed 100% accuracy for zone 1 when using the mid-sternum and 94.6% for zone 3 with the umbilicus as the guide with the distance between the umbilicus, xiphoid process, and pubic ramus. External validation confirmed the accuracy of the landmark-guided method. For zone 1 occlusions, a range of 44-48cm insertion length cross-referenced with the mid-sternal landmark is recommended. For zone 3 occlusions, using the umbilicus as a guide with the distance between the umbilicus, xiphoid process, and pubic ramus provided the highest accuracy.

Effects of organ dose modulation applied to a part of the scan range on radiation dose in computed tomography of the body

In computed tomography (CT), organ dose modulation (ODM) reduces radiation exposure from the anterior side to reduce radiation dose received by the radiosensitive organs located anteriorly. We investigated the effects of ODM applied to a part of the scan range on radiation dose in body CT. The thorax and thoraco-abdominopelvic region of an anthropomorphic whole-body phantom were imaged with and without ODM. ODM was applied to various regions, and the tube current modulation curves were compared. Additionally, the dose indices were compared with and without ODM in thoracic and thoraco-abdominopelvic CTs in 800 patients. ODM was applied to the thyroid in male patients and to the thyroid and breast in female patients. In phantom imaging of the thorax, the application of ODM below the scan range decreased the tube current, and that to the breast showed a further decrease. Decreased tube current was also observed in phantom imaging of the thoraco-abdominopelvic regions with ODM below the scan range, and the application of ODM to the whole scan range, thyroid, breast, and both thyroid and breast further reduced the tube current in the region to which ODM was applied. In patient imaging, the dose indices were significantly lower with ODM than without ODM, regardless of the scan range or sex. The absolute reduction in dose-length product was larger for thoraco-abdominopelvic CT (male, 43.2 mGy cm; female, 59.7 mGy cm) than for thoracic CT (male, 30.8 mGy cm; female, 37.6 mGy cm) in both sexes, indicating dose reduction in the abdominopelvic region to which ODM was not applied. In conclusion, The application of ODM in body CT reduces radiation dose not only in the region to which ODM is applied but also outside the region. In radiation dose management, it should be considered that even ODM applied to a limited region affects the dose indices.

Size specific dose estimation in pediatric CT: preliminary study and conversion factors.

The objective of this paper is to compare the differences between volumetric CT dose index (CTDIVOL) and size-specific dose estimate (SSDEWED) based on water equivalent diameter (WED) in radiation dose measurement, and explore a new method for fast calculation of SSDEWED. The imaging data of 1238 cases of head, 1152 cases of chest and 976 cases of abdominopelvic were analyzed retrospectively, and they were divided into five age groups: ≤ 0.5, 0.5~≤ 1, 1~≤ 5, 5~≤ 10 and 10~≤ 15years according to age. The area of interest (AR), CT value (CTR), lateral diameter (LAT) and anteroposterior diameter (AP) of the median cross-sectional image of the standard scanning range and the SSDEWED were manually calculated, and a t-test was used to compare the differences between CTDIVOL and SSDEWED in different age groups. Pearson analyzed the correlations between DE and age, DE and WED, f and age, and counted the means of conversion factors in each age group, and analyze the error ratios between SSDE calculated based on the mean age group conversion factors and actual measured SSDE. The CTDIVOL in head was (9.41±1.42) mGy and the SSDEWED was (8.25±0.70) mGy: the difference was statistically significant (t=55.04, P<0.001); the CTDIVOL of chest was (2.68±0.91) mGy and the SSDEWED was (5.16±1.16) mGy, with a statistically significant difference (t=-218.78, P<0.001); the CTDIVOL of abdominopelvic was (3.09±1.58) mGy and the SSDEWED was (5.89±2.19) mGy: the difference was also statistically significant (t=-112.28, P<0.001). The CTDIVOL was larger than the SSDEWED in the head except for the ≤ 0.5year subgroup, and CTDIVOL was smaller than SSDEWED within each subgroup in chest and abdominopelvic. There were strong negative correlations between f and age (head: r=-0.81; chest: r=-0.89; abdominopelvic: r=-0.86; P<0.001). The mean values of f at each examination region were 0.81~1.01 for head, 1.65~2.34 for chest and 1.71~2.35 for abdominopelvic region. The SSDEWED could be accurately estimated using the mean f of each age subgroup. SSDEWED can more accurately measure the radiation dose of children. For children of different ages and examination regions, the SSDEWED conversion factors based on age subgroup can be quickly adjusted and improve the accuracy of radiation dose estimation.

Melatonin administration in testicular damage caused by low and high-dose rate radiotherapy: An experimental study

ObjectiveThis study aimed to explore the radioprotective effect of melatonin against acute testicular injury caused by low- and high-dose-rate radiotherapy in rats. Materials and methodsA total of 40 12-week-old adult male rats were divided into 5 groups (n = 8). Group 1 comprised control rats who were not subjected to any procedures. A single dose of 8 Gy (Gy) radiotherapy was administered to the abdominopelvic regions of Group 2 (low-dose rate radiotherapy (LDRR) group) and Group 4 (high-dose rate radiotherapy (HDRR) group) rats at dose rates of 400 MU/min and 1400 MU/min, respectively. A single dose of 8 Gy radiotherapy was administered to Group 3 (low-dose rate radiotherapy + melatonin (LDRR + MEL) group) and Group 5 (high-dose rate radiotherapy + melatonin (HDRR + MEL) group) rats at dose rates of 400 MU/min and 1400 MU/min, respectively. Following this, 50 mg/kg/intraperitoneal melatonin was given to the rats 15 min before radiotherapy. The subjects were sacrificed 48 h after radiotherapy. Histological, immunohistochemical, immunofluorescence, and biochemical analyses of testicular tissue samples were performed. ResultsAs a result of comparing the FF and FFF radiotherapy groups with the control group, a statistically significant difference was observed in histopathological, biochemical, immunohistochemical and immunofluorescent parameters (p < 0.001). An improvement in these parameters was observed in the groups where melatonin was applied along with radiotherapy (p < 0.001). Additionally, no statistically significant difference was found between FF and FFF dose rates (p > 0.05). ConclusionNo significant difference was observed between these low- and high-dose rates of radiotherapy in terms of testicular damage and the effect of melatonin. Further, melatonin may be useful in preventing testicular damage caused by low- and high-dose rate radiotherapy.

Appendiceal actinomycosis mimicking malignant tumor: a rare case report

Introduction: Actinomycosis is an uncommon bacterial infection caused by Actinomyces bacteria that typically progresses slowly and leads to the formation of masses. Although it commonly affects the cervicofacial area, about 20% of cases occur in the abdominopelvic region. Because the disease can be mistaken for a tumour due to its infiltrative mass-like nature on imaging, over 90% of cases are only diagnosed following surgery and histological confirmation. This report describes a case of an appendicular mass, initially suspected to be a malignant tumour, but eventually diagnosed as appendiceal actinomycosis. Presentation of case: Upon initial presentation, a 53-year-old woman with type II diabetes mellitus and no prior surgical history, displayed abnormal appendiceal uptake during a PET-computed tomography (CT) scan conducted for a suspected spinal tumour. Colonoscopy did not indicate any notable observations, and the patient chose to defer immediate action. Several months later, a CT scan revealed an increased mass-like appearance of the appendix compared to the previous PET-CT scan. After multidisciplinary discussions, a right laparoscopic hemicolectomy was recommended due to suspected malignancy. However, histological staining on microscopy confirmed actinomycosis originating from the appendix. Discussion: Chronic appendicitis with radiologic features similar to appendiceal carcinoma, or abdominal masses located in the ileocecal area, in patients with or without a previous surgical history should raise suspicion of actinomycosis. Conclusion: Appendiceal actinomycosis should be considered in the differential diagnosis in the aetiology of chronic appendicitis mimicking appendiceal carcinoma. Awareness and accurate diagnosis of appendiceal actinomycosis can prevent unnecessary extended surgery as was performed in this case.

Surgical evidence-based comparison of [68Ga]Ga-FAPI-04 PET and MRI-DWI for assisting debulking surgery in ovarian cancer patients.

Imaging assessment of abdominopelvic tumor burden is crucial for debulking surgery decision in ovarian cancer patients. This study aims to compare the efficiency of [68Ga]Ga-FAPI-04 FAPI PET and MRI-DWI in the preoperative evaluation and its potential impact to debulking surgery decision. Thirty-six patients with suspected/confirmed ovarian cancer were enrolled and underwent integrated [68Ga]Ga-FAPI-04 PET/MRI. Nineteen patients (15 stage III-IV and 4 I-II stage) who underwent debulking surgery were involved in the diagnostic efficiency analysis. The images of [68Ga]Ga-FAPI-04 PET and MRI-DWI were visually analyzed respectively. Immunohistochemistry on FAP was performed in metastatic lesions to investigate the radiological missing of [68Ga]Ga-FAPI-04 PET as well as its different performance in primary debulking surgery (PDS) and interval debulking surgery (IDS) patients. Potential imaging impact on management was also studied in 35 confirmed ovarian cancer patients. [68Ga]Ga-FAPI-04 PET displayed higher sensitivity (76.8% vs.59.9%), higher accuracy (84.9% vs. 80.7%), and lower missing rate (23.2% vs. 40.1%) than MRI-DWI in detecting abdominopelvic metastasis. The diagnostic superiority of [68Ga]Ga-FAPI-04 PET is more obvious in PDS patients but diminished in IDS patients. [68Ga]Ga-FAPI-04 PET outperformed MRI-DWI in 70.8% abdominopelvic regions (17/24), which contained seven key regions that impact the resectability and surgical complexity. MRI-DWI hold advantage in the peritoneal surface of the bladder and the central tendon of the diaphragm. Of the contradictory judgments between the two modalities (14.9%), [68Ga]Ga-FAPI-04 PET correctly identified more lesions, particularly in PDS patients (73.8%). In addition, FAP expression was independent of lesion size and decreased in IDS patients. [68Ga]Ga-FAPI-04 PET changed 42% of surgical planning that was previously based on MRI-DWI. [68Ga]Ga-FAPI-04 PET is more efficient in assisting debulking surgery in ovarian cancer patients than MRI-DWI. Integrated [68Ga]Ga-FAPI-04 PET/MR imaging is a potential method for planning debulking surgery in ovarian cancer patients.

Primary Monophasic Omental Synovial Sarcoma in Nulliparous Female: A Case Report

Synovial Sarcoma (SS) is an uncommon soft-tissue malignancy that primarily occurs near tendon sheaths and bone joints. Its primary intra-abdominal location is infrequent and characterised by non specific clinical signs. The mainstay of treatment remains wide local excision with negative margins. Hereby the authors report a rare case of monophasic omental SS in a 30-year-old nulliparous female who presented with chief complaints of an enlarging lump in the right abdominopelvic region over the past year and constipation for three months. The mass was non mobile and non tender. The rest of the physical and laboratory examinations were normal. She has a history of diagnostic laparoscopic excision (for the same complaint) of bilateral adnexal masses with right salpingectomy done three months ago in an outside set-up where histopathology diagnosed the mass as a low-grade fibromyxoid tumour. Presently, Contrast- enhanced Magnetic Resonance Imaging (CEMRI) revealed a large lobulated heterogeneous mass of 19.5×15.4×20 cm extending into mesorectal fat and encasing the sigmoid colon, rectosigmoid junction, uterus, and bilateral ovaries. The patient was taken for emergency surgery as she started displaying symptoms of acute obstruction. Debulking surgery (R2 resection) with ileostomy was performed. Histopathology and immunohistochemistry confirmed the diagnosis of monophasic SS. The patient was started on doxorubicin and has completed three cycles of chemotherapy. SS is an infrequent entity with high mortality rates. The main course of treatment is surgery with healthy resection margins. Long-term follow-up is required due to the high recurrence rate.

Ovarian Yolk Sac Tumors: Is Fertility Preservation Possible?

Abstract Yolk sac tumors make up 14% to 20% of all malignant ovarian germ cell tumors. Serum alpha-fetoprotein (AFP) levels are elevated in a significant number of patients and are useful for monitoring the response to treatment and for post-treatment surveillance. Surgery is required for diagnosis, staging, and treatment. The first case is a 12-year-old girl presented with abdominal pain. The ultrasonography (US) showed a huge pelvic tumor. AFP level was high (1000 mg/ml). Right salpingo-oophorectomy and pelvic lymphadenectomy were done. Histopathology reported yolk sac tumor of ovary. She received 3 courses of bleomycin, etoposide, cisplatin (BEP). The second case is a 25-year-old G1AB1 presented with pelvic pain and distension. The US showed a huge pelvic tumor in the right abdominopelvic region. AFP level was high (1000 mg/ml). Right salpingo-oophorectomy, omentectomy, and appendectomy were done. Histopathology reported yolk sac tumor of ovary. The patient received four cycles of BEP protocol; AFP level decreased to 10 mg/ml after the four cycles of chemotherapy. The third case is a 21-year-old girl presented with abdominal pain. The US showed a huge pelvic tumor in the right adnexa. AFP level was high (8700 mg/ml). Right salpingo-oophorectomy and pelvic lymphadenectomy were done. Yolk sac tumor is rare in children and it could be cured usually. In this study, we described three patients with ovarian yolk sac tumors and their fertility preservation treatments.These cases has reminded that in young age with high AFP levels and rapidly growing ovarian mass, diagnosis of the yolk sac tumor has to be kept in mind.

The Dosimetric Analysis of Duodenal and Intestinal Toxicity After a Curative Dose Re-irradiation Using the Intensity-Modulated Radiotherapy for Abdominopelvic Lymph Node Lesions.

This study aimed to examine the influence of dosimetric factors on gastrointestinal toxicity after radical re-irradiation for lymph node recurrence in the abdominopelvic region using a composite plan. Between January 2008 and March 2017, 33 patients underwent radical re-irradiation for lymph node recurrence in the abdominopelvic region with a complete overlap with previous radiation therapy (RT) with the median prescription dose of the second RTof 71.7 Gy10.Re-irradiation planning protocol for target volume and organs at risk (OARs) (duodenum, small and large intestines) was decided as follows: more than equal to 97% of the prescription dose was administered to the D95 (percentage of the minimum dose that covered 95% of the target volume) of planning target volume (PTV); minimal dose to the maximally irradiated doses delivered to 1cc [D1 cc] and 5cc [D5 cc] of OARs was set below 70 Gy3 and 50 Gy3, respectively; and D1 cc and D5 cc in the cumulative plans to OARs were 120 Gy3 and 100 Gy3.Kaplan-Meier analyses were performed to evaluate overall survival (OS) and univariate log-rank and multivariate Cox proportional hazards model analyses were performed to explore predictive factors. Using dose summation of the first and re-irradiation plans, we conducted a dosimetric analysis for grade ≥ 3 toxicities of the duodenum and intestine. With a median follow-up of 18 months, the two-year OSrate was 45.5%. The number of RT fields (localized or multiple) was a significant predisposing factor for OS rate with a hazard ratio of 0.23 (95% confidence interval 0.07-0.73). The two-year OS of the patients with a localized RT field was 63.6% and 9.1% for multiple RT fields (p= 0.00007). Four patients experienced grade ≥3 gastrointestinal toxicity related to re-irradiation (4/33=12.1%). We could not find any predisposing dosimetric value in the comparisons with and without toxicity. The dose constraints presented in this study are relatively low rates of toxicity, which may be useful when planning re-irradiation. Especially, for the patients who could be treated with localized RT field, radical re-irradiation with a high curative dose is a good option. No dosimetric predisposing factor was found for radical re-irradiation of abdominopelvic lesions in the composite plan.

Retroperitoneal anatomy with the aid of pathologic fluid: An imaging pictorial review.

The retroperitoneum, a complex anatomical space within the abdominopelvic region, encompasses various vital abdominal organs. It is compartmentalized by fascial planes and contains potential spaces critical in multiple disease processes, including inflammatory effusions, hematomas, and neoplastic conditions. A comprehensive understanding of the retroperitoneum and its potential spaces is essential for radiologists in identifying and accurately describing the extent of abdominopelvic disease. This pictorial review aims to describe the anatomy of the retroperitoneum while discussing commonly encountered pathologies within this region. Through a collection of illustrative images, this review will provide radiologists with valuable insights into the retroperitoneum, facilitating their diagnostic proficiency to aid in appropriate patient clinical management.

Maternal and Neonatal Outcomes of Gunshot Wounds in Pregnancy: A Systematic Review of Case Reports.

A systematic review was performed to compare adverse maternal and neonatal outcomes among pregnant patients with gunshot wounds (GSW) to the abdominopelvic vs other region(s) at > 20weeks gestation. A search of Medline Ovid, Elsevier Embase, EBSCO CINAHL, and Cochrane Library in July 2022 and reference searches resulted in 1742 studies, which were screened. The 41 included studies reported outcomes for 59 pregnant patients with GSW, of which 31 (52.5%) had an isolated abdominopelvic GSW and 28 (47.5%) had an extremity, thorax, head/neck, back/spine, poly-site, or other/unknown GSW. Stillbirth occurred in 26.7% of abdominopelvic GSW and 26% of non-abdominopelvic GSW. Maternal death occurred in 3.7% of abdominopelvic GSW and 10.7% of non-abdominopelvic GSW. Neonatal death occurred in 9.1% of abdominopelvic GSW and 5.3% of non-abdominopelvic GSW. Further research is needed to standardize the approach for the evaluation and management of patients with GSW in pregnancy.

When Not to Operate on Acute Cases-A Surgeon's Perspective on Rapid Assessment of Emergency Abdominopelvic Computed Tomography.

Clinical problem solving evolves in parallel with advances in technology and discoveries in the medical field. However, it always reverts to basic cognitive processes involved in critical thinking, such as hypothetical-deductive reasoning, pattern recognition, and compilation models. When dealing with cases of acute abdominal pain, clinicians should employ all available tools that allow them to rapidly refine their analysis for a definitive diagnosis. Therefore, we propose a standardized method for the quick assessment of abdominopelvic computed tomography as a supplement to the traditional clinical reasoning process. This narrative review explores the cognitive basis of errors in reading imaging. It explains the practical use of attenuation values, contrast phases, and windowing for non-radiologists and details a multistep protocol for finding radiological cues during CT reading and interpretation. This systematic approach describes the salient features and technical tools needed to ascertain the causality between clinical patterns and abdominopelvic changes visible on CT scans from a surgeon's perspective. It comprises 16 sections that should be read successively and that cover the entire abdominopelvic region. Each section details specific radiological signs and provides clear explanations for targeted searches, as well as anatomical and technical hints. Reliance on imaging in clinical problem solving does not make a decision dichotomous nor does it guarantee success in diagnostic endeavors. However, it contributes exact information for supporting the clinical assessments even in the most subtle and intricate conditions.

A CASE REPORT ON THE BILATERAL PSOAS MINOR MUSCLES WITH CLINICAL SIGNIFICANCE

The Psoas Minor is a thin paired muscle of the posterior abdominopelvic region, placed in front of the Psoas major.The psoas minor muscle is considered inconstant and is often absent, only being present in about 40% of human specimens studied.The psoas minor muscle originates from the vertical fascicles inserted on the last thoracic and first lumbar vertebrae. From there, it passes down onto the medial border of the psoas major and is inserted to the innominate line and the iliopectineal eminence. Additionally, it attaches to and stretches the deep surface of the iliac fascia and occasionally its lowermost fibers reach the inguinal ligament.

Relationships of Radiation Dose Indices with Body Size Indices in Adult Body Computed Tomography.

We investigated the relationships between radiation dose indices and body size indices in adult body computed tomography (CT). A total of 3200 CT scans of the thoracic, abdominal, abdominopelvic, or thoraco-abdominopelvic regions performed using one of four CT scanners were analyzed. Volume CT dose index (CTDIvol) and dose length product (DLP) were compared with various body size indices derived from CT images (water-equivalent diameter, WED; effective diameter, ED) and physical measurements (weight, weight/height, body mass index, and body surface area). CTDIvol showed excellent positive linear correlations with WED and ED. CTDIvol also showed high linear correlations with physical measurement-based indices, whereas the correlation coefficients were lower than for WED and ED. Among the physical measurement-based indices, weight/height showed the strongest correlations, followed by weight. Compared to CTDIvol, the correlation coefficients with DLP tended to be lower for WED, ED, and weight/height and higher for weight. The standard CTDIvol values at 60 kg and dose increase ratios with increasing weight, estimated using the regression equations, differed among scanners. Radiation dose indices closely correlated with body size indices such as WED, ED, weight/height, and weight. The relationships between dose and body size differed among scanners, indicating the significance of dose management considering body size.

Estimating size specific dose estimate from computed tomography radiograph localizer with radiation risk assessment

Quantifying radiation burden is necessary for optimizing imaging protocols. The normalized dose coefficient (NDC) is determined from the water-equivalent diameter (WED) and is used to scale the CTDIvol based on body habitus to determine the size specific dose estimate (SSDE). In this study we determine the SSDE prior to the CT scan and how sensitive the SSDE from WED is to the lifetime attributable risk (LAR) from BEIR VII. For calibration, phantom images are used to relate the mean pixel values along a profile ( ) of the CT localizer to the water-equivalent area (AW ) of the CT axial scan at the same z-location. Images of the CTDIvol phantoms (32cm, 16cm, and ∼1cm) and ACR phantom (Gammex 464) were acquired on four scanners. The relationship between the AW and was used to calculate the WED from the CT localizer for patient scans. A total of 790 CT examinations of the chest and abdominopelvic regions were used in this study. The effective diameter (ED) was calculated from the CT localizer. The LAR was calculated based on the patient chest and abdomen using the National Cancer Institute Dosimetry System for Computed Tomography (NCICT). The radiation sensitivity index (RSI) and risk differentiability index (RDI) were calculated for SSDE and CTDIvol. The WED from CT localizers and CT axials scans show good correlation (R2 =0.96) with the maximum percentage difference being 13.45%. The NDC from WED correlates poorly with LAR for lungs (R2 =0.18) and stomach (R2 =0.19), however that is the best correlation. The SSDE can be determined within 20% as recommended by the report of AAPM TG 220. The CTDIvol and SSDE are not good surrogates for radiation risk, however the sensitivity for SSDE improves when using WED instead of ED.

Clinicopathological Analysis and Treatment of Adult Patients with Inflammatory Myofibroblastic Tumor: A 15-Year Single- Center Study.

Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal malignancy that occurs primarily in children and adolescents. The clinical and pathological features of IMT in adult patients are not well understood. We retrospectively searched for records of adult patients with IMT at Fudan University Shanghai Cancer Center from 2006 to 2021. Clinicopathological data, treatments, and outcomes were collected and analyzed. Thirty adult patients with IMT, mostly women (60.0%), were included. The median age of the patients was 38 (21-77). The most common primary site was abdominopelvic region (53.3%), followed by lungs (20.0%). Seven patients had an abdominal epithelioid inflammatory myofibroblast sarcoma (EIMS). The positivity rate of anaplastic lymphoma kinase (ALK) was 81.5% (22/27). Sixteen patients with advanced ALK-positive disease received crizotinib, with an objective response rate (ORR) of 81.3% and a disease control rate of 87.5%. The median progression-free survival was 20.8 months. EIMS was associated with more aggressive behavior; however, the prognosis was similar to that of non-EIMS patients after treatment with an ALK inhibitor. At a median follow-up time of 30 months (95% confidence interval [CI], 13.6 to 46.4), the 5-year overall survival was 77% (95% CI, 66 to 88) in all patients. Adult IMTs appeared more aggressive, with a higher incidence of recurrence and metastases, and patients with EIMS had more aggressive cases. Treatment with ALK inhibitors resulted in a high ORR and a durable response, which suggested that ALK inhibitors could be used as a first-line treatment option in adult patients with ALK-positive advanced IMT.

The Effects of Melatonin on the Bladder in the Application of Low and High Dose Rate Radiotherapy in the Abdominopelvic Region in Rats

The Effects of Melatonin on the Bladder in the Application of Low and High Dose Rate Radiotherapy in the Abdominopelvic Region in Rats

AUTOMATED DETECTION OF CHILDHOOD OBESITY IN ABDOMINOPELVIC REGION USING THERMAL IMAGING BASED ON DEEP LEARNING TECHNIQUES

Childhood obesity is a preventable disorder which can reduce the risk of the comorbidities linked with an adult obesity. In order to improve the lifestyle of the obese children, early and accurate detection is required by using some non-invasive technique. Thermal imaging helps in evaluation of childhood obesity without injecting any form of harmful radiation in human body. The goal of this proposed research is to evaluate the body surface temperature in abdominopelvic and cervical regions and to evaluate which region is best for predicting childhood obesity using thermal imaging. Next, to customize the ResNet-18 and VGG-19 architecture using transfer learning approach and to obtain the best modified classifier and to study the classification accuracy between normal and obese children. The two-study region which was selected for this study was abdominopelvic and cervical region where the mean skin surface temperature was recorded. From the two selected body regions, abdominopelvic region has depicted highest temperature difference of 10.98% between normal and obese subjects. The proposed modified ResNet-18 model produced an overall accuracy of 94.2% than the modified VGG-19 model (86.5%) for the classification of obese and normal children. Thus, this study can be considered as a non-invasive and cost-effective way for pre-screening the obesity condition in children.

Estimation of organ-specific cancer and mortality risks associated with common indication-specific CT examinations of the abdominopelvic region

IntroductionThere is a paucity of large-scale studies reporting organ doses and cancer risks in patients who undergo indication-specific CT examinations. This study estimated organ-specific lifetime attributable risk (LAR) of cancer incidence and mortality among patients who underwent indication-based computed tomography (CT) examinations [(involving abdominopelvic lesion, kidney stones and computed tomography-intravenous urography (CT-IVU)] in about 70% of the functioning CT facilities in Ghana. MethodsWith a total of 1,100 data sets, organ doses were first determined using the National Cancer Institute Dosimetry System for CT (NCICTX) software version 2.1, and LAR values were predicted using the BEIR VII model. ResultsThe estimated radiation-induced colon cancer risks were likely in 39.4-59.8 out of 100,000 patients who underwent CT because of abdominopelvic lesion. The risk was even higher in CT-IVU examinations (53.3-66.4 patients in 100,000 procedures) but was relatively less (16.8-26.3 patients) in kidney stone procedures. Accordingly, the risk of radiation-induced colon mortality was more common in CT-IVU than in kidney stone procedures (22.7-28.2 versus 7.2-12.5 patients in 100,000 procedures). ConclusionThese results call for further optimisation actions for indication-specific CT examinations to appropriately reduce the potential risk levels for patients’ protection and safety.