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Pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia:report of a case

Hepatobiliary & Pancreatic Diseases International 2007年第5期6卷 553-556页

作者： Rajkumar Krishnasamy shaleen agarwal Shivendra Singh Sunil Puri Puja Sakhuja Anil K agarwal Department of Gastrointestinal Surgery Govind Ballabh Pant Hospital and Maulana Azad Medical College(Delhi University)New Delhi 110002India Department of Radiology Govind Ballabh Pant Hospital and Maulana Azad Medical College(Delhi University)New Delhi 110002 Department of Pathology Govind Ballabh Pant Hospital and Maulana Azad Medical College(Delhi University)New Delhi 110002

BACKGROUND:The presence of pancreatic ductal intraepithelial neoplasia in patients with chronic pancreatitis is a risk factor for development of pancreatic adenocarcinoma. METHOD:A case of pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia was diagnosed in the setting of chronic pancreatitis. RESULTS:Distal pancreatectomy combined with splenec- tomy was performed with a diagnosis of pancreatic body carcinoma.Histopathological examination suggested adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia.The tumor was detected in the remaining head of the pancreas,for which a total pancreatectomy was done. CONCLUSIONS:When a patient with pancreatic ductal intraepithelial neoplasia associated with adenocarcinoma of the pancreas in the setting of chronic pancreatitis is at an increased risk of recurrence in the remaining pancreatic parenchyma,total pancreatectomy may be feasible.

关键词： pancreatectomy pancreatic ductal carcinoma chronic pancreatitis

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Investigation of lnter and Intra-fractional Uncertainties in Lung IMRT Delivery

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Chinese Journal of Biomedical Engineering(English Edition) 2017年第1期26卷 1-4页

作者： Maria Das KJ Arpita agarwal Yoganathan SA Gowtharu Raj D shaleen Kumar Department of Radiotherapy Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

Changes in the tumour position due to inter and intra-fractional motion introduce uncertainty in IMRT delivery. In this work, we experimentally evaluated the effect of inter and intra-fractional motion uncertainties in the IMRT delivery. A lung patient was planned with rive field dynamic IMRT for a total dose of60 Gy in 30 fractions using 6 MV photon beam at a dose rate of 400 MU/min. The plan was delivered on varian CL2100 CD linear accelerator with millennium 120 MLC for a single fraction and measured using IMRT Matri XX placed on Quasar motion platform, aligned with respect to isocentre for planar as well as point dose measurements. This measurement was summated for 30 fractions and taken as a reference. 30 measurements were performed for each inter-fractional, intra-fractional and combined effect. The setup errors(Mean+SD) used to simulate the inter-fractional displacements were RL:-0.10+0.27 mm, SI: 0.17+0.45 mm, AP:-0.04+0.38 mm and Rot: 0.02+0.86 degree. The intra-fractional motion was simulated using the motion platform parallel to the MLC leaf motion, for an amplitude of 1 cm and a period of 4 s. The planner fluence of inter, intra-fractional motion and combination of both was analyzed against the reference using gamma criteria of 3%/3 mm. Similarly, the point dose measurements were also compared. The maximum deviation in point dose during a single fraction was-3.8%, 3.1% and-5.9% for inter-fractional, intra-fractional and combined respectively. The same resulted in deviation of-0.4%,-0.3% and 0.1% respectively when summated for 30 fractions.The percentage of pixels failing the gamma criteria during a single fraction was28.0%, 16.4% and 28.5% for inter-fractional, intra-fractional and combined respectively. The same revealed 11.4%, 12.4% and 19.2% respectively when summated. Though the point dose deviations were nullified over 30 fractions, the planner fluence variation was observed to be considerable.

关键词： MRT inter-fraction intra-fraction uncertainties

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