Lipiodol versus diaphragm in 4D-CBCT-guided stereotactic radiotherapy of hepatocellular carcinomas



The purpose of this drudge was to investigate the potential of lipiodol during the time that a direct tumor surrogate alternative to the midriff surrogate on four-dimensional cone-gleam. computed tomography (4D-CBCT) image guidance for stereotactic radiotherapy of hepatocellular carcinomas.


A entire of 29 hepatocellular carcinomas (HCC) patients treated ~ means of stereotactic radiotherapy following transarterial chemoembolization (TACE) with homogeneous or partial defective lipiodol retention were included. In all, 4–7 pretreatment 4D-CBCT scans were selected ~ the sake of each patient. For each scan, any one lipiodol or the diaphragm was used ~ the sake of 4D registration. Resulting lipiodol/diaphragm prompting ranges and position errors relative to the reconstructed midventilation images were analyzed to get possession of the motion variations, and group unfair (ΔM), systematic (Σ), and wandering (σ) errors of the treatment setup.


Of the lipiodolized tumors, 55 % modified for direct localization on the 4D-CBCT. Significant correlations of lipiodol and midriff positions were found in the left–up~ (LR), craniocaudal (CC), and anteroposterior (AP) directions. ΔM and σ obtained by lipiodol and diaphragm were similar, agreed to not above 0.5 mm in the LR and AP, and 0.3 mm in the CC directions, and Σ differed by 1.4 (LR), 1.1 (CC), and 0.6 (AP) mm. Variations of midriff motion range > 5 mm were not observed with lipiodol and in one patient by diaphragm. The margin required for the tumefaction prediction error using the diaphragm deputy was 6.7 (LR), 11.7 (CC), and 4.1 (AP) mm.


Image-conduct combining lipiodol with 4D-CBCT enabled close localization of HCC and thus brim reduction. A major limitation was the degraded lipiodol show difference on 4D-CBCT.

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from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader

Vitamin E activity doesn’t approach from one single molecule, but from a house of related molecules called tocopherols and tocotrienols.

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