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2 results

  • How can the aetiological factors of rectal distension be managed to reduce interfraction prostate motion during a course of radiotherapy treatment

  • Helen Bayles, Mark Collins, Melanie Clarkson
  • Journal:
    Journal of Radiotherapy in Practice / Volume 15 / Issue 1 / March 2016
    Published online by Cambridge University Press:
    28 September 2015, pp. 76-84
  • Aim

    During radiotherapy of the prostate it is important to minimise interfraction prostate motion to allow dose escalation and reduce normal tissue damage. Rectal volume has been identified as playing a significant role in prostate motion with various methods used to reduce it. The aim was to systematically review published literature to allow evidence based recommendations to be made to current practice to reduce interfraction prostate motion.

    Materials and methods

    A systematic search of CINAHL, Medline, PubMed, Science Direct, NHS Evidence and The Cochrane Library was performed. Limited searches of The Society of Radiographers website, OpenGrey and COPAC were undertaken, alongside manual searches of cross references of eligible articles. The quality of included papers was measured using a pre-existing tool. The causes, consequences and solutions to manage rectal volume and its effect on prostate position were extracted, compared and evaluated to extract solutions to be implemented into clinical practice.

    Results

    Of the 2,339 unique articles systematically retrieved, 23 met the inclusion criteria, 15 of which discuss radiotherapy, five constipation and three flatulence.

    Findings

    A combined medicinal and dietary approach adaptable to departmental workflow is required to manage rectal volume, with special consideration to patients with pre-existing extrinsic factors.

  • 19 - Ultrasonography of the Abdominal Aorta

  • from PART II - ULTRASOUND
  • Edited by J. Christian Fox, University of California, Irvine
  • Book:
    Clinical Emergency Radiology
    Published online:
    07 December 2009
    Print publication:
    29 September 2008, pp 280-286

  • Summary

    The primary indication for emergent ultrasonography of the aorta is to identify an abdominal aortic aneurysm (AAA). AAAs develop slowly and may be asymptomatic or present with life threatening rupture. AAA rupture accounts for more than 10,000 deaths per year in the United States. When ruptured or leaking AAA is suspected, ultrasound has many appealing qualities. Particularly for the hemodynamically unstable patient, bedside ultrasonography offers a prompt, accurate diagnosis. Although ultrasound is an excellent modality for identifying AAA, it is not effective in identifying whether rupture or leaking has occurred. The decision that an AAA is ruptured is typically based on ultrasound findings of the presence of an aneurysm as well the patient's clinical presentation. The presence of an obese body habitus or bowel gas may lead to poor quality ultrasound imaging and make accurate assessment of AAA difficult.