31 research outputs found
Limited Value of Staging Squamous Cell Carcinoma of the Anal Margin and Canal Using the Sentinel Lymph Node Procedure: A Prospective Study with Long-Term Follow-Up
Background. Selection of patients with anal cancer for groin irradiation is based on tumor size, palpation, ultrasound, and fine needle cytology. Current staging of anal cancer may result in undertreatment in small tumors and overtreatment of large tumors. This study reports the feasibility of the sentinel lymph node biopsy (SLNB) in patients with anal cancer and whether this improves the selection for inguinal radiotherapy. Methods. A total of 50 patients with squamous anal cancer were evaluated prospectively. Patients without a SLNB (n = 29) received irradiation of the inguinal lymph nodes based on lymph node status, tumor size, and location of the primary tumor. Inguinal irradiation treatment in patients with a SLNB was based on the presence of metastases in the SLN. Results. SLNs were found in all 21 patients who underwent a SLNB. There were 5 patients (24%) who had complications after SLNB and 7 patients (33%) who had a positive SLN and received inguinal irradiation. However, 2 patients with a tumor-free SLN and no inguinal irradiation developed lymph node metastases after 12 and 24 months, respectively. Conclusions. We conclude that SLNB in anal cancer is technically feasible. SLNB can identify those patients who would benefit from refrain of inguinal irradiation treatment and thereby reducing the incidence of unnecessary inguinal radiotherapy. However, because of the occurrence of inguinal lymph node metastases after a tumor-negative SLNB, introduction of this procedure as standard of care in all patients with anal carcinoma should be done with caution to avoid undertreatment of patient who otherwise would benefit from inguinal radiotherapy
Development of Mo-containing scintillating bolometers for a high-sensitivity neutrinoless double-beta decay search
We report recent achievements in the development of scintillating bolometers to search for neutrinoless double-beta decay of Mo. The presented results have been obtained in the framework of the LUMINEU, LUCIFER and EDELWEISS collaborations, and are now part of the R\&D activities towards CUPID (CUORE Update with Particle IDentification), a proposed next-generation double-beta decay experiment based on the CUORE experience. We have developed a technology for the production of large mass (1 kg), high optical quality, radiopure zinc and lithium molybdate crystal scintillators (ZnMoO and LiMoO, respectively) from deeply purified natural and Mo-enriched molybdenum. The procedure is applied for a routine production of enriched crystals. Furthermore, the technology of a single detector module consisting of a large-volume (~cm) ZnMoO and LiMoO scintillating bolometer has been established, demonstrating performance and radiopurity that are close to satisfy the demands of CUPID. In particular, the FWHM energy resolution of the detectors at 2615 keV --- near the -value of the double-beta transition of Mo (3034~keV) --- is 4--10~keV. The achieved rejection of -induced dominant background above 2.6~MeV is at the level of more than 99.9\%. The bulk activity of Th (Th) and Ra in the crystals is below 10 Bq/kg. Both crystallization and detector technologies favor LiMoO, which was selected as a main element for the realization of a CUPID demonstrator (CUPID-0/Mo) with 7 kg of Mo
A comprehensive overview of radioguided surgery using gamma detection probe technology
The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology