Evaluation and comparing rectum and bladder's clinical complications in pelvis radiotherapy in order to treat prostate cancer by using custom block and MLC for three- dimensional conformal radiotherapy

       Ionization radiation caused to incidence of complications in the exposed organs. In prostate radiotherapy, rectum and bladder have been radiated unwantedly and indicated some complications during and after treatment. The purpose of present study is to consider and to compare clinical complications of rectum and bladder in custom block and MLC for 3- D conformal radiotherapy, in order to determine if both treatments differ with respect to creating radiation protection, subsequently in the incidence of complications. In this respect, 72 patients with prostate cancer classified into two arms, above 60 years without the history of previous radiotherapy, hormone therapy and surgery, were selected randomly in October 2014. In one arm, patients were treated with block 3- D conformal radiotherapy, and in second arm with MLC outbound technique for 3- D radiotherapy. Rectal and bladder clinical complications were recorded before, during (at the end of 10 treatment sessions), 3 and 6 months after treatment then compared based on tables (RTOG/ LENT).Obtained results showed that patients had a significant difference in such complications as urinary frequency after 10 treatment sessions, 3 months after treatment (p<0.02 and p<0.04, respectively)   Also, patients had a significant difference in regard to dysuria at the end of treatment (p<0.02). In both arms, patients had a significant difference in constipation after 30 sessions also at the end of treatment (p<0.02, p<0.02, respectively).In comparing different grades of complications based on RTOG/ LENT tables, it was not observed a significant difference between patients' complications in both arms

Estimation and evaluation of pseudo-CT images using linear regression models and texture feature extraction from MRI images in the brain region to design external radiotherapy planning

AimThe aim of this study is to construct and evaluate Pseudo-CT images (P-CTs) for electron density calculation to facilitate external radiotherapy treatment planning.BackgroundDespite numerous benefits, computed tomography (CT) scan does not provide accurate information on soft tissue contrast, which often makes it difficult to precisely differentiate target tissues from the organs at risk and determine the tumor volume. Therefore, MRI imaging can reduce the variability of results when registering with a CT scan.Materials and methodsIn this research, a fuzzy clustering algorithm was used to segment images into different tissues, also linear regression methods were used to design the regression model based on the feature extraction method and the brightness intensity values. The results of the proposed algorithm for dose-volume histogram (DVH), Isodose curves, and gamma analysis were investigated using the RayPlan treatment planning system, and VeriSoft software. Furthermore, various statistical indices such as Mean Absolute Error (MAE), Mean Error (ME), and Structural Similarity Index (SSIM) were calculated.ResultsThe MAE of a range of 45–55 was found from the proposed methods. The relative difference error between the PTV region of the CT and the Pseudo-CT was 0.5, and the best gamma rate was 95.4% based on the polar coordinate feature and proposed polynomial regression model.ConclusionThe proposed method could support the generation of P-CT data for different parts of the brain region from a collection of MRI series with an acceptable average error rate by different evaluation criteria

A case-control study of Dietary Approaches to Stop Hypertension (DASH) diets, colorectal cancer and adenomas among Iranian population

Abstract Background and aims Colorectal cancer (CRC) is the third most common cancer, worldwide. Recently, much attention has been given to the association between Dietary Approaches to Stop Hypertension (DASH) and CRC, however, data on colorectal adenomas (CRAs) as its precursor are scarce. Thus, the purpose of this case-control study was to investigate the association of DASH score with the risk of CRC and CRA in Iranian adults. Method A total of 499 participants, including 129 CRC and 130 CRA cases, along with 240 controls, were asked about their dietary intake via a validated questionnaire. The DASH score was then calculated based on a priori methods and categorized in quartiles. Multivariate logistic regression was performed to assess the association of DASH score and the risk of CRC and CRA. Results After adjusting for confounding variables, adherence to the DASH diet was associated with a reduction in the risk of CRC and CRA, respectively (OR of 4th versus 1st quartile = 0.04, 95% CI: 0.01–0.11, OR = 0.10, 95% CI: 0.04–0.22). Also, subgroup analysis based on gender showed that women and men with a higher DASH score had a significantly lower risk of CRC and CRAs. Conclusion The results of this study demonstrated that adherence to a DASH dietary pattern could reduce the risk of CRC and CRA in men and women. Promoting a DASH eating plan can be helpful in reducing the risk of CRC

Dietary Inflammatory Index and Odds of Colorectal Cancer and Colorectal Adenomatous Polyps in a Case-Control Study from Iran

Background: Chronic inflammation is implicated in the development of colorectal cancer (CRC) and its precursor; colorectal adenomatous polyps (CAP). Some dietary factors are important triggers for systemic inflammation. Therefore, the present study aimed to investigate the association between the dietary inflammatory index (DII®) and the risk of CRC and CAP in an Iranian case-control study. Methods: 134 newly diagnosed CRC patients, 130 newly diagnosed CAP patients, and 240 hospitalized controls were recruited using convenience sampling. Energy-adjusted DII (E-DII) scores were computed based on dietary intake assessed using a reproducible and valid 148-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) after adjusting for confounders. Results: The E-DII score ranged between −4.23 (the most anti-inflammatory score) to +3.89 (the most pro-inflammatory score). The multivariable-adjusted ORs for participants in the 3rd tertile compared to the 1st tertile was 5.08 (95%CI: 2.70–9.56; P-trend \u3c 0.0001) for CRC and 2.33 (95% CI: 1.30–4.02; P-trend = 0.005) for CAP. Conclusions: Our findings suggest that more pro-inflammatory diets, indicated by higher E-DII scores, might increase the risk of both CRC and CAP. Future steps should include testing these associations in a prospective setting in Iran

The effect of casein phosphopeptide amorphous calcium phosphate fluoride paste (CPP-ACPF) on oral and salivary conditions of patients undergoing chemotherapy: A randomized controlled clinical trial

Background: Oral and saliva conditions of patients undergoing chemotherapy is often affected by the medication they receive. Up to now, no appropriate medication that possesses the positive effects of chemotherapy without presenting oral complications has been introduced. Objective: The aim of this study was to assess the clinical effects of CPP-ACPF paste on the oral and salivary status of patients undergoing chemotherapy. Methods: From October 2013 to April 2014, 20 patients in chemotherapy treatment plans and who met the inclusion criteria enrolled in this randomized parallel single-blind controlled clinical trial in Shohada-e-Tajrish Hospital in Tehran, Iran. Patients were divided into two groups: 1) patients received their daily medication of cancer therapy center (group 1, control); 2) patients applied CPP-ACPF Crème (MI paste plus, GC USA) twice a day as instructed (group 2). The baseline status of oral conditions of patients (mucositis, dry mouth, infection, diminished tasting sense, difficulty in food intake, burning sensation of mucosa, saliva and dental plaque pH, rest and stimulated saliva, buffering capacity of saliva) were recorded and reevaluated after 21 and 42 days. The data were analyzed with a Mann-Whitney U-test. Results: A total of 20 patients were allocated randomly to groups 1 and 2. The Mann-Whitney U-test showed that application of CPP-ACPF paste twice daily did not cause any significant difference in oral complication of the subject group compared with the control group (p>0.05). Among salivary signs, resting and stimulated saliva rates and saliva buffering capacity had significantly altered in the CPP-ACPF group in day 21 and 42 in comparison with those of the control group (p<0.05). Conclusion: Application of CPP-ACPF paste before and during chemotherapy can improve the salivary status of patients undergoing this treatment. Trial registration: The trial is registered at the U.S. National Institutes of Health (https://www.clinicaltrials.gov) with the identification number NCT01737307. Funding: The authors received no financial support for the research, authorship, and/or publication of this articl

A novel algorithm for PET and MRI fusion based on digital curvelet transform via extracting lesions on both images

Background and aim: Merging multimodal images is a useful tool for accurate and efficient diagnosis and analysis in medical applications. The acquired data are a high-quality fused image that contains more information than an individual image. In this paper, we focus on the fusion of MRI gray scale images and PET color images. Methods: For the fusion of MRI gray scale images and PET color images, we used lesion region extracting based on the digital Curvelet transform (DCT) method. As curvelet transform has a better performance in detecting the edges, regions in each image are perfectly segmented. Curvelet decomposes each image into several low- and high-frequency sub-bands. Then, the entropy of each sub-band is calculated. By comparing the entropies and coefficients of the extracted regions, the best coefficients for the fused image are chosen. The fused image is obtained via inverse Curvelet transform. In order to assess the performance, the proposed method was compared with different fusion algorithms, both visually and statistically. Result: The analysis of the results showed that our proposed algorithm has high spectral and spatial resolution. According to the results of the quantitative fusion metrics, this method achieves an entropy value of 6.23, an MI of 1.88, and an SSIM of 0.6779. Comparison of these experiments with experiments of four other common fusion algorithms showed that our method is effective. Conclusion: The fusion of MRI and PET images is used to gather the useful information of both source images into one image, which is called the fused image. This study introduces a new fusion algorithm based on the digital Curvelet transform. Experiments show that our method has a high fusion effec

A Novel Active Contour Model for MRI Brain Segmentation used in Radiotherapy Treatment Planning

Introduction: Brain image segmentation is one of the most important clinical tools used in radiology and radiotherapy. But accurate segmentation is a very difficult task because these images mostly contain noise, inhomogeneities, and sometimes aberrations. The purpose of this study was to introduce a novel, locally statistical active contour model (ACM) for magnetic resonance image segmentation in the presence of intense inhomogeneity with the ability to determine the position of contour and energy diagram. Methods: A Gaussian distribution model with different means and variances was used for inhomogeneity, and a moving window was used to map the original image into another domain in which the intensity distributions of inhomogeneous objects were still Gaussian but were better separated. The means of the Gaussian distributions in the transformed domain can be adaptively estimated by multiplying a bias field by the original signal within the window. Then, a statistical energy function is defined for each local region. Also, to evaluate the performance of our method, experiments were conducted on MR images of the brain for segment tumors or normal tissue as visualization and energy functions. Results: In the proposed method, we were able to determine the size and position of the initial contour and to count iterations to have a better segmentation. The energy function for 20 to 430 iterations was calculated. The energy function was reduced by about 5and 7% after 70 and 430 iterations, respectively. These results showed that, with increasing iterations, the energy function decreased, but it decreased faster during the early iterations, after which it decreased slowly. Also, this method enables us to stop the segmentation based on the threshold that we define for the energy equation. Conclusion: An active contour model based on the energy function is a useful tool for medical image segmentation. The proposed method combined the information about neighboring pixels that belonged to the same class, thereby making it strong to separate the desired objects from the background

Constructing and Validating a Questionnaire to Assess the Psychological Boundaries of the Family Based on the Holy Quran

The purpose of this study was to construct and validate the Family Psychological Boundaries (H.FBQ) questionnaire based on the Holy Quran. The boundaries of the family were extracted and presented from the verses of the Holy Quran and the interpretive narrations below them by the method of religious and psychological Ijtihad. The final pattern includes 5 first-order boundaries, 15 second-order boundaries, and 64 third-order boundaries. A questionnaire was designed based on the extracted boundaries. The content validity of the items was confirmed by experts based on CVI and CVR and the reliability of the questionnaire was calculated by using Cronbach's alpha. The total reliability of the questionnaire was 0.975, general boundaries 0.884, marital boundaries 0.92, parental boundaries 0.925, siblings boundaries 0.789 and outer boundaries 0.761. The questionnaire was administered to a sample of 600 families in Qom. The results of factor analysis showed confirmation of construct validity for five underlying factors (boundaries) and 164 items for measuring them. The results of comparing the boundaries between normal families and families at risk of divorce confirm the validity, construct and resolution of the questionnaire between normal and abnormal families. Examination of psychometric properties of the Family Boundaries Questionnaire showed that the 164-item questionnaire has the desired validity and reliability