Radioaktiv markierte Antikörper gegen tumorassoziierte Antigene

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Nuclear imaging in reflux diagnosis

Mit der hepatobiliären und gastroösophagealen Refluxszintigraphie existieren zwei technisch einfache, nichtinvasive Untersuchungsverfahren zum Nachweis duodenogastraler und gastroösophagealer Refluxe. Nach einer Übersicht über praktische Durchführung und Auswertung werden Ergebnisse und Indikationen diskutiert. Beide Verfahren sollten dann, zum Einsatz kommen, wenn nach ergebnisloser morphologischer Diagnostik funktionelle Störungen vermutet werden.Duodenogastric and gastroesophageal refluxes can be accurately detected by hepatobiliary and gastroesophageal scintigraphy. These procedures are non-invasive and easy to perform. Practical details and evaluation are described. Subsequent to a review of diagnostic results, indications are discussed. Both techniques should be applied in cases where morphological examinations did not yield any pathologic result and clinical Symptoms are suggestive for functional disturbances

Analyzing embedded device programming specifications in critical system to design programming guidelines

Безопасность программного обеспечения является важной характеристикой, показывающей вероятность правильности работы программы при различных условиях эксплуатации. Однако разработчики встроенного программного обеспечения не всегда уделяют должное внимание этому аспекту, особенно в критически важных системах. В данной работе рассматриваются международные стандарты и сертификаты безопасности программного обеспечения. На основе исходного кода снятого с производства электрохирургического медицинского аппарата ЭХВЧ-80 компании НПО "НИКОР" анализируются вопросы обоснованности выбора языка программирования и использованной архитектуры. Приводится алгоритм работы программы, а также описаны основные задачи, выполняемые микроконтроллером. В заключительной части статьи, на основе анализа программного обеспечения автор предлагает рекомендации по упрощению поддержки и возможные варианты уменьшения ошибок, как в коде, так и в архитектуре разрабатываемого приложения. Результаты исследования позволяют повысить безопасность ПО, особенно в критически важных системах.Software safety is an important characteristic, which indicates the probability of correct program operationunder different operating conditions. However, embedded software developers do not always focus on this aspect,especially in critical systems. The present article discusses the international software security standards andcertificates. The author studies the source code of the presently discontinued electrosurgical device EHVCh-80 byNPO "NIKOR" and analyzes the issues of validity of choosing the programming language and architecture. Thepaper provides the algorithm of the program's operation and describes the main tasks performed by themicrocontroller. In conclusion, the author uses the results of this software's analysis to offer recommendations tosimplify software support and possible options to reduce errors, both in the code and in the architecture of thedeveloped application. The results of this research allow increasing software safety, especially in critical systems

[68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning

<p>Abstract</p> <p>Purpose</p> <p>The observation that human meningioma cells strongly express somatostatin receptor (SSTR 2) was the rationale to analyze retrospectively in how far DOTATOC PET/CT is helpful to improve target volume delineation for intensity modulated radiotherapy (IMRT).</p> <p>Patients and Methods</p> <p>In 26 consecutive patients with preferentially skull base meningioma, diagnostic magnetic resonance imaging (MRI) and planning-computed tomography (CT) was complemented with data from [⁶⁸Ga]-DOTA-D Phe¹-Tyr³-Octreotide (DOTATOC)-PET/CT. Image fusion of PET/CT, diagnostic computed tomography, MRI and radiotherapy planning CT as well as target volume delineation was performed with OTP-Masterplan^®. Initial gross tumor volume (GTV) definition was based on MRI data only and was secondarily complemented with DOTATOC-PET information. Irradiation was performed as EUD based IMRT, using the Hyperion Software package.</p> <p>Results</p> <p>The integration of the DOTATOC data led to additional information concerning tumor extension in 17 of 26 patients (65%). There were major changes of the clinical target volume (CTV) which modify the PTV in 14 patients, minor changes were realized in 3 patients. Overall the GTV-MRI/CT was larger than the GTV-PET in 10 patients (38%), smaller in 13 patients (50%) and almost the same in 3 patients (12%). Most of the adaptations were performed in close vicinity to bony skull base structures or after complex surgery. Median GTV based on MRI was 18.1 cc, based on PET 25.3 cc and subsequently the CTV was 37.4 cc. Radiation planning and treatment of the DOTATOC-adapted volumes was feasible.</p> <p>Conclusion</p> <p>DOTATOC-PET/CT information may strongly complement patho-anatomical data from MRI and CT in cases with complex meningioma and is thus helpful for improved target volume delineation especially for skull base manifestations and recurrent disease after surgery.</p

Intensity modulated radiotherapy for high risk prostate cancer based on sentinel node SPECT imaging for target volume definition

BACKGROUND: The RTOG 94-13 trial has provided evidence that patients with high risk prostate cancer benefit from an additional radiotherapy to the pelvic nodes combined with concomitant hormonal ablation. Since lymphatic drainage of the prostate is highly variable, the optimal target volume definition for the pelvic lymph nodes is problematic. To overcome this limitation, we tested the feasibility of an intensity modulated radiation therapy (IMRT) protocol, taking under consideration the individual pelvic sentinel node drainage pattern by SPECT functional imaging. METHODS: Patients with high risk prostate cancer were included. Sentinel nodes (SN) were localised 1.5–3 hours after injection of 250 MBq (99m)Tc-Nanocoll using a double-headed gamma camera with an integrated X-Ray device. All sentinel node localisations were included into the pelvic clinical target volume (CTV). Dose prescriptions were 50.4 Gy (5 × 1.8 Gy / week) to the pelvis and 70.0 Gy (5 × 2.0 Gy / week) to the prostate including the base of seminal vesicles or whole seminal vesicles. Patients were treated with IMRT. Furthermore a theoretical comparison between IMRT and a three-dimensional conformal technique was performed. RESULTS: Since 08/2003 6 patients were treated with this protocol. All patients had detectable sentinel lymph nodes (total 29). 4 of 6 patients showed sentinel node localisations (total 10), that would not have been treated adequately with CT-based planning ('geographical miss') only. The most common localisation for a probable geographical miss was the perirectal area. The comparison between dose-volume-histograms of IMRT- and conventional CT-planning demonstrated clear superiority of IMRT when all sentinel lymph nodes were included. IMRT allowed a significantly better sparing of normal tissue and reduced volumes of small bowel, large bowel and rectum irradiated with critical doses. No gastrointestinal or genitourinary acute toxicity Grade 3 or 4 (RTOG) occurred. CONCLUSION: IMRT based on sentinel lymph node identification is feasible and reduces the probability of a geographical miss. Furthermore, IMRT allows a pronounced sparing of normal tissue irradiation. Thus, the chosen approach will help to increase the curative potential of radiotherapy in high risk prostate cancer patients