The purpose of our study was to describe synchronous primary tumours and previously undetected metastases in 736 dogs with confirmed neoplasia in which computed tomography (CT) scans were performed for diagnostic, staging and/or radiation treatment planning purposes. All CTs were reviewed by a radiologist. Tumour-associated CT abnormalities were detected in 38/736 (5%), including confirmed or suspected synchronous primary neoplasms (n = 24), metastases of the primary tumour (n = 9) or both (n = 3). In lymph nodes (LN) that were considered abnormal on CT scan and were aspirated, 23% contained metastasis, and 6% of 'normal' appearing LN that were aspirated contained metastasis. Thorough evaluation of CTs and routine aspiration of regional LN are critical because results affect recommendations to perform additional staging tests and treatment for the primary and secondary tumour(s).
The "gold standard" for verification of patient positioning before linear acceleratorbased stereotactic radiation therapy is kilovoltage cone-beam computed tomography (kV-CBCT), which is not uniformly available or utilized; planar imaging is sometimes used instead. The primary aim of this study was to determine if the position of the bony skull, when used as a surrogate for isocenter verification, is different when orthogonal megavoltage (MV) portal or kilovoltage (kV/kV) radiographs are used for image guidance, rather than kV-CBCT. A secondary aim was to determine the influence of intra-observer variability, body size and skull conformation on positioning, as determined using these three imaging modalities. Dogs and cats receiving radiotherapy of the head were recruited for this prospective analytical study. Planar (MV portal and kV/kV images) and volumetric (kV-CBCT) images were acquired before treatment, and manually coregistered with reference images. Differences in skull position when matched based on MV portal, kV/kV images and kV-CBCT were compared. A total of 65 subjects and 148 unique datasets were evaluated. TheWilcoxon rank-sum test was used to evaluate effects of transitioning between imaging modalities. When comparing magnitude of shifts in MV to kV-CBCT, MV to kV/kV and kV/kV to kV-CBCT, there were statistically significant differences. Results were not measurably impacted by body size, skull conformation or interobserver differences. Based on shift magnitude and direction, an isotropic setup margin of at least 1 mm should be incorporated within the planning target volume when MV or kV planar imaging is used for position verification.
A 10-year-old 38 kg (84 lbs) castrated male Labrador retriever mix was presented for fractionated radiation therapy (3 Gy per 18 fractions) following the narrow excision of a recurrent grade 3
A 4-y-old, spayed female, mixed-breed domesticated rabbit ( Oryctolagus cuniculus domesticus) was presented because of progressive bilateral exophthalmos, with a large mediastinal mass in the cranial thorax. Palliative radiation therapy was elected, and 4 fractions of 5 Gy were delivered twice weekly under general anesthesia using 3-dimensional conformal radiation therapy for a total dose of 20 Gy, guided by an on-board cone beam CT scan. Quality-of-life and respiratory rate improved before sudden death that followed an episode of dyspnea. The overall survival time following initial diagnosis was 93 d, with 68 d after the first dose of radiation. An autopsy was performed, and the mass was diagnosed as a type A thymoma. The diagnosis was confirmed with positive immunohistochemical labeling of the neoplastic cells for cytokeratin 5/6 and cytokeratin 7.
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