Robert Hermans

The utility of Spect in determining the relationship between radiation dose and salivary gland dysfunction after radiotherapy

Salivary gland scintigraphy (SGS) is used to depict salivary gland dysfunction after radiotherapy (RT). The aim of this study was to investigate the utility of SGS combined with single photon emission computed tomography (SPECT). Twenty-one patients with a carcinoma of head and neck underwent SGS before and 1 month after RT. After injection of 370 MBq 99Tcm-pertechnetate, a biplanar dynamic acquisition (12×1 min) was started, followed by a SPECT acquisition during 4 min. Carbachol was then injected and a second dynamic study (16×1 min) was performed, again followed by a SPECT acquisition. The salivary excretion fraction (SEF) was calculated both from the geometric mean planar image for each parotid and from the SPECT data for each transverse plane through the parotids. The RT-induced changes in the SEF (dSEF) were correlated with the mean radiation dose calculated using tomography-based dosimetry. The mean radiation dose to the parotids was 44 Gy (range 4.4-68.1 Gy). The mean range of the variation in radiation dose to the transverse slices within the parotids of a patient was 24 Gy (range 6.2-51.9 Gy). Considering all transverse planes through the parotids in all patients, a linear correlation was found between the dSEF calculated using SGS-SPECT and the radiation dose (r = 0.45, P = 0.0001). Thirteen patients had a variation in radiation dose within the parotids of more than 20 Gy. In nine of these a significant intra-individual correlation between radiation dose and the dSEF of the transverse parotid slices was found (r range 0.55-0.97; P value range 0.037-0.0001). In conclusion, SGS-SPECT can be used for monitoring radiation-induced parotid gland dysfunction. It offers the unique possibility for the assessment of intra-individual dose-dysfunction curves in patients with large variations in the radiation dose within the parotids.

In vivo animal functional MRI: improved image quality with a body-adapted mold.

To reduce functional magnetic resonance imaging (fMRI) susceptibility distortion at the air/tissue interphase in animal experiments.

A CASE SERIES OF EMBRYONAL RHABDOMYOSARCOMA OF THE HEAD AND NECK IN ADULTS

Abstract Embryonal rhabdomyosarcoma (RMS) is a rare malignant mesenchymal tumour that is believed to arise from cells committed to a skeletal muscle lineage. The head and neck region is among the most frequent locations for embryonal RMS in adults. We present a retrospective review of seven patients treated in our institution between 2000 and 2008. The age at diagnosis ranged from 19 to 41 years. One patient received primary surgery followed by adjuvant radiotherapy. Six inoperable patients were treated along a single chemotherapy protocol: the VIA-VIP regimen (a combination of vincristine, ifosfamide and doxorubicin (VIA) in alternation with etoposide, ifosfamide and cisplatin (VIP) administered in 3-weekly cycles), followed by local therapy, involving radiation therapy and/or surgery. An objective response to chemotherapy was observed in all six patients. Three out of seven patients remain disease-free with a median follow up of 4.5 years. Although the prognosis of head and neck embryonal RMS is worse in adults than in children, a multimodality treatment combining surgery, radiotherapy and intensive chemotherapy is feasible and effective in this population.

Callus originating in the laryngeal skeleton, presenting as a neck lump: a case report

We report on the case of a young woman, presenting with a left lateral neck lump, which turned out to be a bony callus originating from the thyroid cartilage; similar but smaller lesions were found on the same side in the hyoid and cricoid cartilages. The CT, MRI and pathological findings are described.

EP-1040: Development of a CT-based prognostic model for regional control in head and neck cancer after RT

ESTRO 35 2016 _____________________________________________________________________________________________________ mg/m2 (IRMA 1, 2, 3, 5) or Cetuximab 400 mg/m2 (IRMA 4). A dose of 67.5 Gy in 30 fractions (IRMA 1, 2, and 4) or 70.5 Gy in 30 fractions (IRMA 3, 4, and 5) was delivered to primary tumor and involved nodes, 60 Gy were delivered to high risk and 55.5 Gy to low risk lymph node areas. Static (IMRT) or volumetric (VMAT) intensity modulated technique with simultaneous integrated boost was used.