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Jiang W, Xie Q, Qin Y, Ye X, Wang X, Zheng Y. A novel method for spine ultrasound and X-ray radiograph registration. ULTRASONICS 2023; 133:107018. [PMID: 37163859 DOI: 10.1016/j.ultras.2023.107018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/12/2023]
Abstract
Ultrasound is a promising imaging method for scoliosis evaluation because it is radiation free and provide real-time images. However, it cannot provide bony details because ultrasound cannot penetrate the bony structure. Therefore, registration of real-time ultrasound images with the previous X-ray radiograph can help physicians understand the spinal deformity of patients. In this study, an improved free-from deformation registration method based on mutual registration and hierarchical adaptive grid (MRHA-FFD) was developed. The method first performed registration grid preprocessing and then optimized control points and conducted mutual registration. Finally, a Blur-aware Attention Network was adopted for image deblurring. The performance of each step was verified by ablation experiments. Comparison experiment between the proposed method and traditional registration methods was also conducted. The qualitative and quantitative results suggested that MRHA-FFD is a promising approach for registering spine ultrasound image and X-ray radiograph.
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Affiliation(s)
- Weiwei Jiang
- College of Computer Science & Technology, Zhejiang University of Technology, 310023 Hangzhou, China.
| | - Qiaolin Xie
- College of Computer Science & Technology, Zhejiang University of Technology, 310023 Hangzhou, China
| | - Yingyu Qin
- College of Computer Science & Technology, Zhejiang University of Technology, 310023 Hangzhou, China
| | - Xiaojun Ye
- Department of Ultrasound, Hangzhou Women's Hospital, 310023 Hangzhou, China
| | - Xiaoyan Wang
- College of Computer Science & Technology, Zhejiang University of Technology, 310023 Hangzhou, China
| | - Yongping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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2
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Shubayr N, Alashban Y. Estimation of radiation doses and lifetime attributable risk of radiation-induced cancer in the uterus and prostate from abdomen pelvis CT examinations. Front Public Health 2023; 10:1094328. [PMID: 36699908 PMCID: PMC9868812 DOI: 10.3389/fpubh.2022.1094328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Computed tomography (CT) scans are one of the most common radiation imaging modalities, and CT scans are rising steadily worldwide. CT has the potential to enhance radiography practice, but it also has the risk of drastically increasing patient doses. One CT procedure for the abdomen pelvis (AP) area can expose a patient's prostate or uterus to a substantial radiation dose, leading to concerns about radiation-induced cancer. This study aimed to estimate organ doses of the uterus and prostate and evaluate the lifetime attributable risk (LAR) of cancer incidence and mortality resulting from AP CT examinations. This retrospective study included 665 patients, of which 380 (57%) were female, and 285 (43%) were male. Data were collected from the picture archiving and communication system for AP CT procedures and exposure parameter data. Organ doses for the uterus and prostate were calculated using National Cancer Institute CT (NCICT) software. Based on the risk models proposed by the BEIR VII report, the calculated organ doses were used to estimate the LAR of prostate and uterus cancer incidence and mortality due to radiation exposure from AP CT procedures. The mean effective dose resulting from AP CT for females and males was 5.76 ± 3.22 (range: 1.13-12.71 mSv) and 4.37 ± 1.66 mSv (range: 1.36-8.07 mSv), respectively. The mean organ dose to the uterus was 10.86 ± 6.09 mGy (range: 2.13-24.06 mGy). The mean organ dose to the prostate was 7.00 ± 2.66 mGy (range: 2.18-12.94 mGy). The LAR of uterus and prostate cancer incidence was 1.75 ± 1.19 cases and 2.24 ± 1.06 cases per 100,000 persons, respectively. The LAR of cancer mortality rates from uterus and prostate cancers were 0.36 ± 0.22 and 0.48 ± 0.18 cases per 100,000 persons, respectively. The LAR of prostate and uterus cancer occurrence and mortality from radiation doses with AP CT procedures was low but not trivial. Therefore, efforts should be made to lower patient doses while retaining image quality. Although the minimization of the patient's radiation dose must guide clinical practice, the estimated slight increase in risk could aid in easing fears regarding well-justified AP CT procedures.
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Affiliation(s)
- Nasser Shubayr
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia,*Correspondence: Nasser Shubayr ✉
| | - Yazeed Alashban
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Simon S, Kendall G, Bouffler S, Little M. The Evidence for Excess Risk of Cancer and Non-Cancer Disease at Low Doses and Dose Rates. Radiat Res 2022; 198:615-624. [PMID: 36136740 PMCID: PMC9797580 DOI: 10.1667/rade-22-00132.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/06/2022] [Indexed: 12/31/2022]
Abstract
The question of whether there are excess radiation-associated health risks at low dose is controversial. We present evidence of excess cancer risks in a number of (largely pediatrically or in utero exposed) groups exposed to low doses of radiation (<0.1 Gy). Moreover, the available data on biological mechanisms do not provide support for the idea of a low-dose threshold or hormesis for any of these endpoints. There are emerging data suggesting risks of cardiovascular disease and cataract at low doses, but this is less well established. This large body of evidence does not suggest and, indeed, is not statistically compatible with any very large threshold in dose (>10 mGy), or with possible beneficial effects from exposures. The presented data suggest that exposure to low-dose radiation causes excess cancer risks and quite possibly also excess risks of various non-cancer endpoints.
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Affiliation(s)
- S.L. Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (retired)
| | - G.M. Kendall
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom
| | - S.D. Bouffler
- Radiation Effects Department, UK Health Security Agency (UKHSA), Chilton, Didcot OX11 0RQ, United Kingdom
| | - M.P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-9778
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Jiang W, Yu C, Chen X, Zheng Y, Bai C. Ultrasound to X-ray synthesis generative attentional network (UXGAN) for adolescent idiopathic scoliosis. ULTRASONICS 2022; 126:106819. [PMID: 35926252 DOI: 10.1016/j.ultras.2022.106819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/03/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
Standing X-ray radiograph with Cobb's method is the gold standard for scoliosis diagnosis. However, radiation hazard restricts its application, especially for close follow-up of adolescent patients. Compared with X-ray, ultrasound imaging has advantages of being radiation-free and real-time. To combine advantages of the above two imaging modalities, an ultrasound to X-ray synthesis generative attentional network (UXGAN) was proposed to synthesize ultrasound images into X-ray-like images. In this network, a cyclically consistent network was adopted and was trained end-to-end. An attention module was added and different residual blocks were designed. The quantitative comparison results demonstrated the superiority of our method to the state-of-the-art CycleGAN methods. We further compared the Cobb angle values measured on synthesized images and the real X-ray images, respectively. A good linear correlation (r = 0.95) was demonstrated between the two methods. The above results proved that the proposed method is of great significance for providing both X-ray images and ultrasound images based on the radiation-free ultrasound scanning.
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Affiliation(s)
- Weiwei Jiang
- College of Computer Science & Technology, Zhejiang University of Technology, Hangzhou 310023, China
| | - Chaohao Yu
- Hangzhou Kaiyuan Business Vocational School, Hangzhou 310000, China
| | - Xianting Chen
- College of Computer Science & Technology, Zhejiang University of Technology, Hangzhou 310023, China
| | - Yongping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Cong Bai
- College of Computer Science & Technology, Zhejiang University of Technology, Hangzhou 310023, China.
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Trzcińska S, Koszela K. Retrospective Analysis of FED Method Treatment Results in 11-17-Year-Old Children with Idiopathic Scoliosis. CHILDREN 2022; 9:children9101513. [PMID: 36291449 PMCID: PMC9600052 DOI: 10.3390/children9101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/16/2022]
Abstract
(1) Background: Idiopathic scoliosis is a major treatment problem due to its unknown origin and its three-dimensional nature. Attempts to cure it and search for new methods of physiotherapeutic treatment that would lead to its correction are one of the key issues of modern medicine. One of them is the fixation, elongation, de-rotation method (FED), used in the conservative treatment of idiopathic scoliosis. The aim of the study was evaluation of the short-term effectiveness of the FED method in the treatment of patients with idiopathic scoliosis. (2) Methods: Each patient underwent therapy based on the guidelines of the FED method. Patients were tested with the Bunnell scoliometer and the Zebris computer system. The treatment period was three weeks, after which the examinations were repeated. (3) Results: The results appeared to be statistically significant for all tested variables. (4) Conclusions: The examinations showed that the FED method had a statistically significant effect on the improvement of all parameters of posture examination, regardless of the size of the scoliotic deformation angle and bone maturity.
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Affiliation(s)
- Sandra Trzcińska
- Department of Physiotherapy, College of Rehabilitation in Warsaw, 01-234 Warsaw, Poland
| | - Kamil Koszela
- Neuroorthopedics and Neurology Clinic and Polyclinic, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
- Correspondence: ; Tel.: +48-601-441-115
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Pang H, Wong YS, Yip BHK, Hung ALH, Chu WCW, Lai KKL, Zheng YP, Chung TWH, Sharma G, Cheng JCY, Lam TP. Using Ultrasound to Screen for Scoliosis to Reduce Unnecessary Radiographic Radiation: A Prospective Diagnostic Accuracy Study on 442 Schoolchildren. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2598-2607. [PMID: 34210559 DOI: 10.1016/j.ultrasmedbio.2021.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/03/2021] [Accepted: 05/25/2021] [Indexed: 06/13/2023]
Abstract
Scoliosis screening is important for timely initiation of brace treatment to mitigate curve progression in skeletally immature children and adolescents. School scoliosis screening programs in Hong Kong follow the protocol of referring children screened positive with a scoliometer and Moiré topography for confirmatory standard radiography. Despite being highly sensitive (88%) in detecting those who require specialist referral, the screening program was found to have a false-positive rate >50%, which could lead to unnecessary X-ray radiation. Radiation-free ultrasound has been reported to be valid and reliable for quantitative assessment of curve severity in scoliosis patients. The aim of this prospective diagnostic accuracy study was to determine the accuracy of ultrasound in determining the threshold of referral that requires X-ray for children screened positive with the scoliometer and Moiré topography. Our study recruited 442 schoolchildren with a mean Cobb angle of 14.0 ± 6.6°. The sensitivity and specificity of ultrasound in predicting the correct referral status, confirmed by X-ray, were 92.3% and 51.6%, with positive and negative predictive values of 29.0% and 96.9%, respectively. Receiver operating characteristic curve analysis revealed area under the curve values of 0.735 for ultrasound alone and 0.832 for ultrasound in combination with measurement of angle of trunk rotation. The finding supports the accuracy of using ultrasound to determine referral status, which could result in a >50% reduction of unnecessary radiation for children undergoing scoliosis screening.
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Affiliation(s)
- Henry Pang
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Yi-Shun Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Benjamin Hon-Kei Yip
- Division of Family Medicine and Primary Health Care, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Alec Lik-Hang Hung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Winnie Chiu-Wing Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
| | - Kelly Ka-Lee Lai
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | | | - Geeta Sharma
- Student Health Service, Department of Health, Hong Kong SAR
| | - Jack Chun-Yiu Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR; S. H. Ho Scoliosis Research Laboratory, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong SAR
| | - Tsz-Ping Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR; S. H. Ho Scoliosis Research Laboratory, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong SAR.
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Lai KKL, Lee TTY, Lee MKS, Hui JCH, Zheng YP. Validation of Scolioscan Air-Portable Radiation-Free Three-Dimensional Ultrasound Imaging Assessment System for Scoliosis. SENSORS (BASEL, SWITZERLAND) 2021; 21:2858. [PMID: 33921592 PMCID: PMC8073843 DOI: 10.3390/s21082858] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 12/03/2022]
Abstract
To diagnose scoliosis, the standing radiograph with Cobb's method is the gold standard for clinical practice. Recently, three-dimensional (3D) ultrasound imaging, which is radiation-free and inexpensive, has been demonstrated to be reliable for the assessment of scoliosis and validated by several groups. A portable 3D ultrasound system for scoliosis assessment is very much demanded, as it can further extend its potential applications for scoliosis screening, diagnosis, monitoring, treatment outcome measurement, and progress prediction. The aim of this study was to investigate the reliability of a newly developed portable 3D ultrasound imaging system, Scolioscan Air, for scoliosis assessment using coronal images it generated. The system was comprised of a handheld probe and tablet PC linking with a USB cable, and the probe further included a palm-sized ultrasound module together with a low-profile optical spatial sensor. A plastic phantom with three different angle structures built-in was used to evaluate the accuracy of measurement by positioning in 10 different orientations. Then, 19 volunteers with scoliosis (13F and 6M; Age: 13.6 ± 3.2 years) with different severity of scoliosis were assessed. Each subject underwent scanning by a commercially available 3D ultrasound imaging system, Scolioscan, and the portable 3D ultrasound imaging system, with the same posture on the same date. The spinal process angles (SPA) were measured in the coronal images formed by both systems and compared with each other. The angle phantom measurement showed the measured angles well agreed with the designed values, 59.7 ± 2.9 vs. 60 degrees, 40.8 ± 1.9 vs. 40 degrees, and 20.9 ± 2.1 vs. 20 degrees. For the subject tests, results demonstrated that there was a very good agreement between the angles obtained by the two systems, with a strong correlation (R2 = 0.78) for the 29 curves measured. The absolute difference between the two data sets was 2.9 ± 1.8 degrees. In addition, there was a small mean difference of 1.2 degrees, and the differences were symmetrically distributed around the mean difference according to the Bland-Altman test. Scolioscan Air was sufficiently comparable to Scolioscan in scoliosis assessment, overcoming the space limitation of Scolioscan and thus providing wider applications. Further studies involving a larger number of subjects are worthwhile to demonstrate its potential clinical values for the management of scoliosis.
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Affiliation(s)
| | | | | | | | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong; (K.K.-L.L.); (T.T.-Y.L.); (M.K.-S.L.); (J.C.-H.H.)
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8
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Zheng YP, Lee TTY, Lai KKL, Yip BHK, Zhou GQ, Jiang WW, Cheung JCW, Wong MS, Ng BKW, Cheng JCY, Lam TP. A reliability and validity study for Scolioscan: a radiation-free scoliosis assessment system using 3D ultrasound imaging. SCOLIOSIS AND SPINAL DISORDERS 2016; 11:13. [PMID: 27299162 PMCID: PMC4900244 DOI: 10.1186/s13013-016-0074-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Radiographic evaluation for patients with scoliosis using Cobb method is the current gold standard, but radiography has radiation hazards. Several groups have recently demonstrated the feasibility of using 3D ultrasound for the evaluation of scoliosis. Ultrasound imaging is radiation-free, comparatively more accessible, and inexpensive. However, a reliable and valid 3D ultrasound system ready for clinical scoliosis assessment has not yet been reported. Scolioscan is a newly developed system targeted for scoliosis assessment in clinics by using coronal images of spine generated by a 3D ultrasound volume projection imaging method. The aim of this study is to test the reliability of spine deformity measurement of Scolioscan and its validity compared to the gold standard Cobb angle measurements from radiography in adolescent idiopathic scoliosis (AIS) patients. METHODS Prospective study divided into two stages: 1) Investigation of intra- and inter- reliability between two operators for acquiring images using Scolioscan and among three raters for measuring spinal curves from those images; 2) Correlation between the Cobb angle obtained from radiography by a medical doctor and the spine curve angle obtained using Scolioscan (Scolioscan angle). The raters for ultrasound images and the doctors for evaluating radiographic images were mutually blinded. The two stages of tests involved 20 (80 % females, total of 26 angles, age of 16.4 ± 2.7 years, and Cobb angle of 27.6 ± 11.8°) and 49 (69 % female, 73 angles, 15.8 ± 2.7 years and 24.8 ± 9.7°) AIS patients, respectively. Intra-class correlation coefficients (ICC) and Bland-Altman plots and root-mean-square differences (RMS) were employed to determine correlations, which interpreted based on defined criteria. RESULTS We demonstrated a very good intra-rater and intra-operator reliability for Scolioscan angle measurement with ICC larger than 0.94 and 0.88, respectively. Very good inter-rater and inter-operator reliability was also demonstrated, with both ICC larger than 0.87. For the thoracic deformity measurement, the RMS were 2.5 and 3.3° in the intra- and inter-operator tests, and 1.5 and 3.6° in the intra- and inter-rater tests, respectively. The RMS differences were 3.1, 3.1, 1.6, 3.7° in the intra- and inter-operator and intra- and inter-rater tests, respectively, for the lumbar angle measurement. Moderate to strong correlations (R(2) > 0.72) were observed between the Scolioscan angles and Cobb angles for both the thoracic and lumbar regions. It was noted that the Scolioscan angle slightly underestimated the spinal deformity in comparison with Cobb angle, and an overall regression equation y = 1.1797x (R(2) = 0.76) could be used to translate the Scolioscan angle (x) to Cobb angle (y) for this group of patients. The RMS difference between Scolioscan angle and Cobb angle was 4.7 and 6.2°, with and without the correlation using the overall regression equation. CONCLUSIONS We showed that Scolioscan is reliable for measuring coronal deformity for patients with AIS and appears promising in screening large numbers of patients, for progress monitoring, and evaluation of treatment outcomes. Due to it being radiation-free and relatively low-cost, Scolioscan has potential to be widely implemented and may contribute to reducing radiation dose during serial monitoring.
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Affiliation(s)
- Yong-Ping Zheng
- />Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Timothy Tin-Yan Lee
- />Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Kelly Ka-Lee Lai
- />Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Benjamin Hon-Kei Yip
- />School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Guang-Quan Zhou
- />Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Wei-Wei Jiang
- />Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - James Chung-Wai Cheung
- />Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Man-Sang Wong
- />Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Bobby King-Wah Ng
- />Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Jack Chun-Yiu Cheng
- />Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Tsz-Ping Lam
- />Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
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Ahmed M, Dorling L, Kerns S, Fachal L, Elliott R, Partliament M, Rosenstein BS, Vega A, Gómez-Caamaño A, Barnett G, Dearnaley DP, Hall E, Sydes M, Burnet N, Pharoah PDP, Eeles R, West CML. Common genetic variation associated with increased susceptibility to prostate cancer does not increase risk of radiotherapy toxicity. Br J Cancer 2016; 114:1165-74. [PMID: 27070714 PMCID: PMC4865979 DOI: 10.1038/bjc.2016.94] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/04/2016] [Accepted: 03/08/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Numerous germline single-nucleotide polymorphisms increase susceptibility to prostate cancer, some lying near genes involved in cellular radiation response. This study investigated whether prostate cancer patients with a high genetic risk have increased toxicity following radiotherapy. METHODS The study included 1560 prostate cancer patients from four radiotherapy cohorts: RAPPER (n=533), RADIOGEN (n=597), GenePARE (n=290) and CCI (n=150). Data from genome-wide association studies were imputed with the 1000 Genomes reference panel. Individuals were genetically similar with a European ancestry based on principal component analysis. Genetic risks were quantified using polygenic risk scores. Regression models tested associations between risk scores and 2-year toxicity (overall, urinary frequency, decreased stream, rectal bleeding). Results were combined across studies using standard inverse-variance fixed effects meta-analysis methods. RESULTS A total of 75 variants were genotyped/imputed successfully. Neither non-weighted nor weighted polygenic risk scores were associated with late radiation toxicity in individual studies (P>0.11) or after meta-analysis (P>0.24). No individual variant was associated with 2-year toxicity. CONCLUSION Patients with a high polygenic susceptibility for prostate cancer have no increased risk for developing late radiotherapy toxicity. These findings suggest that patients with a genetic predisposition for prostate cancer, inferred by common variants, can be safely treated using current standard radiotherapy regimens.
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Affiliation(s)
- Mahbubl Ahmed
- The Institute of Cancer Research, Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
| | - Sarah Kerns
- Department of Radiation Oncology, University of Rochester Medical Centre, Saunders Research Building, 265 Crittenden Boulevard, Rochester, NY 14620, USA
| | - Laura Fachal
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
- Genomic Medicine Group, CIBERER, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Rebecca Elliott
- Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital NHS Foundation Trust, Manchester M20 4BX, UK
| | | | - Barry S Rosenstein
- Department of Radiation Oncology and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, IDIS, CIBERER, Santiago de Compostela 15706, Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, USC University Hospital Complex, SERGAS, Santiago de Compostela, Spain
| | - Gill Barnett
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
| | - David P Dearnaley
- The Institute of Cancer Research, Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London SM2 5NG, UK
| | - Matt Sydes
- Clinical Trials Unit (CTU), Medical Research Council, London WC2B 6NH, UK
| | - Neil Burnet
- Department of Oncology, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
| | - Ros Eeles
- The Institute of Cancer Research, Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - Catharine M L West
- Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital NHS Foundation Trust, Manchester M20 4BX, UK
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10
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Ungi T, Lasso A, Fichtinger G. Tracked Ultrasound in Navigated Spine Interventions. SPINAL IMAGING AND IMAGE ANALYSIS 2015. [DOI: 10.1007/978-3-319-12508-4_15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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11
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Ungi T, King F, Kempston M, Keri Z, Lasso A, Mousavi P, Rudan J, Borschneck DP, Fichtinger G. Spinal curvature measurement by tracked ultrasound snapshots. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:447-454. [PMID: 24268452 DOI: 10.1016/j.ultrasmedbio.2013.09.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 09/18/2013] [Accepted: 09/19/2013] [Indexed: 06/02/2023]
Abstract
Monitoring spinal curvature in adolescent kyphoscoliosis requires regular radiographic examinations; however, the applied ionizing radiation increases the risk of cancer. Ultrasound imaging is favored over radiography because it does not emit ionizing radiation. Therefore, we tested an ultrasound system for spinal curvature measurement, with the help of spatial tracking of the ultrasound transducer. Tracked ultrasound was used to localize vertebral transverse processes as landmarks along the spine to measure curvature angles. The method was tested in two scoliotic spine models by localizing the same landmarks using both ultrasound and radiographic imaging and comparing the angles obtained. A close correlation was found between tracked ultrasound and radiographic curvature measurements. Differences between results of the two methods were 1.27 ± 0.84° (average ± SD) in an adult model and 0.96 ± 0.87° in a pediatric model. Our results suggest that tracked ultrasound may become a more tolerable and more accessible alternative to radiographic spine monitoring in adolescent kyphoscoliosis.
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Affiliation(s)
- Tamas Ungi
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Ontario, Canada.
| | - Franklin King
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Michael Kempston
- Department of Surgery, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Zsuzsanna Keri
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Andras Lasso
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Ontario, Canada
| | - Parvin Mousavi
- Medical Informatics Laboratory, School of Computing, Queen's University, Kingston, Ontario, Canada
| | - John Rudan
- Department of Surgery, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Daniel P Borschneck
- Department of Surgery, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Gabor Fichtinger
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Ontario, Canada
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