Day 1 :
Keynote Forum
Anat Biegon
Brook University School of Medicine, USA
Keynote: Fetal MRI in utero: Past, present, and future directions
Time : 9:00-9:30
Biography:
Anat Biegon is a Professor of Neurology and Radiology at Stony Brook University School of Medicine. She received a PhD in Neurobiology from the Weizmann Institute of Science in Rehovot , Israel and had held research positions in academia and industry. Employing state of the art brain mapping techniques in human subjects including molecular imaging with positron emission tomography (PET), structural and functional MRI, as well as post mortem analysis of human and animal brain samples, Prof. Biegon is engaged in studies of the brain mechanisms affected in brain injury, stroke, Alzheimer’s disease and neuroinflammation. Her work includes development and validation of novel radiotracers and drugs for improving diagnosis and treatment of brain disorders.
Abstract:
The widespread application of modern MRI techniques to the live fetus in utero is an evolving endeavor, contingent on ongoing improvement in hardware and software. At present, all major MRI techniques, including structural MRI imaging, diffusion weighted imaging (DWI), magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), and functional MRI, have been adapted for studies of the maternal – fetal unit with varying degrees of success. Issues affecting adaptation of MRI techniques to fetal imaging include safety, fetal motion and the small but changing size, anatomy and composition of the fetal organs. Consequently, clinical and research studies employing MRI techniques of the maternal – fetal unit are performed during the 2nd and 3rd trimester, eschewing the use of contrast (gadolinium) agents. Fetal movement is currently addressed by using multiple acquisitions with ultra-fast sequences, to which T2 weighted imaging is most amenable. The changing landscape of fetal size and tissue compositions requires adaptation of the field of view and sequence parameters to the age of the fetus for best contrast and resolution in anatomical as well as physiological (DWI) and biochemical (MRS) imaging techniques. Techniques requiring longer acquisition times and thus more sensitive to fetal motion; such as MRS, DTI and fMRI are used mostly in the research setting. Future expansion of fetal MRI applications rely on the adaptation of 3D acquisition, automated motion correction and volumetry as well as the establishment of multiple normative data bases of fetal development parameters for each gestational week.
Keynote Forum
Richard P Hill
Princess Margaret Cancer Center, Canada
Keynote: Combining AMD3100 with Chemo-Radiotherapy for Treatment of Cervical
Time : 9:30-10:00
Biography:
Hill obtained his B.A. in Physics at St John’s College, Oxford and his PhD in Radiation Biology at St Bartholomew’s Hospital Medical College in London, UK. He is currently a member of the senior scientific staff of Ontario Cancer Institute/Princess Margaret Cancer Centre, which is part of the University Health Network in Toronto, Canada. He has published over 250 scientific papers and is the co-editor (with Drs Ian Tannock, Rob Bristow and Lea Harrington) of the “Basic Science of Oncologyâ€; a book that is widely used in basic courses for oncology trainees and is currently in its fifth edition.
Abstract:
We have used human cervical cancer xenografts grown orthotopically in the cervix of mice to assess the effects of hypoxia on lymph-node metastases and to examine the efficacy of chemo-radiotherapy. We have been particularly interested in the chemokine receptor CXCR4 since it is upregulated by hypoxia and expression of its ligand CXCL12 (SDF1) may be increased following radiation treatment. The clinically-available drug AMD3100 (Plerixafor) blocks the CXCR4/CXCL12 interaction and treatment of xenograft-bearing animals with this drug reduces lymph-node metastases. A small animal imager/irradiator was used to treat the orthotopic tumours with 2Gy fractions (5dys/wk), combined with weekly cisplatin with or without the addition of AMD3100. Interestingly, AMD3100 treatment throughout the course of the chemo-radiotherapy was found to enhance the tumour response as well as reducing lymph-node metastases. The mechanism of this effect is currently unknown but may relate to reduced angiogenesis. When acute toxicity to the normal intestine was assessed using a gut clone assay following single radiation doses given with and without cisplatin and/or AMD 3100, there was no evidence of increased damage associated with the AMD3100 treatment. These results suggest that it may be beneficial to add AMD3100 to standard chemo-radiotherapy for treatment of cervical cancers, particularly for patients whose tumours contain significant regions of hypoxia, since such patients have been found to have increased propensity for metastatic failure following chemo-radiotherapy. This emphasizes the need to assess levels of hypoxia in the tumours by imaging prior to selection of patients for such studies.
Keynote Forum
Mitchell S. Albert
Lakehead Univeristy, Canada
Keynote: New advances in functional MR imaging of the lungs and brain using hyperpolarized and inert gases
Time : 10:00-10:30
Biography:
Dr. Albert is a Research Chair at the Thunder Bay Regional Research Institute and Lakehead University. He is Director of MRI Research, Director of the Hyperpolarized Gas MRI Laboratory, a Scientist at TBRRI, and Professor of Chemistry at Lakehead University. Prior to this he was Associate Professor of Radiology at the Harvard Medical School. Dr. Albert is one of the inventors and pioneers of hyperpolarized gas MRI, and holds 9 patents on its development. He received the United States Presidential Award from President Clinton for this invention and received a CAREER award from the National Science Foundation (NSF).
Abstract:
Hyperpolarized (HP) agents have the potential to vastly improve MRI sensitivity for the diagnosis and management of various diseases. The polarization of 3He and 129Xe can be enhanced by a factor of up to 100,000, which enables direct detection of the HP agent with no background signal. Conventional 1H MR imaging of the lungs is very challenging, particularly due to the low proton density in lung tissue. HP gas MRI, using 3He or 129Xe, can be used to obtain high-quality images of the lung structure and function. Inert fluorinated gas 19F MRI is a new pulmonary imaging modality that may be able to provide images and functional information similar to HP gas MRI. Inert fluorinated gases are nontoxic, abundant, inexpensive, and do not need to be hyperpolarized prior to their use in MRI, and their short T1 allows for signal averaging within a breath-hold. HP 129Xe is a potentially valuable MR tracer for functional brain imaging due to its high solubility in the blood and brain, and its large chemical shift range. We published the first results using HP 129Xe brain imaging techniques for the measurement of cerebral ischemia and cortical brain function in rats. HP 129Xe can also be used in biosensors for molecular MR imaging, and delivered to a target by means of dedicated molecular cage systems that can encapsulate xenon and bind to biological sites of interest using a targeting moiety, such as an antibody or a ligand, which enables detection of a specific biomarker.
- Track 2: Advances in Imaging
Session Introduction
Yogesh Thakur
The University of British Columbia, Canada
Title: Comparison of simultaneous integrated boost intensity-modulated radiation therapy and conventional accelerated hyper-fractionated radiotherapy for limited disease small-cell lung cancer
Biography:
Yogesh Thakur completed his PhD at The University of Western Ontario in 2009. He is currently the Medical Physics Lead at Vancouver Coastal Health Authority and a Clinical Assistant Professor in the Department of Radiology at the University of British Columbia. He has published more than 15 papers in reputed journals, 1 book chapter, and peer reviewed manuscripts for numerous reputed journals. He is a member of the Canadian College of Physicists in Medicine, certified in Diagnostic Imaging and Mammography.
Abstract:
CT examinations are identified as the largest radiation dose/exam contributor to the population from medical imaging. The AAPM report 204 advocated the use of Size Specific Dose Estimates (SSDEs) to dose estimation; however effective dose calculation using SSDE has not been validated. This work aims to determine whether the published k-factor for chest CT is valid using SSDE approach. 24 patients underwent clinically indicated chest CT exams, scanned with our institutional CT protocol. Patient data was categorized into 4 groups based on sex and BMI (large: >25 kg/m2 and small: <25 kg/m2). Monte Carlo (MC) simulations were performed using patient data to estimate organ absorbed dose and calculate E via ICRP-103 methods (E-MC) and compared with E estimated with k-factor (E-k) and with SSDE/k-factor (E-SSDE). A significant difference was found between E-MC and E-k for small females (P<0.05). Differences in E-SSDE and MC-E were significantly different for all groups (P<0.05) except small females, where the difference between E-SSDE and E-MC was not significantly different (P>0.05). The range of difference between E-MC and E-k was +/- 0.8 mSv. Dose was underestimated by 45% for the smallest female (BMI-17.0). Data suggested that E-k is valid to estimate effective dose in chest CT for males between 17-32 BMI and females between 26-30 BMI. Small females were significantly underestimated using the E-k method by upto 45%. SSDE improved E estimates for small females. Use of the currently established k-factor of 0.014 mSv/(mGy-cm) is a valid method to estimate effective dose for males and large females in chest CT.
Farhood Alsoos
Damascus University, Syria
Title: Evaluation of right ventricle systolic function by right ventricular outflow tract systolic excursion using ultrasound
Biography:
Farhood Alsoos completed her Master’s degree in Cardiology from Damascus University, Syria. He has published many papers in reputed journals. He is currently pursuing his research interests in the field of echocardiography
Abstract:
Background: Assessment of Right Ventricle (RV) systolic function has a prognostic and therapeutic value, and this assessment is not easy by using ultrasound. The aim of this study was to assess a new way to evaluate RV systolic function, by studying Right Ventricular Outflow Tract Systolic Excursion (RVOTSE). Methods: RVOTSE was measured by using M-Mode from the parasternal short-axis view at the level of the aortic valve, and was defined as the systolic excursion of the right ventricular outflow tract anterior wall endocardium in millimeter. A total of 104 patients were studied and separated into two groups: 51 patients with reduced RV function, RV fractional area change (FAC) <35% and tricuspid annular plane systolic excursion (TAPSE) <1.6 cm] and 53 patients with normal RV function (FAC) ≥35% and TAPS ≥1.6 cm. RVOTSE was measured in the two groups and compared with right ventricular outflow tract fractional shortening (RVOTFS) and tricuspid annular systolic excursion velocity S¢. Results: The sensitivity of RVOTSE as a method of diagnosing reduced RV systolic function was 98% and the specificity was 100%. The sensitivity of Tissue S¢ was 96% and the specificity was 94%. The sensitivity of RVOTFS was 80% and the specificity was 98%. There was no correlation between RVOTSE and ejection fraction, also between RVOTSE and pulmonary artery systolic pressure in patients with reduced RV systolic function. There was a strong correlation between RVOTSE and the other ways to evaluate RV systolic function. Conclusion: RVOTSE is a new, simple, sensitive and specific ultrasound way to evaluate RV systolic function.
Andrew Smith
Memorial University, Canada
Title: Estimating fluid responsiveness and volume status via tracking and segmenting the IVC in ultrasound imagery at the point of care
Biography:
A Smith completed his MEng in 2001, MD in 2005 and emergency medicine residency training at Memorial University in 2008. He currently works in the Health Sciences ER and was appointed as an Assistant Professor with Memorial in 2012. To date, he developed and served as director of Memorial’s Point of Care Ultrasound program training students and clinicians to use ultrasound at the bedside. He is cross-appointed with the Faculty of Engineering and Applied Sciences with research interests in non-invasive monitoring, Point of Care Ultrasound, and telemedicine. He is using his research interests to create formal biomedical engineering opportunities at Memorial.
Abstract:
Accurate resuscitation of the critically-ill patient using intravenous fluids and blood products is a challenging, time sensitive task. Insufficient or excessive administration of fluids leads to increased morbidity, mortality and length of stay in hospital. In recent years, clinicians have been integrating portable ultrasound with their clinical impression to improve diagnostic certainty and guide fluid administration. Dynamic imaging of the IVC and its respiratory variation correlates moderately well with fluid responsiveness in the intubated and ventilated patient while suggesting hyper and hypovolemia in the spontaneously breathing patient at extremes of volume status. Unfortunately, ultrasound of the IVC is not a panacea however does represent an opportunity for the application of existing and emerging medical image processing techniques to advance the field of non-invasive monitoring. This presentation will highlight first attempt to develop an algorithm capable of automatically tracking and measuring the IVC compared to human operators across a diverse range of image qualities. Researchers incorporated a modified-watershed segmentation technique and centroid tracking to analyze a convenience sample of 15 ultrasound videos from spontaneously breathing patients collected while in the ER. Minimal tracking failures and high levels of agreement between manual and algorithm measurements were demonstrated on good quality videos. Addressing problems such as gaps in the vessel wall and intra-lumen speckle should result in improved performance in average and poor quality videos. Semi-automated measurement of the IVC for the purposes of non-invasive estimation of fluid responsiveness and volume status poses challenges however is feasible.
Sunanda Bhatnagar
Maharashtra University of Health Sciences, India
Title: Ultrasonographic imaging of salivary glands: An early predictor of Sjogren’s syndrome in patients with rheumatoid arthritis
Biography:
Sunanda Bhatnagar is MDS (Gold Medalist) of D Y Patil University School of Dentistry, Navi Mumbai, and she is specialized in Oral Medicine and Radiology. She is the Author of 10-publications in prestigious journals/conference proceedings inclusive of international PubMed indexed journal and specialty journal. She has received Best Scientific Paper Award from the Indian Academy of Oral Medicine and Radiology.
Abstract:
Rheumatoid arthritis is a slowly progressive systemic chronic inflammatory disease of the connective tissue which affects joints, often leading to permanent deformity, influencing other systems also. Sjogren’s syndrome is a chronic auto-immune disorder of the exocrine glands with associated lymphocytic infiltrates. Dryness of mouth and eyes referred to as Sicca syndrome results from involvement of the salivary and lacrimal glands. This exocrinopathy when occurs in the presence of another auto-immune disorder such as Rheumatoid arthritis is termed as secondary Sjogren’s syndrome. This paper is based on a combined radiological and fundamental study of salivary glands aimed to assess the ultra-sonographic technique as a sensitive and an early predictor of Sjogren’s syndrome in patients with Rheumatoid arthritis. The patients were assessed for significant structural changes and salivary functions. Some of the ultra-sonographic findings derived in the study of patients with Rheumatoid arthritis were: Course and heterogeneous parenchymal echo pattern, a few levels IB lymphadenopathy, increased or decreased vascularity, coarse honeycombed parenchymal appearance. The suggested conclusion of this paper is that ultrasonography of salivary glands with Rheumatoid arthritis compared with normal subjects is an effective method for diagnosing early changes and that patients with early onset and long standing history of Rheumatoid arthritis showed representative structural changes, suggestive of increased pre-disposition to secondary Sjogren’s syndrome.
Sornsupha Limchareon
Burapha University, Thailand
Title: Physician-performed focused ultrasound: An update on its role and performance
Biography:
Sornsupha Limchareon is graduated from University of Thailand in 1990 and completed a residency in radiology from Chulalongkorn Hospital in 1993. She is a Head, Division of Radiology and Nuclear Medicine at Burapha University Hospital, Thailand. She has worked in medical imaging for more than 20 years. Her research interests include ultrasound and medical education.
Abstract:
There is an increase in the use of focused ultrasound (US) by physicians because it offers the major benefit of reduction in time to diagnosis. Some of these physicians have received formal training on focused ultrasound, others have not received any such training. However, among the formal training given on focused US, there is inconsistency across the teaching protocols. This review presents performances of focused US commonly performed by physicians, compared with radiology US. The various teaching protocols are also discussed.
Allan Felipe Fattori Alves
Bioscience Institute of University, Brazil
Title: Construction of pediatric homogeneous phantoms for optimization of chest and skull radiographs
Biography:
Allan Alves has completed his Master Degree at the age of 26 years from Univ. Estadual Paulista, Brazil. He is currently a PhD Student at Univ. Estadual Paulista. His main research lines are image quality evaluation in digital radiography systems and dosimetry applied to interventional radiology. Allan also has experience in quality control of X-ray equipments and quality assurance management in hospital routines.
Abstract:
We developed two pediatric patient-equivalent phantoms, the Pediatric Chest Equivalent Patient (PCEP) and the Pediatric Skull Equivalent Patient (PSEP) for children aged 1 to 5 years. We also used both phantoms for image quality evaluations in computed radiography systems to determine Gold Standard (GS) techniques for pediatric patients. We determined the simulator materials thickness (Lucite and aluminum) through biological tissues quantification (lung, soft, and bone) using an automatic computational algorithm. To objectively establish image quality levels, two physical quantities were used: effective detective quantum efficiency and contrast-to-noise ratio. These quantities were associated to values obtained for standard patients from previous studies. Results: For chest radiographies, the GS technique applied was 81 kVp, associated to 2.0 mAs and 83.6Gy of entrance skin dose (ESD), while for skull radiographies, the GS technique was 70 kVp, associated to 5 mAs and 339Gy of ESD. Conclusion: This procedure allowed us to choose optimized techniques for pediatric protocols, thus improving quality of diagnosis for pediatric population and reducing diagnostic costs to our institution. These results could also be easily applied to other services with different equipment technologies.
- Track 4 : Medical Imaging
Track 5 : Imaging Probes, Chemistry and Reporter Genes
Session Introduction
Jonathan Fitzsimmons
Brookhaven National Lab Upton, USA
Title: When beta therapy fails – Is alpha therapy a solution?
Biography:
Jonathan Fitzsimmons completed his master from Johns Hopkins University in 2000, and received his PhD in radiochemistry in 2005 from University of Missouri-Columbia. He performed postdoctoral studies at Los Alamos National Laboratory and research at the University of North Carolina at Chapel Hill. He is currently a medical scientist at Brookhaven National Laboratory, where he developed a production scale separation of 68Ge, and is part of the TriLab team to develop 225Ac on a production scale. He has published over ten papers in reputed journals, has one patent and is serving on an expert panel for the US Pharmacopeia.
Abstract:
Actinium-225 (225Ac) has a half life of 9.92 days, decaying through multiple intermediate nuclei to a daughter isotope Bismuth-213 (213Bi) with a half life of 45 min. Both isotopes have been investigated for targeted alpha therapy. Researchers have shown 213Bi DOTATOC can shrink tumors in patients that had previously not responded to similar treatments with the beta emitting isotopes 90Y and 177Lu . The United States Department of Energy (US DOE) supplies purified 225Ac from a generator system associated with the parent isotope 229Th, but this approach does not supply enough 225Ac for the applications associated with both 225Ac and 213Bi. To meet this demand the US DOE has initiated a Tri-lab (Los Alamos-Brookhaven-Oak Ridge National Laboratories) effort to develop 225Ac by irradiation of a thorium target with high energy (90-200 MeV) protons. One of the main challenges associated with this production route is isolation of 225Ac from bulk thorium and other radionuclides (~400) formed as a result of fission and other nuclear reactions. In targeted alpha therapy with 225Ac the retention of the multiple daughters of 225Ac at the target site has been problematic. A chemical method to produce a targeting nanochelator to: capture 225Ac, retain the daughters of alpha decay, and target tumors will be discussed.
Yuchong Rachel Jiang
Sheridan College, Canada
Title: A 3D computer assisted treatment planning system for breast cancer brachytherapy treatment
Biography:
Yuchong Rachel Jiang is a faculty of Applied Science and Technology, Sheridan College Institute of Technology and Advanced Learning. He specializes in the treatment of breast by using 3D computer assisted treatment.
Abstract:
This paper describes a 3D computer assisted treatment planning system that we created for breast cancer brachytherapy treatment. The system was developed using mathematical theories for accurate volume estimation and dose analysis as well as advanced 3D visualization technologies. The patient treatment volume reconstructed by a method developed in our system significantly improves the accuracy of existing methods and guarantees the high volume accuracy requirement of radioactive seed implantation procedure for this treatment. The virtual 3D environment in our system enables radiation oncologists to perform volume measurements, seed placements, and dose distribution planning and analysis based on 2D contours on patient CT images. Furthermore, the system is able to embed placed seeds on original patient CT images and displayed in 3D. Our system achieves 99.73% accuracy in volume estimation measured against the true volume and is statistically significantly more accurate than current existing commercial software at the p=0.05 level. Further development will be discussed.
Ibrahim Karademir
Eskisehir Military Hospital, Turkey
Title: Short-term reproducibility of apparent diffusion coefficient estimated from diffusion-weighted MRI of the prostate
Biography:
Ibrahim KARADEMIR has completed his M.D. at the age of 25 years from Gulhane Military Medical Faculty and his radiology residency in the same institution 2007 to 2011. He had studied in University of Chicago in 2011-2012 on Prostate Imaging. He is working as a Radiologist in Eskisehir Military Hospital.
Abstract:
Purpose: The purpose of the study is to determine shortterm reproducibility of apparent diffusion coefficient (ADC) estimated from diffusion-weighted magnetic resonance (DW-MR) imaging of the prostate. Methods: Fourteen patients with biopsy-proven prostate cancer were studied under an Institutional Review Board-approved protocol. Each patient underwent two, consecutive and identical DW-MR scans on a 3T system. ADC values were calculated from each scan and a deformable registration was performed to align corresponding images. The prostate and cancerous regions of interest (ROIs) were independently analyzed by two radiologists. The prostate volume was analyzed by sextant. Per-voxel absolute and relative percentage variations in ADC were compared between sextants. Per-voxel and per-ROI variations in ADC were calculated for cancerous ROIs. Results: Per-voxel absolute difference in ADC in the prostate ranged from 0 to 1.60 9 10-3 mm2 /s (per-voxel relative difference 0% to 200%, mean 10.5%). Variation in ADC was largest in the posterior apex (0% to 200%, mean 11.6%). Difference in ADC variation between sextants was not statistically significant. Cancer ROIs’ per-voxel variation in ADC ranged from 0.001 9 10-3 to 0.841 9 10-3 mm2 /s (0% to 67.4%, mean 11.2%) and per-ROI variation ranged from 0 to 0.463 9 10-3 mm2 /s (mean 0.122 9 10-3 mm2 /s).
Luis Moreno Sánchez
Universidad Central de Venezuela, Venezuela.
Title: Irradiation in central nervous system tumors
Biography:
Moreno Sanchez is a Venezuelan Radiation Oncologist and Nuclear Medicine Physician, graduated in Hospital Universitario de Caracas in the Universidad Central de Venezuela (UCV), Caracas, Venezuela, with a fellowship in Advanced Radiotherapy Techniques. Currently works in CDD Radioterapia – Clinica Abreu as an External Advisory and and Assistant Professor in the only radiation oncology residence of Dominican Republic, few months ago was positioned as Radio Oncology Coordinator in the National Cancer Institute Rosa E. Tavares (INCART).
Abstract:
Historically the treatment of brain metastases is viewed with skepticism. The hospitalization by itself prolongs life by one - two months. Treatments with steroids reduce symptoms, but effect is short. Whole Brain Radiotherapy (WBRT) have been made mainstay for several decades, increasing survival up to six months, but it has been associated with neurocognitive impairment. On the other hand, when possible surgery is is the gold standard indication in a single or with significant mass effect lesions. In the past decade radiosurgery has become a very popular alternative, with high efficiency and few side effects, but until now 3D conformal radiotherapy or IMRT continue to be most employee techniques, including WBRT with hippocampal sparing.
Saira Naz Sufian
The Aga Khan University Hospital, Pakistan
Title: Evaluation of common risk factors related with breast carcinoma in females: A hospital based study in Karachi, Pakistan
Biography:
Saira Naz Sufian is an Assistant Professor of Radiation Oncology at The Aga Khan University Hospital. She specializes in the treatment of breast and gynecological cancers. Her research interests include Evaluation of common risk factors related with Breast Carcinoma in females.
Abstract:
Introduction: Breast malignancy is one of the leading causes of death in female worldwide. In Pakistani females breast carcinoma is the most repeatedly diagnosed malignancy. There are a number of risk factors associated with breast cancer but in Karachi Pakistan there is insufficient data available. Materials & Methods: A case control study was conducted on females, age group between 30-80. This study was done by a retrospective data collection from a proforma obtained prior to mammography in Aga Khan University Hospital Karachi, Pakistan. A total of 108 females with primary malignancy of breast were included and 108 controls were also included from same data. Cases were defined as female patients with a histo-pathological proof of breast malignancy. An equal number of controls were selected from same cohort of patient. The controls were healthy with normal mammogram. Relationship of these factors with disease was studied using logistic regression to calculate Odds ratios (ORs) and 95 % confidence interval (CIs). Male cases were excluded and exclusion criteria for controls were those with endocrine disorders, known malignant, hormonal disease, gynecological diseases. Results: A total of 14 variables were analyzed and based on Odds ratio and confidence interval for each of breast cancer factors 7 variables were found to be “the risk factors†for development of breast cancer, these factors were the older age, family history of breast cancer, family history of other carcinomas, personal history of breast carcinoma, early age of menarche, older age of mother at first delivery and lesser number of children. Five factors i.e. parity, breast feeding, Oral Contraceptive Pills consumption, past history of oophorectomy and hysterectomy showed protective association. One variable i.e. use of hormonal replacement therapy showed controversial association and one of the variable i.e. the marital status was not significant in this study. Conclusion: It is concluded that most of the well-known risk factors of breast cancer are also associated with breast cancer in the female population of Karachi Pakistan. High risk patient can be focused by the help of this study and screening can be more effective in the early diagnosis before clinically evident breast malignancy. The breast cancer screening program would be more preventive and effective if high risk patients are highlighted by the clinician.
Jimoh O Agbaje
Katholieke University Leuven, Belgium
Title: Visibility of mandibular canal on panoramic radiograph after bilateral sagittal split osteotomy (BSSO)
Biography:
Agbaje has completed his PhD in 2013 from Katholieke University Leuven. He is an FWO postdoctoral fellow at the same University. He has published more than 30 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
This study aimed to assess the visibility of the mandibular canal (MC) on panoramic radiographs after BSSO, and to investigate what factors affect this MC visibility. We assessed MC visibility on panoramic radiographs of 200 BSSO patients. Images were acquired preoperatively (T0), immediately postoperatively (T1), six months postoperatively (T2), and one year postoperatively (T3), from three different predetermined regions of the mandible: the angle (Angle), distally to the second molar (M2), and mesially to the first molar (M1). All analyses were performed using SAS version 9.22. The visibility of the MC was registered preoperatively in over 96% (387/400) of the measurements at the angle of the mandible, 79% (317/400) at M2, and less than 63% (251/400) at M1. MC visibility decreased immediately after the operation and increased thereafter. Region of the mandible (P ≤ 0.0001), plate removal (P ≤ 0.0001), time of assessment (P ≤ 0.0001), and age (P = 0.0034) were important predictors of whether MC would be radiographically visible. The visibility of the MC decreased immediately after BSSO, especially at the operation site (M2 and M1), while maximum MC visibility was achieved at twelve months postoperatively in our series. Since MC was not visible at the operation site after BSSO for 50% of the subjects, it may be necessary to use additional visualization modalities for postoperative patient assessment in this region.