International Conference on Radiology and Imaging, Oncology Nursing & Cancer Care September 19-20, 2016, Las Vegas, Nevada, USA

Biography:

Gregory G Passmore earned his PhD and MS in Nuclear Medicine Technology from the University of Missouri, USA. He is a tenured Professor and the Director of the Nuclear Medicine Technology Program at the Augusta University, USA. His research interests include both Nuclear Imaging Physics and Nuclear Medicine Education. He has over 100 publications, abstracts and presentations.

Abstract:

Gamma camera imaging of myocardium perfusion with either Tl-201 or Tc-99 m is dependent upon maintaining usable geometry between the detector and the view of the patient through the use of an attached lead (Pb) collimator. Both radioisotopes can indicate the perfusion characteristics of the myocardium. However, only Tl-201 has the capability to indicate if the cardiac tissue retains its viability, or if it is scarred. Current dual-isotope myocardial single-photon emission computed tomography (SPECT) imaging protocols require two scans. Simultaneous imaging of Tl-201 and Tc-99m would have the benefits of optimal perfusion imaging and tissue viability signaling, eliminating potential errors caused by position misalignment between scans, and significantly reducing study time. This would further enhance the diagnostic ability of the modality, especially for those patients contraindicated for other functional imaging. However, the 99mTc Compton down-scatter components and K-shell X-rays from the Pb collimator interfere with imaging the ~70-80 keV 201Tl photons. This cross-talk reduces image resolution and obscures 201Tl defects, falsely indicating viable myocardium. This project suggested replacing the Pb collimator with one of higher density tungsten (W) to reduce the 99mTc cross-talk photons in the 201Tl photo peak range by decreasing the down-scatter component through increased absorption and shifting the k-shell x-ray out of the 201Tl photo peak. The aim of the project was to test the ability of a W pinhole attenuator in reducing the detrimental effects of Pb generated cross-talk during simultaneous dual-isotope201Tl/99mTc imaging. Outcomes indicate a significant reduction in down-scatter cross-talk using W attenuators compared to Pb attenuators.

Biography:

Jan S Lewin is a Professor in the Head and Neck Surgery Department and Section Chief of Speech Pathology and Audiology at UT MD Anderson Cancer Center. She received her undergraduate and graduate degrees from the University of Michigan and her PhD from Michigan State University. She is a recognized authority on functional outcomes in oncology patients. She is a regularly invited participant to national and international cancer survivorship programs and public education networks. Under her direction, the speech pathology and audiology program at MD Anderson is recognized as the premier program for functional rehabilitation of oncology patients.

Abstract:

Speech and swallowing dysfunction are frequent consequences of head and neck cancer and its treatment. Combined modality treatment has replaced highly morbid operations for the treatment of patients with advanced disease. Endoscopic transoral laser and robotic surgeries along with intensity modulated radiation therapy regimens of photons or protons, offer alternatives for functional preservation by sparing uninvolved tissues, essentially saving critical physiology. Despite the often remarkable therapeutic gains, even organ sparing treatment regimens have frequently been accompanied by significant early and late toxicities, including dysphagia and chronic aspiration. Findings from laryngeal preservation trials show aspiration rates up to 40% in unselected groups of head and neck cancer patients. Up to 80% of symptomatic patients will aspirate when laryngopharyngeal function is impaired; and 50% of those who aspirate will do so silently without indication (coughing or throat clearing). Treatment de-intensification is critical, especially for patients with HPV-associated oropharyngeal cancers who are younger, nonsmokers, who have better cancer treatment response and an increased life expectancy. Recent data support proactive, preventative exercise models as best practice to optimize long-term functional outcomes. Appropriate functional evaluations can provide clear prognostic indicators and guide treatment selection especially for patients in whom cancer cure and survival are comparable. Data demonstrate that prospective implementation of appropriately designed treatment regimens offers the best methods for avoiding long-term dysfunction. This session provides a comprehensive overview of the tumor characteristics, risk factors, treatment regimens and associated toxicities as they relate to the long-term functional outcomes of patients with head and neck cancer.

Biography:

Sang Y Lee is an Assistant Professor in the Neurosurgery Department of the Pennsylvania State University College of Medicine (PSUCOM). His research focuses on the role of iron metabolism in neurodegenerative diseases and cancers. His research interests also include drug development for cancers, especially brain cancer, lung cancer, and neuroblastoma. He is a recipient of innovation award from the PSUCOM. He is an active member of BioIron, AACR and SNO. He has published more than 34 peer-reviewed papers and his research has been recognized by multiple private foundations and state and federal governments including NIH. He served grant reviewers for NCI and NIH.

Abstract:

Gliomas account for 28% of all primary brain and central nervous system (CNS) tumors, and 80% of them are malignant. Among gliomas, glioblastoma multiforme (GBM) is the most common malignant type. The median survival time for GBM patients is 14.6 months. The 2 year survival rate of GBM patients is just 10.4% for those treated with radiotherapy alone and 26.5% for patients treated with both chemotherapy, temozolomide (TMZ), and radiation. The current chemotherapeutic standard for GBM is TMZ - an oral alkylating agent. However, at least 50% of TMZ treated patients do not respond to TMZ. This is due primarily to the over-expression of O6-methylguanine methyltransferase (MGMT) and/or lack of a DNA repair pathway in GBM cells. Multiple GBM cell lines are known to contain TMZ resistant cells and several acquired TMZ resistant GBM cell lines have been developed for use in experiments designed to define the mechanism of TMZ resistance and the testing of potential therapeutics. The characteristics of intrinsic and adaptive TMZ resistant GBM cells, however, have not been systemically compared. In this presentation, I will i) compare the characteristics and mechanisms of TMZ resistance in natural and adapted TMZ resistant GBM cell lines, ii) summarizes potential treatment options for TMZ resistant GBMs, and iii) drug development using TMZ resistant cells.

Biography:

Suzanne Alves is currently working as Clinical Nurse Specialist in research and education for peritoneal malignancy. She has a BA in cancer nursing and MSc in Cancer care and wide experience in the care of patients with pseudomyxoma peritonei and education.

Abstract:

Peritoneal malignancy encompasses pseudomyxoma, colorectal carcinoma, ovarian carcinoma and other rare cancers that are suitable for cytoreductive surgery and heated intra-operative intra-peritoneal chemotherapy (HIPEC). Surgery is extensive with multiple visceral and peritoneal resections. Nursing these patients presents challenges, in terms of pain relief, nutrition, stoma care, hallucinations, and post-operative complications. The patient stay averages 21 days and all spend a minimum of 24 hours in ITU and have total parenteral nutrition. Nutrition is difficult and depending on the resections, remains so for some time. Quality of life is poor following surgery and can take up to six months before a good quality is achieved. Those patients unable to have a complete cytoreduction have as much tumour removed as possible, and live with the certainty of further problems at some time in the future with a reduction in life span. Palliative care is an essential part of long term care. A telephone nurse-led follow up provides support and an environment of trust for the patient. The length of follow up for some patients creates a psychological trauma that is revisited annually due to CT scans and tumour markers; however there is 86% survival rate at five years for pseudomyxoma. End of life and survivorship are aspects of care that require considerable long term input and support.

Biography:

Priscila Feliciano de Oliveira is pursuing her Doctorate in Health Sciences from Sergipe Federal University (UFS). She earned her Master of Speech Therapy and Audiology degree from Pontifical Catholic University of São Paulo (2007). In addition, she is post-graduated in Hospitalar Speech Therapy and Audiology and in Hospital Administration. She is a specialist in audiology by Federal Council of Speech Therapy and Audiology and is Adjunct Professor of Audiology at UFS. She is Coordinator of Audiology Monitor Program and Coordinator of Audiological Diagnosis research in Oncology conducted at a Public Hospital of Medical Emergency in Sergipe.

Abstract:

In Brazil, the estimation of cancer for 2015 was 576 thousands of new cases. In the Northeast of Brazil, Aracaju (Sergipe), the numbers have been increasing significantly, once Brazilian National Cancer Institute had notified 3.610 cases in 2010 and in 2015, 4.755 cases. Treatment methods have been widely used given their increase in the successful outcomes and cure of some cancers, but they lead to collateral effects. One of them is the hearing loss, which can affect the middle or inner ear. Generally, hearing loss is sensorineural, bilateral and irreversible, tends to be permanent and can come with tinnitus. The major damage occurs in the basal turn of the cochlea and hits the outer hair cells before some days or weeks after the treatment. In this perspective, a research project was set up in a public hospital in Sergipe, which is reference in cancer ward for the state. In 2012, 30.3% of 43 subjects were identified with some damage in hearing organ. In 2013, were evaluated 63 patients, and 11 of them were followed up monthly. We diagnosed 32.3% with hearing loss and 45.5% had worsening of hearing thresholds. In 2014 and 2015, our hearing assessment was extended for children and elderly, and sensorioneural cases were diagnosed. Furthermore, most of them reported tinnitus (62.2%) and it was identified that poorer quality of life was associated with late diagnosis. To sum up hearing loss cases were referred to use a hearing aid and all cases were discussed with the medical team.

Biography:

Sanjit Kumar founded DiaScan, Inc. along with four others in order to further integrate medicine with data science. We are funded by Christopher Klaus, CEO at Kaneva and former Founder and CTO at Internet Security Systems. DiaScan received the Audience Choice Award at the TechCrunch Pitch-Off in Atlanta in 2016. Additionally, we were accepted into the Cyberlaunch Accelerator program for summer 2016.

Abstract:

Among all types of cancers, lung cancer ranks highest on mortality rate. The only way to diagnose malignant lung cancer is by performing a biopsy or seeing the growth of a malignant tumor between scans, both of which usually lead to late diagnosis and metastasis. This decreases chances of survival dramatically. To make matters worse, current softwares that radiologists use do not really help with analysis, diagnosis, and prognosis. Most CAD softwares do not even automatically calculate pertinent tumor features. Because of this, the false positive rate hovers around 90% nationally, with one NIH study having a false positive rate of 96.4%. DiaScan uses deep learning and feature extraction on CT scans and medical data in order to accurately characterize lung cancer. DiaScan strives to detect cancer at an early stage, reduce the high false positive rate, decrease the amount of unneeded biopsies and repeat scans, assist radiologists by offering better tools and features, and minimize overall costs. DiaScan recieved over 10,000 patients from the National Cancer Institute in order to pursue their research, and is in the middle of developing this software to replace current methods of analyzation. DiaScan’s software will be able to intelligently extract tumor characteristics (size, density, calcifications, spiculations, etc.), predict factors of prognosis (type, stage, grade, etc.), and put all this information into a huge deep neural network in order to classify the tumor as benign or malignant, without invasive procedures. Overall, DiaScan’s research has the potential to help millions of lives around the world.

Biography:

Zoya Vinokur is an alumn of New York City College of Technology. She teaches Radiographic Procedures and Clinical Education. She completed her BSc from Long Island University, MSc in Health Services Management and Policy from New School University and holds advanced certification in Mammography. With over 20 years of professional and teaching experience, she has taught a variety of courses in the medical imaging discipline including, Radiographic Procedures and Positioning, Pediatric Radiography, Advanced Medical Imaging II in a baccalaureate degree program. She is a frequently invited speaker at professional conferences both locally and regionaly. Her areas of concentration and interest includes “Teaching and Technology
Chalenges, Mammography, and MusicTharapy”. She currently serves on various educational advisory boards and has held other board positions in professional organizations including Vice President, Coresponding Secretary, and Nominating Chair.

Abstract:

Radiologic technology education has shifted significantly from the hospital to college-based degree programs. Academically strong programs offer considerable advantage for the health professionals. Radiologic technology education generally has not kept pace with this trend. Traditional learning process, integrating teaching and learning pyramids will be discussed during the presentation. Radiologic technology educators must be mindful of how college students are motivated and use various instructional strategies to increase students’ motivation in the classroom and clinical setting. We as educators must accept differences among students and between students and faculty. One of the challenges we are facing today is, our student’s exhibit increased motivation in classes while educators have high expectations. Implementing different instructional styles such as connecting with students, creating an interactive classroom, and guiding students will result in improved student motivation.

Biography:

Lin Sheng has completed his studies from The General Hospital of the People's Liberation Army hospital. He is the Director of the Department of Interventional Ultrasound, Yuquan Hosiptal, Tsinghua University. He has published more than 25 papers and books in reputed journals and has been five invention patents.

Abstract:

Microwave ablation is used for the treatment of hypersplenism; image guidance and ablation volume assessment is very important to ensure that the ablation is successful. In this study, 3-D ultrasound (US) and magnetic resonance imaging (MRI) were compared with regard to their accuracy in determining the ablation parameters for microwave ablation in a canine splenomegaly model. Microwave ablation was carried out in the spleen of 13 dogs with congestive splenomegaly. Different combinations of power output and ablation time were used: 60 W for 300 s, 50 W for 360 s and 40 W for 450 s. The volume of the ablation zone was measured by 3-D US and 3-D MRI immediately after microwave ablation, and at one, two and eight weeks thereafter. Compared with 3-D MRI, the ablation zone reconstruction rate was lower with 3-D US (92% vs. 100%). However, there was no significant difference with regard to the ablation volume calculated soon after the ablation and one week and two months later. Therefore, 3-D US may be a useful technique for quantifying the volume of microwave ablation zones in the spleens of experimental animals and may be a promising method for clinical examinations.

Biography:

Christian G Chaussy was a Professor of Urology and Head of the Stone Centre from the year 1984-1986. He left this tenure position in 1986 to become Chairman of the Department of Urology Klinikum Harlaching in Munich. In 1996, he started the use of HIFU for the treatment of Localized Prostate Cancer. In 2011 he became the President of the Endourological Society and is currently holding a position of Consultant Professor at the Department of Urology, University of Regensburg. He is also a Clinical Professor of Urology at the Keck School of Medicine, USC.

Abstract:

Currently, on average, prostate cancer is diagnosed 10 years earlier and men live almost 4 years longer than 25 years ago. This means that the therapeutic necessity is more than double the time than it was then. None of the classical therapies is effective enough to cover this time frame as a monotherapy without a significant risk of aggressive recurrence during these years. Therefore, new concepts of multimodal and sequential therapies need to be introduced to cover the longer treatment period effectively to maintain the patient’s quality of life (QOL). One of these new therapeutic modalities is the treatment of prostate cancer with high-intensity focused ultrasound (HIFU). High-intensity focused ultrasound (HIFU) is an emerging, noninvasive, local treatment of prostate cancer with 20 years of clinical experience, during which about 40,000 HIFU treatments have been performed worldwide. This presentation reviews the outcomes of HIFU by Ablatherm (EDAP TMS, Lyon, France), and the evolution currently underway regarding how prostate cancer is diagnosed and treated. This presentation shows the potential of HIFU to be used as local therapy for men with any stage of prostate cancer as an effective tool for salvage therapy and the possibilities for focal therapy of prostate cancer and how these additional therapeutic options can fit within the future armamentarium of a sequential multimodal therapy concept.

Biography:

Saifeng Liu has completed his PhD in 2014 from McMaster University. He is now a Research Scientist in the MRI Institute for Biomedical Research, directed by Dr. E. Mark Haacke. He has published 14 papers on Susceptibility Weighted Imaging (SWI) and Quantitative Susceptibility Mapping (QSM) in top journals on MRI. He has developed several data processing algorithms and software packages for SWI and QSM, which are being widely used by researchers in this field.

Abstract:

Susceptibility Weighted Imaging (SWI) has been widely used in clinical applications such as imaging stroke, traumatic brain injury and neurodegenerative diseases. Its exquisite sensitivity to susceptibility effects is attributed to the use of MR phase images which contain valuable information of in vivo tissue properties. Despite its success in visualizing cerebral vasculature and differentiating calcium from iron content, SWI only provides qualitative measure and is dependent on imaging parameters such as field strength, echo time and orientation. This problem is solved by the quantitative version of SWI, Quantitative Susceptibility Mapping (QSM). In QSM, an inverse problem is solved to extract the susceptibility distribution from the magnetic phase images. The potential of QSM in quantifying iron content in grey matter structures has been demonstrated in various studies. Furthermore, QSM can be combined with SWI to provide true susceptibility weighted imaging (tSWI) which solves the orientation dependence problem in conventional SWI. SWI and QSM have also been extended to body imaging, such as quantifying liver iron concentration and imaging the spine. In this presentation, the recent technical developments in SWI and QSM are introduced, with examples of clinical applications of SWI and QSM in the brain and the liver. In addition, a new imaging protocol named Strategically Acquired Gradient Echo (STAGE) is presented, which enables rapidly imaging of the entire brain in less than 10 minutes and yet provides information for a comprehensive diagnosis of neurovascular and neurodegenerative diseases, based on the recent technical developments in SWI and QSM.

Biography:

A Dommann is heading the Department of Materials Meet Life at Empa. He received his PhD in Solid State Physics in 1988 from ETH Zurich in Switzerland. His research concentrates on the surface analysis, bio surface interactions, structuring, coating and characterization of thin films. He is the member of different national and international committees and teaches Biomaterials, Crystallography and MEMS technology at different Swiss Universities and has published more than 130 papers. He is the member of the Swiss Academy of Engineering Science (SATW) and an Adjunct Professor at the University of Berne, Switzerland.

Abstract:

In the human body, we encounter very often between the strong absorbing bone structures also weakly absorbing structures like cartilage, which needs to be analyzed at different length-scales to understand it completely. This makes them challenging objects for classical X-ray imaging. Research on cartilage is becoming a major topic for medical imaging. The Center for X-ray Analytics at Empa was created to combine all major analytical X-ray technologies in one common platform and to facilitate the development of new instruments and methods exploiting numerous physical interaction mechanisms to address current and future challenges. This expertise of wide-ranging contrast-mechanisms is combined with developments in data-processing and image analysis as well as instrument improvements through the application of novel detector and source concepts, image reconstruction and artefact correction algorithms. Novel developments like phase-contrast and dark-field X-ray imaging, spectral CT or iterative reconstruction help to improve the sensitivity and the contrast of medical imaging. With such tools it might soon be possible to image challenging objects like cartilage or to segment cancerous and normal tissue. Together with micro-CT and diffraction based analytics they have the potential to advance X-ray techniques also into fields where they are not used today. The Empa Center for X-ray Analytics pushes these technologies in close collaboration with radiologists and equipment manufactures to explore synergies between laboratory and clinical equipment.

Biography:

Mariyah Selmi is a Junior Doctor at The Royal Oldham Hospital, Manchester, United Kingdom. She has done MBChB in Imaging Sciences from Kings’ College London. She has multiple publications and international presentation in the field of Radiology with a special interest in Radiation Awareness and Dosimetry.

Abstract:

CT head examinations may result in significant and unnecessary irradiation to the lens of the eye, one of the most radiosensitive tissues in the body. Thus, increasing the likelihood of damage and accelerating cataract formation. Standard CT head examinations expose the lens to approximately 25-103 mGy. The International Commission on Radiological Protection (ICRP) estimates opacity formation with doses as low as 0.5 Gy. A retrospective study of CT head scans for a 2 week period in November 2015 was conducted. The indication and age of patient were noted, and images were analyzed to identify lens inclusion. Of the 321 scans analyzed, 62% had the lens included, with 52% of this group under the age of 65. Of the 48% where the lens was not included, indications were varied, ranging from head injury to seizures. This suggests exclusion of the lens is possible even in challenging clinical circumstances. Common reasons for mal-positioning includes confusion and arthritis, which are generally less prominent features in this age group. Departmental teaching on positioning of radiographic baseline, setting region of interest and use of head rests to achieve optimum positioning has led to radiographers obtaining anatomically sound images without the need to angulate the gantry incurring a radiation dose penalty; with promising initial re-audit results.

Using our findings a new protocol is being developed, with the hope to reduce the unnecessary radiation burden to the lens during CT head scans minimizing the risk of visual impairment.

Biography:

Mariyah Selmi is a Junior Doctor at The Royal Oldham Hospital, Manchester, United Kingdom. She has done MBChB in Imaging Sciences from Kings’ College London. She has multiple publications and international presentation in the field of Radiology with a special interest in Radiation Awareness and Dosimetry.

Abstract:

CT head examinations may result in significant and unnecessary irradiation to the lens of the eye, one of the most radiosensitive tissues in the body. Thus, increasing the likelihood of damage and accelerating cataract formation. Standard CT head examinations expose the lens to approximately 25-103 mGy. The International Commission on Radiological Protection (ICRP) estimates opacity formation with doses as low as 0.5 Gy. A retrospective study of CT head scans for a 2 week period in November 2015 was conducted. The indication and age of patient were noted, and images were analyzed to identify lens inclusion. Of the 321 scans analyzed, 62% had the lens included, with 52% of this group under the age of 65. Of the 48% where the lens was not included, indications were varied, ranging from head injury to seizures. This suggests exclusion of the lens is possible even in challenging clinical circumstances. Common reasons for mal-positioning includes confusion and arthritis, which are generally less prominent features in this age group. Departmental teaching on positioning of radiographic baseline, setting region of interest and use of head rests to achieve optimum positioning has led to radiographers obtaining anatomically sound images without the need to angulate the gantry incurring a radiation dose penalty; with promising initial re-audit results.

Using our findings a new protocol is being developed, with the hope to reduce the unnecessary radiation burden to the lens during CT head scans minimizing the risk of visual impairment.

Biography:

A Dommann is heading the Department of Materials Meet Life at Empa. He received his PhD in Solid State Physics in 1988 from ETHZ in Switzerland. His research concentrates on the surface analysis, bio surface interactions, structuring, coating and characterization of thin films. He is Member of different national and international committees and teaches biomaterials, crystallography and MEMS technology at different Swiss universities and has published more than 130 papers. He is Member of the Swiss Academy of Engineering Science (SATW) and is Adjunct Professor at the University of Berne.

Abstract:

The workshop concentrates on a novel technique that has demonstrated great potential for non-destructive testing (NDT) and non-destructive evaluation (NDE). This method uses the Talbot-Lau grating interferometer principle. It enables X-ray insights extended by two additional contrast mechanisms: X-ray phase contrast imaging (XPCI) and scatter dark field imaging (SDFI). Conventional radiographic systems, based on the absorption of x-rays in the sample, have limited contrast for light materials such as polymers and biological tissues. XPCI, on the other hand, is able to reveal subtle changes in the microstructure of the samples, such as micro-cracks in composite.

Biography:

Benedict B Benigno is a world-renowned Gynecologic Surgeon and Oncologist who has spent his career treating women with ovarian cancer. In 1999, he founded the Ovarian Cancer Institute and serves as its CEO. He received his MD degree from the Georgetown University School of Medicine, and completed his residency in Obstetrics and Gynecology at St. Vincent’s Hospital and Medical Center in New York City. He completed two fellowships in Gynecologic Oncology, one at the Emory University School of Medicine in Atlanta and the other at the M D Anderson Hospital and Tumor Institute in Houston. He is the Founder and President of University Gynecologic Oncology and the Director of Gynecologic Oncology at Northside Hospital in Atlanta, Georgia. He is a member of many societies including the Society of Gynecologic Oncologists, the Felix Rutledge Society, and the American Society of Clinical Oncologists. He is a Clinical Professor in the Department of Obstetrics and Gynecology at the Emory University School of Medicine, the Morehouse School of Medicine, and Mercer University. He serves on the board of the Parker H Petit Institute of Bioengineering and Bioscience at the Georgia Institute of Technology. He has published numerous articles and textbook chapters, and travels the world speaking on various aspects of gynecologic cancer. He is the author of the book, “The Ultimate Guide to Ovarian Cancer: Everything You Need to Know about Diagnosis, Treatment, and Research”. He was honored in 2002 with the Hero of Medicine Award for the Most Innovative Cancer Research in the State of Georgia. In 2014, he was appointed to the ovarian cancer steering committee based in the National Institute of Health.

Abstract:

Very little has changed in the management of patients with ovarian cancer in the last 30 years. Carboplatinum and Taxol are still given as first-line chemotherapy, and drugs such as Doxil, Gemzar and Topotecan, among others, are given for recurrent disease. Avastin, a VEGF inhibitor, is added to a chemotherapy regimen or is given alone. The PARP inhibitors represent a new class of drugs for patients with ovarian cancer. Unlike chemotherapy drugs, which work in various stages of division in the cell cycle, these drugs exert their effect within breaks in the DNA molecule. They are given orally and are far better tolerated than cytotoxic chemotherapy. They can be given only under very strict guidelines, but in those patients who were eligible to take them, we are seeing startling results. Even in patients who have failed three prior regimens of chemotherapy, there is an objective response rate of 34%. This lecture will address the role of these agents in the modern management of ovarian cancer. Physiology, dosage, results and complications will be discussed in detail so that the audience will have an in-depth understanding of this extraordinary new class of drugs.

Biography:

Hiroshi Osawa is a faculty of Department of Oncology and Hematology in Edogawa Hospital Tokyo, Japan. He graduated the Teikyo University School of Medicine in 1990. He got his degree in Oncology and Hematology, & Medicine Doctor's degree at the Tokyo Jikei University. He had learned clinical research and molecular biology at Cancer Institute Hospital (4 yrs) and researched resistance in TGF-β I correlates with aberrant expression of TGF-β receptor II in human B-cell lymphoma cell line at National Institute on Aging (3.5 yrs) as a research fellow, Baltimore, USA. Currently, he has been focusing clinical studies and research on gastrointestinal tract field.

Abstract:

Regardless of the fact that we often perform totally implantable venous-access ports (TIVAPs) for cancer chemotherapy, there have been several reports regarding complications. The objective of this study was to summarize the TIVAPs idiopathic complications of 400 devices in latest 6 years. The patients underwent TIVAPs in the internal jugular or sub-clavian vein via the Seldinger technique in our hospital. We used two different devices, which were the Bard X-Port™, used from 2009 to 2012, and the Power Port™ used from 2012 to 2015. These devices are composed of titanium and silicone rubber port (DomePort™, Bard Inc, Salt Lake City, UT, USA) connected to an 8Fr silastic Groshong™ catheter tube. 400 TIVAPs, total 89,568 days insertion, with a median follow up of 405 days. There were 30 idiopathic complications. The complications consisted of eleven complete occlusions (2.8%), eight pocket infections (2%), three of pneumothorax (0.8%), two pinch-offs and slip-offs due to pedunculated breast (0.5%), one catheter-related bacteremia, rubber port disconnection, rubber port rotation in pocket and wound dehiscence due to bevacizumab™(0.3%). Here, we focus to present the complete occlusion. Although, complete occlusion was most popular idiopathic complication of TIVAPs in this study, one patient has undergone complete occlusion with Trousseau syndrome. When we removed TIVAPs, we experimented 12 cm length red thrombus and elevated D-dimer which possibility triggered Trousseau syndrome in parallel. Finally, these complications were found by nurses, who are important in cancer nursing care.

Biography:

Katie J. Atkinson received her BSN from Villanova University and worked as a RN in pediatrics at NY-Presbyterian Hospital, Weill Cornell Medical Center for several years. She graduated from Columbia University, MSN Family NP Program in 2008, and worked as a NP in pediatric food allergy at the Jaffe Food Allergy Institute at the Mt. Sinai School of Medicine.  In 2014 she returned to Weill Cornell to work with Dr. James Bussel, director of the Platelet Disorders Center.  Katie enjoys working with Dr. Bussel seeing both pediatric and adult ITP patients, and participating in clinical research trials in ITP

Abstract:

Eltrombopag (Promacta) is an oral thrombopoietin (TPO)-receptor agonist that has been widely used in adults with chronic immune thrombocytopenia (cITP) with good success and minimal toxicity since its initial approval in 2008.1-4 Eltrombopag was recently approved in the US for use in children ≥ 1 year of age with cITP based on 2 large randomized, placebo-controlled trials including 171 children.5-6 The key points from these studies were:

1. The primary platelet response rate is high: 60%- 90% depending on the criteria used

2. The time to respond varied with the patient, the dose required to respond, and the time to steadily escalate to that dose, and may take weeks to occur. Platelet responses during the first 6 weeks of the studies are shown in Figure 1

3. As expected, increases in platelet counts were associated with reductions in bleeding and the need for rescue medications

4. Responders were often able to taper off concomitant ITP medications (such as prednisone)

Eltrombopag is generally well tolerated; across all the large studies in adults and children, approximately 3% of patients were unable to tolerate a therapeutic dose of eltrombopag. The main toxicity associated with eltrombopag is elevated aminotransferases, which is often mild and reversible. Risks associated with TPO-receptor agonists include bone marrow fibrosis, which is unlikely to be clinically significant, and thrombosis, which is observed much less frequently in children than it is in adults. Finally, there are important dietary directions to follow while administering eltrombopag; therefore, both physicians and nurses should work in partnership with the parent/caregiver to optimize management of pediatric patients and treatment with eltrombopag. In summary, eltrombopag is a highly effective medication that is taken orally every day and may help safely increase platelet counts in the majority of patients.

Biography:

Niccola Funel received his first graduation in Bio-Molecular Science (2000) from Pisa University, Italy, where he acquired both PhD graduation in “Experimental and Molecular Oncology” (2006) and Specialization in “Clinical Pathology” (2008). Since 2002 he has been working in Surgical Pathology division (Department of Surgery, University of Pisa) where he is involved in different projects focused on Pancreatic Ductal AdenoCarcinoma (PDAC). In 2010 he becomes PI of his project regarding “News therapeutic strategies against PDAC. He awarded six times from AISP at the annual meeting as “young investigator”. He received a grant as “Young Investigator 2013” from “Fondazione Veronesi”, Milan, Italy. He published 65 full papers and more that 150 abstracts presented in international congresses. His field of expertise includes PDAC, Oncology, Biomarkers, TMA, Laser Micro-dissection and Primary cell Cultures.

Abstract:

Introduction: Current therapy for PDAC is surgery followed by adjuvant chemotherapy for early-stage and palliative chemotherapy for advanced disease. Gemcitabine is the standard drug in both adjuvant and palliative treatment. The mixture of Alkaloids (NSC-631570) in combination with gemcitabine significantly increased the median survival of advanced PDAC patients with respect to gemcitabine alone (10.4 vs. 5.2 months; p<0.001). Furthermore, preclinical studies showed that this mixture had selective citotoxic effects in cancer cell lines derived from different tumor types, but not in normal cell lines.

Aim: To evaluate the citotoxic effects of NSC-631570 in 2 Primary Pancreatic Cancer Cell Lines (PPTCCs), fibroblasts derived from PDAC specimens (F-PDAC) and an immortalized epithelial ductal pancreatic cell line (HNPE).

Materials & methods: Cytotoxicity was assessed by the CellTiter 96 kit (Promega) based on the cellular metabolism of the tetrazolium compound XTT, which is reduced by living cells to yield a soluble formazan product in the presence of the electron coupling agent phenazine methosulfate, while the modulation of Ukrain uptake in the medium was studied using the fluorescence property of NSC-631570 with the AlphaDigiDoc software by UV light excitation (ULA-DC test).

Results: Citotoxic effects of Ukrain in PPTCCs were significantly higher than those observed in F-PDAC and HPNE cells (20% vs. 80% live cells, at 10 µM [drug]). Furthermore, the ULA-DC test revealed that PPTCCs cells consumed more drug than F-PDAC and HPNE cells (paired Student’s test, n=4, p<0.001).

Conclusion: These data demonstrated the selective effect of NSC-631570 in PPTCCs, which may be related to a different transport system or higher metabolism of the drug in PDAC. Indeed, the two different up-takes of alkaloids discovered in cancer and no pancreatic cancer cells seem to suggest a higher expression of multi drug resistant systems (MDR) in F-PDAC and HPNE cells and warrant further investigations in order to support the possible role of Ukraine in PDAC treatment.

Biography:

Seyedeh Esmat Hosseini is an MSc student of critical care nursing from Shahid Sadoughi University of Medical Sciences. She is a researcher in Royan Institute and reviewer of Client Care Journal. She has published more than 7 papers in reputed journals. She has been working as supervisor nursery in stem cell therapy and regenerative medicine in Royan Institute for several years and chosen as the model nurse in Royan Institute. She has made speeches in some international congresses in foreign country such as Malaysia and Istanbul.

Abstract:

Introduction: Bone Marrow Aspiration (BMA) is one of the methods for diagnosis and treatment of various diseases, that now day it is widely use in regenerative medicine. Although this procedure in adults is usually performed by using local anesthesia, it is associated with anxiety and pain. The purpose of this study is to research into the effect of Deep Breathing Technique (DBT) on patients who have undergone BMA for appeasement of pain and reduction of anxiety.

Method: This study was a parallel randomized clinical trial. 60 patients who underwent BMA were randomly divided into two groups. Intervention group received DBT training and control group did not go through any training program. To measure the scope of anxiety and severity of pain, Spielberger State Anxiety Inventory (SAI) and Visual Analogue Scale (VAS) were used respectively. The anxiety before and pain after BMA, were evaluated in two groups.

Result: Comparison of anxiety and pain variables in study groups revealed that the mean score of anxiety and VAS average in the intervention group have  been lower than  that of  the control group and this difference was significant (P = 0.018 and P < 0.001 respectively). Comparison of   vital signs before and after DBT showed reduced the vital signs after intervention. However, no significant change was observed in control group.

Conclusion: DBT is an effective technique to reduce anxiety and relieve pain in BMA candidate. Nurses need to be aware anxiety and pain procedures during BMA.

Biography:

Priscila Feliciano de Oliveira is pursuing her Doctorate in Health Sciences from Sergipe Federal University (UFS). She earned her Master of Speech Therapy and Audiology degree from Pontifical Catholic University of São Paulo (2007). In addition, she post-graduated in Hospitalar Speech Therapy and Audiology and in Hospital Administration. She is a specialist in audiology by Federal Council of Speech Therapy and Audiology and is Adjunct Professor of Audiology at UFS. She is Coordinator of Audiology monitor program and Coordinator of Audiological Diagnosis research in Oncology conducted at a Public Hospital of Medical Emergency in Sergipe.

Abstract:

The audiologist, as part of the oncology multidisciplinary team does the early diagnosis of hearing loss and makes an effort at preventing difficulty in oral communication. Besides, there is a concern about quality of life issues, which extends the care of the physical, psychological and social dimensions. In this manner, the research of QOL was carried out in a public hospital of the northeast of Brazil (Aracaju) with 137 patients assessed with EORTC QLQ-C30 questionnaire version 3.0. Most of them were in the end of the cancer treatment, their average age was 53.9 years of age and 41.6% had a diagnosis of breast cancer. The mean score of the global scale was 75.0 points, followed by functional (73, 3) and symptoms (28.8) scales, which indicates a good QOL. However, symptom score had a significant data in statistical analysis (p≤0,005) for women with family history of cancer, delay in the discovery of the disease and delay to carry out the first appointment. In order to welcome and inform patients and family members about the side effects, especially hearing loss and rehabilitation, extension actions were developed with guidance in the waiting room, distribution of educational brochures and conducting turbans workshop to bald patients.

Biography:

Dawn McDonald completed her MSc in Medical Imaging, from Kingston University in 2008, and became a Consultant Mammographer soon afterwards. Working with the same autonomy and professionalism as a Consultant Breast Radiologist, she is responsible for all aspects of breast diagnosis within her unit, including breast interventional and film reading, and works closely with the surgical team. Currently, she is working at the James Paget Hospital in Great Yarmouth UK, and Imperial College London.

Abstract:

Consultant radiographers are a growing breed of clinician in the UK, carrying out roles that were historically only undertaken by consultant radiologists. Completing a master’s degree in medical imaging, and becoming qualified in all aspects of breast diagnosis including clinical breast examination, breast ultrasound, intervention, and film reading, consultant radiographers are fast becoming an integral profession in hospitals in the UK, with their ability to lead and deliver a service with autonomy, professionalism and competency. Initially some barriers had to be broken as there was reluctance to recognise the role, but with the current shortage of consultant radiologists, the value of the consultant radiographer has now become fully recognised. The four key domains of the consultant radiographer role are: Expert clinical practice; professional leadership and consultancy; education, training and service development and; research and evaluation. These are the key areas that we adhere to in our clinical roles. This talk aims to show the view of the consultant mammographer, and illustrates the clinical role with some interesting case studies.

Biography:

Shajeem Shahudeen has completed his M.B.B.S at the age of 24years from Rajiv Gandhi University of Health Sciences and post-graduated (M.D) from D.Y Patil University School of Medicine. I am presently working as a consultant radiologist at Vivid Diagnostic Centre, Kochi and I am the managing director of this centre, which is a premier Health care Centre in Kerala,INDIA. Have five publication in reputed journals like ECR and 2 E-poster.

Abstract:

Role of computed tomography in congenital heart disease

Shajeem Shahudeen

Vivid Diagnostic Centre, India

Background: Congenital Heart Disease births 40,000 affect nearly 1% of year.

Infant deaths due to CHDs is approximately of 4.2% of all neonatal deaths.

Early detection and treatment plays an important role.

Echocardiography and catheter cardio angiography are the primary cardiac imaging modalities, but has its own limitations.

Introduction: Coronary computed tomographic angiography (CTA) is a non-invasive technique for evaluation of congenital heart disease and coronary artery anomalies.

It also enables the evaluation of cardiac chambers, myocardium and valves.

It can be used for accurate depiction of complex cardiovascular anatomic features both before and after surgery and of a variety of post treatment complications.

Procedure details : Using a CT 128 slice scanner:

The scan ranges from the tracheal bifurcation to the bottom of the heart.

Done in ECG gated protocol to achieve motion-free images of the coronary arteries and aorta.

Post processing technique to reconstruct images and volume rendering for evaluation of complex anatomy.

Conclusion: CT is a useful imaging modality for the morphologic evaluation and diagnosis of Congenital Heart Disease.

Reformatted images from multi section spiral CT can accurately and systematically delineate the normal and pathologic morphologic features of the cardiovascular structures.

Biography:

Himadri Sikhor Das, MBBS, MD is a Radiologist from Guwahati, India with 15 years post MD experience with special interest in Neuro-Radiology, Head & Neck, Ocular/Orbital Radiology & Neuro-Ophthalmology. He is presently working as Consultant Radiologist and Executive Director, Matrix (Unit of Apace Imaging & Diagnostic Centre Pvt Ltd.) and Honorary Visiting Consultant & Thesis guide. He is Diplomate of National Board (DNB) Radiology at Institute of Neurosciences-GNRC Hospitals. He completed his MBBS in September ‘93, MD Radiology in February 1999 and Post Degree Fellowship in Neuroradiology in March 2000 followed by Senior Residency in the Department of Neuro-Radiology, AIIMS, New Delhi. He has many national and international publications & presentations and is also involved in many on-going national & international collaborative projects like Population based Indian Cancer Registry (Govt. of India) & the Digital Web Repository with MEDting (Spain). He also is active life Member of many professional societies.

Abstract:

Orbital tumors encompass different variety of lesions according to cell of origin. Careful evaluation of a patient’s history and examination along with modern high-resolution imaging studies provide the best information regarding the possible origin of an orbital lesion. Given the variety of structures within the relatively confined orbit, a systematic approach is necessary to understand the classification and imaging characteristics of orbital tumors. Orbital tumors are also divided anatomically into intraconal and extraconal depending on their relationship with the muscle cone. The muscle cone is formed by the extraocular recti muscles and their intermuscular septae, which separate the intraconal from the extraconal space. The muscle cone has a conical shape with the globe serving as the base and the optic canal as its apex. The diagnostic approach to tumors’ of the orbit should focus on specific anatomical locations –the globe, intraconal space, extraconal space, preseptal space, bony orbit, paranasal sinuses, lacrimal gland, optic nerve and globe. Useful features on CT are density including calcification and contrast enhancement, and on MRI the signal characteristics of the mass and contrast enhancement. As a general rule, benign tumors cause displacement and moulding of adjacent structures, whereas malignant lesions display an aggressive pattern of growth, destroying and obliterating the contours of surrounding structures. In this presentation, a general overview of morphology, pathological characteristics and imaging features of primary orbital tumors is discussed. Metastatic lesions are also briefly reviewed.

Biography:

Dawn McDonald completed her MSc in Medical Imaging, from Kingston University in 2008, and became a Consultant Mammographer soon afterwards. Working with the same autonomy and professionalism as a Consultant Breast Radiologist, she is responsible for all aspects of breast diagnosis within her unit, including breast interventional and film reading, and works closely with the surgical team. Currently, she is working at the James Paget Hospital in Great Yarmouth UK, and Imperial College London.

Abstract:

The density of the breast has been shown to be a significant factor in the detection of breast cancer in the female breast. It can be more difficult to detect breast pathology in younger women who have a denser breast type- in comparison with an older woman with a more fatty breast. This is because as women age head towards the end of their reproductive life, there is an increase in the amount of adipose tissue and a considerable loss of lobular units. Factors such as age, pregnancy and even BMI (Body Mass Index) are thought to be some of the factors influencing breast density and subsequent diagnosis. The significance of this becomes apparent when considering that it is estimated one third of breast cancer can be explained by high breast density. The changes in breast composition can be demonstrated by the breast density in mammography, and this talk aims to show examples of problems that are associated with the dense breast.

Biography:

BogusÅ‚aw Maciejewski has completed his PhD and got scientific title of a Full Professor in Radiotherapy. He released research projects in the UCLA Los Angeles, Gray Lab London, MGH Harvard University, Boston, MDACC Houston and other cancer centers in Europe. He was the Director of Cancer Center–Institute Gliwice, Poland for 24 years, till 2015. He is author of over 200 papers published in reputed journals (IF=1650, citation index=3500). He was awarded G F Fletcher Gold Medal, Gold Medal of Life Achievements in Oncology given by all European Oncologic Societies as he is a honorary Member of American College of Radiology, Radiotherapy Expert of the IAEA in Vienna, and for 10 years, he was a Member of European Board of Radiotherapy, participating in the development European curriculum for radiotherapy. His major scientific interest is importance of treatment time and tumor repopulation and altered dose fractionation in clinical radiotherapy for human tumors.

Abstract:

Enormous, progress in technology and radiotherapy equipment -from simple orthovoltage machines and single dose irradiation through linear accelerators, IMRT, IGRT, particle beams to stereotactic robotic radiosurgery is described and discussed. Also step-by-step progression from 1 H (Holtzknecht) to biologically equivalent doses (NBED) expressed in izobioGy2.0 in relation to dose fractionation modified from conventional to altered hyper-, accelerated and hypofractionation is exemplified by clinical results. Key role of overall treatment time and initial tumor volume seems to be - major factors determining treatment outcome in radiotherapy. Sequential combined therapy is confronted against teragnostic therapy showing therapeutic gain when combined therapeutic methods are individually designed. Importance of molecular margins and genetic and molecular profiling is discussed for selected solid malignant tumors. Significant gain in locoregional control due to combination of microvascular reconstructive surgery combined with postoperative IMRT is illustrated by clinical cases of H&N cancer. Impact of Diffusion Tensor Tractography MRI on efficacy of neurosurgery of glioblastomas is shown as example of stereotactic NeuroRadiosurgery System developed and working in the Gliwice Institute. Examples of clinical importance of molecular profiling of medullary thyroid cancer and breast, stomach and rectal cancers are presented. Significant technological and empirical improvement since Roentgen discovery about 120 years ago result in an increased efficacy of radiotherapy being on important part of individually designed combined treatment strategy.

Biography:

C.V.Patel is Full Professor of Surgery & Chief of Oncology in Seth.G.S.Medical College & K.E.M.Hospital, India. He was done his training in K.E.M.Hospital, Tata Memorial Centre, India, Westminster Hospital, Royal Marsden Hospital & Christie Hospital in England and M.D. Anderson Hospital, Memorial Hospital in USA. Presently, he is work in care of advanced cancer and terminal patients in rural India.

Abstract:

Immunotherapy-an old wine in a new bottle

Auto urine therapy: practised in India for over 5000 years. Based on concept that unused antibodies are excreted in urine after malignancy is established in body. By ingestion of urine, these are returned to the host (e.g. urokinase in patient of myocardial infarct.)

Antioxidants, Vit A, Vit E, extract of Sorghum Vulgare plants

Immune-modulator drugs like Levamisole, Immunomod.

Pyrotherapy- injection of streptococcal toxins, typhoid vaccine and injection of milk

Voluntary apnoea- either by increasing breath holding time, Co2 inhalation or rebreathing in paper bag( as for hiccups)

Specific methods

Extract of semicarpus anacardium (Bibba, Bhilva). The sap of fruit has a very powerful antigenic effect when it comes in contact with living tissues. Used by Dr Wad- Prof of medicine J.J group of hospitals, Mumbai in advanced cases of Ca. Oesophagus in 1930s.

Use of selective action of HEAT on malignant cells in situ.( Hyperthermic, Exsanguinating, Anoxic, Tumour infusion/perfusion). The combination of factors adverse to delicate malignant cells, cause partial or total damage to tumour, the surviving tumour cells activate the antibodies of host. Similar effect can be achieved by devascularisation of tumour cells (ligation of feeding artery or embolisation) in selective cases. Debulking of tumour by thermo-coagulation gives relief from bleeding, obstruction and prolonged suppression of tumour spread.

In special situation like bleeding from bladder tumours, hyperbaria, irrigation with formalin solution (0.5%),and intratumour injection of BCG vaccine has been useful. Application of formalin to surface tumours (Mohs’ chemosurgery with zinc chloride) helps control bleeding and spread of tumours.

Necessity is mother of invention. There is no end to finding out solutions to problems created by malignancy, while laboratory research continues to look for permanent cures.

In 3% of cases the life becomes bearable and comfortable when all accepted modes of treatment have been exhausted. Same thing can be said in treating intractable pain of malignancy by simple intrathecal injection of hypertonic saline

Three cases on record-1) Sherry john-lymphoma (semicarpous anacardium)

2) Dr A.V.Bavdekar- Ca. Stomach (Auto urine & semicarpous anacardium)

3) Mr. Bhagwat –metastatic pancreatic tumour (levamisole)