Search results for: phantom sensations
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 154

Search results for: phantom sensations

94 Improving 99mTc-tetrofosmin Myocardial Perfusion Images by Time Subtraction Technique

Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

Abstract:

Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of 99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of 99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the 99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector

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93 The Biopsychosocial Effects of Amputation on Transtibial Amputees in Kwazulu-Natal

Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

Abstract:

Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

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92 Relevance to Transformation Desire at Venetian Masks

Authors: Yoko Katsumata, Takashi Horikoshi, Noriaki Fukuzumi, Shoji Yamaguchi

Abstract:

This study examined some positive sensations that caused human to experience an intense feeling or sensitivity from Venetian Masks. We surveyed 102 Japanese university students (male; 85, female; 17) about their sensitivity impressions toward Venetian Masks using sensitivity questionnaire. We used questionnaires to examine the relevance to transformation desire at Venetian masks by means of correlation analysis. The positive correlation coefficient was observed between sensitivity impressions and transformation desire.

Keywords: Venetian Masks, sensitivity impression, transformation desire, Japan

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91 Numerical response of Coaxial HPGe Detector for Skull and Knee measurement

Authors: Pabitra Sahu, M. Manohari, S. Priyadharshini, R. Santhanam, S. Chandrasekaran, B. Venkatraman

Abstract:

Radiation workers of reprocessing plants have a potential for internal exposure due to actinides and fission products. Radionuclides like Americium, lead, Polonium and Europium are bone seekers and get accumulated in the skeletal part. As the major skeletal content is in the skull (13%) and knee (22%), measurements of old intake have to be carried out in the skull and knee. At the Indira Gandhi Centre for Atomic Research, a twin HPGe-based actinide monitor is used for the measurement of actinides present in bone. Efficiency estimation, which is one of the prerequisites for the quantification of radionuclides, requires anthropomorphic phantoms. Such phantoms are very limited. Hence, in this study, efficiency curves for a Twin HPGe-based actinide monitoring system are established theoretically using the FLUKA Monte Carlo method and ICRP adult male voxel phantom. In the case of skull measurement, the detector is placed over the forehead, and for knee measurement, one detector is placed over each knee. The efficiency values of radionuclides present in the knee and skull vary from 3.72E-04 to 4.19E-04 CPS/photon and 5.22E-04 to 7.07E-04 CPS/photon, respectively, for the energy range 17 to 3000keV. The efficiency curves for the measurement are established, and it is found that initially, the efficiency value increases up to 100 keV and then starts decreasing. It is found that the skull efficiency values are 4% to 63% higher than that of the knee, depending on the energy for all the energies except 17.74 keV. The reason is the closeness of the detector to the skull compared to the knee. But for 17.74 keV the efficiency of the knee is more than the skull due to the higher attenuation caused in the skull bones because of its greater thickness. The Minimum Detectable Activity (MDA) for 241Am present in the skull and knee is 9 Bq. 239Pu has a MDA of 950 Bq and 1270 Bq for knee and skull, respectively, for a counting time of 1800 sec. This paper discusses the simulation method and the results obtained in the study.

Keywords: FLUKA Monte Carlo Method, ICRP adult male voxel phantom, knee, Skull.

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90 The Effect of Vibration Amplitude on Tissue Temperature and Lesion Size When Using a Vibrating Cardiac Catheter

Authors: Kaihong Yu, Tetsui Yamashita, Shigeaki Shingyochi, Kazuo Matsumoto, Makoto Ohta

Abstract:

During cardiac ablation, high power delivery for deeper lesion formation is limited by electrode-tissue interface overheating which can cause serious complications such as thrombus. To prevent this overheating, temperature control and open irrigation are often used. In temperature control, radiofrequency generator is adjusted to deliver the maximum output power, which maintains the electrode temperature at a target temperature (commonly 55°C or 60°C). Then the electrode-tissue interface temperature is also limited. The electrode temperature is a result of heating from the contacted tissue and cooling from the surrounding blood. Because the cooling from blood is decreased under conditions of low blood flow, the generator needs to decrease the output power. Thus, temperature control cannot deliver high power under conditions of low blood flow. In open irrigation, saline in room temperature is flushed through the holes arranged in the electrode. The electrode-tissue interface is cooled by the sufficient environmental cooling. And high power delivery can also be done under conditions of low blood flow. However, a large amount of saline infusions (approximately 1500 ml) during irrigation can cause other serious complication. When open irrigation cannot be used under conditions of low blood flow, a new overheating prevention may be required. The authors have proposed a new electrode cooling method by making the catheter vibrating. The previous work has introduced that the vibration can make a cooling effect on electrode, which may result form that the vibration could increase the flow velocity around the catheter. The previous work has also proved that increasing vibration frequency can increase the cooling by vibration. However, the effect of the vibration amplitude is still unknown. Thus, the present study investigated the effect of vibration amplitude on tissue temperature and lesion size. An agar phantom model was used as a tissue-equivalent material for measuring tissue temperature. Thermocouples were inserted into the agar to measure the internal temperature. Porcine myocardium was used for lesion size measurement. A normal ablation catheter was set perpendicular to the tissue (agar or porcine myocardium) with 10 gf contact force in 37°C saline without flow. Vibration amplitude of ± 0.5, ± 0.75, and ± 1.0 mm with a constant frequency (31 Hz or 63) was used. A temperature control protocol (45°C for agar phantom, 60°C for porcine myocardium) was used for the radiofrequency applications. The larger amplitude shows the larger lesion sizes. And the higher tissue temperatures in agar phantom are also shown with the higher amplitude. With a same frequency, the larger amplitude has the higher vibrating speed. And the higher vibrating speed will increase the flow velocity around the electrode more, which leads to a larger electrode temperature decrease. To maintain the electrode at the target temperature, ablator has to increase the output power. With the higher output power in the same duration, the released energy also increases. Consequently, the tissue temperature will be increased and lead to larger lesion sizes.

Keywords: cardiac ablation, electrode cooling, lesion size, tissue temperature

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89 Comparative Performance of Standing Whole Body Monitor and Shielded Chair Counter for In-vivo Measurements

Authors: M. Manohari, S. Priyadharshini, K. Bajeer Sulthan, R. Santhanam, S. Chandrasekaran, B. Venkatraman

Abstract:

In-vivo monitoring facility at Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, caters to the monitoring of internal exposure of occupational radiation workers from various radioactive facilities of IGCAR. Internal exposure measurement is done using Na(Tl) based Scintillation detectors. Two types of whole-body counters, namely Shielded Chair Counter (SC) and Standing Whole-Body Monitor (SWBM), are being used. The shielded Chair is based on a NaI detector of 20.3 cm diameter and 10.15 cm thick. The chair of the system is shielded using lead shots of 10 cm lead equivalent and the detector with 8 cm lead bricks. Counting geometry is sitting geometry. Calibration is done using 95 percentile BOMAB phantom. The minimum Detectable Activity (MDA) for 137Cs for the 60s is 1150 Bq. Standing Wholebody monitor (SWBM) has two NaI(Tl) detectors of size 10.16 x 10.16 x 40.64 cm3 positioned serially, one over the other. It has a shielding thickness of 5cm lead equivalent. Counting is done in standup geometry. Calibration is done with the help of Ortec Phantom, having a uniform distribution of mixed radionuclides for the thyroid, thorax and pelvis. The efficiency of SWBM is 2.4 to 3.5 times higher than that of the shielded chair in the energy range of 279 to 1332 keV. MDA of 250 Bq for 137Cs can be achieved with a counting time of 60s. MDA for 131I in the thyroid was estimated as 100 Bq from the MDA of whole-body for one-day post intake. Standing whole body monitor is better in terms of efficiency, MDA and ease of positioning. In case of emergency situations, the optimal MDAs for in-vivo monitoring service are 1000 Bq for 137Cs and 100 Bq for 131I. Hence, SWBM is more suitable for the rapid screening of workers as well as the public in the case of an emergency. While a person reports for counting, there is a potential for external contamination. In SWBM, there is a feasibility to discriminate them as the subject can be counted in anterior or posterior geometry which is not possible in SC.

Keywords: minimum detectable activity, shielded chair, shielding thickness, standing whole body monitor

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88 Development of Multi-Leaf Collimator-Based Isocenter Verification Tool Using Electrical Portal Imaging Device for Stereotactic Radiosurgery

Authors: Panatda Intanin, Sangutid Thongsawad, Chirapha Tannanonta, Todsaporn Fuangrod

Abstract:

Stereotactic radiosurgery (SRS) is a highly precision delivery technique that requires comprehensive quality assurance (QA) tests prior to treatment delivery. An isocenter of delivery beam plays a critical role that affect the treatment accuracy. The uncertainty of isocenter is traditionally accessed using circular cone equipment, Winston-Lutz (WL) phantom and film. This technique is considered time consuming and highly dependent on the observer. In this work, the development of multileaf collimator (MLC)-based isocenter verification tool using electronic portal imaging device (EPID) was proposed and evaluated. A mechanical isocenter alignment with ball bearing diameter 5 mm and circular cone diameter 10 mm fixed to gantry head defines the radiation field was set as the conventional WL test method. The conventional setup was to compare to the proposed setup; using MLC (10 x 10 mm) to define the radiation filed instead of cone. This represents more realistic delivery field than using circular cone equipment. The acquisition from electronic portal imaging device (EPID) and radiographic film were performed in both experiments. The gantry angles were set as following: 0°, 90°, 180° and 270°. A software tool was in-house developed using MATLAB/SIMULINK programming to determine the centroid of radiation field and shadow of WL phantom automatically. This presents higher accuracy than manual measurement. The deviation between centroid of both cone-based and MLC-based WL tests were quantified. To compare between film and EPID image, the deviation for all gantry angle was 0.26±0.19mm and 0.43±0.30 for cone-based and MLC-based WL tests. For the absolute deviation calculation on EPID images between cone and MLC-based WL test was 0.59±0.28 mm and the absolute deviation on film images was 0.14±0.13 mm. Therefore, the MLC-based isocenter verification using EPID present high sensitivity tool for SRS QA.

Keywords: isocenter verification, quality assurance, EPID, SRS

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87 Organ Dose Calculator for Fetus Undergoing Computed Tomography

Authors: Choonsik Lee, Les Folio

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Pregnant patients may undergo CT in emergencies unrelated with pregnancy, and potential risk to the developing fetus is of concern. It is critical to accurately estimate fetal organ doses in CT scans. We developed a fetal organ dose calculation tool using pregnancy-specific computational phantoms combined with Monte Carlo radiation transport techniques. We adopted a series of pregnancy computational phantoms developed at the University of Florida at the gestational ages of 8, 10, 15, 20, 25, 30, 35, and 38 weeks (Maynard et al. 2011). More than 30 organs and tissues and 20 skeletal sites are defined in each fetus model. We calculated fetal organ dose-normalized by CTDIvol to derive organ dose conversion coefficients (mGy/mGy) for the eight fetuses for consequential slice locations ranging from the top to the bottom of the pregnancy phantoms with 1 cm slice thickness. Organ dose from helical scans was approximated by the summation of doses from multiple axial slices included in the given scan range of interest. We then compared dose conversion coefficients for major fetal organs in the abdominal-pelvis CT scan of pregnancy phantoms with the uterine dose of a non-pregnant adult female computational phantom. A comprehensive library of organ conversion coefficients was established for the eight developing fetuses undergoing CT. They were implemented into an in-house graphical user interface-based computer program for convenient estimation of fetal organ doses by inputting CT technical parameters as well as the age of the fetus. We found that the esophagus received the least dose, whereas the kidneys received the greatest dose in all fetuses in AP scans of the pregnancy phantoms. We also found that when the uterine dose of a non-pregnant adult female phantom is used as a surrogate for fetal organ doses, root-mean-square-error ranged from 0.08 mGy (8 weeks) to 0.38 mGy (38 weeks). The uterine dose was up to 1.7-fold greater than the esophagus dose of the 38-week fetus model. The calculation tool should be useful in cases requiring fetal organ dose in emergency CT scans as well as patient dose monitoring.

Keywords: computed tomography, fetal dose, pregnant women, radiation dose

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86 Meditation Applied to Chronic Pain

Authors: John Davodi, Maryam Davodi-Far

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The human body is the most elaborate of all machines and technologies on Earth, while the human mind is the interdependent source that expels and absorbs the five senses: touch, smell, sight, sound, and taste. Meditation is an ancient form of mind power that has many variations. In fact, those who practice meditation may bring about a positive change in their five senses, depending on the aim of the practitioner. This paper examines the research related to meditation and its effects on individuals suffering from chronic pain. Moreover, consideration is given to whether perceptions of pain can be changed by the practice of meditation as well as whether meditation can have a noticeable and long-term positive effect on the human body. Lastly, the paper examines the type of meditation that is best suited to minimize pain sensations for those who suffer from chronic pain.

Keywords: meditation, pain, relaxation, suffering

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85 A Strategy to Reduce Salt Intake: The Use of a Seasoning Obtained from Wine Pomace

Authors: María Luisa Gonzalez-SanJose, Javier Garcia-Lomillo, Raquel Del Pino, Miriam Ortega-Heras, Maria Dolores Rivero-Perez, Pilar Muñiz-Rodriguez

Abstract:

One of the most preoccupant problems related to the diet of the occidental societies is the high salt intake. In Spain, salt intake is almost twice as recommended by the World Health Organization (WHO). A lot of negative health effects of high sodium intake have been described being the hypertension, cardiovascular and coronary diseases ones of the most important. Due to this fact, government and other institutions are working on the gradual reduction of this consumption. Intake of meat products have been described as the main processed products that bring salt to the diet, followed by snacks and savory crackers. However, fortunately, the food industry has also raised awareness of this problem and is working intensely, and in recent years attempts to reduce the salt content in processed products, and is developing special lines with low sodium content. It is important to consider that processed food are the main source of sodium in occidental countries. One of the possible strategies to reduce the salt content in food is to find substitutes that can emulate their taste properties without adding much sodium or products that mask or substitute salty sensations with other flavors and aromas. In this sense, multiple products have been proposed and used until now. Potassium salts produce similar salty sensations without bring sodium, however their intake should be also limited, by healthy reasons. Furthermore, some potassium salts shows some better notes. Other alternatives are the use of flavor enhancers, spices, aromatic herbs, sea-plant derivate products, etc. The wine pomace is rich in potassium salts, content organic acid and other flavored substances, therefore it could be an interesting raw material to obtain derived products that could be useful as alternative ‘seasonings’. Considering previous comments, the main aim of this study was to evaluate the possible use of a natural seasoning, made from red wine pomace, in two different foods, crackers and burgers. The seasoning was made in the pilot plant of food technology of the University of Burgos, where the studied crackers and patties were also made. Different members of the University, students, docent and administrative personal, taste the products, and a trained panel evaluated salty intensity. The seasoning in addition to potassium contain significant levels of dietary fiber and phenolic compounds, which also makes it interesting as a functional ingredient. Both burgers and crackers made with the seasoning showed better taste that those without salt. Obviously, they showed lower sodium content than normal formulation, and were richer in potassium, antioxidant and fiber. Then, they showed lower values of the relation Na/K. All these facts are correlated with more ‘healthy’ products especially to that people with hypertension and other coronary dysfunctions.

Keywords: healthy foods, low salt, seasoning, wine pomace

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84 Image Enhancement Algorithm of Photoacoustic Tomography Using Active Contour Filtering

Authors: Prasannakumar Palaniappan, Dong Ho Shin, Chul Gyu Song

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The photoacoustic images are obtained from a custom developed linear array photoacoustic tomography system. The biological specimens are imitated by conducting phantom tests in order to retrieve a fully functional photoacoustic image. The acquired image undergoes the active region based contour filtering to remove the noise and accurately segment the object area for further processing. The universal back projection method is used as the image reconstruction algorithm. The active contour filtering is analyzed by evaluating the signal to noise ratio and comparing it with the other filtering methods.

Keywords: contour filtering, linear array, photoacoustic tomography, universal back projection

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83 Detecting Rat’s Kidney Inflammation Using Real Time Photoacoustic Tomography

Authors: M. Y. Lee, D. H. Shin, S. H. Park, W.C. Ham, S.K. Ko, C. G. Song

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Photoacoustic Tomography (PAT) is a promising medical imaging modality that combines optical imaging contrast with the spatial resolution of ultrasound imaging. It can also distinguish the changes in biological features. But, real-time PAT system should be confirmed due to photoacoustic effect for tissue. Thus, we have developed a real-time PAT system using a custom-developed data acquisition board and ultrasound linear probe. To evaluate performance of our system, phantom test was performed. As a result of those experiments, the system showed satisfactory performance and its usefulness has been confirmed. We monitored the degradation of inflammation which induced on the rat’s kidney using real-time PAT.

Keywords: photoacoustic tomography, inflammation detection, rat, kidney, contrast agent, ultrasound

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82 Dosimetric Comparison among Different Head and Neck Radiotherapy Techniques Using PRESAGE™ Dosimeter

Authors: Jalil ur Rehman, Ramesh C. Tailor, Muhammad Isa Khan, Jahnzeeb Ashraf, Muhammad Afzal, Geofferry S. Ibbott

Abstract:

Purpose: The purpose of this analysis was to investigate dose distribution of different techniques (3D-CRT, IMRT and VMAT) of head and neck cancer using 3-dimensional dosimeter called PRESAGETM Dosimeter. Materials and Methods: Computer tomography (CT) scans of radiological physics center (RPC) head and neck anthropomorphic phantom with both RPC standard insert and PRESAGETM insert were acquired separated with Philipp’s CT scanner and both CT scans were exported via DICOM to the Pinnacle version 9.4 treatment planning system (TPS). Each plan was delivered twice to the RPC phantom first containing the RPC standard insert having TLD and film dosimeters and then again containing the Presage insert having 3-D dosimeter (PRESAGETM) by using a Varian True Beam linear accelerator. After irradiation, the standard insert including point dose measurements (TLD) and planar Gafchromic® EBT film measurement were read using RPC standard procedure. The 3D dose distribution from PRESAGETM was read out with the Duke Midsized optical scanner dedicated to RPC (DMOS-RPC). Dose volume histogram (DVH), mean and maximal doses for organs at risk were calculated and compared among each head and neck technique. The prescription dose was same for all head and neck radiotherapy techniques which was 6.60 Gy/friction. Beam profile comparison and gamma analysis were used to quantify agreements among film measurement, PRESAGETM measurement and calculated dose distribution. Quality assurances of all plans were performed by using ArcCHECK method. Results: VMAT delivered the lowest mean and maximum doses to organ at risk (spinal cord, parotid) than IMRT and 3DCRT. Such dose distribution was verified by absolute dose distribution using thermoluminescent dosimeter (TLD) system. The central axial, sagittal and coronal planes were evaluated using 2D gamma map criteria(± 5%/3 mm) and results were 99.82% (axial), 99.78% (sagital), 98.38% (coronal) for VMAT plan and found the agreement between PRESAGE and pinnacle was better than IMRT and 3D-CRT plan excludes a 7 mm rim at the edge of the dosimeter. Profile showed good agreement for all plans between film, PRESAGE and pinnacle and 3D gamma was performed for PTV and OARs, VMAT and 3DCRT endow with better agreement than IMRT. Conclusion: VMAT delivered lowered mean and maximal doses to organs at risk and better PTV coverage during head and neck radiotherapy. TLD, EBT film and PRESAGETM dosimeters suggest that VMAT was better for the treatment of head and neck cancer than IMRT and 3D-CRT.

Keywords: RPC, 3DCRT, IMRT, VMAT, EBT2 film, TLD, PRESAGETM

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81 Fabrication of Optical Tissue Phantoms Simulating Human Skin and Their Application

Authors: Jihoon Park, Sungkon Yu, Byungjo Jung

Abstract:

Although various optical tissue phantoms (OTPs) simulating human skin have been actively studied, their completeness is unclear because skin tissue has the intricate optical property and complicated structure disturbing the optical simulation. In this study, we designed multilayer OTP mimicking skin structure, and fabricated OTP models simulating skin-blood vessel and skin pigmentation in the skin, which are useful in Biomedical optics filed. The OTPs were characterized with the optical property and the cross-sectional structure, and analyzed by using various optical tools such as a laser speckle imaging system, OCT and a digital microscope to show the practicality. The measured optical property was within 5% error, and the thickness of each layer was uniform within 10% error in micrometer scale.

Keywords: blood vessel, optical tissue phantom, optical property, skin tissue, pigmentation

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80 Characterization of the MOSkin Dosimeter for Accumulated Dose Assessment in Computed Tomography

Authors: Lenon M. Pereira, Helen J. Khoury, Marcos E. A. Andrade, Dean L. Cutajar, Vinicius S. M. Barros, Anatoly B. Rozenfeld

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With the increase of beam widths and the advent of multiple-slice and helical scanners, concerns related to the current dose measurement protocols and instrumentation in computed tomography (CT) have arisen. The current methodology of dose evaluation, which is based on the measurement of the integral of a single slice dose profile using a 100 mm long cylinder ionization chamber (Ca,100 and CPPMA, 100), has been shown to be inadequate for wide beams as it does not collect enough of the scatter-tails to make an accurate measurement. In addition, a long ionization chamber does not offer a good representation of the dose profile when tube current modulation is used. An alternative approach has been suggested by translating smaller detectors through the beam plane and assessing the accumulated dose trough the integral of the dose profile, which can be done for any arbitrary length in phantoms or in the air. For this purpose, a MOSFET dosimeter of small dosimetric volume was used. One of its recently designed versions is known as the MOSkin, which is developed by the Centre for Medical Radiation Physics at the University of Wollongong, and measures the radiation dose at a water equivalent depth of 0.07 mm, allowing the evaluation of skin dose when placed at the surface, or internal point doses when placed within a phantom. Thus, the aim of this research was to characterize the response of the MOSkin dosimeter for X-ray CT beams and to evaluate its application for the accumulated dose assessment. Initially, tests using an industrial x-ray unit were carried out at the Laboratory of Ionization Radiation Metrology (LMRI) of Federal University of Pernambuco, in order to investigate the sensitivity, energy dependence, angular dependence, and reproducibility of the dose response for the device for the standard radiation qualities RQT 8, RQT 9 and RQT 10. Finally, the MOSkin was used for the accumulated dose evaluation of scans using a Philips Brilliance 6 CT unit, with comparisons made between the CPPMA,100 value assessed with a pencil ionization chamber (PTW Freiburg TW 30009). Both dosimeters were placed in the center of a PMMA head phantom (diameter of 16 cm) and exposed in the axial mode with collimation of 9 mm, 250 mAs and 120 kV. The results have shown that the MOSkin response was linear with doses in the CT range and reproducible (98.52%). The sensitivity for a single MOSkin in mV/cGy was as follows: 9.208, 7.691 and 6.723 for the RQT 8, RQT 9 and RQT 10 beams qualities respectively. The energy dependence varied up to a factor of ±1.19 among those energies and angular dependence was not greater than 7.78% within the angle range from 0 to 90 degrees. The accumulated dose and the CPMMA, 100 value were 3,97 and 3,79 cGy respectively, which were statistically equivalent within the 95% confidence level. The MOSkin was shown to be a good alternative for CT dose profile measurements and more than adequate to provide accumulated dose assessments for CT procedures.

Keywords: computed tomography dosimetry, MOSFET, MOSkin, semiconductor dosimetry

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79 Somatic Delusional Disorder Subsequent to Phantogeusia: A Case Report

Authors: Pedro Felgueiras, Ana Miguel, Nélson Almeida, Raquel Silva

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Objective: Through the study of a clinical case of delusional somatic disorder secondary to phantogeusia, we aim to highlight the importance of considering psychosomatic conditions in differential diagnosis, as well as to emphasize the complexity of its comprehension, treatment, and respective impact on patients’ functioning. Methods: Bearing this in mind, we conducted a critical analysis of a case series based on patient observations, clinical data, and complementary diagnostic methods, as well as a non-systematic review of the literature on the subject. Results: A 61-year-old female patient with no history of psychiatric conditions. Family psychiatric history of mood disorder (depression), with psychotic features found in her mother. Medical history of many comorbidities affecting different organ systems (endocrine, gastrointestinal, genitourinary, ophthalmological). Documented neuroticism traits of personality. The patient’s family described a persistent concern about several physical symptoms across her life, with a continuous effort to obtain explanations about any sensation out of her normal perception. Since being subjected to endoscopy in 2018, she started complaints of persistent phantogeusia (acid taste) and developed excessive thoughts, feelings, and behaviors associated with this somatic symptom. The patient was evaluated by several medical specialties, and an extensive panel of medical exams was carried out, excluding any disease. Besides all the investigation and with no evidence of disease signs, acute anxiety, time, and energy dispended to this symptom culminated in severe psychosocial impairment. The patient was admitted to a psychiatric ward for investigation and treatment of this clinical picture, leading to the diagnosis of the delusional somatic disorder. In order to exclude the acute organic etiology of this psychotic disorder, an analytic panel was carried out with no abnormal results. In the context of a psychotic clinical picture, a CT scan was performed, which revealed a right cortical vascular lesion. Neuropsychological evaluation was made, with the description of cognitive functioning being globally normative. During treatment with an antipsychotic (pimozide), a complete remission of the somatic delusion was associated with the disappearance of gustative perception disturbance. In follow-up, a relapse of gustative sensation was documented, and her thoughts and speech were dominated by concerns about multiple somatic symptoms. Conclusion: In terms of abnormal bodily sensations, the oral cavity is one of the frequent sites of delusional disorder. Patients with these gustatory perception distortions complain about unusual sensations without corresponding abnormal findings in the oral area. Its pathophysiology has not been fully elucidated yet. In terms of its comprehensive psychopathology, this case was hypothesized as a paranoid development of a delusional somatic disorder triggered by a post-invasive procedure phantogeusia (which is described as a possible side effect of an endoscopy) in a patient with an anankastic personality. This case presents interesting psychopathology, reinforcing the complexity of psychosomatic disorders in terms of their etiopathogenesis, clinical treatment, and long-term prognosis.

Keywords: psychosomatics, delusional somatic disorder, phantogeusia, paranoid development

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78 Childhood Sensory Sensitivity: A Potential Precursor to Borderline Personality Disorder

Authors: Valerie Porr, Sydney A. DeCaro

Abstract:

TARA for borderline personality disorder (BPD), an education and advocacy organization, helps families to compassionately and effectively deal with troubling BPD behaviors. Our psychoeducational programs focus on understanding underlying neurobiological features of BPD and evidence-based methodology integrating dialectical behavior therapy (DBT) and mentalization based therapy (MBT,) clarifying the inherent misunderstanding of BPD behaviors and improving family communication. TARA4BPD conducts online surveys, workshops, and topical webinars. For over 25 years, we have collected data from BPD helpline callers. This data drew our attention to particular childhood idiosyncrasies that seem to characterize many of the children who later met the criteria for BPD. The idiosyncrasies we observed, heightened sensory sensitivity and hypervigilance, were included in Adolf Stern’s 1938 definition of “Borderline.” This aspect of BPD has not been prioritized by personality disorder researchers, presently focused on emotion processing and social cognition in BPD. Parents described sleep reversal problems in infants who, early on, seem to exhibit dysregulation in circadian rhythm. Families describe children as supersensitive to sensory sensations, such as specific sounds, heightened sense of smell, taste, textures of foods, and an inability to tolerate various fabrics textures (i.e., seams in socks). They also exhibit high sensitivity to particular words and voice tones. Many have alexithymia and dyslexia. These children are either hypo- or hypersensitive to sensory sensations, including pain. Many suffer from fibromyalgia. BPD reactions to pain have been studied (C. Schmahl) and confirm the existence of hyper and hypo-reactions to pain stimuli in people with BPD. To date, there is little or no data regarding what comprises a normative range of sensitivity in infants and children. Many parents reported that their children were tested or treated for sensory processing disorder (SPD), learning disorders, and ADHD. SPD is not included in the DSM and is treated by occupational therapists. The overwhelming anecdotal data from thousands of parents of children who later met criteria for BPD led TARA4BPD to develop a sensitivity survey to develop evidence of the possible role of early sensory perception problems as a pre-cursor to BPD, hopefully initiating new directions in BPD research. At present, the research community seems unaware of the role supersensory sensitivity might play as an early indicator of BPD. Parents' observations of childhood sensitivity obtained through family interviews and results of an extensive online survey on sensory responses across various ages of development will be presented. People with BPD suffer from a sense of isolation and otherness that often results in later interpersonal difficulties. Early identification of supersensitive children while brain circuits are developing might decrease the development of social interaction deficits such as rejection sensitivity, self-referential processes, and negative bias, hallmarks of BPD, ultimately minimizing the maladaptive methods of coping with distress that characterizes BPD. Family experiences are an untapped resource for BPD research. It is hoped that this data will give family observations the critical credibility to inform future treatment and research directions.

Keywords: alexithymia, dyslexia, hypersensitivity, sensory processing disorder

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77 Gaussian Mixture Model Based Identification of Arterial Wall Movement for Computation of Distension Waveform

Authors: Ravindra B. Patil, P. Krishnamoorthy, Shriram Sethuraman

Abstract:

This work proposes a novel Gaussian Mixture Model (GMM) based approach for accurate tracking of the arterial wall and subsequent computation of the distension waveform using Radio Frequency (RF) ultrasound signal. The approach was evaluated on ultrasound RF data acquired using a prototype ultrasound system from an artery mimicking flow phantom. The effectiveness of the proposed algorithm is demonstrated by comparing with existing wall tracking algorithms. The experimental results show that the proposed method provides 20% reduction in the error margin compared to the existing approaches in tracking the arterial wall movement. This approach coupled with ultrasound system can be used to estimate the arterial compliance parameters required for screening of cardiovascular related disorders.

Keywords: distension waveform, Gaussian Mixture Model, RF ultrasound, arterial wall movement

Procedia PDF Downloads 475
76 Smart Brain Wave Sensor for Paralyzed- a Real Time Implementation

Authors: U.B Mahadevswamy UBM, Siraj Ahmed Siraj

Abstract:

As the title of the paper indicates about brainwaves and its uses for various applications based on their frequencies and different parameters which can be implemented as real time application with the title a smart brain wave sensor system for paralyzed patients. Brain wave sensing is to detect a person's mental status. The purpose of brain wave sensing is to give exact treatment to paralyzed patients. The data or signal is obtained from the brainwaves sensing band. This data are converted as object files using Visual Basics. The processed data is further sent to Arduino which has the human's behavioral aspects like emotions, sensations, feelings, and desires. The proposed device can sense human brainwaves and detect the percentage of paralysis that the person is suffering. The advantage of this paper is to give a real-time smart sensor device for paralyzed patients with paralysis percentage for their exact treatment. Keywords:-Brainwave sensor, BMI, Brain scan, EEG, MCH.

Keywords: Keywords:-Brainwave sensor , BMI, Brain scan, EEG, MCH

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75 Multiple Approaches for Ultrasonic Cavitation Monitoring of Oxygen-Loaded Nanodroplets

Authors: Simone Galati, Adriano Troia

Abstract:

Ultrasound (US) is widely used in medical field for a variety diagnostic techniques but, in recent years, it has also been creating great interest for therapeutic aims. Regarding drug delivery, the use of US as an activation source provides better spatial delivery confinement and limits the undesired side effects. However, at present there is no complete characterization at a fundamental level of the different signals produced by sono-activated nanocarriers. Therefore, the aim of this study is to obtain a metrological characterization of the cavitation phenomena induced by US through three parallel investigation approaches. US was focused into a channel of a customized phantom in which a solution with oxygen-loaded nanodroplets (OLNDs) was led to flow and the cavitation activity was monitored. Both quantitative and qualitative real-time analysis were performed giving information about the dynamics of bubble formation, oscillation and final implosion with respect to the working acoustic pressure and the type of nanodroplets, compared with pure water. From this analysis a possible interpretation of the observed results is proposed.

Keywords: cavitation, drug delivery, nanodroplets, ultra-sound

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74 Social Media Usage in 'No Man's Land': A Populist Paradise

Authors: Nilufer Turksoy

Abstract:

Social media tools successfully connect people from different milieu to each other. This easy access allows politicians with populist attitude to circulate any kind of political opinion or message, which will hardly appear in conventional media. Populism is a relevant concept, especially, in political communication research. In the last decade, populism in social media has been researched extensively. The present study focuses on how social media is used as a playground by Turkish Cypriot politicians to perform populism in Northern Cyprus. It aims to determine and understand the relationship between politicians and social media, and how they employ social media in their political lives. Northern Cyprus’s multi-faced character provides politicians with many possible frames and topics they can make demagogy about ongoing political deadlock, international isolation, economic instability or social and cultural life in the north part of the island. Thus, Northern Cyprus, bizarrely branded as a 'no man's land', is a case par excellence to show how politically and economically unstable geographies are inclined to perform populism. Northern Cyprus is legally invalid territory recognized by no member of the international community other than Turkey and a phantom state, just like Abkhazia and South Ossetia or Nagorno-Karabakh. Five ideological key elements of populism are employed in the theoretical framework of this study: (1) highlighting the sovereignty of the people, (2) attacking the elites, (3) advocacy for the people, (4) excluding others, and (5) invoking the heartland. A qualitative text analysis of typical Facebook posts was conducted. Profiles of popular political leaders who occupy top positions (e.g. member of parliament, minister, chairman, party secretary), who have different political views, and who use their profiles for political expression on daily bases are selected. All official Facebook pages of the selected politicians are examined during a period of five months (1 September 2017-31 January 2018). This period is selected since it was prior to the parliamentary elections. Finding revealed that majority of the Turkish Cypriot politicians use their social media profile to propagate their political ideology in a populist fashion. Populist statements are found across parties. Facebook give especially the left-wing political actors the freedom to spread their messages in manipulative ways, mostly by using a satiric, ironic and slandering jargon that refers to the pseudo-state, the phantom state, the unrecognized Turkish Republic of Northern Cyprus state. While most of the political leaders advocate for the people, invoking the heartland are preferred by right-wing politicians. A broad range of left-wing politicians predominantly conducted attack on the economic elites and ostracism of others. The finding concluded that different politicians use social media differently according to their political standpoint. Overall, the study offers a thorough analysis of populism on social media. Considering the large role social media plays in the daily life today, the finding will shed some light on the political influence of social media and the social media usage among politicians.

Keywords: Northern Cyprus, populism, politics, qualitative text analysis, social media

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73 Design and Parametric Analysis of Pentaband Meander Line Antenna for Mobile Handset Applications

Authors: Shrinivas P. Mahajan, Aarti C. Kshirsagar

Abstract:

Wireless communication technology is rapidly changing with recent developments in portable devices and communication protocols. This has generated demand for more advanced and compact antenna structures and therefore, proposed work focuses on Meander Line Antenna (MLA) design. Here, Pentaband MLA is designed on a FR4 substrate (85 mm x 40 mm) with dielectric constant (ϵr) 4.4, loss tangent (tan ) 0.018 and height 1.6 mm with coplanar feed and open stub structure. It can be operated in LTE (0.670 GHz-0.696 GHz) GPS (1.564 GHz-1.579 GHz), WCDMA (1.920 GHz-2.135 GHz), LTE UL frequency band 23 (2-2.020 GHz) and 5G (3.10 GHz-3.550 GHz) application bands. Also, it gives good performance in terms of Return Loss (RL) which is < -10 dB, impedance bandwidth with maximum Bandwidth (BW) up to 0.21 GHz and realized gains with maximum gain up to 3.28 dBi. Antenna is simulated with open stub and without open stub structures to see the effect on impedance BW coverage. In addition to this, it is checked with human hand and head phantoms to assure that it falls within specified Specific Absorption Rate (SAR) limits.

Keywords: coplanar feed, L shaped ground, Meander Line Antenna, MLA, Phantom, Specific Absorption Rate, SAR

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72 Sparse-View CT Reconstruction Based on Nonconvex L1 − L2 Regularizations

Authors: Ali Pour Yazdanpanah, Farideh Foroozandeh Shahraki, Emma Regentova

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The reconstruction from sparse-view projections is one of important problems in computed tomography (CT) limited by the availability or feasibility of obtaining of a large number of projections. Traditionally, convex regularizers have been exploited to improve the reconstruction quality in sparse-view CT, and the convex constraint in those problems leads to an easy optimization process. However, convex regularizers often result in a biased approximation and inaccurate reconstruction in CT problems. Here, we present a nonconvex, Lipschitz continuous and non-smooth regularization model. The CT reconstruction is formulated as a nonconvex constrained L1 − L2 minimization problem and solved through a difference of convex algorithm and alternating direction of multiplier method which generates a better result than L0 or L1 regularizers in the CT reconstruction. We compare our method with previously reported high performance methods which use convex regularizers such as TV, wavelet, curvelet, and curvelet+TV (CTV) on the test phantom images. The results show that there are benefits in using the nonconvex regularizer in the sparse-view CT reconstruction.

Keywords: computed tomography, non-convex, sparse-view reconstruction, L1-L2 minimization, difference of convex functions

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71 Increasing the Apparent Time Resolution of Tc-99m Diethylenetriamine Pentaacetic Acid Galactosyl Human Serum Albumin Dynamic SPECT by Use of an 180-Degree Interpolation Method

Authors: Yasuyuki Takahashi, Maya Yamashita, Kyoko Saito

Abstract:

In general, dynamic SPECT data acquisition needs a few minutes for one rotation. Thus, the time-activity curve (TAC) derived from the dynamic SPECT is relatively coarse. In order to effectively shorten the interval, between data points, we adopted a 180-degree interpolation method. This method is already used for reconstruction of the X-ray CT data. In this study, we applied this 180-degree interpolation method to SPECT and investigated its effectiveness.To briefly describe the 180-degree interpolation method: the 180-degree data in the second half of one rotation are combined with the 180-degree data in the first half of the next rotation to generate a 360-degree data set appropriate for the time halfway between the first and second rotations. In both a phantom and a patient study, the data points from the interpolated images fell in good agreement with the data points tracking the accumulation of 99mTc activity over time for appropriate region of interest. We conclude that data derived from interpolated images improves the apparent time resolution of dynamic SPECT.

Keywords: dynamic SPECT, time resolution, 180-degree interpolation method, 99mTc-GSA.

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70 Determination of Critical Organ Doses for Liver Scintigraphy Using Cr-51

Authors: O. Maranci, A. B. Tugrul

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Scintigraphy is an imaging method of nuclear events provoked by collisions or charged current interactions with radiation. It is used for diagnostic test used in nuclear medicine via radiopharmaceuticals emitting radiation which is captured by gamma cameras to form two-dimensional images. Liver scintigraphy is widely used in nuclear medicine.Tc-99m and Cr-51 gamma radioisotopes can be used for this purpose. Cr-51 usage is more important for patients’ organ dose that has higher energy and longer half-life as compared to Tc-99m. In this study, it is aimed to determine the required dose for critical organs of patient through liver scintigraphy via Cr-51 gamma radioisotope. Experimental studies were conducted on patients even though conducting experimental studies on patients is extremely difficult for determination of critical organ doses. Torso phantom was utilized to simulate the liver scintigraphy by using 20 mini packages of Cr-51 that were placed on the organ. The radioisotope was produced by irradiation in central thimble of TRIGA MARK II Reactor at 250 KW power. As the results of the study, critical organ doses were determined and evaluated with different critic organs.

Keywords: critical organ doses, liver, scintigraphy, TRIGA Mark-II

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69 Assessing Image Quality in Mobile Radiography: A Phantom-Based Evaluation of a New Lightweight Mobile X-Ray Equipment

Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

Abstract:

Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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68 Comparison of FASTMAP and B0 Field Map Shimming for 4T MRI

Authors: Mohan L. Jayatiake, Judd Storrs, Jing-Huei Lee

Abstract:

The optimal MRI resolution relies on a homogeneous magnetic field. However, local susceptibility variations can lead to field inhomogeneities that cause artifacts such as image distortion and signal loss. The effects of local susceptibility variation notoriously increase with magnetic field strength. Active shimming improves homogeneity by applying corrective fields generated from shim coils, but requires calculation of optimal current for each shim coil. FASTMAP (fast automatic shimming technique by mapping along projections) is an effective technique for finding optimal currents works well at high-field, but is restricted to shimming spherical regions of interest. The 3D gradient-echo pulse sequence was modified to reduce sensitivity to eddy currents and used to obtain susceptibility field maps at 4T. Measured fields were projected onto first-and second-order spherical harmonic functions corresponding to shim hardware. A spherical phantom was used to calibrate the shim currents. Susceptibility maps of a volunteer’s brain with and without FASTMAP shimming were obtained. Simulations indicate that optimal shim currents derived from the field map may provide better overall shimming of the human brain.

Keywords: shimming, high-field, active, passive

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67 Cognitive Fusion and Obstacles to Valued Living: Beyond Pain-Specific Events in Chronic Pain

Authors: Sergio A. Carvalho, Jose Pinto-Gouveia, David Gillanders, Paula Castilho

Abstract:

The role of psychological processes has long been recognized as crucial factors in depressive symptoms in chronic pain (CP). Although some studies have explored the negative impact of being entangled with internal experiences (e.g., thoughts, emotions, physical sensations) – cognitive fusion, it is not extensively explored 1) whether these are pain-related or rather general difficult experiences, and 2) how they relate to experiencing obstacles in committing to valued actions. The current study followed a cross-sectional design in a sample of 231 participants with CP, in which a mediational model was tested through path analyses in AMOS software. The model presented a very good model fit (Χ²/DF = 1.161; CFI = .999; TLI = .996; RMSEA = .026, PCLOSE = .550.), and results showed that pain intensity was not directly related to depressive symptoms (β = .055; p = .239) but was mediated by cognitive fusion with both general and pain-related internal experiences (β = .181, 95%CI [.097; .271]; p = .015). Additionally, results showed that only general cognitive fusion (but not pain-specific fusion) was associated with experiencing obstacles to living a meaningful life, which mediated its impact on depressive symptoms (β = .197, 95%CI [.102; .307]; p = .001). Overall, this study adds on current literature by suggesting that psychological interventions to pain management should not be focused only on management of pain-related experiences, but also on developing more effective ways of relating to overall internal experiences.

Keywords: cognitive fusion, chronic pain, depressive symptoms, valued living

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66 A Monopole Intravascular Antenna with Three Parasitic Elements Optimized for Higher Tesla MRI Systems

Authors: Mohammad Mohammadzadeh, Alireza Ghasempour

Abstract:

In this paper, a new design of monopole antenna has been proposed that increases the contrast of intravascular magnetic resonance images through increasing the homogeneity of the intrinsic signal-to-noise ratio (ISNR) distribution around the antenna. The antenna is made of a coaxial cable with three parasitic elements. Lengths and positions of the elements are optimized by the improved genetic algorithm (IGA) for 1.5, 3, 4.7, and 7Tesla MRI systems based on a defined cost function. Simulations were also conducted to verify the performance of the designed antenna. Our simulation results show that each time IGA is executed different values for the parasitic elements are obtained so that the cost functions of those antennas are high. According to the obtained results, IGA can also find the best values for the parasitic elements (regarding cost function) in the next executions. Additionally, two dimensional and one-dimensional maps of ISNR were drawn for the proposed antenna and compared to the previously published monopole antenna with one parasitic element at the frequency of 64MHz inside a saline phantom. Results verified that in spite of ISNR decreasing, there is a considerable improvement in the homogeneity of ISNR distribution of the proposed antenna so that their multiplication increases.

Keywords: intravascular MR antenna, monopole antenna, parasitic elements, signal-to-noise ratio (SNR), genetic algorithm

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65 Cutaneous Sarcoidosis Treated with Narrow Band Ultraviolet B (NBUVB) Phototherapy

Authors: Hannah Riva, Sarah Mazal, Jessica L. Marquez, Michael Rains

Abstract:

A 70-year-old female with a Fitzpatrick skin phenotype II presented with a 13-year history of a scaly rash located on the left breast and bilateral pretibial regions. The patient’s past medical history was otherwise unremarkable, with the exception of surgery involving the left breast. Physical examination revealed infiltrative hyperpigmented scaly plaques and nodules located on the left breast and pretibial regions bilaterally. A negative systemic workup excluded organ involvement. A clinical diagnosis of cutaneous sarcoidosis was made. Prior treatments included triamcinolone 0.1% topical cream and clobetasol 0.05% ointment, which failed to show improvement. Full-body narrow-band UVB (NBUVB) treatment was performed on a tri-weekly basis for eight months. NBUVB dosage was slowly titrated from 300 mJ/cm2 to a final dose of 1800 mJ/cm2 to prevent discomfort and burning sensations. Throughout the duration of her treatment, the patient adhered to a regimen of clobetasol 0.05% topical ointment applied twice daily in two-week intervals. Improvement was noticed after two months, with continued improvement up to eight months. The patient is continuing NBUVB phototherapy treatments for maintenance. In our case, NBUVB phototherapy treatment demonstrated promising results with improvement after two months of treatment. Physicians should consider NBUVB phototherapy as an effective option for patients presenting with cutaneous sarcoidosis.

Keywords: dermatology, sarcoidosis, phototherapy, ultraviolet

Procedia PDF Downloads 42