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Brachytherapy is often used to treat oral cancer, as it generally yields a good outcome with little oral function loss. In particular, mold brachytherapy is ideally suited for superficial oral cases, such as cancers developing on the gingiva, palate, or buccal mucosa, with little to no bone involvement and thin tissue thickness. Mold brachytherapy including that at a high-dose-rate (HDR) is used to treat gingival cancer, though hospitalization is the typical treatment setting. Reported here are details of HDR mold brachytherapy performed in an outpatient setting for a mandibular gingival case of squamous cell carcinoma (SCC). Mandibular gingival SCC in a 71-year-old man was treated as an outpatient using HDR mold brachytherapy (54 Gy in 9 fractions, 5 days). After receiving mold treatment for thirty months, there was no sign of recurrence or metastasis. To our knowledge, this is the first report of HDR mold brachytherapy in an outpatient setting for treating mandibular gingival cancer.

Objectives: The aim of this study was to investigate the vascular responses and fates of the scaffold after bioresorbable vascular scaffold (BVS) implantation using multimodality imaging. Background: Serial comprehens

Background: Fractional flow reserve derived from CT-coronary angiography (FFRCT) accurately identifies ischaemic vessels which may be associated with clinical outcomes. Its predictive value in grey zone FFRCT values between 0.7-0.8 is not defined. The technique permits estimation of burden of ischaemic myocardium subtended by FFRCT significant vessels. Purpose(s): To evaluate the prognostic value and incremental benefit of FFRCT defined ischaemic myocardial burden when compared to FFRCT alone. Method(s): This is a subanalysis of NXT (Analysis of Coronary Blood-Flow Using CTA:Next-Steps), a prospective study of stable coronary artery disease (CAD) patients referred for invasive angiography (ICA) undergoing invasive FFR, CTA and FFRCT in whom treating physicians had been blinded to FFRCT results. Primary endpoint, defined as a composite of non-fatal myocardial infarction and any revascularisation, was determined in 206 patients (age 64+/-9.5 years, 64% male) and 618 vessels. Burden of ischaemic myocardium was defined as percentage of myocardium subtended beyond the point at which a vessel's FFRCT becomes <=0.8 as estimated by APPROACH score (FFRCT-APPROACH). In significant FFRCT vessels, the predictive value and incremental benefit of FFRCT-APPROACH was compared with significant FFRCT (<=0.8) for primary endpoint as measured by area under the receiver operator characteristic curve (AUC). Significant ischaemic myocardial burden was defined as >10%. The incidence and relationship between the primary endpoint with each 10% increase in FFRCT-APPROACH and 0.05-unit decrease in FFRCT values <=0.8 was determined. Result(s): Significant FFRCT was identified in 52.9% of patients (109/206) and 29.3% of vessels (181/618). At 4.7 years median follow-up the incidence of the primary endpoint in vessels with significant FFRCTAPPROACH was 58.9% (96/163) which was comparable with vessels with significant FFRCT (55.2%,100/181; P=0.50). The predictive value of FFRCT-APPROACH for the pri

Background: Coronary CT angiography with noninvasive fractional flow reserve (FFR) predicts lesion-specific ischemia when compared with invasive FFR. The longer term prognostic value of CT-derived FFR (FFRCT) is unknown. Purpose(s): To determine the prognostic value of FFRCT when compared with coronary CT angiography and describe the relationship of the numeric value of FFRCT with outcomes. Material(s) and Method(s): This prospective subanalysis of the NXT study (Clinicaltrials.gov: NCT01757678) evaluated participants suspected of having stable coronary artery disease who were referred for invasive angiography and who underwent FFR, coronary CT angiography, and FFRCT. The incidence of the composite primary end point of death, myocardial infarction, and any revascularization and the composite secondary end point of major adverse cardiac events (MACE: cardiac death, myocardial infarction, unplanned revascularization) were compared for an FFRCT of 0.8 or less versus stenosis of 50% or greater on coronary CT angiograms, with treating physicians blinded to the FFRCT result. Result(s): Long-term outcomes were obtained in 206 individuals (age, 64 years 6 9.5), including 64% men. At median follow-up of 4.7 years, there were no cardiac deaths or myocardial infarctions in participants with normal FFRCT. The incidence of the primary end point was more frequent in participants with positive FFRCT compared with clinically significant stenosis at coronary CT angiography (73.4% [80 of 109] vs 48.7% [91 of 187], respectively; P , .001), with the majority of outcomes being planned revascularization. Corresponding hazard ratios (HRs) were 9.2 (95% confidence interval [CI]: 5.1, 17; P , .001) for FFRCT and 5.9 (95% CI: 1.5, 24; P = .01) for coronary CT angiography. FFRCT was a superior predictor compared with coronary CT angiography for primary end point (C-index FFRCT, 0.76 vs coronary CT angiography, 0.54; P , .001) and MACE (FFRCT, 0.71 vs coronary CT angiography, 0.52; P = .001).

Background: The long-term prognostic value of CT-derived fractional flow reserve (FFRct) compared to CT coronary angiography (CTA) and the independent relationship of its numeric value with clinical outcomes is not known. Objective(s): 1) To determine the long-term prognostic value of FFRct in predicting death, non-fatal myocardial infarction and revascularisation when compared with CTA alone, and 2) to describe the relationship of the numeric value of FFRct with clinical outcomes. Method(s): This is a subanalysis of NXT (HeartFlowNXT: HeartFlow Analysis of Coronary Blood Flow Using Coronary CT Angiography), a prospective, multicentre study with suspected stable coronary artery disease (CAD) who underwent CTA, FFRct, invasive coronary angiography and FFR. Of the 310 patients with an accepted CTA by FFRct core laboratory, outcome data was available in 206 (age 64+/-9.5, 64% male). We compared the predictive value of an abnormal FFRct (defined as <=0.8) with the presence of significant stenosis on CTA (>50% site read stenosis) for composite primary endpoint of death, nonfatal myocardial infarction and revascularization. In addition, we assessed its relationship with each 0.05-unit strata decrease in FFRct adjusted for clinical and CTA features. Result(s): At a median follow-up of 4.7 years (4.4-5.3), the incidence of the primary endpoint was significantly higher in patients with abnormal FFRct (73.4%, 80/109) compared with patients with significant stenosis on CTA (48.7%, 91/187; P<0.001). This was driven by significantly higher rates of revascularisation in patients with normal FFRct (71.6% vs 46.0%, P<0.001). Hazard ratio (HR) for the primary endpoint for FFRct was 9.19 (95% confidence interval [CI] 5.09-16.60; P<0.001) compared with CTA 5.91 (95% CI 1.46-24.02, P<0.01). FFRct <=0.8 was a superior predictor for the primary endpoint compared to the presence of significant stenosis on CTA as assessed by area under the receiver operator characteristic curve (FFRCT: 0.8