Matthew C Solhjem

Mayo Clinic - Rochester, Рочестер, Minnesota, United States

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Publications (5)17.01 Total impact

  • Matthew C Solhjem · Ivy A Petersen · Michael G Haddock
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    ABSTRACT: To determine the efficacy and complications of adjuvant vaginal high-dose-rate brachytherapy alone for patients with Stage I endometrial cancer in whom complete surgical staging had been performed. Between April 1998 and March 2004, 100 patients with Stage I endometrial cancer underwent surgical staging (total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic +/- paraaortic nodal sampling) and postoperative vaginal high-dose-rate brachytherapy at our institution. The total dose was 2100 cGy in three fractions. With a median follow-up of 23 months (range 2-62), no pelvic or vaginal recurrences developed. All patients underwent pelvic dissection, and 42% underwent paraaortic nodal dissection. A median of 29.5 pelvic nodes (range 1-67) was removed (84% had >10 pelvic nodes removed). Most patients (73%) had endometrioid (or unspecified) adenocarcinoma, 16% had papillary serous carcinoma, and 11% had other histologic types. The International Federation of Gynecology and Obstetrics stage and grade was Stage IA, grade III in 5; Stage IB, grade I, II, or III in 6, 27, or 20, respectively; and Stage IC, grade I, II, or III in 13, 17, or 10, respectively. The Common Toxicity Criteria (version 2.0) complications were mild (Grade 1-2) and consisted primarily of vaginal mucosal changes, temporary urinary irritation, and temporary diarrhea. Adjuvant vaginal high-dose-rate brachytherapy alone may be a safe and effective alternative to pelvic external beam radiotherapy for surgical Stage I endometrial cancer.
    No preview · Article · Aug 2005 · International Journal of Radiation OncologyBiologyPhysics
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    ABSTRACT: To quantify prostate volume (pvol) changes with transrectal ultrasound (TRUS) immediately after permanent prostate brachytherapy (PPB) and to correlate these changes with postimplant computed tomography (CT) volumetrics. To provide data relevant to evaluating the potential of TRUS-based image fusion for intraoperative dosimetry. Between July 2000 and January 2003, 177 patients underwent (125)I PPB monotherapy at our institution, and 165 patients provided research authorization. A total of 136 patients (82%) completed 4 imaging studies: planning TRUS, intraoperative pre- and postimplant TRUS, and CT. Mean planning TRUS pvol was 38.7 +/- 11.7 cc standard deviation (SD), 95% confidence interval (CI) (36.7, 40.7). Mean intraoperative TRUS pvol preimplant was 37.1 +/- 11.7 cc SD, 95% CI (35.1, 39.0), and postimplant was 44.5 +/- 15.1 cc SD, 95% CI (42.0, 47.1). The mean ratio of postimplant:preimplant intraoperative TRUS pvols was 1.2 +/- 0.2 SD, 95% CI (1.18, 1.24), and the difference in mean values was 7.5 cc (p < 0.0001). CT performed within 1 day revealed a mean pvol of 47.9 +/- 15.7 cc SD, 95% CI (45.2, 50.5). The mean volumetric ratio of CT to postimplant TRUS pvol was 1.13 +/- 0.36, 95% CI (1.07-1.19). Whereas mean preimplant step-section TRUS pvol measurements are similar, postimplant TRUS and CT measurements have greater variability that depend on initial pvol. CT-based pvol measurements determined a mean of 10.6 hours after implant were more likely to be identical to those of immediate postimplant TRUS in prostates >33 cc. These data are relevant for establishing accuracy in image-fusion based approaches being investigated for real-time intraoperative PPB dosimetry.
    No preview · Article · Nov 2004 · International Journal of Radiation OncologyBiologyPhysics
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    ABSTRACT: Limited duration neoadjuvant cytoreductive hormonal therapy (NHT) is used before the definitive radiotherapeutic management of prostate cancer to decrease target volume size and/or to decrease urinary obstructive symptoms. The purpose of this study is to examine the effect of NHT on prostate volume before permanent prostate brachytherapy (PPB) and on prostatic edema after PPB. Between May 1998 and February 2004, 408 patients underwent PPB at our institution and provided research authorization for the use of their records. Of these, 122 (30%) underwent NHT. Of the 122, 78 (64%) underwent transrectal ultrasound before the start of NHT. Patients undergoing PPB who received NHT were compared with a similar non-NHT group (N = 286). Detailed measurements of prostate volume were performed by transrectal ultrasound before and after NHT, if applicable. In addition, intraoperative preimplantation transrectal ultrasound and post-implantation transrectal ultrasound were also performed. Post-implantation computed tomography was per formed within 1 day of PPB. The mean duration of NHT was 4.0 +/- 1.1 months (range, 1-8 months). The mean prostate volume before NHT was 63.3 +/- 22.8 cc (range, 19-138 cc), and after NHT (before PPB), it was 41.6 +/- 16.4 cc (18-98 cc). The median prostate volume decrease after NHT was 22.7 cc or 34.9%. There was no significant difference in the degree of postimplantation prostate edema, as measured by the postimplantation to preimplantation ratio (1.18 +/- 0.05 [range, 0.8-1.9]) for the NHT group and 1.21 +/- 0.03 (range, 0.8-1.9) for the non-NHT group (P = 0.5). Prostate volume decreased by approximately one third after 4 months of NHT. NHT did not affect the degree of post-PPB prostatic edema.
    No preview · Article · Oct 2004 · The Cancer Journal
  • MC Solhjem · IA Petersen · MG Haddock

    No preview · Article · Sep 2004 · International Journal of Radiation OncologyBiologyPhysics
  • Matthew Solhjem
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    ABSTRACT: Purpose/Objective: Prostate edema following PPB is variable and affects PI dosimetry (PID). Computed tomography (CT)-based PID is recommended for quality assurance, but has limitations due to interobserver variability in prostate segmentation resulting in clinically relevant differences in dosimetry parameters. The purpose of this study is to quantify the ultrasound-based volumetric changes of the prostate immediately after PPB and to correlate these changes with post-implant CT volumetrics. These data are useful in evaluating the potential of post-implant (PI) CT/TRUS image fusion towards improving PID reproducibility. Materials/Methods: Between July 2000 and January 2003, 177 consecutive patients (pts) underwent I-125 PPB monotherapy at our institution and 165 pts provided research authorization for use of their records. A total of 136 pts (82%) completed 4 imaging studies: planning TRUS, intraoperative pre- and post-implant (PI) TRUS, and CT-based PID. Volumetric comparisons were made by paired t tests. Results: Mean planning TRUS volume was 38.7±11.7cc SD, 95% confidence interval (CI) (36.7,40.7). Mean intraoperative TRUS volume pre-implant was 37.1±11.7cc SD, 95% CI (35.1,39.0) and post-implant was 44.5±15.1cc SD, 95% CI (42.0,47.1). The mean ratio of post-implant/pre-implant intraoperative TRUS volumes was 1.2±0.2 SD, 95% CI (1.18,1.24), and the difference in mean values was 7.5cc (p1.50. Conclusions: The change in immediate PI TRUS prostate volume measurements is similar to that noted in prior studies based on CT and demonstrates that prostatic edema occurs during the course of PPB. Prostate volume by PI TRUS increases on average by 20% but with substantial variability. The average PI CT/TRUS ratio of 1.13 can be attributed to differences in accurately identifying the prostate with different imaging modalities and may also be due to further post-operative edema prior to CT. PI TRUS may be considered for approaches designed to improve PID by image fusion of ultrasound and CT imaging, but the range of CT/TRUS volume ratios identified in this study suggests further refinements are necessary to effectively employ such an approach. (B.D. is a research consultant for Amersham Health, Inc. Research supported by NIH Grant R21 AG19382-01)
    No preview · Conference Paper · Dec 2003