Melkersson-Rosenthal syndrome (MRS) is an uncommon granulomatous condition characterized by persistent or recurrent orofacial oedema, relapsing facial paralysis and fissured tongue. We report here a ...case of MRS with the classical triad of signs accompanied by unilateral anterior uveitis. A 35-year-old man with a fissured tongue, recurrent facial palsy and orofacial oedema presented with a 3-month history of conjunctival redness and decreased vision in the right eye. On evaluation of visual acuity, the patient was only able to count fingers. Slit lamp examination revealed severe conjunctival injection, cells and flare, posterior synechiae and keratic precipitates. Examination of the left eye revealed no evidence of inflammation. Examination of the other systems was normal. The patient was treated with topical corticosteroids and cycloplegics and the visual acuity improved to 7/10. To our knowledge, there are no previous reports of an association between uveitis and MRS.
Purpose:
To develop a tool that can quickly and automatically assess contour quality generated from auto segmentation during online adaptive replanning.
Methods:
Due to the strict time requirement of ...online replanning and lack of ‘ground truth’ contours in daily images, our method starts with assessing image registration accuracy focusing on the surface of the organ in question. Several metrics tightly related to registration accuracy including Jacobian maps, contours shell deformation, and voxel-based root mean square (RMS) analysis were computed. To identify correct contours, additional metrics and an adaptive decision tree are introduced. To approve in principle, tests were performed with CT sets, planned and daily CTs acquired using a CT-on-rails during routine CT-guided RT delivery for 20 prostate cancer patients. The contours generated on daily CTs using an auto-segmentation tool (ADMIRE, Elekta, MIM) based on deformable image registration of the planning CT and daily CT were tested.
Results:
The deformed contours of 20 patients with total of 60 structures were manually checked as baselines. The incorrect rate of total contours is 49%. To evaluate the quality of local deformation, the Jacobian determinant (1.047±0.045) on contours has been analyzed. In an analysis of rectum contour shell deformed, the higher rate (0.41) of error contours detection was obtained compared to 0.32 with manual check. All automated detections took less than 5 seconds.
Conclusion:
The proposed method can effectively detect contour errors in micro and macro scope by evaluating multiple deformable registration metrics in a parallel computing process. Future work will focus on improving practicability and optimizing calculation algorithms and metric selection.
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