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Image-Guided Percutaneous Abdominal Mass Biopsy: Technical and Clinical Considerations.
Lipnik AJ, Brown DB
(2015) Radiol Clin North Am 53: 1049-59
MeSH Terms: Biopsy, Needle, Blood Coagulation Tests, Conscious Sedation, Contraindications, Humans, Image-Guided Biopsy, Kidney Diseases, Liver Diseases, Magnetic Resonance Imaging, Interventional, Neoplasm Seeding, Patient Positioning, Radiography, Interventional, Specimen Handling, Ultrasonography, Interventional
Show Abstract · Added September 18, 2015
Image-guided percutaneous biopsy of abdominal masses is a safe, minimally invasive procedure with a high diagnostic yield for a variety of pathologic processes. This article describes the basic technique of percutaneous biopsy, including the different modalities available for imaging guidance. Patient selection and preparation for safe performance of the procedure is emphasized, and the periprocedural management of coagulation status as well as basic indications and contraindications of the procedure are briefly discussed. In particular, the role of biopsy in the diagnosis of liver and renal masses is highlighted.
Copyright © 2015 Elsevier Inc. All rights reserved.
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14 MeSH Terms
Automatic localization of cochlear implant electrodes in CT.
Zhao Y, Dawant BM, Labadie RF, Noble JH
(2014) Med Image Comput Comput Assist Interv 17: 331-8
MeSH Terms: Algorithms, Artificial Intelligence, Cochlear Implantation, Cochlear Implants, Humans, Pattern Recognition, Automated, Prosthesis Fitting, Radiographic Image Enhancement, Radiographic Image Interpretation, Computer-Assisted, Radiography, Interventional, Reproducibility of Results, Sensitivity and Specificity, Tomography, X-Ray Computed, Treatment Outcome
Show Abstract · Added February 19, 2015
Cochlear Implants (CI) are surgically implanted neural prosthetic devices used to treat severe-to-profound hearing loss. Recent studies have suggested that hearing outcomes with CIs are correlated with the location where individual electrodes in the implanted electrode array are placed, but techniques proposed for determining electrode location have been too coarse and labor intensive to permit detailed analysis on large numbers of datasets. In this paper, we present a fully automatic snake-based method for accurately localizing CI electrodes in clinical post-implantation CTs. Our results show that average electrode localization errors with the method are 0.21 millimeters. These results indicate that our method could be used in future large scale studies to analyze the relationship between electrode position and hearing outcome, which potentially could lead to technological advances that improve hearing outcomes with CIs.
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14 MeSH Terms
Primary cardiac lymphoma diagnosed by multiphase-gated cardiac CT and CT-guided percutaneous trans-sternal biopsy.
Shah RN, Simmons TW, Carr JJ, Entrikin DW
(2012) J Cardiovasc Comput Tomogr 6: 137-9
MeSH Terms: Aged, Biopsy, Needle, Cardiac-Gated Imaging Techniques, Heart Neoplasms, Humans, Lymphoma, B-Cell, Male, Predictive Value of Tests, Radiography, Interventional, Sternum, Tomography, Spiral Computed
Show Abstract · Added February 15, 2014
We present a case of a primary cardiac B-cell lymphoma where a multiphase-gated cardiac CT exam helped to successfully guide trans-sternal needle biopsy to establish a tissue diagnosis.
Copyright © 2012 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
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11 MeSH Terms
Moxifloxacin prophylaxis for chemoembolization or embolization in patients with previous biliary interventions: a pilot study.
Khan W, Sullivan KL, McCann JW, Gonsalves CF, Sato T, Eschelman DJ, Brown DB
(2011) AJR Am J Roentgenol 197: W343-5
MeSH Terms: Anti-Infective Agents, Antibiotic Prophylaxis, Antineoplastic Agents, Aza Compounds, Biliary Tract Diseases, Case-Control Studies, Chemoembolization, Therapeutic, Embolization, Therapeutic, Ethiodized Oil, Female, Fluoroquinolones, Humans, Liver Abscess, Liver Neoplasms, Male, Moxifloxacin, Pilot Projects, Quinolines, Radiography, Interventional, Retrospective Studies, Risk Factors
Show Abstract · Added March 5, 2014
OBJECTIVE - Abscess formation is a common serious adverse event after intraarterial therapy for hepatic malignancy in patients with colonized bile ducts. The combination of antibiotic prophylaxis and bowel preparation has been used to prevent hepatic abscess. We describe our outcomes with moxifloxacin prophylaxis alone without bowel preparation.
CONCLUSION - Ten patients underwent 25 procedures and were followed for a median of 250 days. No abscesses developed. Our results suggest moxifloxacin alone may suffice for prophylaxis.
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21 MeSH Terms
Gastrostomy-to-gastrojejunostomy tube conversion: impact of the method of original gastrostomy tube placement.
Kim CY, Patel MB, Miller MJ, Suhocki PV, Balius A, Smith TP
(2010) J Vasc Interv Radiol 21: 1031-7
MeSH Terms: Adolescent, Adult, Aged, Aged, 80 and over, Combined Modality Therapy, Female, Gastric Bypass, Gastrostomy, Humans, Male, Middle Aged, Prosthesis Implantation, Radiography, Interventional, Treatment Outcome, Young Adult
Show Abstract · Added June 14, 2016
PURPOSE - To determine the outcome of gastrostomy tube-to-gastrojejunostomy tube conversion on the basis of the method of original gastrostomy tube placement.
MATERIALS AND METHODS - One hundred twenty-four patients (age range, 13-87 years; 72 male and 52 female patients) underwent conversion of a primarily placed gastrostomy tube to a gastrojejunostomy tube at the authors' institution between January 2000 and December 2008. The method of original gastrostomy tube placement was radiologic (n = 27), endoscopic (n = 75), laparoscopic (n = 2), or open surgery (n = 20). The method of placement was correlated with the success rates of gastrostomy-to-gastrojejunostomy tube conversion. Medical records and radiologic images were reviewed to determine the frequency of proximal migration of the jejunostomy tube into the stomach. Follow-up data were available for an average of 136 days after gastrostomy-to-gastrojejunostomy tube conversion (median, 63 days; range, 1-1,300 days).
RESULTS - Of 124 gastrostomy tube-to-gastrojejunostomy tube conversions, 109 (87.9%) were successfully performed. Procedural conversion failure occurred in one of the 27 radiologically inserted gastrostomy tubes (3.7%) compared to 14 of the 97 (14%) nonradiologically inserted gastrostomy tubes (P = .19), of which 12 were inserted endoscopically and two were inserted surgically. Of the 109 patients with successful tube conversion, jejunal tip malposition occurred at follow-up in 18 (16.5%). Of these, four patients developed aspiration pneumonia (22%), which contributed to patient death in two. The frequency of jejunal tip malposition was 3.8% (one of 26 patients) for radiologically placed gastrostomy tubes and 20% (17 of 83 patients) for nonradiologically placed gastrostomy tubes (P = .07). Combined, 32% of gastrostomy tubes placed nonradiologically resulted in either procedural failure or eventual jejunal tip malposition, compared to 7.4% of radiologically placed gastrostomy tubes (P = .01).
CONCLUSIONS - The frequency of procedural failure or eventual jejunal tip malposition with conversion of radiologically placed gastrostomy tubes to gastrojejunostomy tubes is significantly lower with radiologically placed gastrostomy tubes than with nonradiologically inserted gastrostomy tubes.
Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
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15 MeSH Terms
Effect of brain shift on the creation of functional atlases for deep brain stimulation surgery.
Pallavaram S, Dawant BM, Remple MS, Neimat JS, Kao C, Konrad PE, D'Haese PF
(2010) Int J Comput Assist Radiol Surg 5: 221-8
MeSH Terms: Atlases as Topic, Brain, Brain Mapping, Deep Brain Stimulation, Female, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Male, Neurosurgical Procedures, Radiography, Interventional, Sensitivity and Specificity, Subthalamic Nucleus, Surgery, Computer-Assisted, Tomography, X-Ray Computed
Show Abstract · Added March 7, 2014
PURPOSE - In the recent past many groups have tried to build functional atlases of the deep brain using intra-operatively acquired information such as stimulation responses or micro-electrode recordings. An underlying assumption in building such atlases is that anatomical structures do not move between pre-operative imaging and intra-operative recording. In this study, we present evidences that this assumption is not valid. We quantify the effect of brain shift between pre-operative imaging and intra-operative recording on the creation of functional atlases using intra-operative somatotopy recordings and stimulation response data.
METHODS - A total of 73 somatotopy points from 24 bilateral subthalamic nucleus (STN) implantations and 52 eye deviation stimulation response points from 17 bilateral STN implantations were used. These points were spatially normalized on a magnetic resonance imaging (MRI) atlas using a fully automatic non-rigid registration algorithm. Each implantation was categorized as having low, medium or large brain shift based on the amount of pneumocephalus visible on post-operative CT. The locations of somatotopy clusters and stimulation maps were analyzed for each category.
RESULTS - The centroid of the large brain shift cluster of the somatotopy data (posterior, lateral, inferior: 3.06, 11.27, 5.36 mm) was found posterior, medial and inferior to that of the medium cluster (2.90, 13.57, 4.53 mm) which was posterior, medial and inferior to that of the low shift cluster (1.94, 13.92, 3.20 mm). The coordinates are referenced with respect to the mid-commissural point. Euclidean distances between the centroids were 1.68, 2.44 and 3.59 mm, respectively for low-medium, medium-large and low-large shift clusters. We found similar trends for the positions of the stimulation maps. The Euclidian distance between the highest probability locations on the low and medium-large shift maps was 4.06 mm.
CONCLUSION - The effect of brain shift in deep brain stimulation (DBS) surgery has been demonstrated using intra-operative somatotopy recordings as well as stimulation response data. The results not only indicate that considerable brain shift happens before micro-electrode recordings in DBS but also that brain shift affects the creation of accurate functional atlases. Therefore, care must be taken when building and using such atlases of intra-operative data and also when using intra-operative data to validate anatomical atlases.
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15 MeSH Terms
Core needle lung biopsy specimens: adequacy for EGFR and KRAS mutational analysis.
Solomon SB, Zakowski MF, Pao W, Thornton RH, Ladanyi M, Kris MG, Rusch VW, Rizvi NA
(2010) AJR Am J Roentgenol 194: 266-9
MeSH Terms: Adenocarcinoma, Antineoplastic Agents, Biopsy, Needle, Clinical Trials, Phase II as Topic, DNA Mutational Analysis, ErbB Receptors, Female, Fluoroscopy, Gefitinib, Humans, Lung Neoplasms, Male, Middle Aged, Prospective Studies, Proto-Oncogene Proteins, Proto-Oncogene Proteins p21(ras), Quinazolines, Radiography, Interventional, Tomography, X-Ray Computed, ras Proteins
Show Abstract · Added March 24, 2014
OBJECTIVE - The purpose of this study was to prospectively compare the adequacy of core needle biopsy specimens with the adequacy of specimens from resected tissue, the histologic reference standard, for mutational analysis of malignant tumors of the lung.
SUBJECTS AND METHODS - The first 18 patients enrolled in a phase 2 study of gefitinib for lung cancer in July 2004 through August 2005 underwent CT- or fluoroscopy-guided lung biopsy before the start of gefitinib therapy. Three weeks after gefitinib therapy, the patients underwent lung tumor resection. The results of EGFR and KRAS mutational analysis of the core needle biopsy specimens were compared with those of EGFR and KRAS mutational analysis of the surgical specimens.
RESULTS - Two specimens were unsatisfactory for mutational analysis. The results of mutational assay results of the other 16 specimens were the same as those of analysis of the surgical specimens obtained an average of 31 days after biopsy.
CONCLUSION - Biopsy with small (18- to 20-gauge) core needles can yield sufficient and reliable samples for mutational analysis. This technique is likely to become an important tool with the increasing use of pharmacotherapy based on the genetics of specific tumors in individual patients.
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20 MeSH Terms
Percutaneous ureteral interventions.
Adamo R, Saad WE, Brown DB
(2009) Tech Vasc Interv Radiol 12: 205-15
MeSH Terms: Catheterization, Catheters, Indwelling, Constriction, Pathologic, Embolization, Therapeutic, Humans, Nephrostomy, Percutaneous, Radiography, Interventional, Stents, Treatment Outcome, Ureteral Obstruction, Urinary Fistula
Show Abstract · Added March 5, 2014
Urinary strictures are commonly managed by interventional radiologists and can result from both benign and malignant etiologies. Many patients end up with lifelong catheters. Although stricture dilation is commonly unsuccessful, some patients can eventually become catheter free. This review describes current outcomes with a variety of dilation and stenting techniques. Management of complex ureteral and urinary complications is also reviewed, including ureteral/arterial fistulas and ureteral embolization for permanent diversion.
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11 MeSH Terms
Management of nephrostomy drains and ureteral stents.
Adamo R, Saad WE, Brown DB
(2009) Tech Vasc Interv Radiol 12: 193-204
MeSH Terms: Algorithms, Catheters, Indwelling, Clinical Protocols, Drainage, Humans, Nephrostomy, Percutaneous, Patient Selection, Prosthesis Design, Radiography, Interventional, Stents, Treatment Outcome, Ureteral Obstruction, Urinary Diversion
Show Abstract · Added March 5, 2014
Nephroureteral and double J stents are routinely placed by interventional radiologists but quality literature on placement and management of these devices is limited. The purpose of this review is to detail indications for ureteral stent placement, review the types of antegrade and retrograde devices that are placed including technical tips, and discuss management of common complications that occur in this patient population. An algorithm for placement and management is included.
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13 MeSH Terms
Research reporting standards for image-guided ablation of bone and soft tissue tumors.
Callstrom MR, York JD, Gaba RC, Gemmete JJ, Gervais DA, Millward SF, Brown DB, Dupuy D, Goldberg SN, Kundu S, Rose SC, Thomas JJ, Cardella JF, Technology Assessment Committee of Society of Interventional Radiology
(2009) J Vasc Interv Radiol 20: 1527-40
MeSH Terms: Biomedical Research, Bone Neoplasms, Catheter Ablation, Humans, Laser Therapy, Magnetic Resonance Imaging, Interventional, Patient Selection, Radiography, Interventional, Reproducibility of Results, Soft Tissue Neoplasms, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Interventional
Added March 5, 2014
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13 MeSH Terms