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CT imaging, increasing accuracy

S A Taylor, F Avni, C G Cronin, C Hoeffel, S H Kim, A Laghi, M Napolitano, P Petit, J Rimola, D J Tolan, M R Torkzad, M Zappa, G Bhatnagar, C A J Puylaert, J Stoker
OBJECTIVES: To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease. METHODS: An expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols...
October 18, 2016: European Radiology
Elisa Tardelli, Sara Mazzarri, Domenico Rubello, Marta Gennaro, Lorenzo Fantechi, Valerio Duce, Antonella Romanini, Sotirios Chondrogiannis, Duccio Volterrani, Patrick M Colletti, Gianpiero Manca
Melanoma is an important public health problem, and its incidence is increasing worldwide. The disease status of regional lymph nodes is the most important prognostic factor in early-stage melanoma patients. Sentinel lymph node biopsy (SLNB) was introduced in the early 1990s as a less invasive procedure than complete lymph node dissection to allow histopathologic evaluation of the "sentinel lymph node" (SLN), which is the first node along the lymphatic pathway from a primary tumor. Sentinel lymph node biopsy has minimal complication risks compared with standard complete lymph node dissection...
October 5, 2016: Clinical Nuclear Medicine
Sergio Prieto-González, Georgina Espígol-Frigolé, Ana García-Martínez, Marco A Alba, Itziar Tavera-Bahillo, José Hernández-Rodríguez, Arturo Renú, Rosa Gilabert, Francisco Lomeña, Maria C Cid
Various imaging modalities, including color duplex ultrasonography, CT angiography, magnetic resonance angiography, and PET, are emerging as important aids to the diagnosis, staging, evaluation of disease activity and response to treatment in systemic vasculitis. Although large-vessel vasculitis is the main target of imaging, refinement and increasing accuracy of imaging modalities are also providing useful information in the evaluation of medium-vessel and small-vessel vasculitis.
November 2016: Rheumatic Diseases Clinics of North America
Yu-Wen Wang, Chin-Shun Wu, Guo-Yi Zhang, Chih-Han Chang, Kuo-Sheng Cheng, Wei-Jen Yao, Yu-Kang Chang, Tsair-Wei Chien, Li-Ching Lin, Keng-Ren Lin
PURPOSE: Minimal axial diameter (MIAD) in magnetic resonance imaging (MRI) was recognized as the most useful parameter in diagnosing lateral retropharyngeal lymph (LRPL) nodes in nasopharyngeal carcinoma (NPC). This study aims to explore the additional nodal parameters in MRI and positron emission tomography-computed tomography for increasing the prediction accuracy. MATERIALS AND METHODS: A total of 663 LRPL nodes were retrospectively collected from 335 patients with NPC...
2016: PloS One
I Diogo, U Walliczeck, J Taube, N Franke, A Teymoortash, J Werner, C Güldner
Due to an increasing number of cochlear implantations, quality control has become more important. In addition to intraoperative biophysical measurements, radiological imaging is another possibility. An upcoming technique regarding this is Cone Beam CT (CBCT). Sixty-five data sets (35 Nucleus Contour Advance-Cochlear; 30 Flex Soft-MedEl) of postoperative imaging by CBCT (Accu-I-tomo F17, Morita, Kyoto, Japan) underwent further evaluation. Insertion angle, height of the cochlea, distance of the electrode to the medial or lateral wall, angle between chorda tympani and facial nerve and the precise position of the electrode cable in the facial-chordal angle were determined...
August 2016: Acta Otorhinolaryngologica Italica
Ran Schwarzkopf, Erik Schnaser, Taiki Nozaki, Yasuhito Kaneko, Michael J Gillman
INTRODUCTION: Patient-specific implants and instruments (PSI) have been used in both knee and shoulder replacements due to the perceived benefits of improved surgical accuracy and efficiency. The proposed benefits of using a PSI in total hip arthroplasty (THA) are numerous and include reduction of operative time and improved mechanical and anatomical alignment leading to increased implant longevity, increased stability, and clinical outcomes. We describe a novel patient-specific instrumentation and a surgical method that may improve directed resection of acetabular bone and accurate cup placement during THA...
October 6, 2016: Surgical Technology International
Shahram Mashouf, Habib Safigholi, Tomas Merino, Abraam Soliman, Ananth Ravi, Gerard Morton, William Y Song
PURPOSE: There is strong evidence relating postimplant dosimetry for low-dose-rate prostate seed brachytherapy to local control rates. The delineation of the prostate on CT images, however, represents a challenge due to the lack of soft-tissue contrast to identify the prostate borders. This study aims at quantifying the sensitivity of prostate V100 and D90 to contouring uncertainty as clinically relevant parameters for evaluation of target coverage in postimplant dosimetry. METHODS AND MATERIALS: CT images, postoperative plans, and contours of a cohort of patients (n = 43; low risk = 55...
October 5, 2016: Brachytherapy
Michael J Cross, Gail S Lebovic, Joseph Ross, Scott Jones, Arnold Smith, Steven Harms
BACKGROUND: Techniques for accurately delineating the tumor bed after breast-conserving surgery (BCS) can be challenging. As a result, the accuracy, and efficiency of radiation treatment (RT) planning can be negatively impacted. Surgically placed clips or the post-surgical seroma are commonly used to determine target volume; however, these methods can lead to a high degree of uncertainty and variability. A novel 3-dimensional bioabsorbable marker was used during BCS and assessed for its impact on RT planning...
October 5, 2016: World Journal of Surgery
Mirjana Josipovic, Gitte F Persson, Jens Peter Bangsgaard, Lena Specht, Marianne C Aznar
OBJECTIVES: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image guided DIBH radiotherapy for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT) guided free-breathing (FB) radiotherapy had an additional CBCT in DIBH at three fractions. These CBCTs were off-line rigidly registered (on tumour) to FB and DIBH CTs acquired at planning. All registrations were repeated to evaluate the intra-observer uncertainty...
October 6, 2016: British Journal of Radiology
Sascha Nitsch, Oliver W Hakenberg, Martin Heuschkel, Desiree Dräger, Guido Hildebrandt, Bernd J Krause, Sarah M Schwarzenböck
Early diagnosis and adequate staging are crucial for the choice of adequate treatment in prostate cancer (PC). Morphologic and functional imaging modalities, such as CT and MRI, have had limited accuracy in the diagnosis and nodal staging of PC. Molecular PET/CT imaging with (11)C- or (18)F-choline-labeled derivatives is increasingly being used, but its role in the diagnosis and initial staging of PC is controversial because of limitations in sensitivity and specificity for the detection of primary PC. For T staging, functional MRI is superior to (11)C- or (18)F-choline PET/CT...
October 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Christine Keller, Nancy E Wang, Daniel L Imler, Shreyas S Vasanawala, Matias Bruzoni, James V Quinn
BACKGROUND: Ionizing radiation and cost make ultrasound (US), when available, the first imaging study for the diagnosis of suspected pediatric appendicitis. US is less sensitive and specific than computed tomography (CT) or magnetic resonance imaging (MRI) scans, which are often performed after nondiagnostic US. OBJECTIVES: We sought to determine predictors of nondiagnostic US in order to guide efficient ordering of imaging studies. METHODS: A prospective cohort study of consecutive patients 4 to 30 years of age with suspected appendicitis took place at an emergency department with access to 24/7 US, MRI, and CT capabilities...
September 27, 2016: Journal of Emergency Medicine
Joshua Grimes, Shuai Leng, Yi Zhang, Thomas Vrieze, Cynthia McCollough
Protocol review is important to decrease the risk of patient injury and increase the consistency of CT image quality. A large volume of CT protocols makes manual review labor-intensive, error-prone, and costly. To address these challenges, we have developed a software system for automatically managing and monitoring CT proto-cols on a frequent basis. This article describes our experiences in the implementation and evaluation of this protocol monitoring system. In particular, we discuss various strategies for addressing each of the steps in our protocol-monitoring workflow, which are: maintaining an accurate set of master protocols, retrieving protocols from the scanners, comparing scanner protocols to master protocols, reviewing flagged differences between the scanner and master protocols, and updating the scanner and/or master protocols...
2016: Journal of Applied Clinical Medical Physics
Li-Sheng Hsu, Jen-Te Hsu, Min-Lang Chen, Chien-Lin Liao
BACKGROUND: Epicardial pacing wires (EPWs) are commonly employed for diagnosis and treatment of arrhythmia in the acute phase after cardiac surgery. Although rare, retained EPWs may cause mild-to-catastrophic complications. The present case demonstrates hemopericardium caused by a mobile retained EPW. METHODS: A 49-year-old woman presented to our emergency department with clinical signs of impending cardiac tamponade. She had undergone ventricular septal defect repair 7 years before this admission...
September 2016: Medicine (Baltimore)
Sun Young Yim, Beom Jin Park, Soon Ho Um, Na Yeon Han, Deuk Jae Sung, Sung Bum Cho, Seung Hwa Lee, Min Ju Kim, Jin Yong Jung, Jin Dong Kim, Yeon Seok Seo, Dong Sik Kim, Hyonggin An, Yun Hwan Kim
To compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with that of computed tomography (CT) during hepatic arteriography and arterial portography (CT HA/AP) for detecting hepatocellular carcinoma (HCC) from small hypervascular nodules.This retrospective study included 38 patients with 131 hypervascular nodules (≤2 cm) who had underwent MRI and CT HA/AP within a 2-week interval. Two observers analyzed MRI while other 2 observers analyzed CT HA/AP. Thereafter, MRI observers reviewed the CT HA/AP and magnetic resonance (MR) images again using both modalities...
September 2016: Medicine (Baltimore)
Vito Cantisani, Emanuele David, Donatella Ferrari, Fabrizio Fanelli, Luca Di Marzo, Carlo Catalano, Filippo Benedetto, Domenico Spinelli, Athanasios Katsargyris, Alfredo Blandino, Giorgio Ascenti, Ferdinando D'Ambrosio
OBJECTIVE: To evaluate the diagnostic effectiveness of color-Doppler ultrasound with Superb Microvascular Imaging (SMI) compared to ultrasound with contrast agent (CEUS), CT multi-slice angiography (64 slices) and angiography required for therapeutic reasons, for follow-up after endovascular aneurysm repair (EVAR) MATERIALS AND METHODS: from March 2014 to May 2015, 57 patients treated with EVAR were evaluated with CT, CEUS, CDUS, SMI and angiography in cases requiring treatment. Evaluation included sac diameter, stent-graft integrity, identification and classification of endoleaks...
September 23, 2016: Annals of Vascular Surgery
Monther A Gharaibeh, Gandhi N Solayar, Ian A Harris, Darren B Chen, Samuel J MacDessi
BACKGROUND: Accelerometer-based, portable navigation devices have been introduced as a less invasive and simpler technique to perform navigated surgical implantation of knee prostheses. They have been postulated to have better accuracy than conventional instruments in restoration of alignment in total knee arthroplasty. METHODS: A total of 190 patients were enrolled in this prospective, randomized controlled trial and underwent total knee arthroplasty using either the KneeAlign or conventional guides...
August 27, 2016: Journal of Arthroplasty
Tadashi Itoh, Mifumi Kawabe, Takahiko Nagase, Katsumi Endo, Masafumi Miyoshi, Kazuro Miyahara
The body surface area (BSA) of an organism is an important parameter for evaluating physiological functions. In drug development, normalization by BSA is an appropriate method for extrapolating doses between species. The BSA of animals has generally been estimated by multiplying a constant by the power of the body weight (BW). Recently, the use of miniature pigs in non-clinical studies for medical drugs or devices has gradually been increasing. However, verification of their BSA is not as yet sufficient. In this study, we measured the BSAs of 40 laboratory miniature pigs (11 males and 9 females of Göttingen minipig and 14 males and 6 females of Nippon Institute for Biological Science [NIBS] miniature pig) by analyzing computed tomography (CT) images, since measurements using a CT scanner were expected to more precisely determine BSA than classical measuring techniques...
2016: Journal of Toxicological Sciences
E P Pappas, I Seimenis, A Moutsatsos, E Georgiou, P Nomikos, P Karaiskos
This work provides characterization of system-related geometric distortions present in MRIs used in Gamma Knife (GK) stereotactic radiosurgery (SRS) treatment planning. A custom-made phantom, compatible with the Leksell stereotactic frame model G and encompassing 947 control points (CPs), was utilized. MR images were obtained with and without the frame, thus allowing discrimination of frame-induced distortions. In the absence of the frame and following compensation for field inhomogeneities, measured average CP disposition owing to gradient nonlinearities was 0...
October 7, 2016: Physics in Medicine and Biology
Ivan M Buzurovic, Jorgen L Hansen, Mandar S Bhagwat, Desmond A O'Farrell, Scott Friesen, Thomas C Harris, Antonio L Damato, Robert A Cormack, Neil E Martin, Phillip M Devlin
PURPOSE: In this study, we present the clinical implementation of a novel transoral balloon centering esophageal applicator (BCEA) and the initial clinical experience in high-dose-rate (HDR) brachytherapy treatment of esophageal cancer, using this applicator. MATERIAL AND METHODS: Acceptance testing and commissioning of the BCEA were performed prior to clinical use. Full performance testing was conducted including measurements of the dimensions and the catheter diameter, evaluation of the inflatable balloon consistency, visibility of the radio-opaque markers, congruence of the markers, absolute and relative accuracy of the HDR source in the applicator using the radiochromic film and source position simulator, visibility and digitization of the applicator on the computed tomography (CT) images under the clinical conditions, and reproducibility of the offset...
August 2016: Journal of Contemporary Brachytherapy
Elisa Scalco, Simona Marzi, Giuseppe Sanguineti, Antonello Vidiri, Giovanna Rizzo
PURPOSE: In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemo-radiotherapy (CRT). METHODS: 30 patients with pathologically confirmed HNSCC treated with CRT were considered...
September 14, 2016: Physica Medica: PM
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