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Interventional radiologist

Nishant Patel, Ravi N Srinivasa, Joseph J Gemmete, Jeffrey Forris Beecham Chick
Biliary interventions are commonplace in interventional radiology. Occasionally, an anastomotic occlusion is encountered that cannot be traversed with fluoroscopy alone. Endoscopy is a tool that should be added to the interventional radiology armamentarium. Unfortunately, most departments do not have endoscopes regularly available for use by nonendoscopists. The disposable single-use flexible LithoVue scope has the potential to provide many applications for interventional radiologists. It is relatively low cost and is easy to use with a simple setup for novice endoscopists...
February 2018: Radiology Case Reports
Antonio Borzelli, Andrea Paladini, Francesco Giurazza, Salvatore Tecame, Flavio Giordano, Enrico Cavaglià, Francesco Amodio, Fabio Corvino, Daniela Beomonte Zobel, Giulia Frauenfelder, Anna Giacoma Tucci, Raffaella Niola
Pulmonary sequestration is a congenital malformation characterized by dysplastic pulmonary tissue which receives blood supply by arterial systemic system, not in communication with tracheobronchial tree. Although it could be asymptomatic, it can also cause recurrent infections and hemoptysis, rarely massive and fatal. The conventional treatment consists in surgical resection of the pulmonary sequestration, but in the last few years endovascular embolization has been proposed as a valid therapeutic alternative...
February 2018: Radiology Case Reports
Alexander Lam, Kevin Bui, Eduardo Hernandez Rangel, Michael Nguyentat, Dayantha Fernando, Kari Nelson, Nadine Abi-Jaoudeh
Radiogenomics involves the integration of mineable data from imaging phenotypes with genomic and clinical data to establish predictive models using machine learning. As a noninvasive surrogate for a tumor's in vivo genetic profile, radiogenomics may potentially provide data for patient treatment stratification. Radiogenomics may also supersede the shortcomings associated with genomic research, such as the limited availability of high-quality tissue and restricted sampling of tumoral subpopulations. Interventional radiologists are well suited to circumvent these obstacles through advancements in image-guided tissue biopsies and intraprocedural imaging...
March 15, 2018: Journal of Vascular and Interventional Radiology: JVIR
Dezső Ribli, Anna Horváth, Zsuzsa Unger, Péter Pollner, István Csabai
In the last two decades, Computer Aided Detection (CAD) systems were developed to help radiologists analyse screening mammograms, however benefits of current CAD technologies appear to be contradictory, therefore they should be improved to be ultimately considered useful. Since 2012, deep convolutional neural networks (CNN) have been a tremendous success in image recognition, reaching human performance. These methods have greatly surpassed the traditional approaches, which are similar to currently used CAD solutions...
March 15, 2018: Scientific Reports
Yaseen Arabi, Fahad Al-Hameed, Karen E A Burns, Sangeeta Mehta, Sami Alsolamy, Mohammed Almaani, Yasser Mandourah, Ghaleb A Almekhlafi, Ali Al Bshabshe, Simon Finfer, Mohammed Alshahrani, Imran Khalid, Yatin Mehta, Atul Gaur, Hassan Hawa, Hergen Buscher, Zia Arshad, Hani Lababidi, Abdulsalam Al Aithan, Jesna Jose, Sheryl Ann I Abdukahil, Lara Y Afesh, Maamoun Dbsawy, Abdulaziz Al-Dawood
BACKGROUND: The Pneumatic CompREssion for Preventing VENous Thromboembolism (PREVENT) trial evaluates the effect of adjunctive intermittent pneumatic compression (IPC) with pharmacologic thromboprophylaxis compared to pharmacologic thromboprophylaxis alone on venous thromboembolism (VTE) in critically ill adults. METHODS/DESIGN: In this multicenter randomized trial, critically ill patients receiving pharmacologic thromboprophylaxis will be randomized to an IPC or a no IPC (control) group...
March 15, 2018: Trials
Alona Zer, Jean Claude Cutz, Harman Sekhon, David M Hwang, Christina Sit, Manjula Maganti, Mike Sung, Matthew Binnie, Anthony Brade, Tae Bong Chung, Suzanne Kamel-Reid, Paul Narinder, Ming S Tsao, Tom Waddell, Gilda da Cunha Santos, Milan Patel, Ron F Carter, Natasha B Leighl
BACKGROUND: Molecular testing in advanced lung cancer is standard in guiding treatment selection. However, population-wide implementation of testing remains a challenge. We developed a knowledge translation intervention to improve understanding among diagnostic specialists about molecular testing and appropriate diagnostic sampling in lung cancer. METHODS: Specialty-specific education programs were developed from existing literature and input from Canadian leaders in lung pathology, respirology, interventional radiology, thoracic surgery, radiation and medical oncology...
March 10, 2018: Journal of Thoracic Oncology
Mitchell A Rees, Nikhil B Amesur, Ruy J Cruz, Amir A Borhani, Kareem M Abu-Elmagd, Guilherme Costa, Anil K Dasyam
Intestinal transplantation has evolved from its experimental origins in the mid-20th century to its status today as an established treatment option for patients with end-stage intestinal failure who cannot be sustained with total parenteral nutrition. The most common source of intestinal failure in both adults and children is short-bowel syndrome, but a host of other disease processes can lead to this common end-point. The development of intestinal transplantation has presented multiple hurdles for the transplant community, including technical challenges, immunologic pitfalls, and infectious complications...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Paul Edmund Smith, Ian Thuan Hien Luong, Andrew Hans van der Vliet
Percutaneous nephrostomy insertion has, in recent times, become a subspecialised skill performed by an interventional trained Radiologist. However, this creates access issues, particularly in remote and regional medical centres. In this article, we describe a simple and effective method for computed tomography (CT)-guided percutaneous nephrostomy insertion, utilising the CT interventional skills of the general radiologist.
March 12, 2018: Journal of Medical Imaging and Radiation Oncology
Jamie J Coleman, Bryan W Carr, Tyrone Rogers, Matthew S Field, Ben L Zarzaur, Stephanie A Savage, Peter M Hammer, Brian L Brewer, David V Feliciano, Grace S Rozycki
BACKGROUND: Abdominal pain is a common reason patients seek treatment in emergency departments (ED), and computed tomography (CT) is frequently used for diagnosis; however, length of stay in the ED and risks of radiation remain a concern. The hypothesis of this study was the Alvarado Score (AS) could be used to reduce CT scans and decrease ED length of stay (LOS) for patients with suspected acute appendicitis (AA). METHODS: A retrospective review of patients who underwent CT to rule out AA from January 1st, 2015, to December 31st, 2015 was performed...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Jana Taron, Jonas Johannink, Michael Bitzer, Konstantin Nikolaou, Mike Notohamiprodjo, Rüdiger Hoffmann
BACKGROUND: To investigate the added diagnostic value of diffusion-weighted imaging (DWI) of the liver and its impact on therapy decisions in patients with hepatic malignancy. METHODS: Interdisciplinary gastrointestinal tumorboard cases concerning patients with hepatic malignancies discussed between 11/2015 and 06/2016 were included in this retrospective, single-center study. Two radiologists independently reviewed the respective liver MR-examination first without, then with DWI...
March 7, 2018: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Julie L Holihan, Deepa Cherla, Katherine J Blair, Steven S Chua, Joseph P Hasapes, Eduardo J Matta, Kaustubh G Shiralkar, Venkateswar R Surabhi, Varaha S Tammisetti, Tien C Ko, Mike K Liang
BACKGROUND: Previous studies suggest that agreement between readers of computed tomography (CT) scans for the diagnosis of a ventral hernia (VH) is poor (32% agreement, κ = 0.21). Recommendations were developed by surgeons and radiologists after determining common reasons for disagreement among CT reviewers; however, the long-term effect of adoption of these recommendations has not been assessed. The aim of this quality improvement (QI) project was to determine whether the incorporation of recommendations developed by surgeons and radiologists improves agreement among reviewers of CT scans in diagnosing a VH...
April 2018: Journal of Surgical Research
Alfonso Quintero-Quintero, Galo Patiño Camargo, Ángela Soriano Cruz, Juan Diego Palma Copete, Jorge Vilar Palop, Maria Del Carmen Pujades, Nieves Llorca Domaica, Facundo Ballester, Javier Vijande, Cristian Candela-Juan
Fluoroscopy guided interventional procedures provide remarkable benefits to patients. However, the medical staff working near the scattered radiation field may be exposed to high cumulative equivalent doses, thus requiring shielding devices such as lead aprons and thyroid collars. In this situation, it remains an acceptable practice to derive equivalent doses to the eye lenses or other unprotected soft tissues with a dosimeter placed above these protective devices. Nevertheless, the radiation backscattered by the lead shield differs from that generated during dosimeter calibration with a water phantom...
March 2, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Jing Luo, Felix S Chew, Alice S Ha
Ankle cheilectomy as surgical treatment for anterior ankle impingement has high rates of procedural success and low rates of complications when performed before the onset of significant osteoarthritis. We present 3 patients who developed insufficiency fractures of the talar neck following cheilectomy for anterior ankle impingement. Due to the high risk of avascular necrosis associated with displaced talar neck fractures, the recognition of talar insufficiency fractures by the radiologist can aid in the timely diagnosis and initiation of intervention...
February 2018: Radiology Case Reports
Boya Abudu, David P Duncan, Elliot Deyoung, Gerant Rivera-Sanfeliz
Paracentesis is a common procedure used in the diagnostic evaluation of peritoneal fluid as well as the therapeutic removal of high-volume ascites. Although generally regarded as a safe procedure, complications may arise from arterial injury, including hematomas and pseudoaneurysms. Transcatheter embolization and surgery are first-line interventions for injuries refractory to conservative management. We present a case where a patient failed conventional therapies for hemoperitoneum following a paracentesis which resolved after thrombin injection into the subcutaneous tissues, a novel use for thrombin...
February 2018: Radiology Case Reports
Ricardo H Alvarez, Rabih I Bechara, Michael J Naughton, Javier A Adachi, James M Reuben
Substantial improvements in the early detection and treatment of breast cancer have led to improvements in survival, but breast cancer remains a significant cause of morbidity and mortality in women. In 2012, the mammalian target of rapamycin (mTOR) inhibitor everolimus was approved by the U.S. Food and Drug Administration for the treatment of advanced breast cancer in patients resistant to endocrine therapy. Although everolimus is generally well tolerated, mTOR inhibitor-associated pneumonitis is one of the most common adverse drug events leading to treatment discontinuation...
February 27, 2018: Oncologist
Anthony N Hage, Ravi N Srinivasa, Steven D Abramowitz, Joseph J Gemmete, Shilpa N Reddy, Jeffrey Forris Beecham Chick
PURPOSE: To report global iliocaval stent reconstruction practices by interventionalists. MATERIALS AND METHODS: A 45-question survey focusing on iliocaval stent reconstruction evaluation was distributed through the Open Forum and Venous Disease Service Line of the Society of Interventional Radiology Connect website from June 20, 2017 until September 7, 2017 and the Cardiovascular and Interventional Radiological Society of Europe electronic newsletter on August 11, 2017...
February 24, 2018: Annals of Vascular Surgery
Richard D Urman, Elizabeth J Lilley, Marguerite Changala, Charlotta Lindvall, David L Hepner, Angela M Bader
BACKGROUND: Periprocedural providers are encountering more patients with code status limitations (CSLs) regarding their preferences for resuscitation and life-sustaining treatment who choose to undergo palliative procedures. Surgical and anesthesia guidelines for preprocedural reconsideration of CSLs have been available for several years, but it is not known whether they are being followed in practice. OBJECTIVE: We assessed compliance with existing guidelines for patients undergoing venting gastrostomy tube (VGT) for malignant bowel obstruction (MBO), serving as an example of a palliative procedure received by patients near the end of life...
February 26, 2018: Journal of Palliative Medicine
Ernest Usang Ekpo, Maram Alakhras, Patrick Brennan
Mammography has been the frontline screening tool for breast cancer for decades. However, high error rates in the form of false negatives (FNs) and false positives (FPs) have persisted despite technological improvements. Radiologists still miss between 10% and 30% of cancers while 80% of woman recalled for additional views have normal outcomes, with 40% of biopsied lesions being benign. Research show that the majority of cancers missed is actually visible and looked at, but either go unnoticed or are deemed to be benign...
February 26, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Andrew B Rosenkrantz, J David Prologo, Wenyi Wang, Danny R Hughes, Zachary L Bercu, Richard Duszak
PURPOSE: To study opioid prescribing behavior of US interventional radiologists (IRs). METHODS: Using Medicare Physician and Other Supplier Public Use File claims, we identified 2,133 radiologists whose practice in 2015 comprised predominantly interventional radiology. Cross-linking the Medicare Part D Prescriber File, their opioid prescription writing behavior was characterized. RESULTS: Most (52.2%) IRs wrote 10 or fewer prescriptions total for Medicare beneficiaries...
February 22, 2018: Journal of the American College of Radiology: JACR
Rebecca Zener, Virginie Demers, Annie Bilodeau, Andrew J Benko, Robert J Abraham, Jason K Wong, John R Kachura
PURPOSE: To investigate the current status and evolution of both the interventional radiologist's role as a clinician and the practice of interventional radiology (IR) over the past decade in Canada. MATERIALS AND METHODS: In 2015, an online survey was e-mailed to 210 interventional radiologists, including all Canadian active members of the Canadian Interventional Radiology Association (CIRA) and nonmembers who attended CIRA's annual meeting. Comparisons were made between interventional radiologists in academic versus community practice...
February 23, 2018: Journal of Vascular and Interventional Radiology: JVIR
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