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Interventional radiologist

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https://www.readbyqxmd.com/read/28108240/degenerative-temporomandibular-joint-changes-associated-with-recent-onset-disc-displacement-without-reduction-in-adolescents-and-young-adults
#1
Jie Lei, Jianhui Han, Muqing Liu, Yi Zhang, Adrian U-Jin Yap, Kai-Yuan Fu
This study evaluated the occurrence of degenerative temporomandibular joint (TMJ) changes in adolescents and young adults with recent on-set disc displacement without reduction (DDw/oR) using high-resolution cone beam computed tomography (CBCT). The associations between types of osteoarthrosis (OA) changes and clinical factors including disease duration were also examined. CBCT and clinical data of 300 patients (84.70% females, mean age 20.93 ± 4.77 years) diagnosed with unilateral DDw/oR (≤12 months) based on RDC/TMD were acquired...
December 21, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28104643/reduced-patient-radiation-exposure-during-neurodiagnostic-and-interventional-x-ray-angiography-with-a-new-imaging-platform
#2
K van der Marel, S Vedantham, I M J van der Bom, M Howk, T Narain, K Ty, A Karellas, M J Gounis, A S Puri, A K Wakhloo
BACKGROUND AND PURPOSE: Advancements in medical device and imaging technology as well as accruing clinical evidence have accelerated the growth of the endovascular treatment of cerebrovascular diseases. However, the augmented role of these procedures raises concerns about the radiation dose to patients and operators. We evaluated patient doses from an x-ray imaging platform with radiation dose-reduction technology, which combined image noise reduction, motion correction, and contrast-dependent temporal averaging with optimized x-ray exposure settings...
January 19, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28103513/interventional-radiology-in-the-management-of-thoracic-duct-injuries-anatomy-techniques-and-results
#3
REVIEW
Mohammad Toliyat, Kanwar Singh, Robert C Sibley, Murthy Chamarthy, Sanjeeva P Kalva, Anil K Pillai
Disruption of the thoracic duct can have devastating consequences and be associated with a high morbidity and mortality. Conservative therapies have been attempted to treat chylothorax without much success. Surgical management has traditionally been necessary to provide definitive treatment at the expense of increased morbidity. Lymphatic interventions have recently emerged as a new frontier for interventional radiologists to add value and provide minimally invasive therapies for debilitating conditions. The goal of this manuscript is to review the anatomy of the thoracic duct, describe various percutaneous techniques for accessing the duct, and briefly discuss outcomes as reported in the literature...
January 3, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28097389/observation-time-after-outpatient-non-arterial-interventional-procedures-standards-safety-and-outcomes
#4
Christine K Chen, Johannes Boos, Ammar Sarwar, Bridget O'Bryan-Alberts, Muneeb Ahmed, Olga R Brook
PURPOSE: To evaluate the impact of standardized reduced post-procedure observation time on subsequent healthcare encounters such as emergency department (ED) visits, hospital admissions, and clinic visits. METHODS: 800 consecutive patients undergoing outpatient non-arterial interventional radiologic procedures within the vascular interventional department between 1 June 2013 and 21 July 2014 were included in this IRB-approved, HIPAA-compliant single center observational retrospective study...
January 17, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28089887/ureteral-stone-diameter-on-computerized-tomography-coronal-reconstructions-is-clinically-important-and-underreported
#5
Mustafa Kadihasanoglu, Tracy Marien, Nicole L Miller
OBJECTIVES: The aim of this study is to compare the maximum stone diameter of ureteral stones in the coronal plane to the axial and determine the clinical significance of the coronal diameter. METHODS: A retrospective chart review was performed on patients seen in clinic between September 2013 and November 2015.Patients were included if they had a history of ureteral stone noted on CT performed with coronal reconstructions. Patients were excluded if they had multiple ureteral stones, history of upper urinary tract abnormalities, need for urgent intervention, or no follow-up...
January 12, 2017: Urology
https://www.readbyqxmd.com/read/28078378/post-procedural-care-in-interventional-radiology-what-every-interventional-radiologist-should-know-part-i-standard-post-procedural-instructions-and-follow-up-care
#6
Bedros Taslakian, Divya Sridhar
Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#7
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072757/organ-procurement-organization-survey-of-practices-and-beliefs-regarding-prerecovery-percutaneous-liver-biopsy-in-donation-after-neurologic-determination-of-death
#8
Joseph Benton Oliver, Andrea Fleisch Marcus, Mark Paster, Joseph Nespral, Advaith Bongu, George Dikdan, Lloyd Brown, Nikole Neidlinger, Baburao Koneru
BACKGROUND: Prerecovery liver biopsy (PLB) allows histological evaluation of the organ prior to procurement. The opinions and what factors might influence PLB use within Organ Procurement Organizations (OPOs) are unknown. METHODS: A survey instrument was distributed by the Association of OPOs to the clinical directors of all 58 OPOs. Descriptive statistics were calculated. Results were also stratified based on OPO characteristics. RESULTS: 84...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28072673/the-use-of-ultrasound-measured-optic-nerve-sheath-diameter-to-predict-ventriculoperitoneal-shunt-failure-in-children
#9
Sophia D Lin, Kimberly R Kahne, Amira El Sherif, Kevin Mennitt, David Kessler, Mary J Ward, Shari L Platt
OBJECTIVE: The goal of this study was to assess the accuracy of ultrasound-measured optic nerve sheath diameter (ONSD) as a screen for ventriculoperitoneal shunt failure. METHODS: We prospectively enrolled a convenience sample of children presenting to the ED with suspected shunt failure. The ONSD was measured by ultrasound and compared with computed tomography/magnetic resonance imaging (CT/MRI) and neurosurgical impression. We defined shunt failure on ultrasound as an ONSD greater than 4...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28062898/why-vascular-surgeons-and-interventional-radiologists-collaborate-or-compete-a-look-at-endovascular-stent-placements
#10
Eric J Keller, Jeremy D Collins, Megan Crowley-Matoka, Howard B Chrisman, Magdy P Milad, Robert L Vogelzang
PURPOSE: To understand how cultural differences between vascular surgeons (VSs) and interventional radiologists (IRs) affect their clinical decision making and inter-specialty relationships. METHODS: Twenty-four conversational interviews were conducted with IRs and VSs about their approaches to patient care, views of their specialty and others, and solutions to any expressed concerns. Interview transcripts were systematically analyzed to identify and compare key themes according to the constructivist grounded theory and content analysis using NVivo 10 software...
January 6, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28061965/report-of-the-acr-s-economics-committee-on-value-based-payment-models
#11
Giles W Boland, Lucille Glenn, Shlomit Goldberg-Stein, Saurabh Jha, Mark Mangano, Samir Patel, Kurt A Schoppe, David Seidenwurm, John Lohnes, Ezequiel Silva, Richard Abramson, Daniel J Durand, Laura Pattie, Pamela Kassing, Richard E Heller
A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services...
January 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28049511/prepancreatic-postduodenal-portal-vein-a-case-report-and-review-of-the-literature
#12
Naeem Goussous, Steven C Cunningham
BACKGROUND: Prepancreatic postduodenal portal vein is extremely rare, with only 13 cases reported in the literature. CASE PRESENTATION: A 55-year-old white woman presented to our emergency department with abdominal pain. She underwent a computed tomography of her abdomen, which showed a portal vein coursing anterolaterally to her pancreas and posteriorly to the first portion of her duodenum, constituting a prepancreatic postduodenal portal vein. Imaging revealed choledocholithiasis, requiring endoscopic sphincterotomy, but due to a history of a gastric bypass procedure, she was lost to follow-up after being referred to an advanced endoscopist...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28048678/tu-d-209-07-monte-carlo-assessment-of-dose-to-the-lens-of-the-eye-of-radiologist-using-realistic-phantoms-and-eyeglass-models
#13
X Xu, H Lin, Y Gao, P Caracappa, Y Wang, W Huo, Y Pi, M Feng, Z Chen, L Dauer, R Thornton, Z Dauer, K Alvarado, J St Germain, S Solomon
PURPOSE: To study how eyeglass design features and postures of the interventional radiologist affect the radiation dose to the lens of the eye. METHODS: A mesh-based deformable phantom, consisting of an ultra-fine eye model, was used to simulate postures of a radiologist in fluoroscopically guided interventional procedure (facing the patient, 45 degree to the left, and 45 degree to the right). Various eyewear design features were studied, including the shape, lead-equivalent thickness, and separation from the face...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048675/tu-fg-209-07-medical-physics-1-0-versus-medical-physics-2-0-a-case-study
#14
D Carver, C Willis, P Stauduhar, T Nishino, J Wells, E Samei
PURPOSE: To illustrate how performance analytics can identify performance decrement in digital radiography systems. METHODS: Subsequent to a radiologist's image quality complaint, four different advanced methods contributed to root cause analysis. Our system was a GE Revolution XQi digital radiography unit. Initially, we reviewed weekly GE Quality Assurance Procedures (QAP) results in a database dating from 2001. Next, we evaluated objective image quality metrics of individual PA Chest radiographs acquired...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048319/su-f-p-19-fetal-dose-estimate-for-a-high-dose-fluoroscopy-guided-intervention-using-modern-data-tools
#15
J Moirano
PURPOSE: An accurate dose estimate is necessary for effective patient management after a fetal exposure. In the case of a high-dose exposure, it is critical to use all resources available in order to make the most accurate assessment of the fetal dose. This work will demonstrate a methodology for accurate fetal dose estimation using tools that have recently become available in many clinics, and show examples of best practices for collecting data and performing the fetal dose calculation...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047742/su-f-r-17-advancing-glioblastoma-multiforme-gbm-recurrence-detection-with-mri-image-texture-feature-extraction-and-machine-learning
#16
V Yu, D Ruan, D Nguyen, T Kaprealian, R Chin, K Sheng
PURPOSE: To test the potential of early Glioblastoma Multiforme (GBM) recurrence detection utilizing image texture pattern analysis in serial MR images post primary treatment intervention. METHODS: MR image-sets of six time points prior to the confirmed recurrence diagnosis of a GBM patient were included in this study, with each time point containing T1 pre-contrast, T1 post-contrast, T2-Flair, and T2-TSE images. Eight Gray-level co-occurrence matrix (GLCM) texture features including Contrast, Correlation, Dissimilarity, Energy, Entropy, Homogeneity, Sum-Average, and Variance were calculated from all images, resulting in a total of 32 features at each time point...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046941/su-g-iep3-13-real-time-patient-and-staff-dose-monitoring-in-fluoroscopy-guided-interventions
#17
L Vergoossen, A Sailer, L Paulis, J Wildberger, C Jeukens
PURPOSE: Interventional radiology procedures involve the use of X-rays, which can pose a large radiation burden on both patients and staff. Although some reports on radiation dose are available, most studies focus on limited types of procedures and only report patient dose. In our cathlabs a dedicated real-time patient and staff monitoring system was installed in November 2015. The aim of this study was to investigate the patient and staff dose exposure for different types of interventions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046769/su-g-iep4-15-ultrasound-imaging-of-absorbable-inferior-vena-cava-filters-for-proper-placement
#18
T Mitcham, R Bouchard, A Melancon, M Eggers, M Melancon
PURPOSE: Inferior vena cava filters (IVCFs) are used in patients with a high risk of pulmonary embolism in situations when the use of blood thinning drugs would be inappropriate. These filters are implanted under x-ray guidance; however, this provides a dose of ionizing radiation to both patient and physician. B-mode ultrasound (US) imaging allows for localization of certain implanted devices without radiation dose concerns. The goal of this study was to investigate the feasibility of imaging the placement of absorbable IVCFs using US imaging to alleviate the dosage concern inherent to fluoroscopy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046649/su-f-i-72-evaluation-of-the-ancillary-lead-shielding-for-optimizing-radiation-protection-in-the-interventional-radiology-department
#19
E Tonkopi, C Lightfoot, E LeBlanc
PURPOSE: The rising complexity of interventional fluoroscopic procedures has resulted in an increase of occupational radiation exposures in the interventional radiology (IR) department. This study assessed the impact of ancillary shielding on optimizing radiation protection for the IR staff. METHODS: Scattered radiation measurements were performed in two IR suites equipped with Axiom Artis systems (Siemens Healthcare, Erlangen, Germany) installed in 2006 and 2010...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046338/th-ab-207a-04-assessment-of-patients-cumulative-effective-dose-from-ct-examinations
#20
M Bostani, C Cagnon, A Sepahdari, K Beckett, T Oshiro, M McNitt-Gray
PURPOSE: The Joint Commission requires institutions to consider patient's age and recent imaging exams when deciding on the most appropriate type of imaging exam. Additionally, knowing patient's imaging history can help prevent duplicate scans. Radiation dose management software affords new opportunities to identify and utilize patients with high cumulative doses as one proxy for subsequent review of imaging history and opportunities in avoiding redundant exams. METHODS: Using dose management software (Radimetrics, Bayer Healthcare) a total of 72073 CT examinations performed from Jan 2015 to Jan 2016 were examined to categorize patients with a cumulative effective dose of 100 mSv and above...
June 2016: Medical Physics
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