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https://www.readbyqxmd.com/read/28648410/the-great-unknown-a-systematic-literature-review-about-risk-associated-with-intraoperative-imaging-during-orthopaedic-surgeries
#1
REVIEW
Amir Matityahu, Ryan K Duffy, Sabine Goldhahn, Alexander Joeris, Peter H Richter, Florian Gebhard
INTRODUCTION: Modern techniques in orthopaedic surgery using minimally invasive procedures, and increased use of fluoroscopic imaging present a potential increased risk to surgeons due to ionizing radiation exposure. This article is a systematic review of recent literature on radiation exposure of orthopaedic surgeons. MATERIALS AND METHODS: Pubmed and Cochrane searches were performed on intraoperative radiation exposure covering English and German articles published between 1...
April 21, 2017: Injury
https://www.readbyqxmd.com/read/28647400/intraoperative-registered-ultrasound-and-fluoroscopy-iruf-for-dose-calculation-during-prostate-brachytherapy-improved-accuracy-compared-to-standard-ultrasound-based-dosimetry
#2
Junghoon Lee, Omar Y Mian, Yi Le, Hee Joon Bae, E Clif Burdette, Theodore L DeWeese, Jerry L Prince, Daniel Y Song
BACKGROUND AND PURPOSE: Intraoperative transrectal ultrasound dosimetry during low-dose-rate prostate brachytherapy is imprecise due to sonographic distortion caused by seed echoes and needle tracks that obscure seed positions or create false signals as well as traumatic edema. Here we report the results of a pilot study comparing a combined ultrasound and fluoroscopy-based seed localization method (iRUF) to standard ultrasound-based dosimetry (USD). MATERIAL AND METHODS: Eighty patients undergoing permanent Pd-103 seed implantation for prostate cancer were prospectively enrolled...
June 21, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28647197/characterizing-tissue-perfusion-after-lower-extremity-intervention-using-two-dimensional-color-coded-digital-subtraction-angiography
#3
Ann H Kim, Andrew J Shevitz, Katherine L Morrow, Daniel E Kendrick, Karem Harth, Henry Baele, Vikram S Kashyap
OBJECTIVE: Digital subtraction angiography (DSA) of the peripheral arterial vasculature provides lumenographic information but only a qualitative assessment of blood flow. The ability to quantify adequate tissue perfusion of the lower extremities would enable real-time perfusion assessment during DSA of patients with peripheral arterial disease (PAD). In this study, we used a novel real-time imaging software to delineate tissue perfusion parameters in the foot in PAD patients. METHODS: Between March 2015 and June 2016, patients (N = 31) underwent lower extremity angiography using a two-dimensional perfusion (2DP) imaging protocol (Philips Healthcare, Andover, Mass)...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28645599/biplanar-fluoroscopy-guided-percutaneous-lead-implantation-for-spinal-cord-stimulation-a-technical-note
#4
Aaron Lawson McLean, Susanne Frank, Daniel Staribacher, Rolf Kalff, Rupert Reichart
INTRODUCTION: The correct positioning of spinal cord stimulator leads is assessed radiographically during their percutaneous implantation for trial stimulation. Usually the C-arm is repositioned several times to allow imaging in different planes, which may extend the total duration of surgery. The study aimed to evaluate whether the concurrent intraoperative use of two C-arms could safely reduce the duration of surgery. MATERIALS: This retrospective study included cases of percutaneous implantation of an SCS lead for trial neurostimulation between 2006 and 2011...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28644122/fluoroscopic-exposure-with-use-of-mini-c-arm-during-routine-hand-surgery-a-prospective-comparison-of-hand-versus-eye-radiation-dosage
#5
Mark L Wang, C Edward Hoffler, Asif M Ilyas, Pedro K Beredjiklian, Charles F Leinberry
Radiation exposure with use of intraoperative fluoroscopy is a potential orthopedic occupational risk factor. The purpose of this study was to perform a prospective comparison of hand versus eye radiation exposure associated with mini-C-arm utilization and to test the hypothesis that routine mini-C-arm does not yield hand or eye dosages exceeding current recommended levels. Over a 12-month period, hand and eye radiation exposure was prospectively measured in a single board-certified hand surgeon using mini-C-arm fluoroscopy...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28643518/mini-c-arm-fluoroscopy-does-its-configuration-matter-for-radiation-exposure-to-the-surgeon
#6
Talia Chapman, Dennis P Martin, Christopher Williamson, Brian Tinsley, Mark L Wang, Asif M Ilyas
BACKGROUND: The risk of occupational radiation exposure to the surgeon associated with the use of a mini C-arm has yet to reach a wide consensus. Using a distal radius fracture surgery model, we tested the hypothesis that radiation exposure to the surgeon's critical body parts is independent of mini C-arm configuration. METHODS: An anthropomorphic mannequin (representing the upper body of a 60" male surgeon) was seated at a hand table as if operating on a volar-plated wrist Sawbone model...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28638169/organ-and-effective-dose-reduction-for-region-of-interest-roi-cbct-and-fluoroscopy
#7
Zhenyu Xiong, Sarath Vijayan, Stephen Rudin, Daniel R Bednarek
In some medical-imaging procedures using CBCT and fluoroscopy, it may be needed to visualize only the center of the field-of-view with optimal quality. To reduce the dose to the patient as well as enable increased contrast in the region of interest (ROI) during CBCT and fluoroscopy procedures, a 0.7 mm thick Cu ROI attenuator with a circular aperture 12% of the FOV was used. The aim of this study was to quantify the dose-reduction benefit of ROI imaging during a typical CBCT and interventional fluoroscopy procedures in the head and torso...
February 11, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28632552/comparative-study-of-c-arms-for-intraoperative-3-dimensional-imaging-and-navigation-in-minimally-invasive-spine-surgery-part-ii-radiation-exposure
#8
Jan-Helge Klingler, Ronen Sircar, Christian Scheiwe, Evangelos Kogias, Marie T Krüger, Christoph Scholz, Ulrich Hubbe
STUDY DESIGN: A radiation exposure study in vitro. OBJECTIVE: This study aimed to compare the radiation exposure of 2 different 3-dimensional (3D) C-arm devices on an anthropomorphic phantom. SUMMARY OF BACKGROUND DATA: Minimally invasive pedicle screw placement requires intraoperative imaging techniques for visualization of the unexposed spine. Mobile 3D C-arms compose a 3D image data set out of multiple successive fluoroscopic images. METHODS: We compared the 3D C-arm devices Siremobil Iso-C 3D (Siemens Sector Healthcare, Erlangen, Germany) and Vision FD Vario 3D (Ziehm Imaging, Nuremberg, Germany) regarding their radiation exposure...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28632551/comparative-study-of-c-arms-for-intraoperative-3-dimensional-imaging-and-navigation-in-minimally-invasive-spine-surgery-part-i-applicability-and-image-quality
#9
Jan-Helge Klingler, Ronen Sircar, Christian Scheiwe, Evangelos Kogias, Florian Volz, Marie T Krüger, Ulrich Hubbe
STUDY DESIGN: This was a retrospective analysis. OBJECTIVE: This study compares 2 different 3-dimensional (3D) C-arm devices for intraoperative imaging and navigation with regard to clinical applicability and image quality. SUMMARY OF BACKGROUND DATA: Minimally invasive spine surgery requires intraoperative imaging techniques to adequately visualize the unexposed spine. For this purpose, mobile 3D C-arms became available along with the evolution of intraoperative navigation techniques...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28622024/comparison-of-radiation-exposure-from-fixed-table-fluoroscopy-to-a-portable-c-arm-during-ureteroscopy
#10
Fernando Cabrera, Richard Shin, Kyle Waisanen, Giao Nguyen, Charles D Scales, Michael N Ferrandino, Glenn M Preminger, Terry T Yoshizumi, Michael Eric Lipkin
INTRODUCTION: Fluoroscopy is widely used during endourologic procedures and is associated with treatment required radiation exposure. Our objective was to estimate patient radiation exposure during fluoroscopy with either a fixed table or portable C-arm using a validated anthropomorphic adult male model. MATERIALS AND METHODS: A validated male anthropomorphic model was placed supine on both a cystoscopy operating room table and a fixed fluoroscopy table unit. Metal oxide semiconductor field effect transistor dosimeters were placed at 20 organ-specific locations in the model to measure organ specific dosages...
June 16, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28617908/validation-of-single-c-arm-biplane-fluoroscopy-system-for-in-vivo-measurement-of-porcine-abdominal-strains
#11
Lindsey G Kahan, Charlotte Guertler, Jeffrey A Blatnik, Spencer P Lake
Hernia meshes significantly reduce recurrence rates in hernia repair. It's known that they affect the abdominal wall post-implantation, yet the understanding of in vivo mechanics in the mesh placement area is lacking. We established a single c-arm biplane fluoroscopic system to study strains at the interface between the mesh and repaired abdominal tissues. We aimed to validate this system for future porcine hernia repair studies. Custom MATLAB programs were written to correct for pincushion distortion, and direct linear transformation reconstructed objects in 3D...
June 15, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28616298/imaging-guided-thoracoscopic-resection-of-a-ground-glass-opacity-lesion-in-a-hybrid-operating-room-equipped-with-a-robotic-c-arm-ct-system
#12
Chen-Ping Hsieh, Ming-Ju Hsieh, Hsin-Yueh Fang, Yin-Kai Chao
The intraoperative identification of small pulmonary nodules through video-assisted thoracoscopic surgery remains challenging. Although preoperative CT-guided nodule localization is commonly used to detect tumors during video-assisted thoracoscopic surgery (VATS), this approach carries inherent risks. We report the case of a patient with stage I lung cancer presenting as an area of ground-glass opacity (GGO) in the right upper pulmonary lobe. He successfully underwent a single-stage, CT-guided localization and removal of the pulmonary nodule within a hybrid operating room (OR) equipped with a robotic C-arm...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28609790/analysis-of-patients-x-ray-exposure-in-146-percutaneous-radiologic-gastrostomies
#13
Tim Ole Petersen, Martin Reinhardt, Jochen Fuchs, Dieter Gosch, Alexey Surov, Patrick Stumpp, Thomas Kahn, Michael Moche
Purpose Analysis of patient´s X-ray exposure during percutaneous radiologic gastrostomies (PRG) in a larger population. Materials and Methods Data of primary successful PRG-procedures, performed between 2004 and 2015 in 146 patients, were analyzed regarding the exposition to X-ray. Dose-area-product (DAP), dose-length-product (DLP) respectively, and fluoroscopy time (FT) were correlated with the used x-ray systems (Flatpanel Detector (FD) vs. Image Itensifier (BV)) and the necessity for periprocedural placement of a nasogastric tube...
June 13, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28598494/decreased-radiation-exposure-among-orthopedic-residents-is-maintained-when-using-the-mini-c-arm-after-undergoing-radiation-safety-training
#14
David Gendelberg, William L Hennrikus, Carissa Sawyer, Douglas Armstrong, Steven King
The resident curriculum of the American Board of Orthopaedic Surgery emphasizes radiation safety. Gendelberg showed that, immediately after a program on fluoroscopic safety, residents used less radiation when using the mini C-arm to reduce pediatric fractures. The current study evaluated whether this effect lasted. Residents underwent a new annual 3-hour session on mini C-arm use and radiation. Group A included 53 reductions performed before training. Group B included 45 reductions performed immediately after training...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28586601/outcome-of-two-column-acetabular-fractures-treated-operatively-through-single-posterior-approach
#15
Muhammad Naeem Ur Razaq, Muhammad Ayaz Khan, Abbas Ali
OBJECTIVE: Involvement of both columns in acetabular fractures is a common presentation; these fractures create a challenging situation for the surgeons in terms of understanding the dimensions of osseous injury and selection of surgical approach. The study was done with an objective to evaluate the efficacy of single posterior approach for acetabular fractures involving both columns directly reducing the posterior wall and column and indirectly reducing the anterior column. METHODS: An evaluation of 25 adult patients 18 male and 7 female presenting in the accident and emergency department of Khyber Teaching Hospital from December 2013 to June 2015 having acetabular fracture involving both the anterior and posterior column were included in this case series study...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28585724/assessment-of-volumetric-absorbed-dose-for-mobile-fluoroscopic-3d-image-acquisition
#16
Stephanie Leon
Mobile fluoroscopy (c-arm) units offering 3D image reconstruction are becoming more common in surgical settings. Although these images are "CT-like" and sometimes replace the postoperative CT, the acquisition is technically very different from a traditional CT acquisition. Dose assessment is complicated by a large beam width, automatic exposure rate control, and a rotation of less than 360°. The purpose of this work was to explore the impact of these factors on the volumetric dose calculation and to provide practical recommendations for clinical physicists assessing dose from these units using commonly available equipment...
June 6, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28581263/dose-decreasing-effect-of-the-first-reversed-laser-beam-collimator-for-c-arm-type-angiographic-equipment
#17
Yeong Cheol Heo, Jae Hwan Cho, Dong Kyoon Han
This is a study on the dose-decreasing effect of the first reversed laser beam collimator (RLBC) for C-arm type angiographic equipment. A laser beam was located at the center of each plane at an oblique angle to the angiographic equipment detector. A field of view, which could be seen with the naked eye, was made by focusing the laser beam in the direction of the X-ray source. The height of the table was fixed at 75 cm and the iron balls were located within 2 mm of the top, bottom, left, and right edges of the output image...
July 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28572694/c-arm-positioning-using-virtual-fluoroscopy-for-image-guided-surgery
#18
T De Silva, J Punnoose, A Uneri, J Goerres, M Jacobson, M D Ketcha, A Manbachi, S Vogt, G Kleinszig, A J Khanna, J-P Wolinksy, G Osgood, J H Siewerdsen
INTRODUCTION: Fluoroscopically guided procedures often involve repeated acquisitions for C-arm positioning at the cost of radiation exposure and time in the operating room. A virtual fluoroscopy system is reported with the potential of reducing dose and time spent in C-arm positioning, utilizing three key advances: robust 3D-2D registration to a preoperative CT; real-time forward projection on GPU; and a motorized mobile C-arm with encoder feedback on C-arm orientation. METHOD: Geometric calibration of the C-arm was performed offline in two rotational directions (orbit α, orbit β)...
February 11, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28571704/percutaneous-radiofrequency-ablation-of-lung-metastases-from-colorectal-carcinoma-under-c-arm-cone-beam-ct-guidance
#19
G Amouyal, S Pernot, C Déan, B Cholley, F Scotté, M Sapoval, O Pellerin
PURPOSE: The aim of this study was to assess the feasibility, safety and efficacy of percutaneous radiofrequency ablation of lung metastases from colorectal carcinoma using C-arm cone beam computed tomography (CBCT) guidance. MATERIAL AND METHODS: This single-center prospective observational study was performed from August 2013 to August 2016, and included consecutive patients referred for radiofrequency ablation of lung metastases from colorectal cancer. Radiofrequency ablation procedures were performed under C-arm CBCT guidance...
May 29, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28560770/a-radiographic-measurement-of-the-anterior-epidural-space-at-l4-5-disc-level
#20
Rui-Sheng Xu, Jie-Shi Wu, Hai-Dan Lu, Hao-Gang Zhu, Xia Li, Jian Dong, Feng-Lai Yuan
To observe the morphology character of the anterior epidural space at the L4-5 disc level and to provide an anatomical basis for safely and accurately performing a percutaneous endoscopic lumbar discectomy (PELD). Fifty-five cases with L5 S1 lumbar disc herniation were included in this study, and cases with L4-5 disease were excluded. When the puncture needle reached the epidural space at the L5 S1 level, iohexol was injected at the pressure of 50 cm H2 O during the PELD, then C-Arm fluoroscopy was used to obtain standard lumbar frontal and lateral images...
May 30, 2017: Orthopaedic Surgery
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