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https://www.readbyqxmd.com/read/28441687/c-arm-positioning-is-a-significant-source-of-radiation-in-spine-surgery
#1
Elizabeth W Reiser, Rupen Desai, Sarah A Byrd, Harrison Farber, Deborah Chi, Cary S Idler, Robert E Isaacs
STUDY DESIGN: Prospective chart review. OBJECTIVE: It is well-known that radiation exposure during minimally invasive spine procedures can be substantial. Less interest has focused on setup radiation exposure before incision, including preoperative images used for surgical approach. The present study seeks to better quantify the significance of setup radiation in the total radiation exposure of minimally invasive spine surgery. SUMMARY OF BACKGROUND DATA: Radiographic localization is necessary in minimally invasive spine procedures to visualize anatomy, but increased radiation exposure is associated with health risks...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28439307/fluoroscopic-imaging-overestimates-the-screw-tip-to-subchondral-bone-distance-in-a-cadaveric-model-of-slipped-capital-femoral-epiphysis
#2
M J Heffernan, B Snyder, H Zhou, X Li
PURPOSE: Intra-operative imaging plays a key role in screw placement for slipped capital femoral epiphysis (SCFE). Complications have been associated with inadequate screw position. The purpose of this study was to evaluate computed tomography (CT) (3D fluoroscopy) and standard fluoroscopy (C-arm) images as compared with direct anatomic measurement to determine final screw position in a cadaveric SCFE model. METHODS: Osteotomy with pinning was performed at the physeal scar in ten cadaveric hips...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28429363/two-unilateral-puncturation-comparative-analyses-of-multiple-level-fresh-osteoporotic-vertebral-body-compression-fractures-treated-with-percutaneous-vertebroplasty-guided-by-c-arm-fluoroscopy-or-in-senile-patients
#3
J-C Xu, G-H Wu, L-L Zhou, X-J Yang, J-T Liu
OBJECTIVE:  To compare the curative effects of two unilateral puncturation percutaneous vertebroplasty (PVP) for the pain caused by multiple-level osteoporotic vertebral body compression fractures (OVCF) in senile patients. PATIENTS AND METHODS: From June 2008 to November 2014, eighty-nine cases suffering from fresh multiple-level OVCF were randomly divided into experimental group (n=51) and control group (n=38). Patients underwent PVP guided by C-arm fluoroscopy in the prone position...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28422397/a-novel-radiation-protection-device-based-on-tungsten-functional-paper-for-application-in-interventional-radiology
#4
Hajime Monzen, Mikoto Tamura, Kohei Shimomura, Yuichi Onishi, Shinichi Nakayama, Takahiro Fujimoto, Kenji Matsumoto, Kohei Hanaoka, Takeshi Kamomae
Tungsten functional paper (TFP), which contains 80% tungsten by weight, has radiation-shielding properties. We investigated the use of TFP for the protection of operators during interventional or therapeutic angiography. The air kerma rate of scattered radiation from a simulated patient was measured, with and without TFP, using a water-equivalent phantom and fixed C-arm fluoroscopy. Measurements were taken at the level of the operator's eye, chest, waist, and knee, with a variable number of TFP sheets used for shielding...
April 19, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28416994/the-radiation-safety-education-and-the-pain-physicians-efforts-to-reduce-radiation-exposure
#5
Tae Hee Kim, Seung Wan Hong, Nam Sik Woo, Hae Kyoung Kim, Jae Hun Kim
BACKGROUND: C-arm fluoroscopy equipment is important for interventional pain management and can cause radiation injury to physicians and patients. We compared radiation safety education and efforts to reduce the radiation exposure of pain specialists. METHODS: A survey of 49 pain specialists was conducted anonymously in 2016. The questionnaire had 16 questions. That questionnaire was about radiation safety knowledge and efforts to reduce exposure. We investigated the correlation between radiation safety education and efforts of radiation protection...
April 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28414927/integration-of-free-hand-3d-ultrasound-and-mobile-c-arm-cone-beam-ct-feasibility-and-characterization-for-real-time-guidance-of-needle-insertion
#6
E Marinetto, A Uneri, T De Silva, S Reaungamornrat, W Zbijewski, A Sisniega, S Vogt, G Kleinszig, J Pascau, J H Siewerdsen
This work presents development of an integrated ultrasound (US)-cone-beam CT (CBCT) system for image-guided needle interventions, combining a low-cost ultrasound system (Interson VC 7.5MHz, Pleasanton, CA) with a mobile C-arm for fluoroscopy and CBCT via use of a surgical tracker. Imaging performance of the ultrasound system was characterized in terms of depth-dependent contrast-to-noise ratio (CNR) and spatial resolution. US-CBCT system was evaluated in phantom studies simulating three needle-based procedures: drug delivery, tumor ablation, and lumbar puncture...
April 3, 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/28413743/real-time-fluoroscopic-and-c-arm-computed-tomography-evaluation-of-ommaya-reservoir-integrity
#7
Adrienne M Moraff, Melanie Hayden Gephart, Larry M Shuer, Jeremy J Heit
We describe a case of a 24-year-old patient with relapsed acute myelogenous leukemia involving the central nervous system. After placement of an Ommaya reservoir for intrathecal chemotherapy administration, the patient developed progressive headache, nausea, and drowsiness and was found to have an enlarging subdural collection underlying the Ommaya. To exclude leakage of the Ommaya system into the subdural space, real-time fluoroscopic and C-arm computed tomographic evaluation of the Ommaya reservoir was performed after iodinated contrast injection into the reservoir...
March 15, 2017: Curēus
https://www.readbyqxmd.com/read/28408632/4d-dsa-for-dynamic-visualization-of-cerebral-vasculature-a-single-center-experience-in-26-cases
#8
S Lang, P Gölitz, T Struffert, J Rösch, K Rössler, M Kowarschik, C Strother, A Doerfler
BACKGROUND AND PURPOSE: 4D DSA allows acquisition of time-resolved 3D reconstructions of cerebral vessels by using C-arm conebeam CT systems. The aim of our study was to evaluate this new method by qualitative and quantitative means. MATERIALS AND METHODS: 2D and 4D DSA datasets were acquired in patients presenting with AVMs, dural arteriovenous fistulas, and cerebral aneurysms. 4D DSA was compared with 2D DSA in a consensus reading of qualitative and quantitative parameters of AVMs (eg, location, feeder, associated aneurysms, nidus size, drainage, Martin-Spetzler Score), dural arteriovenous fistulas (eg, fistulous point, main feeder, diameter of the main feeder, drainage), and cerebral aneurysms (location, neck configuration, aneurysmal size)...
April 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28408264/single-session-hematoma-removal-and-transcranial-coil-embolization-for-a-cavernous-sinus-dural-arteriovenous-fistula-a-technical-case-report
#9
Yosuke Akamatsu, Kenichi Sato, Hidenori Endo, Yasushi Matsumoto, Teiji Tominaga
BACKGROUND: Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. CASE DESCRIPTION: We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28403104/effect-of-bipolar-pulsed-radiofrequency-on-refractory-chronic-cervical-radicular-pain-a-report-of-two-cases
#10
Min Cheol Chang
RATIONALE: Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28393672/radiation-awareness-for-endovascular-abdominal-aortic-aneurysm-repair-in-the-hybrid-operating-room-an-instant-patient-risk-chart-for-daily-practice
#11
Quirina M de Ruiter, Crystel M Gijsberts, Constantijn E Hazenberg, Frans L Moll, Joost A van Herwaarden
PURPOSE: To determine which patient and C-arm characteristics are the strongest predictors of intraoperative patient radiation dose rates (DRs) during endovascular aneurysm repair (EVAR) procedures and create a patient risk chart. METHODS: A retrospective analysis was performed of 74 EVAR procedures, including 16,889 X-ray runs using fixed C-arm imaging equipment. Four multivariate log-linear mixed models (with patient as a random effect) were constructed. Mean air kerma DR (DRAK, mGy/s) and the mean dose area product DR (DRDAP, mGycm(2)/s) were the outcome variables utilized for fluoroscopy as differentiated from digital subtraction angiography (DSA)...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28392852/a-systematic-review-and-meta-analysis-of-c-arm-cone-beam-ct-guided-percutaneous-transthoracic-needle-biopsy-of-lung-nodules
#12
Gao-Wu Yan, Anup Bhetuwal, Gao-Wen Yan, Qin-Quan Sun, Xiang-Ke Niu, Yu Zhou, Li-Fa Li, Bin-Zhong Li, Hao Zeng, Chuan Zhang, Bing Li, Xiao-Xue Xu, Han-Feng Yang, Yong Du
BACKGROUND: A systematic review and meta-analysis of all available publications was performed to evaluate the diagnostic accuracy of percutaneous transthoracic needle biopsy (PTNB) using a C-Arm Cone-Beam CT (CBCT) system in patients with lung nodules. MATERIAL/METHODS: Thedatabases of PUBMED, OVID, EBSCO, EMBASE, and China National Knowledge Infrastructure (CNKI) were systematically searched for relevant original articles on the diagnostic accuracy of CBCT-guided PTNB for the diagnosis of nodules in the lungs...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28377262/evaluation-of-malrotation-following-intramedullary-nailing-in-a-femoral-shaft-fracture-model-can-a-3d-c-arm-improve-accuracy
#13
Austin J Ramme, Jonathan Egol, Gregory Chang, Roy I Davidovitch, Sanjit Konda
INTRODUCTION: Difficulty determining anatomic rotation following intramedullary (IM) nailing of the femur continues to be problematic for surgeons. Clinical exam and fluoroscopic imaging of the hip and knee have been used to estimate femoral version, but are inaccurate. We hypothesize that 3D c-arm imaging can be used to accurately measure femoral version following IM nailing of femur fractures to prevent rotational malreduction. METHODS: A midshaft osteotomy was created in a femur Sawbone to simulate a transverse diaphyseal fracture...
March 31, 2017: Injury
https://www.readbyqxmd.com/read/28371198/evaluation-of-the-new-c-arm-guiding-system-clearguide%C3%A2-in-an-orthopaedic-and-trauma-operating-theatre
#14
Marcus Christian Müller, Sophie Frege, Andreas Christian Strauss, Martin Gathen, Michael Windemuth, Eva Nadine Striepens
BACKGROUND: The objective was to evaluate whether the new intraoperative C-arm guiding system ClearGuide® (CG) reduces radiation exposure of the staff in an Orthopaedic and Trauma operation theatre. METHODS: Data of 95 patients CG was used were retrospectively compared using matched-pair analysis with controls without CG. Radiation dose (RD), fluoroscopic time (FT) and operation time (OT) were analysed in ten types of operative procedures. RESULTS: Use of CG led to a significant reduction (p ≤ 0...
April 3, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28368989/intraoperative-computed-tomography-versus-3d-c-arm-imaging-for-navigated-spinal-instrumentation
#15
Nils Hecht, Hadya Yassin, Marcus Czabanka, Bettina Föhre, Klaus Arden, Thomas Liebig, Peter Vajkoczy
STUDY DESIGN: A prospective case-series study and a retrospective analysis of historical patients for comparison of data. OBJECTIVE: To compare accuracy and limitations of intraoperative computed tomography (iCT)- versus 3D C-arm-based spinal navigation for posterior pedicle screw implantation. SUMMARY OF BACKGROUND DATA: Despite the higher accuracy of navigated compared to non-navigated pedicle screw implantation, it remains a matter of debate whether the use of iCT imaging may further benefit navigated spinal instrumentation compared to more commonly used isocentric 3D C-arm imaging...
March 31, 2017: Spine
https://www.readbyqxmd.com/read/28343303/can-real-time-rgbd-enhance-intraoperative-cone-beam-ct
#16
Javad Fotouhi, Bernhard Fuerst, Wolfgang Wein, Nassir Navab
PURPOSE: Cone-Beam Computed Tomography (CBCT) is an important 3D imaging technology for orthopedic, trauma, radiotherapy guidance, angiography, and dental applications. The major limitation of CBCT is the poor image quality due to scattered radiation, truncation, and patient movement. In this work, we propose to incorporate information from a co-registered Red-Green-Blue-Depth (RGBD) sensor attached near the detector plane of the C-arm to improve the reconstruction quality, as well as correcting for undesired rigid patient movement...
March 25, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28341937/percutaneous-needle-biopsy-of-mediastinal-masses-under-c-arm-conebeam-ct-guidance-diagnostic-performance-and-safety
#17
Chiara Floridi, Alfonso Reginelli, Raffaella Capasso, Enrico Fumarola, Filippo Pesapane, Antonio Barile, Marcello Zappia, Ferdinando Caranci, Luca Brunese
The aim of this study is to evaluate the feasibility of percutaneous needle biopsy of mediastinal masses under conebeam computed tomography (CBCT) and "XperGuide" navigation guidance. From September 2013 to April 2016, 40 patients (25 men and 15 women; mean age 52.5 years; range 18.7-86.4 years) with 40 mediastinal masses underwent CBCT-/"XperGuide"-guided percutaneous needle biopsies. Technical success, sensibility, specificity, positive predictive value (ppv), negative predictive value (npv) and complications rate were evaluated...
April 2017: Medical Oncology
https://www.readbyqxmd.com/read/28325434/radiation-exposure-and-the-orthopedic-surgeon-s-hand-measurement-of-the-equivalent-dose-over-13%C3%A2-months
#18
F Loisel, G Menu, E Boyer, I Pluvy, L Obert
Exposure to ionizing radiation in the operating room is governed by practical prevention and protection measures on the international, national and local levels. We evaluated the equivalent dose to the hand of an orthopedic surgeon over 13 months. An orthopedic surgeon wore a ring dosimeter on the ring finger of his right hand for all surgical procedures requiring intraoperative fluoroscopy between March 2014 and April 2015. Monthly doses were evaluated by the IRSN over the study period. The number and type of procedures were compiled as well as the type of fluoroscopy unit used...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28306699/dynamic-measurement-of-arterial-liver-perfusion-with-an-interventional-c-arm-system
#19
Sanjit Datta, Kerstin Müller, Terilyn Moore, Lior Molvin, Sonja Gehrisch, Jarrett Rosenberg, Yamil Saenz, Michael Manhart, Yu Deuerling-Zheng, Nishita Kothary, Rebecca Fahrig
PURPOSE: Objective intraprocedural measurement of hepatic blood flow could provide a quantitative treatment end point for locoregional liver procedures. This study aims to validate the accuracy and reproducibility of cone-beam computed tomography perfusion (CBCTp) measurements of arterial liver perfusion (ALP) against clinically available computed tomography perfusion (CTp) measurements in a swine embolization model. METHODS: Triplicate CBCTp measurements using a selective arterial contrast injection were performed before and after complete embolization of the left lobe of the liver in 5 swine...
March 17, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28304221/fluoroscopy-time-is-not-accurate-as-a-surrogate-for-radiation-exposure
#20
Edvard Skripochnik, Shang A Loh
Objective The Food and Drug Administration and the Vascular Quality Initiative still utilize fluoroscopy time as a surrogate marker for procedural radiation exposure. This study demonstrates that fluoroscopy time does not accurately represent radiation exposure and that dose area product and air kerma are more appropriate measures. Methods Lower extremity endovascular interventions ( N = 145) between 2013 and 2015 performed at an academic medical center on a Siemens Artis-Zee floor mounted c-arm were identified...
January 1, 2017: Vascular
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