• Title/Summary/Keyword: Interventional Radiology

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Exoskeleton System for Radiation Protection in Interventional Radiology

  • Clarissa Hosse;Johannes Kolck;Elif Can;Uli Fehrenbach;Timo A. Auer;Fabio Pivetta;Federico Collettini;Bernhard Gebauer;Maximilian de Bucourt
    • Journal of Radiation Protection and Research
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    • v.49 no.2
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    • pp.78-84
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    • 2024
  • Background: As the quantity and complexity of radiological interventions are constantly increasing, gear that offers optimal protection while maintaining mobility and a low weight burden is becoming more important. A newly developed exoskeleton radiation protection system (ERPS) (StemRad MD; StemRad Ltd.) can carry the weight of the shielding. The aim of our study was to analyze initial experience, especially in terms of advantages and disadvantages, with this new ERPS in interventional radiology. Materials and Methods: Forty-six interventions utilizing the ERPS were analyzed. The interventional radiologists completed a 15-question survey evaluating various aspects of the protective system, including weight, mobility, comfort, and radiation protection adequacy. Results and Discussion: In 98% of procedures, interventionalists reported being very satisfied (89%) or slightly satisfied (9%) and would recommend the system to colleagues. The exoskeleton system was rated as 100% comfortable, not too heavy, and did not restrict mobility in 98% of cases. Conclusion: The ERPS is a recommendable alternative to standard lead aprons, providing flexibility, comfort, and effective weight distribution without restricting mobility.

Percutaneous Sacroplasty for Painful Sacral Metastases Involving Multiple Sacral Vertebral Bodies: Initial Experience with an Interpedicular Approach

  • Qing-Hua Tian;He-Fei Liu;Tao Wang;Ying-Sheng Cheng;Chun-Gen Wu
    • Korean Journal of Radiology
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    • v.20 no.6
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    • pp.939-946
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    • 2019
  • Objective: To report our initial experience of percutaneous sacroplasty (PSP) with an interpedicular approach for treating painful sacral metastases involving multiple sacral vertebral bodies. Materials and Methods: This study prospectively enrolled 10 consecutive patients (six men and four women; mean age, 56.3 ± 13.8 years) who underwent PSP for painful sacral metastases involving multiple sacral vertebral bodies from March 2017 to September 2018. Visual analogue scale (VAS) scores, Oswestry disability index (ODI) values, and the number of opioids prescribed to the patients were assessed before and after PSP. The procedure duration, length of hospitalization, and complications were also recorded. Results: Mean VAS and ODI declined significantly from 6.90 ± 1.20 and 74.40 ± 5.48 before the procedure to 2.70 ± 1.34 and 29.60 ± 14.57 after the procedure, respectively (p < 0.01). The median number of opioids prescribed per patient decreased from 2 (interquartile range [IQR] 1-3) pre-procedure to 1 (IQR 0-3) post-procedure (p < 0.01). Nine of the 10 patients showed no or decreased opioid usage, and only 1 patient showed unchanged usage. The mean procedure duration was 48.5 ± 3.0 minutes. The average length of hospitalization was 4.7 ± 1.7 days. Extraosseous cement leakage occurred in three cases without causing any clinical complications. Conclusion: PSP with an interpedicular approach is a safe and effective treatment in patients with painful sacral metastases involving multiple sacral vertebral bodies and can relieve pain and improve mobility.

Differentiation of Benign from Malignant Adnexal Masses by Functional 3 Tesla MRI Techniques: Diffusion-Weighted Imaging and Time-Intensity Curves of Dynamic Contrast-Enhanced MRI

  • Malek, Mahrooz;Pourashraf, Maryam;Mousavi, Azam Sadat;Rahmani, Maryam;Ahmadinejad, Nasrin;Alipour, Azam;Hashemi, Firoozeh Sadat;Shakiba, Madjid
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3407-3412
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    • 2015
  • Background: The aim of this study was to evaluate and compare the accuracy of diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) value, and time-intensity curve (TIC) type analysis derived from dynamic contrast-enhanced MR imaging (DCE-MRI) in differentiating benign from malignant adnexal masses. Materials and Methods: 47 patients with 56 adnexal masses (27 malignant and 29 benign) underwent DWI and DCE-MRI examinations, prior to surgery. DWI signal intensity, mean ADC value, and TIC type were determined for all the masses. Results: High signal intensity on DWI and type 3 TIC were helpful in differentiating benign from malignant adnexal masses (p<0.001). The mean ADC value was significantly lower in malignant adnexal masses (p<0.001). An ADC value< $1.20{\times}10^{-3}mm^2/s$ may be the optimal cutoff for differentiating between benign and malignant tumors. The negative predictive value for low signal intensity on DWI, and type 1 TIC were 100%. The pairwise comparison among the receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) of TIC was significantly larger than the AUCs of DWI and ADC (p<0.001 for comparison of TIC and DWI, p<0.02 for comparison of TIC and ADC value). Conclusions: DWI, ADC value and TIC type derived from DCE-MRI are all sensitive and relatively specific methods for differentiating benign from malignant adnexal masses. By comparing these functional MR techniques, TIC was found to be more accurate than DWI and ADC.

Analysis of Different Ways of Drainage for Obstructive Jaundice Caused by Hilar Cholangiocarcinoma

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5617-5620
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    • 2014
  • Objective: To evaluate the prognosis of different ways of drainage for patients with obstructive jaundice caused by hilar cholangiocarcinoma. Materials and Methods: During the period of January 2006- March 2012, percutaneous transhepatic catheter drainage (PTCD)/ percutaneous transhepatic biliary stenting (PTBS) were performed for 89 patients. According to percutaneous transhepatic cholangiography (PTC), external drainage was selected if the region of obstruction could not be passed by guide wire or a metallic stent was inserted if it could. External drainage was the first choice if infection was diagnosed before the procedure, and a metallic stent was inserted in one week after the infection was under control. Selection by new infections, the degree of bilirubin decrease, the change of ALT, the time of recurrence of obstruction, and the survival time of patients as the parameters was conducted to evaluate the methods of different interventional treatments regarding prognosis of patients with hilar obstruction caused by hilar cholangiocarcinoma. Results: PTCD was conducted in 6 patients and PTBS in 7 (p<0.05). Reduction of bilirubin levels and ALT levels was obvious after the procedures (p<0.05). The average survival time with PTCD was 161 days and with PTBS was 243 days (p<0.05). Conclusions: With both drainage procedures for obstructive jaundice caused by hilar cholangiocarcinoma improvement in liver function was obvious. PTBS was found to be better than PTCD for prolonging the patient survival.

POSTOPERATIVE COMPLICATIONS IN LIVER TRANSPLANTATION DONORS AND USEFULNESS OF INTERVENTIONAL MANAGEMENT (생체 간이식 수술 후 공여자의 합병증 및 중재적 시술의 유용성)

  • Lee In Sick;Lee Hyeong Jin;Ryoo Myung Sun;Ko Gi Young
    • Journal of The Korean Radiological Technologist Association
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    • v.28 no.1
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    • pp.83-89
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    • 2002
  • To evaluate the incidence of postoperative complication,』 following living liver donation and the effectiveness of interventional management for treating postoperative complications. Between January 1997 and December 2001, 386 consecutive healthy honors f

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The Role of Interventional Radiology in Treatment of Patients with Acute Trauma: A Pictorial Essay (급성 외상 환자 치료에서 인터벤션 영상의 역할: 임상화보)

  • Kyung Sik Kang;Mu Sook Lee;Doo Ri Kim;Young Hwan Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.347-358
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    • 2021
  • Acute trauma is a common cause of mortality in individuals aged < 40 years. As organ preservation has become important in treating trauma patients, the treatment is shifting from surgical management to non-operative management. A multidisciplinary team approach, including interventional radiology (IR), is essential for the optimal management of trauma patients, as IR plays an important role in injury evaluation and management. IR also contributes significantly to achieving the best clinical outcomes in critically ill trauma patients. This pictorial essay aims to present and summarize various interventional treatments in trauma patients requiring critical care.

Pulmonary Arteriovenous Malformation and Its Vascular Mimickers

  • Hyoung Nam Lee;Dongho Hyun
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.202-217
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    • 2022
  • Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in patient management. The diagnosis of pulmonary AVM is simple and can usually be made based on CT images. Endovascular treatment, that is, selective embolization of the pulmonary artery feeding the nidus of the pulmonary AVM, and/or selectively either the nidus or draining vein, has become a first-line treatment with advances in interventional devices. However, some vascular diseases can simulate pulmonary AVMs on CT and pulmonary angiography. This subset can confuse interventional radiologists and referring physicians. Vascular mimickers of pulmonary AVM have not been widely known and described in detail in the literature, although some of these require surgical correction, while others require regular follow-up. This article reviews the clinical and radiologic features of pulmonary AVMs and their mimickers.

Usefulness of Virtual Fluoroscopy in Emergency Interventional Radiology (응급 인터벤션 영상의학에서 가상 투시영상 검사의 유용성)

  • Yoshihiro Tanaka;Akitoshi Oosone;Asuka Tsuchiya
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.852-862
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    • 2020
  • Interventional radiology (IR) embolization requires image guidance to steer catheters to the site of bleeding, where embolic agents such as Gelfoam or coils are administered to stem blood flow. In addition to treating iatrogenic trauma, embolization is suitable for injuries precluding surgery such as blush-bleeding of the liver or kidney and for locating and treating intimal blood vessel tears. However, during hospital off-hours (such as nights and holidays), experienced IR personnel are not always available. In such situations, there is a dire need to build a coordinated IR team to treat seriously injured patients rapidly and reliably. This article reviews the current principles and techniques used in IR such as virtual fluoroscopy and their usefulness, and makes a convincing case for emergency IR.

Reference Levels for Radiation Dose in Angiography and Interventional Radiology : In the Cerebrum (혈관 조영 검사 및 중재적 방사선 시술시 방사선량에 대한 참고 기준치 : 대뇌 중심으로)

  • Han, Jae-Bok
    • The Journal of the Korea Contents Association
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    • v.11 no.3
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    • pp.302-308
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    • 2011
  • The aim of this study is to compare reference levels for radiation dose in angiography and interventional radiology. Proposed reference levels for various procedures and classification of diseases are provided by fluoroscopy time and kerma area product(KAP) rate normalizing the body habitus focusing the cerebrum. Subarachnoid hemorrhage(SAH) represents the highest KAP-rates and aneurysm represents the lowest KAP-rates. According to these types of procedures, internal carotid artery(ICA), common carotid artery(CCA), and vertebral artery(VA) show the highest KAP-rates and guglielmi detachable coil shows the lowest KAP-rates. Therefore, the present study can suggested reference levels for patient radiation dose and is expected to be further useful in the field of radiation dose education and management of angiography and interventional radiology.