• Title/Summary/Keyword: Ultrasonography guidance

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In vivo verification of regional hyperthermia in the liver

  • Noh, Jae Myoung;Kim, Hye Young;Park, Hee Chul;Lee, So Hyang;Kim, Young-Sun;Hong, Saet-Byul;Park, Ji Hyun;Jung, Sang Hoon;Han, Youngyih
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.256-261
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    • 2014
  • Purpose: We performed invasive thermometry to verify the elevation of local temperature in the liver during hyperthermia. Materials and Methods: Three 40-kg pigs were used for the experiments. Under general anesthesia with ultrasonography guidance, two glass fiber-optic sensors were placed in the liver, and one was placed in the peritoneal cavity in front of the liver. Another sensor was placed on the skin surface to assess superficial cooling. Six sessions of hyperthermia were delivered using the Celsius TCS electro-hyperthermia system. The energy delivered was increased from 240 kJ to 507 kJ during the 60-minute sessions. The inter-session cooling periods were at least 30 minutes. The temperature was recorded every 5 minutes by the four sensors during hyperthermia, and the increased temperatures recorded during the consecutive sessions were analyzed. Results: As the animals were anesthetized, the baseline temperature at the start of each session decreased by $1.3^{\circ}C$ to $2.8^{\circ}C$ (median, $2.1^{\circ}C$). The mean increases in temperature measured by the intrahepatic sensors were $2.42^{\circ}C$ (95% confidence interval [CI], 1.70-3.13) and $2.67^{\circ}C$ (95% CI, 2.05-3.28) during the fifth and sixth sessions, respectively. The corresponding values for the intraperitoneal sensor were $2.10^{\circ}C$ (95% CI, 0.71-3.49) and $2.87^{\circ}C$ (1.13-4.43), respectively. Conversely, the skin temperature was not increased but rather decreased according to application of the cooling system. Conclusion: We observed mean $2.67^{\circ}C$ and $2.87^{\circ}C$ increases in temperature at the liver and peritoneal cavity, respectively, during hyperthermia. In vivo real-time thermometry is useful for directly measuring internal temperature during hyperthermia.

Fine Needle Aspiration Cytology vs. Core Needle Biopsy for Thyroid Nodules: A Prospective, Experimental Study Using Surgical Specimen (갑상선 결절에 대한 세침 흡인 세포 검사와 중심부 바늘 생검의 비교: 수술 검체를 기반으로 한 전향적, 실험적 비교 연구)

  • Hyuk Kwon;Jandee Lee;Soon Won Hong;Hyeong Ju Kwon;Jin Young Kwak;Jung Hyun Yoon
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.645-657
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    • 2022
  • Purpose To evaluate and compare the diagnostic outcomes of ultrasonography (US)-guided fine needle aspiration (FNA) and core needle biopsy (CNB) performed on the same thyroid nodule using a surgical specimen for direct comparison. Materials and Methods We included 89 thyroid nodules from 88 patients from February 2015 to January 2016. The inclusion criterion was thyroid nodules measuring ≥ 20 mm (mean size: 40.0 ± 15.3 mm). Immediately after surgical resection, FNA and subsequent CNB were performed on the surgical specimen under US guidance. FNA and CNB cytopathologic results on the specimen were compared with the surgical diagnosis. Results Among the 89 nodules, 30 were malignant and 59 were benign. Significantly higher inconclusive rates were seen in FNA for malignant than benign nodules (80.0% vs. 39.0%, p < 0.001). For CNB, conclusive and inconclusive rates did not differ between benign and malignant nodules (p = 0.796). Higher inconclusive rates were seen for FNA among cancers regardless of US features, and in the subgroup of size ≥ 40 mm (62.5% vs. 22.9%, p = 0.028). Eleven cancers were diagnosed with CNB (36.7%, 11/30), while none was diagnosed using FNA. Conclusion In this experimental study using surgical specimens, CNB showed a potential to provide improved diagnostic sensitivity for thyroid cancer, especially when a conclusive diagnosis is limited with FNA.

The Usefulness of Ultrasound-Guided Fine Needle Aspiration Cytology of Impalpable Neck Nodes in Patients with Lung Cancer (폐암 환자에서 촉진되지 않는 경부 림프절에 대한 초음파 유도 하 세침흡인 세포검사의 유용성)

  • Kim, Hee Kyoo;Ha, Seung In;Kim, Yu Ri;Park, Chan Bog;Oak, Chul Ho;Jang, Tae Won;Jung, Maan Hong;Oh, Kyung Seung;Chun, Bong Kwon;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.505-513
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    • 2004
  • Background : In lung cancer patients, the presence of metastatic neck nodes is a crucial indicator of inoperabilty. So thorough physical examination of neck is always mandatory, but sometimes those are hardly palpable even by the skillful hand. Ultrasonography is a useful diagnostic method in detection of small impalpable lymph nodes and in guidance of fine needle aspiration biopsy. In this study we evaluated the clinical usefulness of ultrasonography(USG) and ultrasound-guided fine needle aspiration cytology(US-FNA) in lung cancer patients without palpable neck nodes. Methods and Materials : From Sep 2002 to Sep 2003, 36 non-small cell lung cancer patients (20 adenocarcinoma, 16 squamous cell cancer) and 10 small cell lung cancer patients without palpable neck nodes on physical examiation were enrolled. patients who had contralateral mediastinal nodal enlargement(>1cm) on chest CT were excluded. After the routine check of USG on the neck, US-FNA was done in cases with enlarged neck nodes (${\geq}5mm$ in the short axis). The presence of enlarged lymph node on USG, and of malignant cells on cytology were evaluated by the histological type and the patients' clinical stage of lung cancer. Results : Among 36 non-small lung cell cancer patients, 14 (38.8%) had enlarged neck nodes on USG, and 5 of 10 small cell lung carcinoma patients. The mean diameter of the neck nodes was 9.8 mm (range, 7-12 mm). US-FNA of 14 non-small cell lung cancer patients revealed tumor cells in eight patients (57.1%). In 5 small cell lung cancer pateints, tumor cells were found in all cases. By the result of US-FNA, the clinical stage of 8 out of 36 (22.2%) non-small cell lung cancer patients had changed, including two cases of shift from the operable IIIa to the inoperable IIIb. In small cell lung cancer patients their clinical stage was not changed after US-FNA, but their pathological diagnosis was easily done in two cases, in whom endobronchial lesions were not found on bronchoscopy. Conclusions : USG and US-FNA of neck node seem to be safe, sensitive and cost-effective diagnostic tools in the evaluation of lung cancer patients without palpable neck nodes.

The Study for Results of Complex Cystic Breast Masses by Biopsy on Ultrasound (초음파상 복합성 낭성 유방 종괴의 조직 검사 결과에 관한 연구)

  • Kang, Hye-Kyoung;Dong, Kyung-Rae
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.129-134
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    • 2008
  • Purpose: We examined the roles of Ultrasonography conductors by analyzing the results of tissue biopsy of complex cystic masse under the guidance of breast US. Objects and methods: This study was performed to a group of 178 who showed breast US indicating complex cystic masses among 342 patients who were definitely diagnosed by tissue biopsies and operations in our hospital from June 30th, 2003 to June 30th, 2007. The evaluation of tissues around, calcification, the distribution state of blood flow were excluded from the analysis subjects and logic 200 made by GE corporation and gun for core biopsy(Kimal corp., K7/MBD23) were used in this study. Results: The biopsy results of 178 subjects showed FCC (fibrocystic change)(n=56 : 31.4%), Fibrosis (n=41 : 23.0%), Fibroadenoma (n=20 : 11.2%), Epithelial hyperplasia (n=17 : 9.6%), Carcinoma (n=15 : 8.4%), Fibroadipose (n=8 : 4.5%), Sclerosing adenosis (n=7 : 3.9%), Duct ectasia (n=5 : 2.8%), Papiloma (n=5 : 2.8%), and Fat necrosis (n=1 : 0.6%), Hemangioma (n=1 : 0.6%), Abscess (n=1 : 0.6%), Dystrophic calcification(n=1 : 0.6%). Conclusion: The US showed that the results of the tissue biopsy of complex cystic masses were mostly carcinoma(8.4%). Most of them were benign and only 9.6% of epithelial hyperplasia which has high progression rate into malignant tumors epidemically showed malignancy. Most of them were included in the spectrum of fibrous cystic nodule. Even though these results are confirmed, further studies are required. As a result, a nodule which is not certified by US should be right to take the tissue biopsy, but if it's difficult due to patients or another reasons, re-check tests in three months are required. And systemic ultrasonography evaluation should be well recognized to conduct more careful and specific tests.

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Efficacy of Preliminary Magnetic Resonance Imaging Measurement in Ultrasonography-Guided L4 Selective Nerve Root Block (초음파 유도하 요추 4번 선택적 신경근 차단술 시 자기공명영상 계측의 유용성)

  • Shim, Dae Moo;Kweon, Seok Hyun;Cho, Hyung Gyu;Yu, Hyun Kyu;Lim, Kyeong Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.229-236
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    • 2020
  • Purpose: This study examined the utility of preliminary magnetic resonance imaging (MRI) measurements in the ultrasound-guided L4 selective nerve root block. Materials and Methods: As a retrospective study, 71 patients, who met the criteria for outpatient visits from March 2016 to December 2017, were included. From March 2016 to February 2017, 31 patients who underwent an L4 nerve root block without MRI were classified as group A, and 40 patients who underwent an L4 nerve root block through MRI measurements from March 2017 to December 2017 were classified as group B. Group A was injected under ultrasound-guidance through the pararadicular approach without a pre-interventional MRI evaluation, and group B was injected under ultrasound-guidance according to the preliminary MRI measurements. The results were assessed using the numeric rating scale scores before, three hours, and two, six, and 12 weeks after the procedure. Results: At three hours after the procedure, the proportion of patients better than good results were 51.6% in group A and 67.5% in group B. At two weeks after the procedure, the proportion of patients with better than good results were 48.4% and 70.0% in groups A and B, respectively; 58.1% and 62.5% of patient of groups A and B, respectively, showed better than good results after six weeks. In 12 weeks after the procedure, the results of group A and B were 67.7% and 62.5%, respectively. At three hours and two weeks after the procedure, group B showed significant symptom improvement than group A (p<0.05). The procedures were repeated 2.8 and 1.7 times in groups A and B, respectively, between two and six weeks for satisfactory pain relief (p<0.05). Conclusion: A pre-interventional MRI evaluation might improve pain relief within the initial two weeks after ultrasound-guided L4 selective nerve root block by improving the success rate of the procedure.

Safety and Efficacy of Ultrasound-Guided Percutaneous Core Needle Biopsy of Pancreatic and Peripancreatic Lesions Adjacent to Critical Vessels (주요 혈관 근처의 췌장 또는 췌장 주위 병변에 대한 초음파 유도하 경피적 중심 바늘 생검의 안전성과 효율성)

  • Sun Hwa Chung;Hyun Ji Kang;Hyo Jeong Lee;Jin Sil Kim;Jeong Kyong Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1207-1217
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    • 2021
  • Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.