822 POSTER 10 Years follow-up of 665 patients with prostate adenocarcinoma treated with 3 dimensional-CT guided brachytherapy with a pararectal approach

The aims of this study were to 1) determine if continuous eruption occurs in the maxillary teeth, 2) assess the magnitude of the continuous eruption, and 3) evaluate the effects of continuous eruption on the different periodontal parameters by using data from the population-based cohort of the Study of Health in Pomerania (SHIP). The jaw casts of 140 participants from the baseline (SHIP-0) and 16-y follow-up (SHIP-3) were digitized as 3-dimensional models. Robust reference points were set to match the tooth eruption stage at SHIP-0 and SHIP-3. Reference points were set on the occlusal surface of the contralateral premolar and molar teeth, the palatal fossa of an incisor, and the rugae of the hard palate. Reference points were combined to represent 3 virtual occlusal planes. Continuous eruption was measured as the mean height difference between the 3 planes and rugae fix points at SHIP-0 and SHIP-3. Probing depth, clinical attachment levels, gingiva above the cementoenamel junction (gingival height), and number of missing teeth were clinically assessed in the maxilla. Changes in periodontal variables were regressed onto changes in continuous eruption after adjustment for age, sex, number of filled teeth, and education or tooth wear. Continuous tooth eruption >1 mm over the 16 y was found in 4 of 140 adults and averaged to 0.33 mm, equaling 0.021 mm/y. In the total sample, an increase in continuous eruption was significantly associated with decreases in mean gingival height ( B = −0.34; 95% CI, −0.65 to −0.03). In a subsample of participants without tooth loss, continuous eruption was negatively associated with PD. This study confirmed that continuous eruption is clearly detectable and may contribute to lower gingival heights in the maxilla.

Download Full-text

Comparison of Pulsed Radiofrequency, Oxygen-Ozone Therapy and Epidural Steroid Injections for the Treatment of Chronic Unilateral Radicular Syndrome

Medicina ◽

10.3390/medicina57020136 ◽

2021 ◽

Vol 57 (2) ◽

pp. 136

Author(s):

Pavel Ryska ◽

Jiri Jandura ◽

Petr Hoffmann ◽

Petr Dvorak ◽

Blanka Klimova ◽

...

Keyword(s):

Pain Relief ◽

Analogue Scale ◽

Pulsed Radiofrequency ◽

Ozone Therapy ◽

Ct Guided ◽

The Third ◽

Vas Score ◽

Radicular Syndrome ◽

Epidural Steroid

Background and objectives: For the treatment of chronic unilateral radicular syndrome, there are various methods including three minimally invasive computed tomography (CT)-guided methods, namely, pulsed radiofrequency (PRF), transforaminal oxygen ozone therapy (TFOOT), and transforaminal epidural steroid injection (TFESI). Despite this, it is still unclear which of these methods is the best in terms of pain reduction and disability improvement. Therefore, the purpose of this study was to evaluate the short and long-term effectiveness of these methods by measuring pain relief using the visual analogue scale (VAS) and improvement in disability (per the Oswestry disability index (ODI)) in patients with chronic unilateral radicular syndrome at L5 or S1 that do not respond to conservative treatment. Materials and Methods: After screening 692 patients, we enrolled 178 subjects, each of whom underwent one of the above CT-guided procedures. The PRF settings were as follows: pulse width = 20 ms, f = 2 Hz, U = 45 V, Z ˂ 500 Ω, and interval = 2 × 120 s. For TFOOT, an injection of 4–5 mL of an O2-O3 mixture (24 μg/mL) was administered. For the TFESI, 1 mL of a corticosteroid (betamethasone dipropionate), 3 mL of an anaesthetic (bupivacaine hydrochloride), and a 0.5 mL mixture of a non-ionic contrast agent (Iomeron 300) were administered. Pain intensity was assessed with a questionnaire. Results: The data from 178 patients (PRF, n = 57; TFOOT, n = 69; TFESI, n = 52) who submitted correctly completed questionnaires in the third month of the follow-up period were used for statistical analysis. The median pre-treatment visual analogue scale (VAS) score in all groups was six points. Immediately after treatment, the largest decrease in the median VAS score was observed in the TFESI group, with a score of 3.5 points (a decrease of 41.7%). In the PRF and TFOOT groups, the median VAS score decreased to 4 and 5 points (decreases of 33% and 16.7%, respectively). The difference in the early (immediately after) post-treatment VAS score between the TFESI and TFOOT groups was statistically significant (p = 0.0152). At the third and sixth months after treatment, the median VAS score was five points in all groups, without a statistically significant difference (p > 0.05). Additionally, there were no significant differences in the Oswestry disability index (ODI) values among the groups at any of the follow-up visits. Finally, there were no significant effects of age or body mass index (BMI) on both treatment outcomes (maximum absolute value of Spearman’s rank correlation coefficient = 0.193). Conclusions: Although the three methods are equally efficient in reducing pain over the entire follow-up, we observed that TFESI (a corticosteroid with a local anaesthetic) proved to be the most effective method for early post-treatment pain relief.

Download Full-text

Clinical Application of CT-Guided Percutaneous Microwave Ablation for the Treatment of Lung Metastasis from Colorectal Cancer

Gastroenterology Research and Practice ◽

10.1155/2017/9621585 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9

Author(s):

Lin Li ◽

Ketong Wu ◽

Haiyang Lai ◽

Bo Zhang

Keyword(s):

Colorectal Cancer ◽

Lung Metastasis ◽

Microwave Ablation ◽

Progression Free Survival ◽

Ct Guided ◽

Metastatic Lesions ◽

Local Progression ◽

Invasive Method ◽

Percutaneous Microwave Ablation

Objective. The aim of our research is to explore the clinical efficacy and safety of CT-guided percutaneous microwave ablation (MWA) for the treatment of lung metastasis from colorectal cancer. Materials and Methods. CT-guided percutaneous MWA was performed in 22 patients (male 14, female 8, mean age: 56.05 ± 12.32 years) with a total of 36 lung metastatic lesions from colorectal cancer between February 2014 and May 2017. Clinical data were retrospectively analyzed with respect to the efficacy, safety, and outcome. Results. Of the 36 lesions, 34 lesions (94.4%) reduced obviously with small cavitations or fibrous stripes formed and had no evidence of recurrence during follow-up. The volume of the other 2 lesions demonstrated local progression after 6 months by follow-up CT. The primary complications included pneumothorax (28%), chest pain (21%), and fever (5%). These symptoms and signs were obviously relieved or disappeared after several-day conservative treatment. The mean follow-up of the patients was 25.54 ± 12.58 months (range 2–41 months). The estimated progression-free survival rate was 94.4%. Conclusion. Our results demonstrate that CT-guided percutaneous MWA appears to be an effective, reliable, and minimally invasive method for the treatment of lung metastasis from colorectal cancer. This trial is registered with ChiCTR-ORC-17012904.

Download Full-text

Peritricuspid annular prostate pellet

BMJ Case Reports ◽

10.1136/bcr-2020-238076 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238076

Author(s):

Bryan O'Sullivan ◽

Richard Tanner ◽

Peter Kelly ◽

Gerard Fahy

Keyword(s):

Right Ventricle ◽

Left Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Prostate Adenocarcinoma ◽

Left Ventricular ◽

Premature Ventricular Contractions ◽

Left Ventricular Outflow ◽

Metallic Object ◽

The Right

A 75-year-old was treated for prostate adenocarcinoma with brachytherapy in September 2018. A routine follow-up chest radiograph 3 months later revealed a metallic object of the same dimensions as a brachytherapy pellet located in the right ventricle. Further imaging showed the brachtherapy pellet was located in the anterobasal right ventricular endocardium close to the tricuspid valve. Frequent asymptomatic premature ventricular contractions were observed with likely origin from the left ventricular outflow tract, an area remote from the site of the pellet. The patient remains asymptomatic and subsequent imaging shows that the position of the pellet has not changed.

Download Full-text

Posterior Arch Augmentation (Spinoplasty) before and after Single and Double Interspinous Spacer Introduction at the Same Level: Preventing and Treating the Failure?

Interventional Neuroradiology ◽

10.15274/inr-2014-10052 ◽

2014 ◽

Vol 20 (5) ◽

pp. 626-631 ◽

Cited By ~ 5

Author(s):

Luigi Manfré

Keyword(s):

Spinal Canal ◽

Prophylactic Treatment ◽

Bone Remodelling ◽

Posterior Arch ◽

Ct Guided ◽

Interspinous Spacer ◽

Canal Stenosis ◽

Spinous Processes ◽

Before And After

Lumbar spinal canal stenosis (LSCS) is one of the most common degenerative diseases in elderly patients. Failure of he treatment can occur, generally related to bone remodelling/fracture of spinous processes. PMMA augmentation of the posterior arch (spinoplasty, SP) has recently been proposed in case of neoplastic involvement. This study evaluated the efficacy of SP as a prophylactic treatment before introducing an interspinous spacer (IS). Moreover, we consider the possibility to treat patients who previously underwent IS implants with subsequent failure of the device, by introducing a second spacer at the same level, performing accessory SP. From January 2009 to September 2011, 174 patients with LSCS underwent CT-guided percutaneous IS implant in our department. From January 2011, all patients with osteoporosis underwent prophylactic SP before introducing the spacer. Moreover, in patients with re-stenosis related to bone remodelling and/or fracture, after strengthening the spinous processes with PMMA introduction, a second similar device was introduced to re-open the stenotic spinal canal. In patients with prophylactic treatment before spacer introduction, no restenosis occurred at three to 12 month follow-up. Patients who underwent second spacer implant at the same level after posterior arch augmentation again obtained a resolution of symptoms, and no further bone remodelling had occurred at follow-up controls. In conclusion, prophylactic SP prevents single spacer failure for bone remodelling/fracture, and allows failure repair by introducing a second spacer at the same level.

Download Full-text

Heads-Up Macular Surgery with a 27-Gauge Microincision Vitrectomy System and Minimal Illumination

Case Reports in Ophthalmology ◽

10.1159/000452993 ◽

2016 ◽

Vol 7 (3) ◽

pp. 543-547 ◽

Cited By ~ 16

Author(s):

Hiroshi Kunikata ◽

Toshiaki Abe ◽

Toru Nakazawa

Keyword(s):

Case Series ◽

Macular Disease ◽

3 Dimensional ◽

Illumination System ◽

Invasive Method ◽

Microincision Vitrectomy Surgery ◽

Intraoperative Visualization ◽

Vitrectomy Surgery ◽

Vitrectomy System

Objective: We combined heads-up 3-dimensional (3D) 27-gauge microincision vitrectomy surgery (27GMIVS) with a very low-intensity illumination system. Methods: This study was based on a retrospective, interventional case series of 6 eyes of 6 patients with macular disease. All patients underwent heads-up 3D 27GMIVS and the power of the intraocular illuminator was set to its minimum level, 1% (approximately 0.1 lm), throughout the surgery. Results: We found that the procedure was easy when the heads-up 3D system was used, but not through the eyepiece of a microscope. All surgeries were successfully finished without any complications. Postoperative visual acuity was restored or maintained in all eyes during the follow-up period. Conclusion: Heads-up, 3D system-assisted 27GMIVS with minimal illumination enabled excellent intraoperative visualization of retinal tissues, caused minimal phototoxicity to the macular retinal cells, and might therefore represent the next step in the development of an ideal, minimally invasive method of treating macular disease.

Download Full-text

2216 RADIATION DOSE ASSOCIATED WITH CT-GUIDED PERCUTANEOUS RENAL MASS ABLATION AND IMAGING FOLLOW-UP

The Journal of Urology ◽

10.1016/j.juro.2011.02.2456 ◽

2011 ◽

Vol 185 (4S) ◽

Author(s):

Sarah Hoch ◽

Jeremy Durack ◽

Mathew Sorensen ◽

Robert Gould ◽

Marshall Stoller

Keyword(s):

Radiation Dose ◽

Renal Mass ◽

Ct Guided

Download Full-text

Number of Biopsies in Diagnosing Pulmonary Nodules

Clinical Medicine Insights Circulatory Respiratory and Pulmonary Medicine ◽

10.4137/ccrpm.s4816 ◽

2010 ◽

Vol 4 ◽

pp. CCRPM.S4816 ◽

Cited By ~ 5

Author(s):

M. Wehrschuetz ◽

E. Wehrschuetz ◽

H.R. Portugaller

Keyword(s):

Benign Lesion ◽

Pulmonary Nodules ◽

Ct Guided ◽

Biopsy Needle ◽

Pulmonary Lesions ◽

Introducer Needle ◽

Lost To Follow Up ◽

Work Up ◽

Positive Results

Purpose To determine the number of specimens to be obtained from pulmonary lesions to get the highest possible accuracy in histological work-up. Materials and methods A retrospective evaluation (January 1999 to April 2004) covered 260 patients with thoracic lesions who underwent computer tomography (CT)-guided core-cut biopsy in coaxial technique. All biopsies were performed utilizing a 19 gauge introducer needle and a 20 gauge core-cut biopsy needle. In all, 669 usable biopsies were taken (from 1-5 biopsies in each setting). The specimens were marked sequentially and each biopsy was worked up histologicaly. The biopsy results were correlated to histology after surgery, clinical follow-up or autopsy. The number of biopsies was determined that is necessary to achieve the highest possible accuracy in diagnosing pulmonary lesions. Results In 591 of 669 biopsies (88.3%), there were correct positive results. The overall accuracy was 87.4%. In 193 of 260 (74.2%) patients, a suspected malignancy was confirmed. In 50 of 260 (19.2%) patients, a benign lesion was correctly diagnosed. Seventeen (6.5%) patients were lost to follow-up. The first, second and third biopsies had cumulative accuracies of 63.6%, 89.2% and 91.5%, respectively ( P < 0.02). More biopsies did not show any higher impact on accuracy. Conclusion For the highest possible accuracy in diagnosing pulmonary lesions by CT-guided core-cut biopsy, at least three usable specimens are recommended to be taken.

Download Full-text

A Case of Giant Primary Pleuropulmonary Synovial Sarcoma

Journal of Surgical Oncology ◽

10.31487/j.jso.2020.04.01 ◽

2020 ◽

pp. 1-4

Author(s):

Wickii T. Vigneswaran ◽

Brittany C. Fields ◽

Vijayalakshmi Ananthanarayanan ◽

Wickii T. Vigneswaran

Keyword(s):

Synovial Sarcoma ◽

Soft Tissue Sarcomas ◽

Extrapleural Pneumonectomy ◽

Ct Guided ◽

Prosthetic Reconstruction ◽

Pathologic Features ◽

Synovial Sarcomas ◽

Primary Pulmonary Synovial Sarcoma ◽

Rare Group

Synovial sarcomas represent an extremely rare subtype of an already rare group of malignancies, soft tissue sarcomas. Among these, primary pulmonary synovial sarcomas comprise an even smaller number, though they have become more frequently reported in the literature. This case report details a case of giant primary pulmonary synovial sarcoma in a 44-year-old male patient who presented with left-sided chest pain and shortness of breath and was found to have a large left-sided pleural effusion. No malignant cells were demonstrated on cytology of pleural fluid after thoracentesis; however, CT-guided needle biopsy of pleural nodules seen on imaging demonstrated pathologic features consistent with monophasic type synovial sarcoma. He was treated with neoadjuvant chemotherapy with minimal response; thus, he was referred for surgical management. A left extrapleural pneumonectomy with resection of the left hemi-diaphragm and Gore-Tex prosthetic reconstruction was performed. Imaging at six-month follow-up demonstrated a new nodule in the contralateral lung, suggestive of metastasis at that time and the patient later developed ascites at nine months, consistent with further intra-abdominal metastasis. Perhaps early diagnosis and aggressive multimodality therapy may have a place in the treatment of this aggressive disease.

Download Full-text

Motion-Preserving Navigated Primary Internal Fixation of Unstable C1 Fractures

Asian Spine Journal ◽

10.31616/asj.2019.0189 ◽

2020 ◽

Vol 14 (4) ◽

pp. 466-474

Author(s):

Shanmuganathan Rajasekaran ◽

Dilip Chand Raja Soundararajan ◽

Ajoy Prasad Shetty ◽

Rishi Mugesh Kanna

Keyword(s):

Neck Disability Index ◽

Optimal Placement ◽

Range Of Movement ◽

Ct Guided ◽

Duration Of Surgery ◽

The Mean ◽

The Right ◽

Neck Disability ◽

Displaced Fracture

Study Design: Prospective observational study.Purpose: To assess the safety, efficacy, and benefits of computed tomography (CT)-guided C1 fracture fixation.Overview of Literature: The surgical management of unstable C1 injuries by occipitocervical and atlantoaxial (AA) fusion compromises motion and function. Monosegmental C1 osteosynthesis negates these drawbacks and provides excellent functional outcomes.Methods: The patients were positioned in a prone position, and cranial traction was applied using Mayfield tongs to restore the C0–C2 height and obtain a reduction in the displaced fracture fragments. An intraoperative, CT-based navigation system was used to enable the optimal placement of C1 screws. A transverse rod was then placed connecting the two screws, and controlled compression was applied across the fixation. The patients were prospectively evaluated in terms of their clinical, functional, and radiological outcomes, with a minimal follow-up of 2 years.Results: A total of 10 screws were placed in five patients, with a mean follow-up of 40.8 months. The mean duration of surgery was 77±13.96 minutes, and the average blood loss was 84.4±8.04 mL. The mean combined lateral mass dislocation at presentation was 14.6±1.34 mm and following surgery, it was 5.2±1.64 mm, with a correction of 9.4±2.3 mm (<i>p</i> <0.001). The follow-up CT showed excellent placement of screws and sound healing. There were no complications and instances of AA instability. The clinical range of movement at 2 years in degrees was as follows: rotation to the right (73.6°±9.09°), rotation to the left (71.6°±5.59°), flexion (35.4°±4.5°), extension (43.8°±8.19°), and lateral bending on the right (28.4°±10.45°) and left (24.8°±11.77°). Significant improvement was observed in the functional Neck Disability Index from 78±4.4 to 1.6±1.6. All patients returned to their occupation within 3 months.Conclusions: Successful C1 reduction and fixation allows a motion-preserving option in unstable atlas fractures. CT navigation permits accurate and adequate monosegmental fixation with excellent clinical and radiological outcomes, and all patients in this study returned to their preoperative functional status.

Download Full-text