scholarly journals CT Fluoroscopy-Guided Drain Placement to Treat Infected Gastric Leakage after Sleeve Gastrectomy: Technical and Clinical Outcome of 31 Procedures

2019 ◽  
Vol 192 (02) ◽  
pp. 163-170
Author(s):  
Jens Schwarz ◽  
Frederik Franz Strobl ◽  
Philipp M Paprottka ◽  
Melvin D’Anastasi ◽  
Fritz W. Spelsberg ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Clinical Outcome ◽  
Clinical Success ◽  
High Risk Patient ◽  
Ct Scanner ◽  
Ct Fluoroscopy ◽  
Dose Length Product ◽  
Ct Guided ◽  
Gastric Leakage ◽  
Drain Placement

Purpose To observe the technical and clinical outcome as well as safety of CT fluoroscopy-guided drain placement in the multimodal clinical complication management of superinfected gastric leakage after sleeve gastrectomy. Materials and Methods All consecutive patients who underwent CT fluoroscopy-guided drain placement to treat superinfected postoperative leakage after sleeve gastrectomy in our department between 2007 and 2014 were included in this retrospective study. All interventions were performed on a 16- or 128-row CT scanner under intermittent CT fluoroscopy guidance (15–25 mAs, 120 kV). The technical and clinical success rates as well as complications, additional therapies and patient radiation dose were analyzed. Results 14 patients (mean age: 43.8 ± 11.3 years, mean BMI: 52.9 ± 13.5, 7 women) who underwent a total of 31 CT fluoroscopy-guided drain placement procedures were included. 30 of 31 interventions (96.8 %) were technically successful. 7 patients underwent more than one intervention due to drain obstruction or secondary dislocation or as further treatment. During and after the intervention no procedure-associated complications occurred. In all patients, inflammation parameters decreased within days after the CT-guided intervention. The total interventional dose length product (DLP) was 1561 ± 1035 mGy*cm. Conclusion CT fluoroscopy-guided drain placement has been shown to be a safe minimally invasive procedure that rarely leads to complications for treating superinfected gastric leakage occurring after sleeve gastrectomy. We assume that operative revisions in a high-risk patient group can be avoided using this procedure. Key Points:  Citation Format

scholarly journals Occupational Radiation Dose to Eye Lenses in CT-Guided Interventions Using MDCT-Fluoroscopy

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 646
Author(s):  
Yohei Inaba ◽  
Shin Hitachi ◽  
Munenori Watanuki ◽  
Koichi Chida
Keyword(s):  
Radiation Dose ◽  
Radiation Protection ◽  
Medical Staff ◽  
Ct Fluoroscopy ◽  
Related Factors ◽  
Dose Length Product ◽  
Ct Guided ◽  
Reduction Methods ◽  
Ct System ◽  
Occupational Radiation

In computed tomography (CT)-guided interventions (CTIs), physicians are close to a source of scattered radiation. The physician and staff are at high risk of radiation-induced injury (cataracts). Thus, dose-reducing measures for physicians are important. However, few previous reports have examined radiation doses to physicians in CTIs. This study evaluated the radiation dose to the physician and medical staff using multi detector (MD)CT-fluoroscopy, and attempted to understand radiation-protection and -reduction methods. The procedures were performed using an interventional radiology (IVR)-CT system. We measured the occupational radiation dose (physician and nurse) using a personal dosimeter in real-time, gathered CT-related parameters (fluoroscopy time, mAs, CT dose index (CTDI), and dose length product (DLP)), and performed consecutive 232 procedures in CT-guided biopsy. Physician doses (eye lens, neck, and hand; μSv, average ± SD) in our CTIs were 39.1 ± 36.3, 23.1 ± 23.7, and 28.6 ± 31.0, respectively. Nurse doses (neck and chest) were lower (2.3 ± 5.0 and 2.4 ± 4.4, respectively) than the physician doses. There were significant correlations between the physician doses (eye and neck) and related factors, such as CT-fluoroscopy mAs (eye dose: r = 0.90 and neck dose: r = 0.83). We need to understand the importance of reducing/optimizing the dose to the physician and medical staff in CTIs. Our study suggests that physician and staff doses were not significant when the procedures were performed with the appropriate radiation protection and low-dose techniques.

scholarly journals Implementation of ultra-low-dose lung protocols in CT-guided lung biopsies: feasibility and safety in the clinical setting

2017 ◽  
Vol 45 (6) ◽  
pp. 2101-2109 ◽  
Author(s):  
Barbara K Frisch ◽  
Karin Slebocki ◽  
Kamal Mammadov ◽  
Michael Puesken ◽  
Ingrid Becker ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Low Dose ◽  
Standard Dose ◽  
Complication Rates ◽  
Dose Length Product ◽  
Ct Guided ◽  
Total Radiation Dose ◽  
Lung Biopsies ◽  
Histological Results

Objective To evaluate the use of ultra-low-dose computed tomography (ULDCT) for CT-guided lung biopsy versus standard-dose CT (SDCT). Methods CT-guided lung biopsies from 115 patients (50 ULDCT, 65 SDCT) were analyzed retrospectively. SDCT settings were 120 kVp with automatic mAs modulation. ULDCT settings were 80 kVp with fixed exposure (20 mAs). Two radiologists evaluated image quality (i.e., needle artifacts, lesion contouring, vessel recognition, visibility of interlobar fissures). Complications and histological results were also evaluated. Results ULDCT was considered feasible for all lung interventions, showing the same diagnostic accuracy as SDCT. Its mean total radiation dose (dose–length product) was significantly reduced to 34 mGy-cm (SDCT 426 mGy-cm). Image quality and complication rates ( P = 0.469) were consistent. Conclusions ULDCT for CT-guided lung biopsies appears safe and accurate, with a significantly reduced radiation dose. We therefore recommend routine clinical use of ULDCT for the benefit of patients and interventionalists.

scholarly journals Optimization of head computed tomography scan in a tertiary institution in Edo State, South-South Nigeria

2021 ◽  
Vol 8 (4) ◽  
pp. 225-230
Author(s):  
Chikezie Chukwuemeka Udo ◽  
Akintayo Daniel Omojola ◽  
Chukwuemeka Christian Nzotta
Keyword(s):  
Computed Tomography ◽  
Ct Scanner ◽  
Tertiary Institution ◽  
Dose Length Product ◽  
Volume Computed Tomography ◽  
The United Kingdom ◽  
Ct Protocol ◽  
Tube Current ◽  
Edo State ◽  
Computed Tomography Dose Index

Objective: The study is aimed at optimizing the existing CT protocol for head scans in a Specialist Teaching Hospital in Edo State with a 16-slice Siemens Somatom Emotion scanner. Also, the study determined the volume computed tomography dose index (CTDIvol) and Dose Length Product (DLP) from the patient's dose profiles. The results from this study were compared with relevant studies. Materials and Methods: The scanner was used to acquire head CT of 160 patients retrospectively. Also, a locally designed head phantom was used to simulate individual patients using a similar protocol by changing the tube current (mA) and total scan width (TSW) only from the existing protocol. Results: Percentage dose reduction (PDR) for the CTDIvol and DLP ranged 42.00-46.80% and 37.13-43.54% respectively. The optimized CTDIvol and DLP were lowest compared to studies in the United Kingdom (UK), Italy, India, Ireland, Sudan, Nigeria, European Commission (EC), United States of America (USA) and Japan. Only the DLP for India was lower than our optimized value. Conclusion: The need to understudy CT configuration is necessary, this will allow end-users to optimize certain parameters in the CT scanner, which will reduce the patient dose without compromising image quality

Sleeve Gastrectomy in the High-Risk Patient

2006 ◽  
Vol 16 (11) ◽  
pp. 1445-1449 ◽  
Author(s):  
Nahid Hamoui ◽  
Gary Anthone ◽  
Howard Kaufman ◽  
Peter Crookes
Keyword(s):  
Sleeve Gastrectomy ◽  
High Risk ◽  
High Risk Patient ◽  
Risk Patient

scholarly journals The Clinical Outcome of Postoperative Invasive Fungal Infections Complicating Laparoscopic Sleeve Gastrectomy

2018 ◽  
Vol 28 (10) ◽  
pp. 3268-3275
Author(s):  
Yoav Bichovsky ◽  
Leonid Koyfman ◽  
Michael Friger ◽  
Boris Kirshtein ◽  
Abraham Borer ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Clinical Outcome ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Fungal Infections ◽  
Invasive Fungal Infections

Feasibility and safety of percutaneous computed tomography guided radiofrequency ablation of lymph nodes in oligometastatic patients: a single center’s experience

2021 ◽  
Vol 94 (1121) ◽  
pp. 20200445
Author(s):  
Dimitrios Filippiadis ◽  
George Charalampopoulos ◽  
Athanasios Tsochatzis ◽  
Lazaros Reppas ◽  
Argyro Mazioti ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Lymph Nodes ◽  
Clinical Success ◽  
Complete Response ◽  
Tumor Control ◽  
Complication Rates ◽  
Ct Guided ◽  
Female Ratio ◽  
Contrast Enhanced Ct ◽  
The Mean

Objectives: To retrospectively evaluate feasibility and safety of CT-guided percutaneous radiofrequency ablation (RFA) of metastatic lymph nodes (LN) in terms of achieving local tumor control. Methods: Institutional database research identified 16 patients with 24 metastatic LNs who underwent percutaneous CT-guided radiofrequency ablation. Mean patient age was 66.6 ± 15.70 years (range 40–87) and male/female ratio was 8/8. Contrast-enhanced CT or MRI was used for post-ablation follow-up. Patient and tumor characteristics and RFA technique were evaluated. Technical and clinical success on per tumor and per patient basis as well as complication rates were recorded. Results: Mean size of the treated nodes was 1.78 ± 0.83 cm. The mean number of tumors per patient was 1.5 ± 0.63. The mean procedure time was 56.29 ± 24.27 min including local anesthesia, electrode(s) placement, ablation and post-procedural CT evaluation. Median length of hospital stay was 1.13 ± 0.34 days. On a per lesion basis, the overall complete response post-ablation according to the mRECIST criteria applied was 75% (18/24) of evaluable tumors. Repeat treatment of an index tumor was performed on two patients (three lesions) with complete response achieved in 87.5% (21/24) of evaluable tumors following a second RFA. On a per patient basis, disease progression was noted in 10/16 patients at a mean of 13.9 ± 6.03 months post the ablation procedure. Conclusion: CT-guided percutaneous RFA for oligometastatic LNs is a safe and feasible therapy. Advances in knowledge: With this percutaneous therapeutic option, metastatic LNs can be eradicated with a very low complication rate.

Conversion from dose-length product to effective dose in computed tomography venography of the lower extremities

2022 ◽  
Author(s):  
Yusuke Inoue ◽  
Yuka Yonekura ◽  
Kazunori Nagahara ◽  
Ayuka Uehara ◽  
Hideki Ikuma
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Conversion Factor ◽  
Lower Extremities ◽  
Pulmonary Angiography ◽  
Ct Scanner ◽  
Dose Length Product ◽  
Ct Venography ◽  
Simplified Method ◽  
Imaging Conditions

Abstract For radiation dose assessement of computed tomography (CT), effective dose (ED) is often estimated by multiplying the dose-length product (DLP), provided automatically by the CT scanner, by a conversion factor. We investigated such conversion in CT venography of the lower extremities performed in conjunction with CT pulmonary angiography. The study subjects consisted of eight groups imaged using different scanners and different imaging conditions (five and three groups for the GE and Siemens scanners, respectively). Each group included 10 men and 10 women. The scan range was divided into four anatomical regions (trunk, proximal thigh, knee and distal leg), and DLP was calculated for each region (regional DLP). Regional DLP was multiplied by a conversion factor for the respective region, to convert it to ED. The sum of the ED values for the four regions was obtained as standard ED. Additionally, the sum of the four regional DLP values, an approximate of the scanner-derived DLP, was multiplied by the conversion factor for the trunk (0.015 mSv/mGy/cm), as a simplified method to obtain ED. When using the simplified method, ED was overestimated by 32.3%−70.2% and 56.5%−66.2% for the GE and Siemens scanners, respectively. The degree of overestimation was positively and closely correlated with the contribution of the middle and distal portions of the lower extremities to total radiation exposure. ED/DLP averaged within each group, corresponding to the conversion factor, was 0.0089−0.0114 and 0.0091−0.0096 mSv/mGy/cm for the GE and Siemens scanners, respectively. In CT venography of the lower extremities, ED is greatly overestimated by multiplying the scanner-derived DLP by the conversion factor for the trunk. The degree of overestimation varies widely depending on the imaging conditions. It is recommended to divide the scan range and calculate ED as a sum of regional ED values.

Arterial Stiffness Is Associated with Clinical Outcome and Cardiorenal Injury in Lateralized Primary Aldosteronism

2020 ◽  
Vol 105 (11) ◽  
Author(s):  
Chieh-Kai Chan ◽  
Wei-Shiung Yang ◽  
Yen-Hung Lin ◽  
Kuo-How Huang ◽  
Ching-Chu Lu ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Clinical Outcome ◽  
Left Ventricular Mass ◽  
Primary Aldosteronism ◽  
Clinical Success ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Secondary Outcome ◽  
Ventricular Mass

Abstract Context The association between arterial stiffness and clinical outcome in lateralized primary aldosteronism (PA) patients after adrenalectomy has not been clearly identified. Objective We hypothesized that arterial stiffness estimated by brachial-ankle pulse wave velocity (baPWV) before adrenalectomy was associated with the clinical outcomes and cardiorenal injury in lateralized PA patients after adrenalectomy. Design and Patients We designed a retrospective observational cohort study. We collected lateralized PA patients who had undergone adrenalectomy between 2013 and 2016 from the Taiwan Primary Aldosteronism Investigation database. The primary outcome was achieving complete clinical success at 1 year after adrenalectomy. The secondary outcome was estimated glomerular filtration rate declining over 20% and improved left ventricular mass index. Results We enrolled 221 patients with lateralized PA (50.7% men; mean age, 51.9 years), of whom 101 patients (45.7%) achieved complete clinical success at the 1-year follow-up assessment after adrenalectomy. Lower baPWV before adrenalectomy (odds ratio = 0.998; 95% confidence interval, 0.996-0.999; P = 0.003) correlated with higher likelihood of complete clinical success by multivariate logistic regression analysis. Multifactorial adjusted generalized additive model demonstrated that preoperative baPWV<1600 cm/sec was significantly associated with complete cure of hypertension. In addition, higher preoperative baPWV was associated with renal function decline and less left ventricular mass regression after adrenalectomy in lateralized PA patients during the follow-up period. Conclusions Our study demonstrated that the preoperative severe arterial stiffness was associated with absent complete clinical success in lateralized PA patients after adrenalectomy, and this effect may contribute to cardiorenal injury, which at least partially explains kidney function deterioration and lessened regression of heart mass.

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