Internal Mammarial Lymphoscintigraphy with SPECT after Ultrasound-Guided Injection of 99mTc-Dextran

Twenty-two women with stage II or III breast cancer were evaluated by SPECT to determine the number, size, three-dimensional localization and depth from skin surface of the internal mammary lymph nodes for accurate radiotherapy portal planning. The results were also compared with those of planar imaging (PI). Two-step injections of 99mTc-dextran were made under ultrasound guidance into the anterior sheath of the M. rectus abdominis first at the ablation side. 1.5 h thereafter an anterior planar view was obtained to evaluate cross drainage (13.6% was observed). Then, the second injection was done at the opposite side in the same manner. Planar and tomographic images were obtained 1.5 h after the second injection. Similar values were obtained for the depth from skin surface, distance from the midline and diameter of the lymph nodes with both PI and SPECT. The total number of nodes in 22 patients detected by SPECT was higher (138) than that from PI (129), the difference being statistically significant (0.005 > p >0.0005).

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Presurgical, ultrasound-guided anchor-wire marking of impalpable cervical lymph nodes

The Journal of Laryngology & Otology ◽

10.1258/0022215054516241 ◽

2005 ◽

Vol 119 (8) ◽

pp. 627-628 ◽

Cited By ~ 13

Author(s):

J A Bryant ◽

N J Siddiqi ◽

E J Loveday ◽

G H Irvine

Keyword(s):

Lymph Node ◽

High Risk ◽

Lymph Nodes ◽

Cervical Lymph Node ◽

Ultrasound Guidance ◽

Operating Time ◽

High Risk Patient ◽

Wire Localization ◽

Ultrasound Guided ◽

Cervical Lymph Nodes

This case illustrates the surgical use of wire localization, a well tried technique from a different field of surgery, in the removal of an ultrasound-detected, impalpable deep lower cervical lymph node in a high-risk patient. A localization needle with an echogenic tip was placed freehand under ultrasound guidance, immediately before surgery. The imaging and marking of the impalpable cervical lymph node resulted in a precise surgical dissection and a reduction in operating time whilst minimizing risks to the patient and staff.

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Incidental irradiation of internal mammary lymph nodes in breast cancer: conventional two-dimensional radiotherapy versus conformal three-dimensional radiotherapy

Radiologia Brasileira ◽

10.1590/0100-3984.2015.0003 ◽

2016 ◽

Vol 49 (3) ◽

pp. 170-175 ◽

Cited By ~ 5

Author(s):

Elton Trigo Teixeira Leite ◽

Rafael Tsuneki Ugino ◽

Marco Antônio Santana ◽

Denis Vasconcelos Ferreira ◽

Maurício Russo Lopes ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Radiation Therapy Oncology Group ◽

Three Dimensional ◽

Two Dimensional ◽

Immediate Reconstruction ◽

Internal Mammary Lymph Nodes ◽

Internal Mammary ◽

The Mean ◽

3D Radiotherapy

Abstract Objective: To evaluate incidental irradiation of the internal mammary lymph nodes (IMLNs) through opposed tangential fields with conventional two-dimensional (2D) or three-dimensional (3D) radiotherapy techniques and to compare the results between the two techniques. Materials and Methods: This was a retrospective study of 80 breast cancer patients in whom radiotherapy of the IMLNs was not indicated: 40 underwent 2D radiotherapy with computed tomography for dosimetric control, and 40 underwent 3D radiotherapy. The total prescribed dose was 50.0 Gy or 50.4 Gy (2.0 or 1.8 Gy/day, respectively). We reviewed all plans and defined the IMLNs following the Radiation Therapy Oncology Group recommendations. For the IMLNs, we analyzed the proportion of the volume that received 45 Gy, the proportion of the volume that received 25 Gy, the dose to 95% of the volume, the dose to 50% of the volume, the mean dose, the minimum dose (Dmin), and the maximum dose (Dmax). Results: Left-sided treatments predominated in the 3D cohort. There were no differences between the 2D and 3D cohorts regarding tumor stage, type of surgery (mastectomy, breast-conserving surgery, or mastectomy with immediate reconstruction), or mean delineated IMLN volume (6.8 vs. 5.9 mL; p = 0.411). Except for the Dmin, all dosimetric parameters presented higher mean values in the 3D cohort (p < 0.05). The median Dmax in the 3D cohort was 50.34 Gy. However, the mean dose to the IMLNs was 7.93 Gy in the 2D cohort, compared with 20.64 Gy in the 3D cohort. Conclusion: Neither technique delivered enough doses to the IMLNs to achieve subclinical disease control. However, all of the dosimetric parameters were significantly higher for the 3D technique.

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The role of laboratory processing in determining diagnostic conclusiveness of breast fine needle aspirations: conventional smearing versus a monolayer preparation

Journal of Clinical Pathology ◽

10.1136/jcp.2009.066589 ◽

2009 ◽

Vol 62 (10) ◽

pp. 931-934 ◽

Cited By ~ 8

Author(s):

C A P Wauters ◽

B Kooistra ◽

L J A Strobbe

Keyword(s):

Ultrasound Guidance ◽

Needle Aspiration ◽

Processing Technique ◽

Benign Lesions ◽

Ultrasound Guided ◽

Fine Needle ◽

Malignant Lesions ◽

The Difference

Aim:To compare breast fine needle aspiration (FNA) specimens prepared by conventional smearing (CS) versus monolayer preparation (MP), with respect to the conclusiveness of the cytopathological diagnosis.Methods:From 1992 to 1996, aspirators prepared aspirates themselves by direct smearing onto 2–4 slides. From 1999 to 2003, aspirate preparation was performed in the laboratory, creating a MP, using a Hettich cytocentrifuge. FNA diagnoses were categorised into inadequate (C1), benign (C2), atypical (C3), suspicious for malignancy (C4) and malignant (C5). The reference standard constituted histological follow-up. A conclusive FNA diagnosis was defined as C2 in lesions benign on follow-up and C5 in lesions malignant on histology.Results:From 1992 to 1996, 692 aspirates were processed by CS, whereas from 1999 to 2003, 1301 aspirates were processed by MP. More FNA were ultrasound-guided in the MP group (85.6% versus 21.5%, p<0.001). When compared with CS, MP-prepared FNA had conclusive diagnoses significantly more often (72.8% versus 58.5%, p<0.001). This effect remained significant when corrected for the difference in ultrasound guidance (adjusted odds ratio 1.7, 95% confidence interval 1.3 to 2.2, p<0.001), and was larger for malignant lesions than for benign lesions (51.7% versus 79.9%, p<0.001).Conclusion:Patients presenting with breast lesions can more often be offered a same-day, conclusive cytopathological diagnosis when FNA are prepared by a manual MP processing technique.

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Partially Automated Method for Localizing Standardized Acupuncture Points on the Heads of Digital Human Models

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/483805 ◽

2015 ◽

Vol 2015 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Jungdae Kim ◽

Dae-In Kang

Keyword(s):

Structural Characteristics ◽

Three Dimensional ◽

Skin Surface ◽

Acupuncture Points ◽

Tomographic Images ◽

Automated Method ◽

Positioning Method ◽

Digital Human Models ◽

Image Models ◽

Digital Human

Having modernized imaging tools for precise positioning of acupuncture points over the human body where the traditional therapeutic method is applied is essential. For that reason, we suggest a more systematic positioning method that uses X-ray computer tomographic images to precisely position acupoints. Digital Korean human data were obtained to construct three-dimensional head-skin and skull surface models of six individuals. Depending on the method used to pinpoint the positions of the acupoints, every acupoint was classified into one of three types: anatomical points, proportional points, and morphological points. A computational algorithm and procedure were developed for partial automation of the positioning. The anatomical points were selected by using the structural characteristics of the skin surface and skull. The proportional points were calculated from the positions of the anatomical points. The morphological points were also calculated by using some control points related to the connections between the source and the target models. All the acupoints on the heads of the six individual were displayed on three-dimensional computer graphical image models. This method may be helpful for developing more accurate experimental designs and for providing more quantitative volumetric methods for performing analyses in acupuncture-related research.

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Comparison of Fetal Nuchal Fold Thickness Measurements by Two- and Three-Dimensional Ultrasonography (3DXI Multislice View)

Obstetrics and Gynecology International ◽

10.1155/2012/837307 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Leonardo da Silva Valladão de Freitas ◽

Fernanda Silveira de Bello Barros ◽

Rômulo Negrini ◽

Luiz Cláudio de Silva Bussamra ◽

Edward Araujo Júnior ◽

...

Keyword(s):

Standard Deviation ◽

Three Dimensional ◽

Skin Surface ◽

Cross Sectional Study ◽

Rank Test ◽

Cross Sectional ◽

The Mean ◽

The Difference ◽

3D Ultrasonography ◽

Thickness Measurements

Purpose. To compare the measurements of fetal nuchal fold (NF) thickness by two-dimensional (2D) and three-dimensional (3D) ultrasonography using the three-dimensional extended imaging (3DXI).Methods. A cross-sectional study was performed with 60 healthy pregnant women with a gestational age between 16 and 20 weeks and 6 days. The 2D-NF measurements were made as the distance from the outer skull bone to the outer skin surface in the transverse axial image in the suboccipital-bregmatic plane of the head. For the 3D we employed the 3DXI multislice view software, in which3×2tomographic planes was displayed on the screen and the distance between the tomographic slices was 0.5 mm. Maximum, minimum, mean, and standard deviation were calculated for 2D and 3D ultrasonography, as well the maximum and minimum, mean, and standard deviation for the difference between both methods. The Wilcoxon signed-rank test was used to compare the two different techniques.Results. 2D-NF showed a mean of thickness of3.52±0.95 mm (1.69–7.14). The mean of 3D-NF was3.90±1.02 mm (2.13–7.72). The mean difference between the methods was 0.38 mm, with a maximum difference of 3.12 mm.Conclusion. The NF thickness measurements obtained by 3D ultrasonography were significantly larger than those detected with 2D ultrasonography.

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Can ultrasound guidance reduce the risk of pneumothorax following thoracentesis?

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132014000100002 ◽

2014 ◽

Vol 40 (1) ◽

pp. 6-12 ◽

Cited By ~ 15

Author(s):

Alessandro Perazzo ◽

Piergiorgio Gatto ◽

Cornelius Barlascini ◽

Maura Ferrari-Bravo ◽

Antonello Nicolini

Keyword(s):

Ultrasound Guidance ◽

Volume Of Fluid ◽

Ultrasound Guided ◽

Clinical Trial Registry ◽

Fluid Removal ◽

Standardized Protocol ◽

Iatrogenic Complications ◽

Support Team ◽

The Mean ◽

The Difference

OBJECTIVE: Thoracentesis is one of the bedside procedures most commonly associated with iatrogenic complications, particularly pneumothorax. Various risk factors for complications associated with thoracentesis have recently been identified, including an inexperienced operator; an inadequate or inexperienced support team; the lack of a standardized protocol; and the lack of ultrasound guidance. We sought to determine whether ultrasound-guided thoracentesis can reduce the risk of pneumothorax and improve outcomes (fewer procedures without fluid removal and greater volumes of fluid removed during the procedures). In our comparison of thoracentesis with and without ultrasound guidance, all procedures were performed by a team of expert pulmonologists, using the same standardized protocol in both conditions. METHODS: A total of 160 participants were randomly allocated to undergo thoracentesis with or without ultrasound guidance (n = 80 per group). The primary outcome was pneumothorax following thoracentesis. Secondary outcomes included the number of procedures without fluid removal and the volume of fluid drained during the procedure. RESULTS: Pneumothorax occurred in 1 of the 80 patients who underwent ultrasound-guided thoracentesis and in 10 of the 80 patients who underwent thoracentesis without ultrasound guidance, the difference being statistically significant (p = 0.009). Fluid was removed in 79 of the 80 procedures performed with ultrasound guidance and in 72 of the 80 procedures performed without it. The mean volume of fluid drained was larger during the former than during the latter (960 ± 500 mL vs. 770 ± 480 mL), the difference being statistically significant (p = 0.03). CONCLUSIONS: Ultrasound guidance increases the yield of thoracentesis and reduces the risk of post-procedure pneumothorax. (Chinese Clinical Trial Registry identifier: ChiCTR-TRC-12002174 [http://www.chictr.org/en/])

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Scanning electron microscopy of freeze-fractured prescapular lymph node of caprine

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100111331 ◽

1984 ◽

Vol 42 ◽

pp. 244-245

Author(s):

O. Faroon ◽

F. Al-Bagdadi ◽

T. G. Snider ◽

C. Titkemeyer

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymphatic System ◽

Three Dimensional ◽

Meat Products ◽

The Body ◽

Morphological Data ◽

The World ◽

Cellular Constituent ◽

Scanning Electron

The lymphatic system is very important in the immunological activities of the body. Clinicians confirm the diagnosis of infectious diseases by palpating the involved cutaneous lymph node for changes in size, heat, and consistency. Clinical pathologists diagnose systemic diseases through biopsies of superficial lymph nodes. In many parts of the world the goat is considered as an important source of milk and meat products.The lymphatic system has been studied extensively. These studies lack precise information on the natural morphology of the lymph nodes and their vascular and cellular constituent. This is due to using improper technique for such studies. A few studies used the SEM, conducted by cutting the lymph node with a blade. The morphological data collected by this method are artificial and do not reflect the normal three dimensional surface of the examined area of the lymph node. SEM has been used to study the lymph vessels and lymph nodes of different animals. No information on the cutaneous lymph nodes of the goat has ever been collected using the scanning electron microscope.

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Defocus ramp correction in spot-scan imaging

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100121053 ◽

1992 ◽

Vol 50 (1) ◽

pp. 130-131

Author(s):

Kenneth H. Downing

Keyword(s):

Computer Control ◽

Three Dimensional ◽

Sufficient Accuracy ◽

Objective Lens ◽

Electron Crystallography ◽

Contrast Transfer Function ◽

Tilt Axis ◽

Specimen Height ◽

The Difference ◽

Envelope Functions

Three-dimensional structures of a number of samples have been determined by electron crystallography. The procedures used in this work include recording images of fairly large areas of a specimen at high tilt angles. There is then a large defocus ramp across the image, and parts of the image are far out of focus. In the regions where the defocus is large, the contrast transfer function (CTF) varies rapidly across the image, especially at high resolution. Not only is the CTF then difficult to determine with sufficient accuracy to correct properly, but the image contrast is reduced by envelope functions which tend toward a low value at high defocus.We have combined computer control of the electron microscope with spot-scan imaging in order to eliminate most of the defocus ramp and its effects in the images of tilted specimens. In recording the spot-scan image, the beam is scanned along rows that are parallel to the tilt axis, so that along each row of spots the focus is constant. Between scan rows, the objective lens current is changed to correct for the difference in specimen height from one scan to the next.

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