scholarly journals 671 Fetus-In-Fetu Found at Excision of An Antenatally Diagnosed Abdominal Mass: Multi-Disciplinary Approach

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Smith ◽  
A Moore ◽  
S Popov ◽  
M Adams ◽  
E Folaranmi ◽  
...  
Keyword(s):  
Current Literature ◽  
Surgical Planning ◽  
Abdominal Mass ◽  
Female Infant ◽  
Cross Sectional ◽  
Treatment Pathways ◽  
Fetus In Fetu ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Multi Disciplinary Team

Abstract We present a case of antenatally detected abdominal mass and an alternative diagnostic course for suspected neonatal neuroblastoma as a result of investigative findings. A female infant presented antenatally with a left upper quadrant mass initially managed as a suspected neonatal neuroblastoma; further cross-sectional imaging suggested a wider differential including teratoma and aided surgical planning. The multi-disciplinary team (MDT) decision was for an early excision at 31 days and post-operative histology identified a diagnosis of fetus-in-fetu (FIF). We describe this case as a compliment to the current literature and an example of a necessary variation to recognised diagnostic and treatment pathways as a result of investigative findings.

Radiology of acute mastoiditis and its complications: a pictorial review and interpretation checklist

2019 ◽  
Vol 133 (10) ◽  
pp. 856-861
Author(s):  
M W Mather ◽  
P D Yates ◽  
J Powell ◽  
I Zammit-Maempel
Keyword(s):  
Head And Neck ◽  
Surgical Planning ◽  
Systematic Approach ◽  
Acute Mastoiditis ◽  
Cross Sectional ◽  
Imaging Technology ◽  
Radiological Features ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

AbstractBackgroundMastoiditis is an otological emergency, and cross-sectional imaging has a role in the diagnosis of complications and surgical planning. Advances in imaging technology are becoming increasingly sophisticated and, by the same token, the ability to accurately interpret findings is essential.MethodsThis paper reviews common and rare complications of mastoiditis using case-led examples. A radiologist-derived systematic checklist is proposed, to assist the ENT surgeon with interpreting cross-sectional imaging in emergency mastoiditis cases when the opinion of a head and neck radiologist may be difficult to obtain.ResultsA 16-point checklist (the ‘mastoid 16’) was used on a case-led basis to review the radiological features of both common and rare complications of mastoiditis; this is complemented with imaging examples.ConclusionAcute mastoiditis has a range of serious complications that may be amenable to treatment, once diagnosed using appropriate imaging. The proposed checklist provides a systematic approach to identifying complications of mastoiditis.

scholarly journals 469 Novel Applications of Cross-Sectional Imaging in Oncoplastic Surgical Planning for Breast Cancer Following Neoadjuvant Chemotherapy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Begaj ◽  
R McLean ◽  
P Bhaskar
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Planning ◽  
Skin Flap ◽  
Breast Mri ◽  
Observer Agreement ◽  
Arterial Supply ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Abstract Background Cross-sectional imaging using MRI is most commonly used to evaluate the response to neoadjuvant chemotherapy. Furthermore, CT scan of chest, abdomen, and pelvis (CAP) is used in staging the breast cancer. This study seeks to evaluate the feasibility of using preoperative cross-sectional imaging in oncoplastic surgical planning for patients undergoing neoadjuvant chemotherapy for breast cancer. Method All female patients who underwent neoadjuvant chemotherapy for breast cancer between January 2019 and January 2020 and underwent breast MRI pre- and post-neoadjuvant chemotherapy and staging CTCAP were included. All images were independently reviewed and analysed by two consultant breast radiologists. Chest wall symmetry, breast volume differences, skin flap thickness, arterial supply to nipple, intercostal perforators and LD pedicle were assessed on both CT and MRI. Results Nineteen women were included in this study. Breast measurements were best made by MRI due to difficulty interpreting the CT images when supine. The majority of the patients had a dual arterial supply. There was substantial inter–observer agreement in visualisation of MICAP and AICAP. The inter–observer reliability reduced when the radiologists were asked to visualize the LICAP and the thoracodorsal artery with moderate inter–observer agreement, as the MRI images were difficult to interpret laterally. Conclusions This study shows that MRI is suitable to detect most intercostal perforators and is the first study to highlight cross-sectional modalities for assessment of intercostal perforators and may aid preoperative surgical planning and choice of perforator. We have suggested potential addition of CT angiography in cases where the surgeon plans oncoplastic surgery.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

The role of pre-biopsy mpMRI in lymph node staging for prostate cancer

2021 ◽  
pp. 039156032110168
Author(s):  
Nassib Abou Heidar ◽  
Robert El-Doueihi ◽  
Ali Merhe ◽  
Paul Ramia ◽  
Gerges Bustros ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Gleason Score ◽  
Gold Standard ◽  
Cross Sectional ◽  
Significant Difference ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Kappa Agreement

Introduction: Prostate cancer (PCa) staging is an integral part in the management of prostate cancer. The gold standard for diagnosing lymph node invasion is a surgical lymphadenectomy, with no superior imaging modality available at the clinician’s disposal. Our aim in this study is to identify if a pre-biopsy multiparametric MRI (mpMRI) can provide enough information about pelvic lymph nodes in intermediate and high risk PCa patients, and whether it can substitute further cross sectional imaging (CSI) modalities of the abdomen and pelvis in these risk categories. Methods: Patients with intermediate and high risk prostate cancer were collected between January 2015 and June 2019, while excluding patients who did not undergo a pre-biopsy mpMRI or a CSI. Date regarding biopsy result, PSA, MRI results, CSI imaging results were collected. Using Statistical Package for the Social Sciences (SPSS) version 24.0, statistical analysis was conducted using the Cohen’s Kappa agreement for comparison of mpMRI with CSI. McNemar’s test and receiver operator curve (ROC) curve were used for comparison of sensitivity of both tests when comparing to the gold standard of lymphadenectomy. Results: A total of 143 patients fit the inclusion criteria. We further stratified our patients into according to PSA level and Gleason score. Overall, agreement between mpMRI and all CSI was 0.857. When stratifying patients based on Gleason score and PSA, the higher the grade or PSA, the higher agreement between mpMRI and CSI. The sensitivity of mpMRI (73.7%) is similar to CSI (68.4%). When comparing CSI sensitivity to that of mpMRI, no significant difference was present by utilizing the McNemar test and very similar receiver operating characteristic curve. Conclusion: A pre-biopsy mpMRI can potentially substitute further cross sectional imaging in our cohort of patients. However, larger prospective studies are needed to confirm our findings.

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