scholarly journals A Simple and Safe Technique for CT Guided Lung Nodule Marking prior to Video Assisted Thoracoscopic Surgical Resection Revisited

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
James A. Stephenson ◽  
Ayman Mahfouz ◽  
Sridhar Rathinam ◽  
Apostolos Nakas ◽  
Amrita Bajaj
Keyword(s):  
Low Dose ◽  
Lung Nodule ◽  
Care Hospital ◽  
Ct Fluoroscopy ◽  
Thoracoscopic Resection ◽  
Ct Guided ◽  
Pleural Surface ◽  
Mean Size ◽  
Safe Technique ◽  
Fluoroscopy Guidance

Aim. We describe our experience of a simple, safe, and reproducible technique for lung nodule marking prethoracoscopic metastasectomy. Thoracoscopic lung nodule resection reduces patient discomfort, complications, higher level of care, hospital stay, and cost; however, small deeply placed lung nodules are difficult to locate and resect thoracoscopically. Materials and Methods. We describe and review the success of our novel technique, where nodules are identified on a low dose CT and marked with methylene blue using CT fluoroscopy guidance immediately prior to surgery. Results. 30 nodules were marked with a mean size of 8 mm (4–18 mm) located at a mean depth of 17 mm, distributed through both lungs. Dye was detected at the pleural surface in 97% of the patients and at the nodule in 93%. There were no major complications. Thoracoscopic resection was possible in 90%. Conclusion. This is a simple and safe method of lung nodule marking to facilitate thoracoscopic resection in cases where this may not be technically possible due to nodule location.

scholarly journals 04:21 PM Abstract No. 295 CT-guided vascular interventions using ultra-low-dose CT fluoroscopy and 4D CT DSA: a feasibility study

2019 ◽  
Vol 30 (3) ◽  
pp. S131-S132
Author(s):  
P. Laeseke ◽  
M. Wagner ◽  
F. Lee ◽  
Y. Wu ◽  
C. Strother ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Low Dose ◽  
Ct Fluoroscopy ◽  
Ct Guided ◽  
4D Ct ◽  
Low Dose Ct

scholarly journals Uniportal VATS Coil-Assisted Resections for GGOs

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Maria Teresa Congedo ◽  
Roberto Iezzi ◽  
Dania Nachira ◽  
Anna Rita Larici ◽  
Marco Chiappetta ◽  
...  
Keyword(s):  
Lung Resection ◽  
Pulmonary Nodules ◽  
Ground Glass ◽  
Ct Guided ◽  
Pleural Surface ◽  
Preoperative Ct ◽  
Mean Size ◽  
Accurate Procedure ◽  
The Mean ◽  
Mixed Ground

Backgrounds. Although uniportal video-assisted thoracic surgery (VATS) theoretically allows the direct palpation of any zone of the lung through a small incision, sometimes it can be difficult to localize pure ground-glass opacities anyway. The aim of this study is to evaluate the usefulness and safety of preoperative computed tomography (CT)-guided microcoil localization of GGO nodules in patients undergoing uniportal VATS lung resection.Methods. The clinical data and CT images of 30 consecutive patients (30 pulmonary nodules) who underwent preoperative CT-guided coil localization and subsequent uniportal VATS resection, from January 2017 to October 2018, were reviewed.Results. All the CT-localization procedures have been performed with success (30/30) and the mean procedure time was 35±15 minutes. The mean size of the nodules was 15,53±6,72 mm, and the mean distance of the nodules from the pleural surface was 19,08±12,08 mm. Eleven nodules (36,7%) were pure ground-glass opacities and 19 (63,3%) were mixed ground-glass with a solid component of 50% or more. In 5 cases, the localization procedure was complicated by asymptomatic pneumothoraxes and in 1 case the pneumothorax required chest tube insertion. In any case a conversion to thoracotomy was avoided because all nodules were identified and resected through uniportal VATS.Conclusions. Preoperative CT-guided coil localization seems to be a feasible, safe, and accurate procedure. It makes uniportal VATS an easy approach even for resecting small, deep, and impalpable nodules.

scholarly journals Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty

2019 ◽  
Vol 25 (5) ◽  
pp. 353-359 ◽  
Author(s):  
Veer Shah ◽  
◽  
Travis Hillen ◽  
Jack Jennings ◽  
◽  
...  
Keyword(s):  
Low Dose ◽  
Ct Fluoroscopy ◽  
Low Dose Ct ◽  
Fluoroscopy Guidance

LUNGRADS AND UPDATE OF LUNG NODULES SCREENING BY LOW DOSE COMPUTED TOMOGRAPHY

2015 ◽  
pp. 12-19
Author(s):  
Thi Ngoc Ha Hoang ◽  
Trong Khoan Le
Keyword(s):  
Lung Cancer ◽  
Low Dose ◽  
False Negative ◽  
Lung Nodule ◽  
Lung Cancer Mortality ◽  
Smoking History ◽  
Low Dose Ct ◽  
History Of ◽  
Chest X Ray ◽  
Low Dose Computed Tomography

Background: A pulmonary nodule is defined as a rounded or irregular opacity, well or poorly defined, measuring up to 3 cm in diameter. Early detection the malignancy of nodules has a significant role in decreasing the mortality, increasing the survival time and consider as early diagnosis lung cancer. The main risk factors are those of current or former smokers, aged 55 to 74 years with a smoking history of at least 1 pack-day. Low dose CT: screening individuals with high risk of lung cancer by low dose CT scans could reduce lung cancer mortality by 20 percent compared to chest X-ray. Radiation dose has to maximum reduced but respect the rule of ALARA (As Low as Resonably Archivable). LungRADS 2014: Classification of American College of Radiology, LungRADS, is a newly application but showed many advantages in comparison with others classification such as increasing positive predict value (PPV), no result of false negative and cost effectiveness. Key words: LungRADS, screening lung nodule, low dose CT, lung cancer

Low Dose Depot Oral Vitamin D3 Versus Daily Oral Vitamin D3 for Treating Nutritional Rickets: A Randomized Clinical Trial

2021 ◽  
pp. 1-18
Author(s):  
Ravneet Kaur Saluja ◽  
Pooja Dewan ◽  
Sunil Gomber ◽  
SV Madhu ◽  
Shuchi Bhatt ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D3 ◽  
Low Dose ◽  
Care Hospital ◽  
Oral Vitamin ◽  
Nutritional Rickets ◽  
Vitamin D Levels ◽  
Radiological Healing ◽  
25 Oh Vitamin D

Abstract Objective: To compare the efficacy of daily versus low dose depot oral vitamin D3 for treating nutritional rickets. Design: Randomized Controlled Trial Setting: Paediatrics department of a tertiary care hospital catering to semi-urban and rural population in Delhi, India Methods: We randomized 66 children aged 3 months to 5 years with nutritional rickets to receive either daily oral vitamin D3 drops (3-12 months: 2000 IU; >12 months-5y: 4000 IU; n=33) for 12 weeks duration, or a single oral depot dose of vitamin D3 granules (3-12 months: 60,000 IU; >12 months-5y: 150,000 IU; n=33). Results: Participants in both groups had comparable demographic characteristics, laboratory features and radiological severity of rickets. 33 participants in each group received the assigned intervention and all were followed up till 12 weeks. At 12 weeks follow up, children in both groups showed a significant improvement in all biochemical parameters [serum calcium, phosphorus, alkaline phosphatase, parathormone and 25(OH) vitamin D levels] as well as radiological healing. At 12 weeks, the mean (SD) serum 25(OH) vitamin D levels (nmol/L) were statistically comparable in both groups [daily: 120.2 (83.2), depot: 108 (74), P=0.43] and 31 (94%) children in each group had radiological healing (Thacher score <1.5). Two children in each group persisted to have raised alkaline phosphatase and one child each in the daily group continued to have hypocalcemia and hypophosphatemia at 12 weeks. Conclusion: Low dose oral depot vitamin D3 is an effective alternative to daily oral vitamin D3 for nutritional rickets.

Direct reconstruction of anatomical change in low-dose lung nodule surveillance

2021 ◽  
Vol 8 (02) ◽  
Author(s):  
Jessica D. Flores ◽  
Grace J. Gang ◽  
Hao Zhang ◽  
Cheng T. Lin ◽  
Shui K. Fung ◽  
...  
Keyword(s):  
Low Dose ◽  
Lung Nodule ◽  
Anatomical Change

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 Safety and reliability of computed tomography-guided lipiodol marking for undetectable pulmonary lesions

2020 ◽  
Vol 30 (4) ◽  
pp. 546-551
Author(s):  
Kazuhiro Ito ◽  
Junichi Shimada ◽  
Masanori Shimomura ◽  
Kunihiko Terauchi ◽  
Motohiro Nishimura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lesion Size ◽  
Ct Guided ◽  
Pulmonary Lesions ◽  
Pleural Surface ◽  
Intraoperative Fluoroscopy ◽  
Safety And Reliability ◽  
Preoperative Ct ◽  
The Mean ◽  
Lipiodol Marking

Abstract OBJECTIVES This study aimed to evaluate the safety and reliability of percutaneous computed tomography (CT)-guided lipiodol marking for undetectable pulmonary lesions before video-assisted thoracic surgery (VATS). METHODS We retrospectively analysed the cases of CT-guided lipiodol marking followed by VATS in 9 institutes from May 2006 to March 2018. Lipiodol (0.2–0.5 ml) was percutaneously injected closely adjacent to undetectable pulmonary lesions with computed-tomography guidance. Lipiodol spots were identified using C-arm-shaped fluoroscopy during VATS. We grasped the lipiodol spots, including the target lesions, with ring-shaped forceps and resected them. RESULTS Of 1182 lesions, 1181 (99.9%) were successfully marked. In 1 case, the injected lipiodol diffused, and no spot was created. Of the 1181 lesions, 1179 (99.8%) were successfully resected with intraoperative fluoroscopy. Two lipiodol spots were not detected because of the lipiodol distribution during the division of pleural adhesions. The mean lesion size was 9.1 mm (range 1–48 mm). The mean distance from the pleural surface was 10.2 mm (range 0–43 mm). Lipiodol marking-induced pneumothorax occurred in 495 (57.1%) of 867 cases. Of these, chest drainage was required in 59 patients (6.8%). The other complications were 19 (2.2%) cases of bloody sputum, 3 (0.35%) cases of intravascular air, 1 (0.12%) case of pneumonia and 1 (0.12%) case of cerebral infarction. There were no lipiodol marking-induced deaths or sequelae. CONCLUSIONS Preoperative CT-guided lipiodol marking followed by VATS resection was shown to be a safe and reliable procedure with a high success rate and acceptably low severe complication rate.

scholarly journals Dosimetry and Comparison between Different CT Protocols (Low Dose, Ultralow Dose, and Conventional CT) for Lung Nodules’ Detection in a Phantom

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Cleverson Alex Leitão ◽  
Gabriel Lucca de Oliveira Salvador ◽  
Priscilla Tazoniero ◽  
Danny Warszawiak ◽  
Cristian Saievicz ◽  
...  
Keyword(s):  
Detection Rate ◽  
Low Dose ◽  
Lung Nodule ◽  
Lung Nodules ◽  
Ultralow Dose ◽  
Thermoluminescent Dosimeters ◽  
Significant Difference ◽  
Nodule Detection ◽  
The Difference ◽  
Conventional Ct

Background. The effects of dose reduction in lung nodule detection need better understanding. Purpose. To compare the detection rate of simulated lung nodules in a chest phantom using different computed tomography protocols, low dose (LD), ultralow dose (ULD), and conventional (CCT), and to quantify their respective amount of radiation. Materials and Methods. A chest phantom containing 93 simulated lung nodules was scanned using five different protocols: ULD (80 kVp/30 mA), LD A (120 kVp/20 mA), LD B (100 kVp/30 mA), LD C (120 kVp/30 mA), and CCT (120 kVp/automatic mA). Four chest radiologists analyzed a selected image from each protocol and registered in diagrams the nodules they detected. Kruskal–Wallis and McNemar’s tests were performed to determine the difference in nodule detection. Equivalent doses were estimated by placing thermoluminescent dosimeters on the surface and inside the phantom. Results. There was no significant difference in lung nodules’ detection when comparing ULD and LD protocols ( p = 0.208 to p = 1.000 ), but there was a significant difference when comparing each one of those against CCT ( p < 0.001 ). The detection rate of nodules with CT attenuation values lower than −600 HU was also different when comparing all protocols against CCT ( p < 0.001 to p = 0.007 ). There was at least moderate agreement between observers in all protocols (κ-value >0.41). Equivalent dose values ranged from 0.5 to 9 mSv. Conclusion. There is no significant difference in simulated lung nodules’ detection when comparing ULD and LD protocols, but both differ from CCT, especially when considering lower-attenuating nodules.

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