Ultrasound-Guided Shockwave Lithotripsy Reduces Radiation Exposure and Has Better Outcomes for Pediatric Cystine Stones

2016 ◽  
Vol 98 (4) ◽  
pp. 429-435 ◽  
Author(s):  
Mehmet Resit Goren ◽  
Vinil Goren ◽  
Cevahir Ozer
Author(s):  
Samer N. Narouze

Ultrasound provides direct visualization and imaging of various soft tissues without radiation exposure. Thus, it is a very appealing modality in neck injections, with the magnitude of critical soft-tissue structures compacted in a very vascular area. Moreover, ultrasound imaging allows real-time needle advancement and monitoring the spread of injectate, which improves the accuracy of the block and minimizes the risk of intravascular injection. This chapter reviews the feasibility and safety of the ultrasound-guided approach. It also provides a new insight into the technique and why some practitioners prefer an “extraforaminal” nerve root approach rather than the traditional “transforaminal” epidural approach.


2020 ◽  
Author(s):  
Mamoru Takenaka ◽  
Makoto Hosono ◽  
Madan Rehani ◽  
Yasutaka Chiba ◽  
Yasuo Otsuka ◽  
...  

Multimodality Imaging Guidance for Interventional Pain Management is a comprehensive resource covering fluoroscopy-guided procedures, ultrasound interventions, and computed tomography (CT)-guided procedures used in interventional pain management. Fluoroscopy-guided procedures have been the standard of care for many years and are widely available and affordable. Due to the lack of radiation exposure and the ability to see various soft tissue structures, ultrasound-guided interventions are more precise and safer. The benefits, disadvantages, and basic techniques of CT-guided procedures, primarily performed by radiologists, are also included in the volume. By covering all imaging modalities, Multimodality Imaging Guidance for Interventional Pain Management allows for an efficient comparison of the capabilities of each modality.


2020 ◽  
Vol 27 (2) ◽  
pp. 128-132
Author(s):  
Ryota Kimura ◽  
Naohisa Miyakoshi ◽  
Yusuke Yuasa ◽  
Yoichi Shimada

Background: To reduce the risk of radiation exposure, we explored whether the total dorsal ramus block can be performed under ultrasound guidance. We evaluated the accuracy and effect of ultrasound-guided total dorsal ramus block for chronic low back pain. Methods: Accuracy of ultrasound guidance after total dorsal ramus block to the L4–L5 level was evaluated using fluoroscopy ( n = 5). A second group was assigned into two groups: ultrasound-guided group ( n = 19) or fluoroscopy-guided group ( n = 18). The effects and adverse events were compared. Results: In all cases, the fluoroscopic findings revealed an accurate injection at the L5 level. Significant alleviation of pain was observed after ultrasound-guided total dorsal ramus block, and comparable effectiveness was observed with both ultrasound guidance and fluoroscopic guidance. There were no complications. Conclusions: The ultrasound-guided total dorsal ramus block may sufficiently block all three branches of the lumbar dorsal ramus at the targeted level resulting in significant pain reduction.


1999 ◽  
Vol 1 (3) ◽  
pp. 143-151 ◽  
Author(s):  
William Que ◽  
Nelson Videla ◽  
Deanna Langer

Purpose: (1) To present data on I–125 seed calibration in a clinical setting so that reasonable tolerance levels can be set for the discrepancy in seed strength between manufacturer specified value and institution measured value; (2) To present data on measured exposure rates and estimate radiation exposure levels associated with I–125 prostate implants.Methods and Materials: Ten percent of each batch for 50 batches of I–125 seeds were calibrated using an HDR 1000 PLUS well chamber with a single source holder. Exposure rates due to I–125 were measured by survey meters with a scintillation probe designed for low energy photon counting, as well as a survey meter of the ionization chamber type. Exposure rates of an unshielded I–125 seed, a needle loaded with three seeds, and 54 prostate implant patients immediately after the implant were obtained.Results: Compared to the manufacturer stated midrange seed strength for a batch of seeds, the average seed strength of sampled seeds had maximum deviations of ±8%, however for 45 out of 50 batches the deviation was less than ±5%. Measured single seed strength deviated up to ±12% from the manufacturer stated midrange value, and between −11% to 7% from the mean of the sampled batch. The exposure rate of a 1.39×107 Bq (0.375 mCi) unshielded I–125 seed was about 1.548×10−8C/kgh (0.06 mR/h) at 1 m, and 1.29×10−6C/kgh (5 mR/h) at 10 cm. For a needle loaded with three seeds, the exposure rate was 1.29×10−8C/kgh (0.05 mR/h) at the handle, and 1.29×10−7C/kgh (0.5 mR/h) along the shaft. For patients implanted with I–125 seeds in the prostate, the average exposure rate was 3.61×10−8C/kgh (0.14 mR/h) at 1m, and 4.13×10−7C/kgh (1.6 mR/h) at the pelvis surface.Conclusions: For the mean seed strength a first action level should be set at a deviation of at least 5% deviation from the manufacturer stated midrange value. For individual seeds, a first action level set at 10% deviation from the manufacturer stated midrange value seems reasonable. A person performing I–125 seed calibration or seed loading could receive up to 0.5 mSv (50 mR) per case to the hands. In the first year following an I–125 prostate implant, the spouse of the patient could receive slightly over 1mSv from the I–125 in the patient. A co-worker should not receive more than 0.5 mSv from the patient.


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