scholarly journals Unresectable Carcinoma Pancreas : Efficacy of Imaging in Diagnosing and Labeling them as ‘Unresectable’

2013 ◽  
Vol 12 (3) ◽  
pp. 23-26 ◽  
Author(s):  
Md Abdullah Al Farooq ◽  
MA Mushfiqur Rahman ◽  
Tania Tajreen ◽  
Eqramur Rahman ◽  
Md Minhajuddin Sajid ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pancreatic Carcinoma ◽  
Imaging Modality ◽  
Preoperative Imaging ◽  
Mri Imaging ◽  
Medical College ◽  
Magnetic Resonance Imaging Mri ◽  
Carcinoma Pancreas ◽  
Operative Findings ◽  
Better Than

Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imaging like ultrasonography (USG), computerized tomography (CT) scan and magnetic resonance imaging (MRI).Imaging also gives the opportunity to assess resectability. In our country MRI and CT scan are not widely available and most of the pancreatic carcinoma is too advanced for curative surgical resection when diagnosed. These are unresectable carcinoma pancreas (UCP). Objectives: To evaluate the efficacy of imaging in diagnosing carcinoma pancreas and to assess resectability after comparing them with peroperative findings. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in Bangladesh Institute for Research and Rehabilitation in Diabetic Endocrine and Metabolic disorders (BIRDEM) hospital, Dhaka, Bangladesh from July 2004 to June 2006 (2 years). After laparotomy findings and histopathological confirmation 50 patients were labeled as UCP. Among 50 patients male were 28 & female patients were 22. Imaging modalities used before surgery was assessed and compared with per operative findings. USG were done in all patients and CTscan in 45 patients. MRI was done in 08 patients suspected clinically as pancreatic carcinoma where USG /CT scan had failed to reach a conclusion. Findings of the various imaging studies regarding diagnosis and unresectability were compared with per operative findings. Results: USG was able to diagnose 42 (84%) pancreatic carcinoma patients with unresectibility in 29 (69%). Forty five patients (90%) were diagnosed by CT scan and could label 38 (84.44%) as unresectable. MRI was 100% accurate to diagnose and label the entire 08 patient as unresectable carcinoma pancreas. Cumulative multimodal preoperative imaging was 91.33% accurate in diagnosing carcinoma pancreas and could tell the features of unresectibility in 73.59% patients. Conclusion: CT scan should be the primary imaging modality for diagnosing pancreatic carcinoma and its resectability. MRI is very promising for diagnosing and assessing UCP. Multimodal imaging is better than single imaging. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 23-26

MRI-only Radiation Therapy: Pseudo-CT Based on Cubic-Feature Extraction and Alternative Regression Forest

2020 ◽  
Vol 34 (14) ◽  
pp. 2054033
Author(s):  
Yongsheng Hu ◽  
Liyi Zhang
Keyword(s):  
Radiation Therapy ◽  
Ct Scan ◽  
Local Binary Pattern ◽  
Mapping Method ◽  
Random Forest Regression ◽  
Tissue Contrast ◽  
Gabor Feature ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri ◽  
Better Than

Despite the extensive attention attracted by magnetic resonance imaging (MRI) in the radiation therapy, computed tomography was reintroduced by the researchers. During the calculation process of the 3D dose distribution of tissues, there were some arguments about the electron density information obtained from the CT scan. However, the CT-provided bones are accurate for constructing a radiograph. Recently, the advantages boosted by the soft tissue contrast relying on MRI and as well as the advantages boosted by CT imaging have been combined by the using of MRI/CT. Unfortunately, disadvantages still exist in the MRI/CT workflow because the voxel-intensities are unbalanced in the MRI and the CT scan. Here, based on the mapping method of CT and MRI, the potential of pseudo-CT (PCT) instead of CT planning was studied. The estimated PCT only from the corresponding MRI was obtained by using the patch-based random forest regression. The CT voxel target was trained by 3D Gabor feature in the MRI cube and the Local Binary Pattern (LBP). Besides, the regression task was solved by the alternative regression forest. According to the experiment, the method performs better than the current dictionary learning-based (DLB) method or atlas-based (AB) method.

Use of Preoperative Imaging in Primary Hyperparathyroidism

2020 ◽  
Vol 106 (1) ◽  
pp. e328-e337
Author(s):  
David T Broome ◽  
Robert Naples ◽  
Richard Bailey ◽  
Zehra Tekin ◽  
Moska Hamidi ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Ct Scan ◽  
Predictive Value ◽  
Imaging Modalities ◽  
Preoperative Imaging ◽  
Multiglandular Disease ◽  
Cure Rate ◽  
4D Ct ◽  
Operative Findings ◽  
Double Adenomas

Abstract Context Preoperative imaging is performed routinely to guide surgical management in primary hyperparathyroidism, but the optimal imaging modalities are debated. Objective Our objectives were to evaluate which imaging modalities are associated with improved cure rate and higher concordance rates with intraoperative findings. A secondary aim was to determine whether additive imaging is associated with higher cure rate. Design, Setting, and Patients This is a retrospective cohort review of 1485 adult patients during a 14-year period (2004-2017) at an academic tertiary referral center that presented for initial parathyroidectomy for de novo primary hyperparathyroidism. Main Outcome Measures Surgical cure rate, concordance of imaging with operative findings, and imaging performance. Results The overall cure rate was 94.1% (95% confidence interval, 0.93-0.95). Cure rate was significantly improved if sestamibi/single-photon emission computed tomography (SPECT) was concordant with operative findings (95.9% vs. 92.5%, P = 0.010). Adding a third imaging modality did not improve cure rate (1 imaging type 91.8% vs. 2 imaging types 94.4% vs. 3 imaging types 87.2%, P = 0.59). Despite having a low number of cases (n = 28), 4-dimensional (4D) CT scan outperformed (higher sensitivity, specificity, positive predictive value, negative predictive value) all imaging modalities in multiglandular disease and double adenomas, and sestamibi/SPECT in single adenomas. Conclusions Preoperative ultrasound combined with sestamibi/SPECT were associated with the highest cure and concordance rates. If pathology was not found on ultrasound and sestamibi/SPECT, additional imaging did not improve the cure rate or concordance. 4D CT scan outperformed all imaging modalities in multiglandular disease and double adenomas, and sestamibi/SPECT in single adenomas, but these findings were underpowered.

scholarly journals Injection propofol and ketamine in pediatric and adult patients undergoing diagnostic radiological procedure (magnetic resonance imaging and computed tomography scan)

2020 ◽  
Vol 9 (1) ◽  
pp. 56
Author(s):  
Mahendra Agrawal ◽  
Pushpal Gandhi ◽  
Bhavika Agrawal ◽  
Simarn Behl
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
Adult Patients ◽  
Resonance Imaging ◽  
Observation Study ◽  
Medical College ◽  
Radiological Procedure ◽  
Magnetic Resonance Imaging Mri

Background: The purpose of this study was to evaluate the effect of propofol and ketamine in pediatric and adult patients undergoing diagnostic radiological procedure (magnetic resonance imaging (MRI) and computed tomography (CT) scan).  Methods: A comparative observation study conducted at Sri Aurobindo Medical College and PG Institute, Indore, Department of Anesthesiology after approval from Institutional ethical committee. The duration of this study was April 2019 to May 2020. Group KP: Inj. combination of ketamine and propofol (ketofol) with bolus dose of 0.50 mg/kg and 0.75 mg/kg respectively in initial 10 min followed by infusion at the rate of 0.05 ml/kg/hr till the completion of imaging.Results: The mean age was 11.55±2.80 in children and 31.34±2.43 in adult. Mean weight of patients were 30.54±8.86 in children and 60.21±10.45 in adult. Gender distribution (male:female) were 24/16 and 26/14 children group and adult group.  Conclusions: We found that the combination of ketamine (ketofol) and propofol to be safe and well tolerated in pediatric patients and adult patients undergoing diagnostic radiological procedure (MRI and CT scan). 

scholarly journals Magnifying i-scan Imaging for Endoscopic Diagnosis of Helicobacter pylori Infection: A Prospective Study

2020 ◽  
Vol 11 (02) ◽  
pp. 112-117
Author(s):  
Avinash Bhat Balekuduru ◽  
Aarathi Rau ◽  
Mangala Gouri ◽  
Athish Shetty ◽  
Satyaprakash Bonthala Subbaraj
Keyword(s):  
Helicobacter Pylori ◽  
Imaging Modality ◽  
Accurate Diagnosis ◽  
Women Patients ◽  
Diagnostic Ability ◽  
White Light Endoscopy ◽  
Medical College ◽  
A Prospective Study ◽  
Better Than

Abstract Background DEFINA (EPK 3000) plus (with i-scan) is a digital chromoendoscopy. It uses surface/tone/contrast enhancement for detection, demarcation, and characterization of lesions. The aim of this study was to compare the usefulness of i-scan and conventional magnification white light endoscopy (M-WLE) for diagnosing Helicobacter pylori (Hp) infection in stomach. Patients and Methods Subjects undergoing evaluation for functional dyspepsia were prospectively enrolled at Ramaiah Medical College and Hospitals, Bangalore from November 2018 to February 2019. In total, 68 participants underwent gastroscopy with standard M-WLE followed by i-scan. Two biopsies from greater curve at 3 cm from the angulus were collected for histology. Successful diagnosis of Hp using imaging modality with M-WLE and i-scan were compared with histology. Results A total of 68 (36 men and 32 women) patients with a mean age of 47 ± 13 years (range 18–75 years) were enrolled in our study. The prevalence of Hp on the biopsies was 41%; 64% of the patients used proton pump inhibitors, 20% were current smokers; 25% of the patients were consuming alcohol. The sensitivity: 96.4%; specificity: 95%; accuracy: 95.5% of i-scan in diagnosis of Hp gastritis is better than the sensitivity: 50%; specificity: 50%; accuracy: 50% with M-WLE. Conclusion In conclusion, the diagnostic ability of i-scan (95%) for predicting Hp status is acceptable as compared with M-WLE (50%) for accurate diagnosis. The results suggest that i-scan improves endoscopic diagnostic accuracy of Hp infection compared with M-WLE.

High-Resolution CT Angiogram for Lower Extremity Vein Mapping

2017 ◽  
Vol 83 (3) ◽  
pp. 257-259
Author(s):  
Mark P. Wright ◽  
Matthew R. Smeds ◽  
Lonnie Wright ◽  
Ahsan T. Ali
Keyword(s):  
High Resolution ◽  
Lower Extremity ◽  
Imaging Modality ◽  
Duplex Ultrasound ◽  
Preoperative Imaging ◽  
Venous Anatomy ◽  
Region Duplication ◽  
Ct Angiogram ◽  
Diagnostic Angiography ◽  
Operative Findings

High-resolution CTangiogram (CTA) has replaced traditional diagnostic angiography as the main preoperative imaging modality for vascular surgery patients. Although the use of CTA is increasing for arterial imaging, it has not been used routinely for vein mapping. The goal of this study was to evaluate the accuracy of CTA for venous anatomy and compare it to a standard venous duplex ultrasound (DUS). When the vein was used for bypass, the quality and size of the vein were evaluated in the operating room. As part of a preoperative workup before lower extremity revascularization, 16 patients underwent a CTA followed by a DUS. Although the CTA provided useful arterial anatomy, the greater saphenous vein (GSV) was also evaluated. In total, 22 GSV were evaluated in 11 patients. The vein diameter was measured by CTA at four locations: saphenofemoral junction, midthigh, knee joint, and midcalf region. Duplication or other anomalies were also noted, when present. These measurements were taken by an interventional radiologist independently and before the DUS. Routine vein mapping with diameter measurements were then performed with DUS in a vascular laboratory by registered vascular technicians. Measurements for each limb were then compared between CTA and DUS using linear regression (mean ± SD). There was no statistical difference in the diameter of the GSV when measured using a CT or a DUS at the standard points of measurements. Furthermore, the operative findings confirmed the CTA to be very accurate. There were four duplications in the GSV which were all seen on the CTA, whereas only two of these were identified by DUS. There was one vein found to be sclerotic and unusable by DUS that was not identified by CTA. CTA is as accurate as DUS for evaluation of superficial venous anatomy in the lower extremities. CTA can provide global anatomy and can be used as a one-stop imaging modality for both arterial and venous anatomy. However, sclerosis is not detected by CTA.

scholarly journals Diagnostic Accuracy of Computed Tomogram in the Evaluation of a Neck Mass

2011 ◽  
Vol 51 (184) ◽  
Author(s):  
M K Shrestha ◽  
D Ghartimagar ◽  
A Ghosh
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Imaging Modality ◽  
Neck Mass ◽  
Benign Tumors ◽  
Benign Lesions ◽  
Medical College ◽  
Neck Masses ◽  
Malignant Lesions ◽  
Malignant And Benign Tumors

Introduction: The concept of dividing extracranial head and neck into different spaces is a notion that dates back to the 1800s. Various studies have led to detailed description of the soft tissue spaces that are contained within the fascial layers. This study was carried out to determine the accuracy of computed tomogram (CT) in differentiating malignant from benign lesions in the neck, to study the spatial distribution of different types of histological groups in the neck and the prevalence of malignant versus benign diseases involving the neck. Methods: This was a hospital-based, prospective study conducted in the department of Radiodiagnosis, Kasturba Medical college, Mangalore, from 2005-2008. A hundred consecutive patients referred for CT scan examination presenting with complaints related to involvement of neck spaces or presence of palpable neck masses were enrolled in this study. The details of all the cases regarding their radiological fi ndings and histopathology were reviewed. Results: Of the 100 patients studied, 53 % had malignant lesions, out of which 43 % were squamous cell carcinoma and 4 % were metastatic lymph nodal involvement. Twenty percent of the lesions were of an infective origin while 23 % were benign and congenital cystic lesions. Conclusions: CT scan as an imaging modality has the ability to evaluate the malignant and benign tumors of the neck. Considering histopathology as the gold standard, the sensitivity of CT in detecting malignant/benign lesions was 96.5 % with a specifi city of 100 %. The positive predictive value was 100 % and the negative predictive value 95.2 %. Keywords: CT scan, neck mass, neck spaces.

scholarly journals Usefulness of CT Scan and MRI for the Detection and Evaluation of Brain Tumors

2020 ◽  
Vol 8 (1) ◽  
pp. 154-158
Author(s):  
D. Saraswathi ◽  
G. Srirama Murthy
Keyword(s):  
Brain Tumors ◽  
Ct Scan ◽  
Cross Sectional Study ◽  
Brain Parenchyma ◽  
Intracranial Tumors ◽  
Mri Imaging ◽  
Cross Sectional ◽  
Female Ratio ◽  
Magnetic Resonance Imaging Mri ◽  
Male To Female

Background: Intracranial tumors can arise from various locations in the brain parenchyma. Computed tomography scan (CT) and magnetic resonance imaging (MRI) are important modalities for diagnosis of intracranial tumors. The aim of the study is to study the usefulness of CT scan and MRI for the detection and evaluation of brain tumors. Subjects and Methods: This was a prospective cross sectional study comprising of 95 patients diagnosed with brain tumors clinically. CT scan was done in all the patients and MRI was done in 45 patients. Findings were correlated with histopathology. Results: In the present study, age group distribution included from 20 years to more than 50 years.In the present study males were predominant and the male to female ratio was 1.3:1. All the cases, (100%) presented with seizures, followed by headache, hemiparesis and vomiting. Conclusion: CT scan and MRI imaging modalities are of utmost importance in diagnosing brain tumors. Early diagnosis is important and the imaging guides the neurosurgeon regarding appropriate surgical approach.

scholarly journals National trends of preoperative imaging modalities before partial nephrectomy for renal masses in the U.S. from 2007–2015

2018 ◽  
Vol 13 (3) ◽  
Author(s):  
Jae Heon Kim ◽  
Shufeng Li ◽  
Yash Khandwala ◽  
Francesco Del Giudice ◽  
Kyung Jin Chung ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Imaging Modalities ◽  
Preoperative Imaging ◽  
Observational Period ◽  
Renal Masses ◽  
Frequency Rate ◽  
Increasing Trend ◽  
Magnetic Resonance Imaging Mri ◽  
National Trends ◽  
Performance Rate

Introduction: Although the performance of partial nephrectomies (PN) for renal masses has increased rapidly over the years, only a few studies have investigated the frequency and patterns of preoperative imaging modalities. The aim of this study was to investigate the frequency and patterns in preoperative imaging modalities before PN. Methods: A total of 21 445 patients who underwent PN between 2007 and 2015 were selected from a national representative population in the MarketScan database and included in this study. The annual incidence and proportion of PN, as well as the use of each preoperative imaging modality were analyzed. Results: Both annual crude number and frequency rate of PN decreased or became static since 2012. Computed tomography (CT) shows the greatest proportion of the crude number and percentage; despite a slight decrease in percentage, it is still >80%. Among the combinations, CT alone and CT combined with ultrasonography showed the highest performance rate during the complete observational period. The proportion of all other combinations, which include other complex combinations except CT alone, CT plus ultrasonography, CT plus magnetic resonance imaging (MRI), and CT plus MRI plus ultrasonography, was 13.95% in 2007, but increased to 19.04% in 2014. Conclusions: CT still plays a major role in preoperative imaging for renal masses, whereby CT alone and CT combined with ultrasonography account for a major proportion of the preoperative imaging patterns. The use of other imaging combinations, as well as renal biopsies, shows an increasing trend. Additional studies are needed to investigate whether this trend in preoperative imaging is related to the frequency rate of PN.

Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin
Keyword(s):  
Comparative Study ◽  
Acute Urinary Retention ◽  
Bladder Capacity ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

Comparative study of ultrasonographic findings with the operative findings of biliary surgery

2020 ◽  
Vol 22 (1) ◽  
pp. 25-29
Author(s):  
Zubayer Ahmad ◽  
Mohammad Ali ◽  
Kazi lsrat Jahan ◽  
ABM Khurshid Alam ◽  
G M Morshed
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Imaging Modality ◽  
False Positive Rate ◽  
Gallstone Disease ◽  
False Negative ◽  
False Negative Rate ◽  
Biliary Disease ◽  
Biliary Surgery ◽  
Operative Findings

Background: Biliary disease is one of the most common surgical problems encountered all over the world. Ultrasound is widely accepted for the diagnosis of biliary system disease. However, it is a highly operator dependent imaging modality and its diagnostic success is also influenced by the situation, such as non-fasting, obesity, intestinal gas. Objective: To compare the ultrasonographic findings with the peroperative findings in biliary surgery. Methods: This prospective study was conducted in General Hospital, comilla between the periods of July 2006 to June 2008 among 300 patients with biliary diseases for which operative treatment is planned. Comparison between sonographic findings with operative findings was performed. Results: Right hypochondriac pain and jaundice were two significant symptoms (93% and 15%). Right hypochondriac tenderness, jaundice and palpable gallbladder were most valuable physical findings (respectively, 40%, 15% and 5%). Out of 252 ultrasonically positive gallbladder, stone were confirmed in 249 cases preoperatively. Sensitivity of USG in diagnosis of gallstone disease was 100%. There was, however, 25% false positive rate detection. Specificity was, however, 75% in this case. USG could demonstrate stone in common bile duct in only 12 out of 30 cases. Sensitivity of the test in diagnosing common bile duct stone was 40%, false negative rate 60%. In the series, ultrasonography sensitivity was 100% in diagnosing stone in cystic duct. USG could detect with relatively good but less sensitivity the presence of chronic cholecystitis (92.3%) and worm inside gallbladder (50%). Conclusion: Ultrasonography is the most important investigation in the diagnosis of biliary disease and a useful test for patients undergoing operative management for planning and anticipating technical difficulties. Journal of Surgical Sciences (2018) Vol. 22 (1): 25-29

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