scholarly journals Intraoperative Digital Analysis of Ablation Margins (DAAM) by Fluorescent Confocal Microscopy to Improve Partial Prostate Gland Cryoablation Outcomes

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4382
Author(s):  
Oscar Selvaggio ◽  
Ugo Giovanni Falagario ◽  
Salvatore Mariano Bruno ◽  
Marco Recchia ◽  
Maria Chiara Sighinolfi ◽  
...  

Partial gland cryoablation (PGC) aims at destroying prostate cancer (PCa) foci while sparing the unaffected prostate tissue and the functionally relevant structures around the prostate. Magnetic Resonance Imaging (MRI) has boosted PGC, but available evidence suggests that ablation margins may be positive due to MRI-invisible lesions. This study aimed at determining the potential role of intraoperative digital analysis of ablation margins (DAAM) by fluoresce confocal microscopy (FCM) of biopsy cores taken during prostate PGC. Ten patients with low to intermediate risk PCa scheduled for PGC were enrolled. After cryo-needles placement, 76 biopsy cores were taken from the ablation margins and stained by the urologist for FCM analysis. Digital images were sent for “real-time” pathology review. DAAM, always completed within the frame of PGC treatment (median time 25 min), pointed out PCa in 1/10 cores taken from 1 patient, thus prompting placement of another cryo-needle to treat this area. Standard HE evaluation confirmed 75 cores to be cancer-free while displayed a GG 4 PCa in 7% of the core positive at FCM. Our data point out that IDAAM is feasible and reliable, thus representing a potentially useful tool to reduce the risk of missing areas of PCa during PGC.

Author(s):  
Krithika Rangarajan ◽  
Manisha Jana ◽  
Nagesh Wadgera ◽  
Arun Kumar Gupta ◽  
Minu Bajpai ◽  
...  

Abstract Objectives Accurate delineation of anatomy in children with ambiguous genitalia early in life is important. This commonly involves conventional fluoroscopic genitogram (traumatic to the child) and magnetic resonance imaging (MRI) examination (involves sedation). In this study, our objectives were twofold: (1) to describe the findings on transperineal ultrasound (TPUS) in normal children and (2) to describe the findings on TPUS in children with ambiguous genitalia and correlate them with conventional genitogram. Materials and Methods TPUS was prospectively performed in 10 children without genital ambiguity (5 girls and 5 boys). Subsequently, 15 consecutive children having disorders of sex differentiation (DSDs) with genital ambiguity underwent TPUS. The presence or absence of müllerian structures was documented. Of these patients, 14 also underwent conventional genitogram as a part of routine evaluation. The gold standard was established either by comparison with surgical findings (in patients who underwent surgery) or by comparison with a combination of findings on genitogram and transabdominal ultrasound in patients who did not undergo surgery. Results In all normal children, lower urogenital tracts could be clearly delineated on TPUS. Out of the 15 children with ambiguous genitalia, TPUS could establish the presence/absence of müllerian structures in 14. This was concordant with findings on conventional genitogram/surgery. In one patient, müllerian structure was missed on TPUS but demonstrated on genitogram. In two children, TPUS showed the müllerian structure, which was not seen on genitogram. When both the controls and the cases were combined, TPUS had an accuracy of 95% and specificity of 100% in the detection of müllerian structures. Conclusion TPUS is feasible and accurate in demonstration of lower urogenital tract anatomy in children with DSDs having ambiguous genitalia. It can be performed without sedation, and is suitable for use as a screening modality in children with ambiguous genitalia.


Author(s):  
  Нина Юрьевна Шокина ◽  
  Габриэль Тешнер ◽  
  Андреас Бауэр ◽  
  Камерон Тропеа ◽  
  Херберт Эггер ◽  
...  

Напряжение сдвига на стенке количественно определяет силу трения течения крови о стенки сосудов. Магнитнорезонансная томография (МРТ) позволяет проводить неинвазивные измерения скорости течения крови, которая требуется для вычисления напряжения сдвига на стенке. В статье представлено введение в квантификацию напряжения сдвига на стенках больших кровеносных сосудов с помощью МРТ. Рассмотрены роль напряжения сдвига на стенке как потенциального биомаркера сердечнососудистых заболеваний, сердечнососудистая МРТ, методы квантификации напряжения на стенке с помощью МРТ, их точность и валидация. В качестве примера представлен универсальный метод нелинейной регрессии для квантификации напряжения сдвига на стенке с помощью МРТ для полностью развившихся турбулентных течений в трубах. Новый, полностью автоматический и быстрый локальный метод даёт точные оценки независимо от пространственного разрешения и может служить надёжным эталонным методом для валидации более обобщённых методов оценки напряжения сдвига на стенке перед их клиническим применением. Wall shear stress (WSS) quantifies the frictional force that flowing blood exerts on a vessel wall. Magnetic Resonance Imaging (MRI) enables noninvasive measurements of blood flow velocities that are needed for WSS computation. An introduction into MRIbased WSS quantification in large blood vessels is presented. The possible role of WSS as a potential biomarker in cardiovascular diseases, cardiovascular MRI, MRbased WSS quantification methods, and their accuracy and validation are considered. As an example, the generic nonlinear regression method for MRIderived WSS quantification in fully developed turbulent stationary pipe flows is presented. The new method is a fully automatic and fast local WSS estimator, which produces accurate estimates independent from the spatial resolution of the measurement and may serve as a reliable reference for validation of more generic WSS estimators prior to their clinical applications.


2009 ◽  
Vol 19 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Vanessa N. Harry ◽  
Heather Deans ◽  
Emma Ramage ◽  
David E. Parkin ◽  
Fiona J. Gilbert

Magnetic resonance imaging (MRI) has become an indispensable tool in the assessment of malignant disease. With increasingly sophisticated systems and technical advancements, MRI has continued to expand its role in providing crucial information regarding cancer diagnosis and management. In gynecological malignancies, this modality has assumed greater responsibility, particularly in the evaluation of cervical and endometrial cancers. In addition to conventional imaging, innovative techniques such as dynamic contrast-enhanced MRI and diffusion-weighted MRI show promise in offering early assessment of tumor response. This paper reviews the current role of MRI in gynecological cancers and highlights the potential of novel techniques in improving patient care.


2017 ◽  
Vol 01 (04) ◽  
pp. E294-E306 ◽  
Author(s):  
Mike Wattjes ◽  
Peter Raab

AbstractMagnetic resonance imaging (MRI) plays an important role in the diagnosis of multiple sclerosis and has been incorporated into the McDonald diagnostic criteria for MS. In particular, for the exclusion of important differential diagnosis and comorbidities, new MRI markers have been established such as the “central vein sign”. In addition to diagnostic purposes, the role of MRI in MS monitoring is becoming increasingly important, particularly for pharmacovigilance. This includes treatment efficacy monitoring, prediction of treatment response and safety monitoring. Quantitative MRI methods and ultra-high-field MRI offer the opportunity for the quantitative assessment of damage in normal-appearing brain tissue. However, the standardization of these techniques with the goal of implementation in clinical routine will be one of the major challenges in the near future.


2009 ◽  
Vol 56 (3) ◽  
pp. 39-44
Author(s):  
R.M. Maksimovic ◽  
B.A. Banko ◽  
J.P. Milovanovic

Computed tomography (CT) and magnetic resonance imaging (MRI) are enabling more precise diagnosis and treatment planning in patients with diseases of the larynx. The aim of this article is to describe the role of these methods in assessment of the laringeal diseases and key local anatomic characteristics important for spread of the disease. CT and MRI have a valuable contribution to the staging of the tumors due to the possibility to show the relationship to the ventricular complex, involvement of the subumucosal spaces, defining craniocaudal and anterposterior extension, laringeal cartilage invasion, as well as regional lymph node metastases.


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