WorldWideScience

Sample records for hifu technique lesions

  1. Measurements of HIFU-induced Lesions in BSA Gel Phantoms for HIFU Treatment of Varicose Veins of Lower Extremity

    Science.gov (United States)

    Ushijima, Hiroyuki; Senoo, Naohiko; Suzuki, Jun; Ichiyanagi, Mitsuhisa; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2011-09-01

    HIFU treatment has been developed for various diseases because of its minimal invasiveness, and we are now developing a HIFU treatment for varicose veins of the lower extremity. Previous studies have succeeded in occluding rabbit's veins with HIFU, but the success rate was low (about 10%). Failures were mainly caused by skin burns. When the heating lesion comes close to skin, the absorbed ultrasound energy may cause skin burns. Therefore, it is necessary to study the relationships between HIFU lesions and skin burns to improve the success rate. To visualize heating lesions from HIFU, we used tissue-mimicking BSA gel phantoms. We tried various concentrations of BSA in gels, and determined 14% BSA as the most suitable for phantoms for experiments. The attenuation coefficient of the gel was 0.73 dB/cm, and the denaturation temperature was 70 °C. We put the BSA gel phantom in a water tank in which the temperature was kept at 39 °C, and used HIFU exposures at various intensities and irradiation times. After irradiation, we measured the sizes and positions of HIFU-induced lesions, and the results indicate that the sizes of lesion become larger when the intensitiy rises or irradiation time becomes longer. Furthermore, when the intensity rises and irradiation time becomes longer, the heating lesions move closer to upper surface of the gel, which means skin easily gets burned. Thus we have investigated relationships between HIFU parameters and heated lesions that can be used for further research into HIFU treatment of varicose veins of the lower extremity.

  2. Assessment of HIFU lesions by shear-wave elastography: Initial in-vivo results

    Science.gov (United States)

    Anquez, Jeremie; Corréas, Jean-Michel; Criton, Aline; Lacoste, François; Yon, Sylvain

    2012-11-01

    The aim of this work was to evaluate Shear Wave Elastography (SWE) as a tool to visualize HIFU lesions in an acute in-vivo setting. Extracorporeal HIFU sonications of liver were performed on 14 rabbits in 19 consecutive, adjacent pulses, with in situ energies between 75 J and 228 J. A set of images of the sonicated area was acquired prior and post HIFU ablation: 2 orthogonal SWE images (transverse and sagittal) and contrast enhanced CT scan. SWE images were acquired with theAixplorer® device (SuperSonic Imagine, Aix, France). Prior to the treatment, the liver elasticity appeared homogeneous, with a elasticity comprised between 5 and 11 kPa. The lesion extents were manually segmented on post-treatment SWE images and their areas A(SWE)T (transverse) and A(SWE)S (sagittal) were computed. On 3D CT the lesions were segmented as a hypo intense (devascularized) region on 3D CT images, and considered as "ground truth". The transverse and sagittal planes passing by their centers of mass were extracted. The lesion areas were computed for each plane, respectively A(CT)T and A(CT)S. The ratios A(CT)T/A(SWE)T and A(CT)S/A(SWE)S were computed for all the 14 cases. SWE appear to underestimate the lesion extent in the sagittal orientation with respect to CT images, while a good matching is obtained in the transverse orientation.

  3. Fast lesion mapping during HIFU treatment using harmonic motion imaging guided focused ultrasound (HMIgFUS) in vitro and in vivo

    Science.gov (United States)

    Han, Yang; Wang, Shutao; Payen, Thomas; Konofagou, Elisa

    2017-04-01

    The successful clinical application of high intensity focused ultrasound (HIFU) ablation depends on reliable monitoring of the lesion formation. Harmonic motion imaging guided focused ultrasound (HMIgFUS) is an ultrasound-based elasticity imaging technique, which monitors HIFU ablation based on the stiffness change of the tissue instead of the echo intensity change in conventional B-mode monitoring, rendering it potentially more sensitive to lesion development. Our group has shown that predicting the lesion location based on the radiation force-excited region is feasible during HMIgFUS. In this study, the feasibility of a fast lesion mapping method is explored to directly monitor the lesion map during HIFU. The harmonic motion imaging (HMI) lesion map was generated by subtracting the reference HMI image from the present HMI peak-to-peak displacement map, as streamed on the computer display. The dimensions of the HMIgFUS lesions were compared against gross pathology. Excellent agreement was found between the lesion depth (r 2  =  0.81, slope  =  0.90), width (r 2  =  0.85, slope  =  1.12) and area (r 2  =  0.58, slope  =  0.75). In vivo feasibility was assessed in a mouse with a pancreatic tumor. These findings demonstrate that HMIgFUS can successfully map thermal lesions and monitor lesion development in real time in vitro and in vivo. The HMIgFUS technique may therefore constitute a novel clinical tool for HIFU treatment monitoring.

  4. Evaluation of HIFU-induced lesion region using temperature threshold and equivalent thermal dose methods

    Science.gov (United States)

    Chang, Shihui; Xue, Fanfan; Zhou, Wenzheng; Zhang, Ji; Jian, Xiqi

    2017-03-01

    Usually, numerical simulation is used to predict the acoustic filed and temperature distribution of high intensity focused ultrasound (HIFU). In this paper, the simulated lesion volumes obtained by temperature threshold (TRT) 60 °C and equivalent thermal dose (ETD) 240 min were compared with the experimental results which were obtained by animal tissue experiment in vitro. In the simulation, the calculated model was established according to the vitro tissue experiment, and the Finite Difference Time Domain (FDTD) method was used to calculate the acoustic field and temperature distribution in bovine liver by the Westervelt formula and Pennes bio-heat transfer equation, and the non-linear characteristics of the ultrasound was considered. In the experiment, the fresh bovine liver was exposed for 8s, 10s, 12s under different power conditions (150W, 170W, 190W, 210W), and the exposure was repeated 6 times under the same dose. After the exposures, the liver was sliced and photographed every 0.2mm, and the area of the lesion region in every photo was calculated. Then, every value of the areas was multiplied by 0.2mm, and summed to get the approximation volume of the lesion region. The comparison result shows that the lesion volume of the region calculated by TRT 60 °C in simulation was much closer to the lesion volume obtained in experiment, and the volume of the region above 60 °C was larger than the experimental results, but the volume deviation was not exceed 10%. The volume of the lesion region calculated by ETD 240 min was larger than that calculated by TRT 60 °C in simulation, and the volume deviations were ranged from 4.9% to 23.7%.

  5. Thermal ablation of a confluent lesion in the porcine kidney with a clinically available MR-HIFU system

    Science.gov (United States)

    van Breugel, J. M. M.; de Greef, M.; Wijlemans, J. W.; Schubert, G.; van den Bosch, M. A. A. J.; Moonen, C. T. W.; Ries, M. G.

    2017-07-01

    The incidence of small renal masses (SRMs) sized  lesion in the kidney using respiratory-gated MR-HIFU under clinical conditions in a pre-clinical study and (ii) to evaluate the reproducibility of the MR-HIFU ablation strategy. Healthy pigs (n  =  10) under general anesthesia were positioned on a clinical MR-HIFU system with integrated cooling. A honeycomb pattern of seven overlapping ablation cells (4  ×  4  ×  10 mm3, 450 W, <30 s) was ablated successively in the cortex of the porcine kidney. Both MR thermometry and acoustic energy delivery were respiratory gated using a pencil beam navigator on the contralateral kidney. The non-perfused volume (NPV) was visualized after the last sonication by contrast-enhanced (CE) T 1-weighted MR (T 1 w) imaging. Cell viability staining was performed to visualize the extent of necrosis. Results: a median NPV of 0.62 ml was observed on CE-T 1 w images (IQR 0.58-1.57 ml, range 0.33-2.75 ml). Cell viability staining showed a median damaged volume of 0.59 ml (IQR 0.24-1.35 ml, range 0-4.1 ml). Overlooking of the false rib, shivering of the pig, and too large depth combined with a large heat-sink effect resulted in insufficient heating in 4 cases. The NPV and necrosed volume were confluent in all cases in which an ablated volume could be observed. Our results demonstrated the feasibility of creating a confluent volume of ablated kidney cortical tissue in vivo with MR-HIFU on a clinically available system using respiratory gating and near-field cooling and showed its reproducibility.

  6. A new FPGA-driven P-HIFU system with harmonic cancellation technique

    Science.gov (United States)

    Wu, Hao; Shen, Guofeng; Su, Zhiqiang; Chen, Yazhu

    2017-03-01

    This paper introduces a high intensity focused ultrasound system for ablation using switch-mode power amplifiers with harmonic cancellation technique eliminating the 3rdharmonic and all even harmonics. The efficiency of the amplifier is optimized by choosing different parameters of the harmonic cancellation technique. This technique requires double driving signals, and specific signal waveform because of the full-bridge topology. The new FPGA-driven P-HIFU system has 200 channels of phase signals that can form 100 output channels. An FPGA chip is used to generate these signals, and each channel has a phase resolution of 2 ns, less than one degree. The output waveform of the amplifier, voltage waveform across the transducer, shows fewer harmonic components.

  7. High intensity focused ultrasound (HIFU) focal spot localization using harmonic motion imaging (HMI).

    Science.gov (United States)

    Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

    2015-08-07

    Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of high-intensity focused ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic motion imaging for focused ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the -3dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R(2) = 0.821 at p tissue ablation and can be fully integrated into any HMI

  8. Modeling and simulation of HIFU induced lesions using different treatment pattern

    Science.gov (United States)

    Qiao, Shan; Shen, Guofeng; Bai, Jingfeng; Chen, Yazhu

    2012-10-01

    Long heating time is needed to ablate a large area using high intensity focused ultrasound, while multiple-focus pattern or single-focus scan is used. This process may cause unexpected temperature rise in pre-focal regions, which can distort acoustic propagation and affect lesion formations. This article simulates this process by using a thermo-acoustic model, which is based on linear acoustic equations and the heat transfer equation, considering parameter variations due to temperature rising of media on the propagation path. Perfect matched layer (PML) technique is introduced for the absorb boundary condition. Finite difference time-domain (FDTD) method is applied to solve the thermo-acoustic model. The simulations that describe lesion formations in multiple-layer media with different treatment patterns-single focus, multiple-focus and single-focus scan are investigated respectively. These simulations indicate that distortions can be serious with single-focus scan method. Additionally, the single-focus scan patterns applying different interval time length are also simulated. The results imply that the proper interval time can minimize the ultrasound distribution distortion caused by pre-focal heating.

  9. Feasibility of monitoring HIFU prostate cancer therapy using elastography

    Science.gov (United States)

    Souchon, Remi; Chapelon, Jean Y.; Bertrand, Michel J.; Kallel, Faouzi; Ophir, Jonathan

    2001-05-01

    The objective of this study is to investigate the feasibility of elastographic monitoring of High Intensity Focused Ultrasound (HIFU) therapy of prostate cancer. Elastography is an imaging technique based on strain estimation in soft tissues under quasi-static compression. Since pathological tissues and HIFU-induced lesions exhibit different elastic properties than normal tissues, elastography is potentially able to achieve these goals. An ultrasound scanner was connected to a PC to acquire RF images. This setup is compatible with a HIFU device used for prostate cancer therapy by transrectal route. The therapy transducer and the biplane-imaging probe are covered with a balloon filled with a coupling liquid. Compression of the prostate is applied by inflating the balloon, while imaging sector scans of the prostate. In-vivo elastograms of the prostate were acquired before HIFU treatment. Problems inherent to in-vivo acquisitions are reported, such as undesired tangential displacements during the radial compression. This study shows the potential for in-vivo elastogram acquisition of HIFU-induced lesions in the human prostate.

  10. TU-B-210-02: MRg HIFU - Advanced Approaches for Ablation and Hyperthermia

    Energy Technology Data Exchange (ETDEWEB)

    Moonen, C. [University Medical Center Utrecht (Netherlands)

    2015-06-15

    MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

  11. TU-B-210-01: MRg HIFU - Bone and Soft Tissue Tumor Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ghanouni, P. [Stanford University (United States)

    2015-06-15

    MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

  12. 高强度聚焦超声(HIFU)肿瘤热消融技术的关键问题简析%Analysis of key problem of high intensity focused ultrasound (HIFU) thermal ablation technique

    Institute of Scientific and Technical Information of China (English)

    李发琪

    2011-01-01

    目的 1988年,王智彪萌发了用高强度聚焦超声(high intensity focused ultrasound,HIFU)从体外对体内肿瘤进行非侵入切除的灵感.在之后的10年中,他和他的团队在该领域提出了"生物学焦域"、"超声治疗剂量学"、"组织声环境"等概念.在实时超声监控、治疗系统优化、远程医疗系统、临床方案等方面突破了相应的关键技术壁垒.将HIFU治疗技术成功运用于外科治疗,在国际上积累了数量最多的临床病例.在该领域的设备研制、临床应用及若干基础研究方面走在了世界前列.%In 1988, Zhibiao Wang had an inspiration of ablating tumor in vivo non-invasively by high intensity focused ultrasound (HIFU). In the following 10 years, he and his team first proposed concepts such as "biological focal region", "ultrasound therapy dosimetry", "acoustic environment in tissue" and so on. They had broken down the key technical barriers in real-time ultrasound monitoring, treatment system optimization, telemedicine system, clinical protocols and other aspects, making HIFU therapy successfully applied to surgery and accumulated the largest number of clinical cases internationally. They have been playing a leading role around the world in equipment development, clinical application and some basic research in this field.

  13. TU-A-210-01: HIFU Physics and Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Eames, M. [Focused Ultrasound Foundation (United States)

    2015-06-15

    High-intensity focused ultrasound (HIFU) has developed rapidly in recent years and is used frequently for clinical treatments in Asia and Europe with increasing clinical use and clinical trial activity in the US, making it an important medical technology with which the medical physics community must become familiar. Akin to medical devices that deliver treatments using ionizing radiation, HIFU relies on emitter geometry to non-invasively form a tight focus that can be used to affect diseased tissue while leaving healthy tissue intact. HIFU is unique in that it does not involve the use of ionizing radiation, it causes thermal necrosis in 100% of the treated tissue volume, and it has an immediate treatment effect. However, because it is an application of ultrasound energy, HIFU interacts strongly with tissue interfaces, which makes treatment planning challenging. In order to appreciate the advantages and disadvantages of HIFU as a thermal therapy, it is important to understand the underlying physics of ultrasound tissue interactions. The first lecture in the session will provide an overview of the physics of ultrasound wave propagation; the mechanism for the accumulation of heat in soft-tissue; image-guidance modalities including temperature monitoring; current clinical applications and commercial devices; active clinical trials; alternate mechanisms of action (future of FUS). The second part of the session will compare HIFU to existing ionization radiation techniques. The difficulties in defining a clear concept of absorbed dose for HIFU will be discussed. Some of the technical challenges that HIFU faces will be described, with an emphasis on how the experience of radiation oncology physicists could benefit the field. Learning Objectives: Describe the basic physics and biology of HIFU, including treatment delivery and image guidance techniques. Summarize existing and emerging clinical applications and manufacturers for HIFU. Understand that thermal ablation with

  14. TU-A-210-00: HIFU Therapies - A Primer

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    High-intensity focused ultrasound (HIFU) has developed rapidly in recent years and is used frequently for clinical treatments in Asia and Europe with increasing clinical use and clinical trial activity in the US, making it an important medical technology with which the medical physics community must become familiar. Akin to medical devices that deliver treatments using ionizing radiation, HIFU relies on emitter geometry to non-invasively form a tight focus that can be used to affect diseased tissue while leaving healthy tissue intact. HIFU is unique in that it does not involve the use of ionizing radiation, it causes thermal necrosis in 100% of the treated tissue volume, and it has an immediate treatment effect. However, because it is an application of ultrasound energy, HIFU interacts strongly with tissue interfaces, which makes treatment planning challenging. In order to appreciate the advantages and disadvantages of HIFU as a thermal therapy, it is important to understand the underlying physics of ultrasound tissue interactions. The first lecture in the session will provide an overview of the physics of ultrasound wave propagation; the mechanism for the accumulation of heat in soft-tissue; image-guidance modalities including temperature monitoring; current clinical applications and commercial devices; active clinical trials; alternate mechanisms of action (future of FUS). The second part of the session will compare HIFU to existing ionization radiation techniques. The difficulties in defining a clear concept of absorbed dose for HIFU will be discussed. Some of the technical challenges that HIFU faces will be described, with an emphasis on how the experience of radiation oncology physicists could benefit the field. Learning Objectives: Describe the basic physics and biology of HIFU, including treatment delivery and image guidance techniques. Summarize existing and emerging clinical applications and manufacturers for HIFU. Understand that thermal ablation with

  15. Development of a HIFU Phantom

    Science.gov (United States)

    King, Randy L.; Herman, Bruce A.; Maruvada, Subha; Wear, Keith A.; Harris, Gerald R.

    2007-05-01

    The field of high intensity focused ultrasound (HIFU) is developing rapidly. For basic research, quality control, and regulatory assessment a reusable phantom that has both thermal and acoustic properties close to that of soft tissue is critical. A hydrogel-based tissue mimicking material (TMM) has been developed that shows promise for such a phantom. The acoustic attenuation, speed of sound, B/A, thermal diffusivity and conductivity, as well as the cavitation threshold, were measured and found to mimic published values for soft tissue. The attenuation of 0.53f1.04 from 1 MHz to 8 MHz, as well as the sound speed of 1565 m/s and the tissue-like image quality, indicate the usefulness of the TMM for ultrasound imaging applications. These properties along with the thermal conductivity of 0.58 W/m- °C, diffusivity of 0.15 (mm2)/s, and the ability to withstand temperatures above 95 °C make this material appropriate for HIFU applications. The TMM also allows for the embedding of thermocouples and the formation of wall-less vessels that do not deteriorate as a result of continuous flow of blood mimicking fluids through the material. Tissue characteristics are strongly dependent on the fabrication technique, and care must be taken to achieve reproducible results. Note: This research was supported by the Defense Advanced Research Projects Agency (DARPA).

  16. Cardiac Ventricular HIFU: Convergence of Experiment and Theory in the Canine Model

    Science.gov (United States)

    Muratore, Robert; Abe, Yukio; Homma, Shunichi; Bernardi, Richard; Kalisz, Andrew; Feleppa, Ernest J.

    2007-05-01

    OBJECTIVE: HIFU is a promising technique for treating cardiac ventricular diseases such as sustained ventricular tachycardia. Ablations can potentially destroy arrhythmogenic foci and block reentrant circuits. Towards this end, we have learned to control HIFU lesions in the canine model in vivo. METHODS: Experiment — Thoracotomies were performed on anesthetized dogs, following IACUC guidelines. In this open-chest configuration, a polyethylene water-filled bag was coupled to the myocardium with degassed ultrasound gel. The transducer was lowered into the water. Ventricular locations were targeted and insonified with multiple 200-ms HIFU bursts of 60-W acoustic power; the bursts were triggered with the electrocardiogram QRS complex. The therapeutic transducer was a 35-mm focal length, 33-mm diameter PZT annular array, excited at 5.25 MHz. Its -3dB focal region dimensions were 2.5 mm axially and 0.3 mm transversely. A confocal diagnostic transducer was used for aiming and for recording backscattered radiofrequency ultrasound data. Theory — A comprehensive acoustic model has been developed. Individual modules numerically simulate physical processes such as ultrasound beam propagation, energy transfer, and heat flow within tissue. One set of modules simulates HIFU ablation in moving tissue. Tissue motion was obtained from digitized B-mode videos of transverse cross sections of a beating canine heart. Epicardial and endocardial surface positions were extracted from the video frames. Additional simulations of static tissue compared linear and nonlinear propagation models. RESULTS: Significant agreement between simulated and measured lesion sizes and between linear and nonlinear propagation models was demonstrated.

  17. Beam localization in HIFU temperature measurements using thermocouples, with application to cooling by large blood vessels.

    Science.gov (United States)

    Dasgupta, Subhashish; Banerjee, Rupak K; Hariharan, Prasanna; Myers, Matthew R

    2011-02-01

    Experimental studies of thermal effects in high-intensity focused ultrasound (HIFU) procedures are often performed with the aid of fine wire thermocouples positioned within tissue phantoms. Thermocouple measurements are subject to several types of error which must be accounted for before reliable inferences can be made on the basis of the measurements. Thermocouple artifact due to viscous heating is one source of error. A second is the uncertainty regarding the position of the beam relative to the target location or the thermocouple junction, due to the error in positioning the beam at the junction. This paper presents a method for determining the location of the beam relative to a fixed pair of thermocouples. The localization technique reduces the uncertainty introduced by positioning errors associated with very narrow HIFU beams. The technique is presented in the context of an investigation into the effect of blood flow through large vessels on the efficacy of HIFU procedures targeted near the vessel. Application of the beam localization method allowed conclusions regarding the effects of blood flow to be drawn from previously inconclusive (because of localization uncertainties) data. Comparison of the position-adjusted transient temperature profiles for flow rates of 0 and 400ml/min showed that blood flow can reduce temperature elevations by more than 10%, when the HIFU focus is within a 2mm distance from the vessel wall. At acoustic power levels of 17.3 and 24.8W there is a 20- to 70-fold decrease in thermal dose due to the convective cooling effect of blood flow, implying a shrinkage in lesion size. The beam-localization technique also revealed the level of thermocouple artifact as a function of sonication time, providing investigators with an indication of the quality of thermocouple data for a given exposure time. The maximum artifact was found to be double the measured temperature rise, during initial few seconds of sonication.

  18. Combination of bubble liposomes and high-intensity focused ultrasound (HIFU) enhanced antitumor effect by tumor ablation.

    Science.gov (United States)

    Hamano, Nobuhito; Negishi, Yoichi; Takatori, Kyohei; Endo-Takahashi, Yoko; Suzuki, Ryo; Maruyama, Kazuo; Niidome, Takuro; Aramaki, Yukihiko

    2014-01-01

    Ultrasound (US) is used in the clinical setting not only for diagnosis but also for therapy. As a therapeutic US technique, high-intensity focused ultrasound (HIFU) can be applied to treat cancer in a clinical setting. Microbubbles increased temperature and improved the low therapeutic efficiency under HIFU; however, microbubbles have room for improvement in size, stability, and targeting ability. To solve these issues, we reported that "Bubble liposomes" (BLs) containing the US imaging gas (perfluoropropane gas) liposomes were suitable for ultrasound imaging and gene delivery. In this study, we examined whether BLs and HIFU could enhance the ablation area of the tumor and the antitumor effect. First, we histologically analyzed the tumor after BLs and HIFU. The ablation area of the treatment of BLs and HIFU was broader than that of HIFU alone. Next, we monitored the temperature of the tumor, and examined the antitumor effect. The temperature increase with BLs and HIFU treatment was faster and higher than that with HIFU alone. Moreover, treatment with BLs and HIFU enhanced the antitumor effect, which was better than with HIFU alone. Thus, the combination of BLs and HIFU could be efficacious for cancer therapy.

  19. Motion tracing system for ultrasound guided HIFU

    Science.gov (United States)

    Xiao, Xu; Jiang, Tingyi; Corner, George; Huang, Zhihong

    2017-03-01

    One main limitation in HIFU treatment is the abdominal movement in liver and kidney caused by respiration. The study has set up a tracking model which mainly compromises of a target carrying box and a motion driving balloon. A real-time B-mode ultrasound guidance method suitable for tracking of the abdominal organ motion in 2D was established and tested. For the setup, the phantoms mimicking moving organs are carefully prepared with agar surrounding round-shaped egg-white as the target of focused ultrasound ablation. Physiological phantoms and animal tissues are driven moving reciprocally along the main axial direction of the ultrasound image probe with slightly motion perpendicular to the axial direction. The moving speed and range could be adjusted by controlling the inflation and deflation speed and amount of the balloon driven by a medical ventilator. A 6-DOF robotic arm was used to position the focused ultrasound transducer. The overall system was trying to estimate to simulate the actual movement caused by human respiration. HIFU ablation experiments using phantoms and animal organs were conducted to test the tracking effect. Ultrasound strain elastography was used to post estimate the efficiency of the tracking algorithms and system. In moving state, the axial size of the lesion (perpendicular to the movement direction) are averagely 4mm, which is one third larger than the lesion got when the target was not moving. This presents the possibility of developing a low-cost real-time method of tracking organ motion during HIFU treatment in liver or kidney.

  20. Characterization of HIFU ablation using DNA fragmentation labeling as apoptosis stain

    Science.gov (United States)

    Anquez, Jeremie; Corréas, Jean-Michel; Pau, Bernard; Lacoste, François; Yon, Sylvain

    2012-11-01

    The goal of this work was to compare modalities to precisely quantify the extent of thermally induced lesions: gross pathology vs. histopathology vs. devascularization. Liver areas of 14 rabbits were targeted with HIFU and RF ablations in an acute study. Contrast enhanced computorized tomography (CE-CT) scan images were acquired two hours after HIFU and RF treatment to obtain the devascularized volumes of the livers. The animals were then euthanized and deep frozen. The livers were sliced and each slice was photographed and stacked yielding a volume of gross pathology. The volume VGP of the HIFU lesions were derived. The area AGP of the lesions were computed on a particular slice. The lesions were segmented as hypo intense (devascularized) regions on CE-CT images and their volumes VC were computed. The ratios VC/VGP were computed for all the HIFU lesions on all the 14 subjects with a mean value of 1.2. Histology was performed on the livers using Hematoxyline Eosine Staining (HES) and DNA Fragmentation labeling (TUNEL® technology) which characterizes apoptosis. Apoptotic regions of area AT were segmented on the images stained by TUNEL®. No necrosis was identified on the HES data. While TUNEL® did not mark the cores of the RF lesions as apoptotic, the periphery of HIFU and RF lesions was always recognized with TUNEL® as apoptotic. The ratio AGP/AT was computed. The mean value was 0.95 and 0.25 for HIFU and RF lesions respectively. These findings show that the devascularized territory seen on CE-CT scan coincide with the coagulated territories seen with gross pathology. Those actually correspond to cells in apoptosis. It is confirmed that HES stain does not show necrosis 2 hours after thermal ablation. TUNEL® technology for DNA fragmentation labeling appears as a useful marker for thermally induced acute lesions in the liver.

  1. TU-A-210-02: HIFU: Why Should a Radiation Oncology Physicist Pay Attention?

    Energy Technology Data Exchange (ETDEWEB)

    Schlesinger, D. [University of Virginia Health Systems (United States)

    2015-06-15

    High-intensity focused ultrasound (HIFU) has developed rapidly in recent years and is used frequently for clinical treatments in Asia and Europe with increasing clinical use and clinical trial activity in the US, making it an important medical technology with which the medical physics community must become familiar. Akin to medical devices that deliver treatments using ionizing radiation, HIFU relies on emitter geometry to non-invasively form a tight focus that can be used to affect diseased tissue while leaving healthy tissue intact. HIFU is unique in that it does not involve the use of ionizing radiation, it causes thermal necrosis in 100% of the treated tissue volume, and it has an immediate treatment effect. However, because it is an application of ultrasound energy, HIFU interacts strongly with tissue interfaces, which makes treatment planning challenging. In order to appreciate the advantages and disadvantages of HIFU as a thermal therapy, it is important to understand the underlying physics of ultrasound tissue interactions. The first lecture in the session will provide an overview of the physics of ultrasound wave propagation; the mechanism for the accumulation of heat in soft-tissue; image-guidance modalities including temperature monitoring; current clinical applications and commercial devices; active clinical trials; alternate mechanisms of action (future of FUS). The second part of the session will compare HIFU to existing ionization radiation techniques. The difficulties in defining a clear concept of absorbed dose for HIFU will be discussed. Some of the technical challenges that HIFU faces will be described, with an emphasis on how the experience of radiation oncology physicists could benefit the field. Learning Objectives: Describe the basic physics and biology of HIFU, including treatment delivery and image guidance techniques. Summarize existing and emerging clinical applications and manufacturers for HIFU. Understand that thermal ablation with

  2. Feasibility of laser-integrated high intensity focused ultrasound (HIFU) treatment for bladder tumors: in vitro study (Conference Presentation)

    Science.gov (United States)

    Nguyen, Van Phuc; Park, Suhyun; Oh, Junghwan; Kang, Hyun Wook

    2016-02-01

    Previous studies have shown that photothemal therapy combined with high intensity focused ultrasound (HIFU) can provide a promising method to achieve rapid thermal coagulation during surgical procedures. The current study investigated the feasibility of the laser-integrated high intensity focused ultrasound (HIFU) application to treat bladder tumors by enhancing thermal effects and therapeutic depth in vitro. To generate thermal coagulation, a single element HIFU transducer with a central frequency of 2.0 MHz was used to transmit acoustic energy to 15 fresh porcine bladders injected with an artificial tumor (100 µl gelatin and hemoglobin solution) in vitro. Simultaneously, an 80-W 532-nm laser system was also implemented to induce thermal necrosis in the targeted tissue. The intensity of 570 W/cm2 at the focus of HIFU and laser energy of 0.9 W were applied to all the samples for 40 s. The temperature rise increased up to about 1.6 or 3 folds (i.e., ΔT=32±3.8 K for laser-integrated HIFU, ΔT=20±6.5 K for HIFU only, and ΔT=11±5.6 K for laser only). The estimated lesion depth also increased by 1.3 and 2 folds during the dual-thermal treatment, in comparison with the treatment by either HIFU or laser. The results indicated that the laser-integrated HIFU treatment can be an efficient hyperthermic method for tumor coagulation.

  3. Advanced endoscopic ultrasound management techniques for preneoplastic pancreatic cystic lesions

    Science.gov (United States)

    Arshad, Hafiz Muhammad Sharjeel; Bharmal, Sheila; Duman, Deniz Guney; Liangpunsakul, Suthat; Turner, Brian G

    2017-01-01

    Pancreatic cystic lesions can be benign, premalignant or malignant. The recent increase in detection and tremendous clinical variability of pancreatic cysts has presented a significant therapeutic challenge to physicians. Mucinous cystic neoplasms are of particular interest given their known malignant potential. This review article provides a brief but comprehensive review of premalignant pancreatic cystic lesions with advanced endoscopic ultrasound (EUS) management approaches. A comprehensive literature search was performed using PubMed, Cochrane, OVID and EMBASE databases. Preneoplastic pancreatic cystic lesions include mucinous cystadenoma and intraductal papillary mucinous neoplasm. The 2012 International Sendai Guidelines guide physicians in their management of pancreatic cystic lesions. Some of the advanced EUS management techniques include ethanol ablation, chemotherapeutic (paclitaxel) ablation, radiofrequency ablation and cryotherapy. In future, EUS-guided injections of drug-eluting beads and neodymium:yttrium aluminum agent laser ablation is predicted to be an integral part of EUS-guided management techniques. In summary, International Sendai Consensus Guidelines should be used to make a decision regarding management of pancreatic cystic lesions. Advanced EUS techniques are proving extremely beneficial in management, especially in those patients who are at high surgical risk. PMID:27574295

  4. Non-invasive estimation of temperature using diagnostic ultrasound during HIFU therapy

    Science.gov (United States)

    Georg, O.; Wilkens, V.

    2017-03-01

    The use of HIFU for thermal ablation of human tissues requires safe real-time monitoring of the lesion formation during the treatment to avoid damage of the surrounding healthy tissues and to control temperature rise. Besides MR imaging, several methods have been proposed for temperature imaging using diagnostic ultrasound, and echoshift estimation (using speckle tracking) is the most promising and commonly used technique. It is based on the thermal dependence of the ultrasound echo that accounts for two different physical phenomena: local change in speed of sound and thermal expansion of the propagating medium due to changes in temperature. In our experiments we have used two separate transducers: HIFU exposure was performed using a 1.06 MHz single element focusing transducer of 64 mm aperture and 63.2 mm focal length; the ultrasound diagnostic probe of 11 MHz operated in B-mode for image guidance. The temperature measurements were performed in an agar-based tissue-mimicking phantom. To verify the obtained results, numerical modeling of the acoustic and temperature fields was carried out using KZK and Pennes Bioheat equations, as well as measurements with thermocouples were performed.

  5. A pulled sutures technique for bony Bankart lesion.

    Science.gov (United States)

    Lee, Byung Ill; Choi, Hyung Suk; Min, Kyung Dae; Kwon, Sai Won; Kim, Jun Bum; Kim, Yong-Beom; Chun, Dong-Il

    2014-05-01

    In an attempt to present a new surgical technique for arthroscopic bony Bankart fixation, the authors developed the pulled sutures technique. In executing the new method, the authors first passed several non-absorbable sutures through labroligamentous tissue with displaced articular fragment by mimicking transglenoid suture technique. Aimed at achieving a safe and stable fixation, using a knotless anchor rather than transglenoid suture, was deployed. Overall, this pulled sutures technique was shown to be effective with the result of direct reduction, stable, and safe fixation for bony Bankart's lesion.

  6. Whole Body Bone Scan Findings after High Intensity Focused Ultrasound (HIFU) Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Ye Young; O, Joo Hyun; Sohn, Hyung Sun; Choi, Eun Kyoung; Yoo, Ik Dong; Oh, Jin Kyoung; Han, Eun Ji; Jung, Seung Eun; Kim, Sung Hoon [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2011-12-15

    This study aims to examine the findings of {sup 99mT}c diphosphonate bone scans in cancer patients with a history of HIFU treatment. Bone scan images of patients with a history of HIFU treatment for primary of metastatic cancer from January 2006 to July 2010 were retrospectively reviewed. Cases of primary bone tumor or HIFU treatment reaching only the superficial soft tissue layer were excluded. Bone scan images of 62 patients (26 female, 36 male; mean age 57{+-}9 years) were studied. HIFU treatment was performed in the liver (n=40), pancreas (n=40), pancreas (n=16), and breast (n=6). Mean interval time between HIFU treatment and bone scan was 106{+-}105 days (range: 1-572 days). Of 62 scans, 43 showed diffusely decreased uptake of bone within the path of HIFU treatment: antero axillary and/or posterior arcs of right 5th to 11th ribs in 34 cases after treatment of hepatic lesions; anterior arcs of 2nd to 5th ribs in 5 cases after treatment for breast tumors; and posterior arcs of left 9th to 11th ribs or thoraco lumbar vertebrae in 4 cases after treatment for pancreas tumor. Of 20 patients who had bone scans more than twice, five showed recovered uptake of the radiotracer in the involved ribs in the follow up bone scan. Of 62 bone scans in patients with a history of HIFU treatment for primary of metastatic cancer, 69% presented diffusely decreased uptake in the bone in the path of HIFU treatment.

  7. Initial Experience with the Extracorporeal HIFU Knife with 49 Patients: Japanese Experience

    Science.gov (United States)

    Ganaha, F.; Okuno, T.; Lee, C. O.; Shimizu, T.; Osako, K.; Oka, S.; Lee, K. H.; Chen, W. Z.; Zhu, H.; Park, S. H.; Qi, Z.; Shi, D.; Song, H. S.

    2005-03-01

    Forty nine patients with 63 tumours were treated with the Chongqing Haifu knife, as an adjunct to intra-arterial chemoinfusion. Treatment targets included breast (20 lesions), liver (16), bone (8), lymph-node (6), soft tissue (4), lung and pleura (4), pancreas (2), kidney (2) and adrenal gland (1). Follow-up contrast MRI was performed at 3 weeks to assess the effects of HIFU ablation. All cases completed the planned treatment. Of 25 lesions treated with the intention of complete tumour ablation, complete necrosis was obtained in 19 lesions (76%) including 4 secondary success cases. Among 32 lesions having partial and palliative treatment, tumour size was decreased in 6 lesions (21%), and good pain control was obtained in 6 out of 7 patients (86%). Skin injury was the most common complication after HIFU (16%), and was mostly a superficial dermal burn that did not necessitate any treatment. However, there was one patient with deep skin injury at an operation scar which resulted in skin perforation. Other adverse events included soft tissue swelling, prolonged fever, anorexia, persistent pain, shortness of the breath, sacroiliac joint fracture and prolonged diarrhoea. In our limited experience, superficial lesions (e.g. breast cancer, bone, soft tissue, lymph-node and pleural metastasis) appear to be good candidates for HIFU treatment. There appears to be a role for the HIFU knife in pain control for patients with bone metastasis and pancreatic cancer.

  8. Techniques for cytologic sampling of pancreatic and bile duct lesions.

    Science.gov (United States)

    Brugge, William; Dewitt, John; Klapman, Jason B; Ashfaq, Raheela; Shidham, Vinod; Chhieng, David; Kwon, Richard; Baloch, Zubair; Zarka, Matthew; Staerkel, Gregg

    2014-04-01

    The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound guided fine-needle aspiration biopsy, techniques of the endoscopic retrograde cholangiopancreatography, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings over an 18-month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology website [www.papsociety.org]. This document presents the results of these discussions regarding the use of ancillary testing in the cytological diagnosis of biliary and pancreatic lesions. This document summarizes the current state of the art for techniques in acquiring cytology specimens from the biliary tree as well as solid and cystic lesions of the pancreas. Copyright © 2014 Wiley Periodicals, Inc.

  9. High-Intensity Focused Ultrasound (Hifu) Treatment For Thyroid Nodules: Experimental And First Clinical Studies

    Science.gov (United States)

    Esnault, Olivier; Franc, Brigitte; Leenhardt, Laurence; Rouxel, Agnès; Ménégaux, Fabrice; Lacoste, François

    2007-05-01

    OBJECTIVE: Thyroid nodules are common and can only be removed by surgery. High-intensity focused ultrasound (HIFU) could be a possible minimally invasive alternative treatment. The aim of this study was to assess the feasibility of using HIFU to precisely ablate thyroid nodules without affecting neighbouring structures. METHODS: HIFU was generated by a 3-MHz spherical piezocomposite transducer moved across the target in a stepwise fashion. In a first clinical study 25 patients had their nodules treated with HIFU 2 weeks prior to planned thyroidectomy, using increasing energy. The last patients received a local anesthesia. The lesions were assessed by the pathologist. RESULTS: The histological lesions were clearly visible in most of the fully treated patients, particularly those who received higher energy. Superficial and reversible skin blisters were observed in 7 patients. The design of the treatment head was subsequently modified to eliminate such risk. CONCLUSION: The patient trials confirmed the precision of the targeting and set the energy levels for safe thyroid nodule ablation with HIFU. Further study is needed to assess nodule's changes at longer follow-up.

  10. Emerging HIFU applications in cancer therapy.

    Science.gov (United States)

    Maloney, Ezekiel; Hwang, Joo Ha

    2015-05-01

    High intensity focused ultrasound (HIFU), is a promising, non-invasive modality for treatment of tumours in conjunction with magnetic resonance imaging or diagnostic ultrasound guidance. HIFU is being used increasingly for treatment of prostate cancer and uterine fibroids. Over the last 10 years a growing number of clinical trials have examined HIFU treatment of both benign and malignant tumours of the liver, breast, pancreas, bone, connective tissue, thyroid, parathyroid, kidney and brain. For some of these emerging indications, HIFU is poised to become a serious alternative or adjunct to current standard treatments--including surgery, radiation, gene therapy, immunotherapy, and chemotherapy. Current commercially available HIFU devices are marketed for their thermal ablation applications. In the future, lower energy treatments may play a significant role in mediating targeted drug and gene delivery for cancer treatment. In this article we introduce currently available HIFU systems, provide an overview of clinical trials in emerging oncological targets, and briefly discuss selected pre-clinical research that is relevant to future oncological HIFU applications.

  11. A Knotless Labro-Bicipital Repair Technique for SLAP Lesions.

    Science.gov (United States)

    Koyuncu, Özgür; Eren, Ilker; Seyahi, Aksel; Uludag, Serkan; Demirhan, Mehmet

    2015-10-01

    Fixation methods for SLAP lesions are still controversial, and the strength of the fixation, suture and knot irritation, and placement and number of anchors are still being discussed. This uncertainty is directly related to the function and anatomy of the superior labrum and attached biceps. Knotless fixation methods close to the biceps anchorage at the 12-o'clock position are favored in recent literature. We describe a practical SLAP repair technique, with a mattress configuration through the biceps anchorage, using a single knotless anchor. Fixing the biceps attachment instead of the labrum alone, in proximity to the biceps, without sutures or knots left in contact with the other intra-articular structures is the superiority of the described technique.

  12. Safety Issues for HIFU Transducer Design

    Science.gov (United States)

    Fleury, Gérard; Berriet, Rémi; Chapelon, Jean Yves; ter Haar, Gail; Lafon, Cyril; Le Baron, Olivier; Chupin, Laurent; Pichonnat, Fabrice; Lenormand, Jérôme

    2005-03-01

    In contrast with most ultrasound modalities for medical applications, (especially ultrasound imaging), High Intensity Focused Ultrasound (HIFU) involves technologies and procedures which may present risk to the patient. These risks, resulting from the high power levels required for effective therapy, should be taken into account at the earliest stages in the design of a system dedicated to HIFU treatment. An understanding of these risks must thus be shared amongst the many players in the field of therapy using high power ultrasound. Moreover, since the number of applications of HIFU has increased appreciably over recent years and the technology is ready to move from the research to the industrial level, it is worth now considering solutions that should be put in place to guarantee the safety of the patient during HIFU treatment. This paper reports thoughts on this, identifies some risks to the patient that must be taken into consideration in the design of HIFU transducers, and proposes some solutions that could prevent the deleterious consequences of transducer misuse or failure. For the main risks identified, such as exceeding the desired acoustic power or poor control of tissue targeting, a description of transducer performance that could potentially result in problems is systematically sought. This allows proposals for precautions to be taken during operation to be made. Parameters which should be monitored to ensure safe use are also suggested. This type of approach, which should be undertaken for the different components of a therapeutic system, highlights the challenges that must be faced in the immediate future for the development and safe exploitation of HIFU systems. The necessity for standard definitions of the parameters to be checked or monitored during HIFU treatments is crucial in this approach, as is the availability of reliable dedicated measurement devices. Co-ordinated action on these topics in the HIFU community would contribute to the

  13. Tissue Erosion Using Shock Wave Heating and Millisecond Boiling in HIFU Fields

    Science.gov (United States)

    Canney, Michael S.; Khokhlova, Tatiana D.; Khokhlova, Vera A.; Bailey, Michael R.; Ha Hwang, Joo; Crum, Lawrence A.

    2010-03-01

    A wide variety of treatment protocols have been employed in high intensity focused ultrasound (HIFU) treatments, and the resulting bioeffects observed include both mechanical as well as thermal effects. In recent studies, there has been significant interest in generating purely mechanical damage using protocols with short, microsecond pulses. Tissue erosion effects have been attained by operating HIFU sources using short pulses of 10-20 cycles, low duty cycles (<1%), and pulse average intensities of greater than 20 kW/cm2. The goal of this work was to use a modified pulsing protocol, consisting of longer, millisecond-long pulses of ultrasound and to demonstrate that heating and rapid millisecond boiling from shock wave formation can be harnessed to induce controlled mechanical destruction of soft tissue. Experiments were performed in excised bovine liver and heart tissue using a 2-MHz transducer. Boiling activity was monitored during exposures using a high voltage probe in parallel with the HIFU source. In situ acoustic fields and heating rates were determined for exposures using a novel derating approach for nonlinear HIFU fields. Several different exposure protocols were used and included varying the duty cycle, pulse length, and power to the source. After exposures, the tissue was sectioned, and the gross lesion morphology was observed. Different types of lesions were induced in experiments that ranged from purely thermal to purely mechanical depending on the pulsing protocol used. Therefore, shock wave heating and millisecond boiling may be an effective method for reliably generating significant tissue erosion effects.

  14. High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

    Science.gov (United States)

    Diana, Michele; Schiraldi, Luigi; Liu, Yu-Yin; Memeo, Riccardo; Mutter, Didier; Pessaux, Patrick

    2016-01-01

    Background High intensity focused ultrasound (HIFU) is emerging as a valid minimally-invasive image-guided treatment of malignancies. We aimed to review to current state of the art of HIFU therapy applied to the digestive system and discuss some promising avenues of the technology. Methods Pertinent studies were identified through PubMed and Embase search engines using the following keywords, combined in different ways: HIFU, esophagus, stomach, liver, pancreas, gallbladder, colon, rectum, and cancer. Experimental proof of the concept of endoluminal HIFU mucosa/submucosa ablation using a custom-made transducer has been obtained in vivo in the porcine model. Results Forty-four studies reported on the clinical use of HIFU to treat liver lesions, while 19 series were found on HIFU treatment of pancreatic cancers and four studies included patients suffering from both liver and pancreatic cancers, reporting on a total of 1,682 and 823 cases for liver and pancreas, respectively. Only very limited comparative prospective studies have been reported. Conclusions Digestive system clinical applications of HIFU are limited to pancreatic and liver cancer. It is safe and well tolerated. The exact place in the hepatocellular carcinoma (HCC) management algorithm remains to be defined. HIFU seems to add clear survival advantages over trans arterial chemo embolization (TACE) alone and similar results when compared to radio frequency (RF). For pancreatic cancer, HIFU achieves consistent cancer-related pain relief. Further research is warranted to improve targeting accuracy and efficacy monitoring. Furthermore, additional work is required to transfer this technology on appealing treatments such as endoscopic HIFU-based therapies. PMID:27500145

  15. Full acoustic and thermal characterization of HIFU field in the presence of a ribcage model

    Science.gov (United States)

    Cao, Rui; Le, Nhan; Nabi, Ghulam; Huang, Zhihong

    2017-03-01

    In the treatment of abdominal organs using high intensity focused ultrasound (HIFU), the patient's ribs are in the pathway of the HIFU beams which could result in acoustic distortion, occasional skin burns and insufficient energy delivered to the target organs. To provide full characterization of HIFU field with the influence of ribcage, the ribcage phantom reconstructed from a patient's CT images was created by tissue mimicking materials and its effect on acoustic field was characterized. The effect of the ribcage on acoustic field has been provided in acoustic pressure distribution, acoustic power and focal temperature. Measurement result shows focus splitting with one main focus and two secondary intensity maxima. With the presence of ribcage phantom, the acoustic pressure was reduced by 48.3% and another two peak values were observed near the main focus, reduced by 65.0% and 71.7% respectively. The acoustic power was decreased by 47.5% to 52.5%. With these characterization results, the form of the focus, the acoustic power, acoustic pressure and temperature rise are provided before the transcostal HIFU treatment, which are significant to determine the energy delivery dose. In conclusion, this ribcage model and characterization technique will be useful for the further study in the abdominal HIFU treatment.

  16. The Efficacy of High-Intensity Focused Ultrasound (HIFU) in Advanced Pancreatic Cancer

    Institute of Scientific and Technical Information of China (English)

    Bo Xie; Jiajun Ling; Weiming Zhang; Xueqin Huang; Jihua Zhen; Yanzhe Huang

    2008-01-01

    OBJECTIVE To observe the efficacy of high-intensity focused ultrasound (HIFU)in the treatment of late-stage pancreatic cancer.METHODS Sixteen patients with advanced pancreatic cancer received HIFU therapy.Evaluation of efficacy was made on the basis of changes in clinical symptoms and variations in the tumor echo and size.RESULTS Clinical symptoms such as pain were significantly alleviated,echo of the tumor was enhanced with B-US and the quality of life such as eating,sleeping and mental status was markedly improved;no serious complications were observed.CONCLUSION The use of HIFU in the treatment of advanced pancreatic cancer is feasible and safe.It is effective in killing the carcinoma cells and alleviaring pain.This technique may offer non-invasive therapy for the treatment of patients with late-stage pancreatic cancer.

  17. Cavitation damage in blood clots under HIFU

    Science.gov (United States)

    Weiss, Hope; Ahadi, Golnaz; Hoelscher, Thilo; Szeri, Andrew

    2010-11-01

    High Intensity Focused Ultrasound (HIFU) has been shown to accelerate thrombolysis, the dissolution of blood clots, in vitro and in vivo, for treatment of ischemic stroke. Cavitation in sonothrombolysis is thought to play an important role, although the mechanisms are not fully understood. The damage to a blood clot associated with bubble collapses in a HIFU field is studied. The region of damage caused by a bubble collapse on the fibrin network of the blood clot exposed to HIFU is estimated, and compared with experimental assessment of the damage. The mechanical damage to the network caused by a bubble is probed using two independent approaches, a strain based method and an energy based method. Immunoflourescent fibrin staining is used to assess the region of damage experimentally.

  18. Electropotential evaluation as a new technique for diagnosing breast lesions.

    Science.gov (United States)

    Faupel, M; Vanel, D; Barth, V; Davies, R; Fentiman, I S; Holland, R; Lamarque, J L; Sacchini, V; Schreer, I

    1997-01-01

    A new approach, termed the Biofield test, may have the potential to augment the process of diagnosing breast cancer. This technique is based on the analysis of skin surface electrical potentials measured by an array of specially designed sensors which are placed on the breasts. Measurements are recorded noninvasively and then analyzed using pattern recognition algorithms to produce an immediate and objective assessment of breast tissue in vivo. Initial clinical trials suggests that the test can achieve a sensitivity of approximately 90% and a specificity of 40-50%, which indicates that the test might be useful for excluding cancer when it is, in fact, absent. Although research to date has focused on the differential diagnosis of suspicious breast lesions, future applications could include breast cancer screening, close surveillance and diagnosis of recurrent cancers in breasts previously treated with conservative therapy, and monitoring the effectiveness of breast cancer therapies. Improvements and new applications are expected to occur as additional research and validation in actual clinical settings is performed.

  19. Intercostal HIFU Treatment: A Tissue Phantom

    Science.gov (United States)

    Illing, Rowland O.; Kennedy, James E.; ter Haar, Gail R.

    2005-03-01

    High-intensity focused ultrasound (HIFU) when used clinically to treat liver and kidney tumours is often directed between the ribs. This paper details the construction of a tissue phantom, incorporating ribs, and its use to assess the clinical safety of HIFU exposures. The prefocal, acoustic side-lobes of the ultrasonic beam were studied with and without rib interference, and thermocouples used to assess in-situ temperature changes. The results show that there are implications in regards to the safety of clinical treatment, should the operator be unaware of the characteristics of the transducer being used.

  20. HIFU as a Neoadjuvant Therapy in Cancer Treatment

    Science.gov (United States)

    Zhong, P.; Xing, F.; Huang, X.; Zhu, H.; Lo, H. W.; Zhong, X.; Pruitt, S.; Robertson, C.

    2011-09-01

    To broaden the application spectrum of HIFU in cancer therapy, we performed a pilot experiment to evaluate the potential of using HIFU as a neoadjuvant therapy prior to surgery. Mice bearing wild-type B16F10 melanoma inoculated subcutaneously were either untreated (control) or treated by HIFU, CPA-7 or HIFU+CPA-7 before surgical resection of the primary tumor two days after HIFU treatment. The animals were then followed for four weeks or up to the humane endpoint to determine local recurrence, distant metastasis, and survival rate. The results demonstrate that animals treated by HIFU+CPA-7 (which is a small molecule that suppresses STAT3 activity) had a significantly lower recurrence rate, and slower growth of the recurrent tumor, with concomitantly higher survival rate, followed by those treated with CPA-7 and HIFU, respectively. Immunological assays revealed that CPA-7 treatment could significantly lower STAT3, and subsequently, Treg activities. In particular, the combination of HIFU and CPA-7 can induce a much stronger anti-tumor immune response than HIFU or surgery alone, as assessed by CTL and IFN-γ secretion. Overall, our results suggest that HIFU in combination with immunotherapy strategies has the potential to be used as a neoadjuvant therapy to prime the host with a strong anti-tumor immune response before surgical resection of the primary tumor. This multimodality, combinational therapy has the potential to greatly broaden the range of HIFU applications in cancer therapy with lower tumor recurrence and improved survival rate.

  1. Arthroscopic Repair of Combined Bankart and SLAP Lesions: Operative Techniques and Clinical Results

    OpenAIRE

    Cho, Hyung Lae; Lee, Choon Key; Hwang, Tae Hyok; Suh, Kuen Tak; Park, Jong Won

    2010-01-01

    Background To evaluate the clinical results and operation technique of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP) lesions, all of which had an anterior-inferior Bankart lesion that continued superiorly to include separation of the biceps anchor in the patients presenting recurrent shoulder dislocations. Methods From May 2003 to January 2006, we reviewed 15 cases with combined Bankart and SLAP lesions among 62 patients with recurrent shoulder dislo...

  2. An Ultrasound Image-Based Dynamic Fusion Modeling Method for Predicting the Quantitative Impact of In Vivo Liver Motion on Intraoperative HIFU Therapies: Investigations in a Porcine Model.

    Directory of Open Access Journals (Sweden)

    W Apoutou N'Djin

    Full Text Available Organ motion is a key component in the treatment of abdominal tumors by High Intensity Focused Ultrasound (HIFU, since it may influence the safety, efficacy and treatment time. Here we report the development in a porcine model of an Ultrasound (US image-based dynamic fusion modeling method for predicting the effect of in vivo motion on intraoperative HIFU treatments performed in the liver in conjunction with surgery. A speckle tracking method was used on US images to quantify in vivo liver motions occurring intraoperatively during breathing and apnea. A fusion modeling of HIFU treatments was implemented by merging dynamic in vivo motion data in a numerical modeling of HIFU treatments. Two HIFU strategies were studied: a spherical focusing delivering 49 juxtapositions of 5-second HIFU exposures and a toroidal focusing using 1 single 40-second HIFU exposure. Liver motions during breathing were spatially homogenous and could be approximated to a rigid motion mainly encountered in the cranial-caudal direction (f = 0.20 Hz, magnitude > 13 mm. Elastic liver motions due to cardiovascular activity, although negligible, were detectable near millimeter-wide sus-hepatic veins (f = 0.96 Hz, magnitude 75%. Fusion modeling predictions were preliminarily validated in vivo and showed the potential of using a long-duration toroidal HIFU exposure to accelerate the ablation process during breathing (from 0.5 to 6 cm3 · min(-1. To improve HIFU treatment control, dynamic fusion modeling may be interesting for assessing numerically focusing strategies and motion compensation techniques in more realistic conditions.

  3. MR Guidance, Monitoring and Control of Brain HIFU Therapy in Small Animals: In Vivo Demonstration in Rats

    Science.gov (United States)

    Larrat, B.; Pernot, M.; Dervishi, E.; Souilah, A.; Seilhean, D.; Marie, Y.; Boch, A. L.; Aubry, J. F.; Fink, M.; Tanter, M.

    2010-03-01

    In the framework of HIFU transcranial brain therapy, it is mandatory to develop techniques capable of assessing the focusing quality and location before the treatment. Monitoring heat deposition in real time and verifying the extension of the treated area are also important steps. In this study, an imaging protocol is proposed to:1/ locate the US radiation force induced displacement in tissues and quantify the acoustic pressure at focus prior to HIFU; 2/ monitor the temperature rise during HIFU; and 3/ assess the changes in elasticity in the treated area. A 7T MRI scanner was equipped with a home-made stereotactic frame for rats and a US focused transducer working at 1.5 MHz. Such a tool is key for the evaluation of the biological effects of HIFU on brain tissue and tumors. The proposed protocol was successfully tested on 12 rats with and without injected tumors. The accurate localization of the focal point prior to HIFU was demonstrated in vivo. Furthermore, the pressure estimation in situ allowed to accurately simulate the heat deposition at focus and to plan the treatment (electrical power, duration). The temperature measurements were in good accordance with the predicted curves. The elasticity maps showed significant changes after treatment in some cases.

  4. Multimodality treatment by FOLFOX plus HIFU in a case of advanced pancreatic carcinoma. A case report.

    Science.gov (United States)

    Dimitrov, Dobromir; Andreev, Tihomir; Feradova, Hyuliya; Ignatov, Borislav; Zhou, Kunn; Johnson, Colin; Delijski, Tashko; Gortchev, Grigor; Tomov, Slavcho

    2015-01-31

    Pancreatic cancer is one of the most aggressive malignant diseases in which the survival rate has not improved in the past 40 years. A fifty-one-year-old male patient with inoperable metastatic pancreatic cancer and low response to chemotherapy with gemcitabine as single therapy underwent palliative high intensity focused ultrasound (HIFU) ablation. Continuing chemotherapy with folinic acid, oxaliplatin and 5-fluorouracil (FOLFOX) was made. Tools, provided by the European Organization for Research and Treatment of Cancer (EORTC) were used to evaluate his quality of life. The Global Health Status improved from 25 to 42 out of 100 and the body mass index (BMI) increased from 14.9 to 18.1 kg/m(2). Measured by the visual analog scale, the pain was reduced from 7 to 2 out of 10. Twelve months after the HIFU ablation, CT revealed decreased size of the tumor and liver lesions. FOLFOX plus interventional, physical destruction of the primary tumor by HIFU sufficiently improved the quality of life, reduced pancreatic pain and provided better survival in this case.

  5. Multimodality Treatment by FOLFOX plus HIFU in a Case of Advanced Pancreatic Carcinoma. A Case Report

    Directory of Open Access Journals (Sweden)

    Dobromir Dimitrov

    2015-01-01

    Full Text Available Context Pancreatic cancer is one of the most aggressive malignant diseases in which the survival rate has not improved in the past 40 years. Case report A fifty-one-year-old male patient with inoperable metastatic pancreatic cancer and low response to chemotherapy with gemcitabine as single therapy underwent palliative high intensity focused ultrasound (HIFU ablation. Continuing chemotherapy with folinic acid, oxaliplatin and 5-fluorouracil (FOLFOX was made. Tools, provided by the European Organization for Research and Treatment of Cancer (EORTC were used to evaluate his quality of life. The Global Health Status improved from 25 to 42 out of 100 and the body mass index (BMI increased from 14.9 to 18.1 kg/m2. Measured by the visual analog scale, the pain was reduced from 7 to 2 out of 10. Twelve months after the HIFU ablation, CT revealed decreased size of the tumor and liver lesions. Conclusion FOLFOX plus interventional, physical destruction of the primary tumor by HIFU sufficiently improved the quality of life, reduced pancreatic pain and provided better survival in this case.

  6. In Vitro Validation of a Sector-Switching HIFU Device for Accelerated Treatment

    Science.gov (United States)

    Petrusca, Lorena; Brasset, Lucie; Cotton, Francois; Salomir, Rares; Chapelon, Jean-Yves

    2009-04-01

    A sector-switching method that increases the HIFU sequence duty-cycle and reduces the equivalent treatment time was tested in vitro. The MR-compatible HIFU device used consisted of 2 symmetric sectors arranged on a truncated spherical cap (focus = 45 mm, long diameter = 57.5 mm, short diameter = 35 mm). A MR-compatible, 2D positioning system provided 0.5 mm accuracy. Two sonication sequences were considered, each with the same pattern for the focal point trajectory and with identical on-state power. First, both sectors radiated simultaneously, with a power duty cycle of 60%. Second, the sectors radiated separately with balanced temporally-interleaved sonication and a power duty cycle of 87.5%. Numerical simulations were performed to predict the shape of the lesion for a given set of sequence parameters, according to a theoretical model. Fast MR thermometry (voxel size: 0.85×0.85×4.25 mm3; temporal resolution: 2 sec) was performed in two orthogonal planes (sagittal and transverse) while the 2D sonication pattern was contained in the coronal plane. Fresh samples of degassed porcine liver were used, and the macroscopic lesions were measured after HIFU. The 14400 s equivalent thermal dose isolevel was compared respectively for the two sonication sequences, both with numerical simulations and experimental MR data. No susceptibility or RF artifacts could be detected on MR data. The lesion's size ratio between reference versus the sector-switched sequence was 1.12 from simulations and 1.25 (±3.2%) from MRI derived TD. Switching the device sectors reduced the treatment time by 20% while the shape and size of the lesions were maintained. In vivo studies are required for pre-clinical validation.

  7. Development of HIFU Treatment for Lower Extremity Varicose Veins

    Science.gov (United States)

    Senoo, Naohiko; Ushijima, Hiroyuki; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2011-09-01

    High-intensity focused ultrasound (HIFU) has recently been developed as a noninvasive therapeutic method. In our study, a novel noninvasive therapy with HIFU was proposed for occlusion of lower extremity varicose veins. The temperature increase caused by HIFU is used to occlude varicose veins. Occluded veins became fibrotic, resulting in complete recovery. Our final goal is the medical application of HIFU treatment for varicose veins. In this study, we attempted to occlude the veins of rabbits. Prior to venous occlusion experiments, the area heated by HIFU was investigated using bovine serum albumin (BSA) gel, which denatures at >70 °C. The results indicate that the size of the heated area mainly depends on intensity at the focal point and the exposure time. A tendency was also seen for the heated area to extend toward the transducer with increasing exposure time. In animal experiments, skin burns during HIFU exposure represented a critical problem. We therefore examined the safe range of HIFU intensities in abdominal exposure experiments before conducting venous occlusion experiments. The ultrasound frequency was 1.7 MHz. Intensity at the focal point was 900 W/cm2, and the exposure time was 20 s. Rabbits underwent chemical depilation and echo gel was applied to the exposed skin to fill the boundary gap. Target veins were compressed during HIFU exposure to avoid thermal dissipation, and hyaluronan water solution was injected between the veins and skin to maintain the distance between the skin and veins at ≥5 mm. Veins were then exposed to HIFU and occluded. The capability of HIFU treatment to occlude lower extremity varicose veins was verified by the present study.

  8. Arthroscopic repair of combined Bankart and SLAP lesions: operative techniques and clinical results.

    Science.gov (United States)

    Cho, Hyung Lae; Lee, Choon Key; Hwang, Tae Hyok; Suh, Kuen Tak; Park, Jong Won

    2010-03-01

    To evaluate the clinical results and operation technique of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP) lesions, all of which had an anterior-inferior Bankart lesion that continued superiorly to include separation of the biceps anchor in the patients presenting recurrent shoulder dislocations. From May 2003 to January 2006, we reviewed 15 cases with combined Bankart and SLAP lesions among 62 patients with recurrent shoulder dislocations who underwent arthroscopic repair. The average age at surgery was 24.2 years (range, 16 to 38 years), with an average follow-up period of 15 months (range, 13 to 28 months). During the operation, we repaired the unstable SLAP lesion first with absorbable suture anchors and then also repaired Bankart lesion from the inferior to superior fashion. We analyzed the preoperative and postoperative results by visual analogue scale (VAS) for pain, the range of motion, American Shoulder and Elbow Surgeon (ASES) and Rowe shoulder scoring systems. We compared the results with the isolated Bankart lesion. VAS for pain was decreased from preoperative 4.9 to postoperative 1.9. Mean ASES and Rowe shoulder scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1, respectively. There were no specific complication and no significant limitation of motion more than 10 degree at final follow-up. We found the range of motions after the arthroscopic repair in combined lesions were gained more slowly than in patients with isolated Bankart lesions. In recurrent dislocation of the shoulder with combined Bankart and SLAP lesion, arthroscopic repair using absorbable suture anchors produced favorable clinical results. Although it has technical difficulty, the concomitant unstable SLAP lesion should be repaired in a manner that stabilizes the glenohumeral joint, as the Bankart lesion can be repaired if the unstable SLAP lesion is repaired first.

  9. MRI-based evaluation of MR-HIFU induced thermal effects

    NARCIS (Netherlands)

    Lam, M.K.

    2016-01-01

    High intensity focused ultrasound (HIFU) is novel technology for non-invasive thermal therapy and can be combined with magnetic resonance imaging (MRI). MRI-guided HIFU (MR-HIFU) allows for real-time acquisition of MRI scans during the HIFU treatment, for planning, monitoring and evaluation. The pur

  10. MRgHIFU: Feedback temperature control with automatic deduction of BHT tissue parameters

    Science.gov (United States)

    Mougenot, Charles; Kabongo, Luis; Quesson, Bruno; Moonen, Chrit T. W.

    2009-04-01

    The Bio Heat Transfer Equation (BHTE) has been shown to be an efficient tissue representation during HIFU heating. This model requires knowledge of the following tissue parameters: ultrasound absorption, thermal diffusion and perfusion. The proposed technique, comparing BHTE simulation with MR thermal map, provides in real time an accurate and stable measurement of the ultrasound absorption and thermal diffusion and can be used to measure also perfusion. Therefore, temperature feedback control is significantly improved with more stable and faster convergence of the temperature.

  11. Lesion Detection in CT Images Using Deep Learning Semantic Segmentation Technique

    Science.gov (United States)

    Kalinovsky, A.; Liauchuk, V.; Tarasau, A.

    2017-05-01

    In this paper, the problem of automatic detection of tuberculosis lesion on 3D lung CT images is considered as a benchmark for testing out algorithms based on a modern concept of Deep Learning. For training and testing of the algorithms a domestic dataset of 338 3D CT scans of tuberculosis patients with manually labelled lesions was used. The algorithms which are based on using Deep Convolutional Networks were implemented and applied in three different ways including slice-wise lesion detection in 2D images using semantic segmentation, slice-wise lesion detection in 2D images using sliding window technique as well as straightforward detection of lesions via semantic segmentation in whole 3D CT scans. The algorithms demonstrate superior performance compared to algorithms based on conventional image analysis methods.

  12. Respiratory-Gated MRgHIFU in Upper Abdomen Using an MR-Compatible In-Bore Digital Camera

    Directory of Open Access Journals (Sweden)

    Vincent Auboiroux

    2014-01-01

    Full Text Available Objective. To demonstrate the technical feasibility and the potential interest of using a digital optical camera inside the MR magnet bore for monitoring the breathing cycle and subsequently gating the PRFS MR thermometry, MR-ARFI measurement, and MRgHIFU sonication in the upper abdomen. Materials and Methods. A digital camera was reengineered to remove its magnetic parts and was further equipped with a 7 m long USB cable. The system was electromagnetically shielded and operated inside the bore of a closed 3T clinical scanner. Suitable triggers were generated based on real-time motion analysis of the images produced by the camera (resolution 640×480 pixels, 30 fps. Respiratory-gated MR-ARFI prepared MRgHIFU ablation was performed in the kidney and liver of two sheep in vivo, under general anaesthesia and ventilator-driven forced breathing. Results. The optical device demonstrated very good MR compatibility. The current setup permitted the acquisition of motion artefact-free and high resolution MR 2D ARFI and multiplanar interleaved PRFS thermometry (average SNR 30 in liver and 56 in kidney. Microscopic histology indicated precise focal lesions with sharply delineated margins following the respiratory-gated HIFU sonications. Conclusion. The proof-of-concept for respiratory motion management in MRgHIFU using an in-bore digital camera has been validated in vivo.

  13. A new "double-pulley" dual-row technique for arthroscopic fixation of bony Bankart lesion.

    Science.gov (United States)

    Zhang, Jin; Jiang, Chunyan

    2011-09-01

    The double-row technique is a new concept for arthroscopic treatment of bony Bankart lesion in shoulder instability. It presents a new and reproducible technique for arthroscopic fixation of bony Bankart fragments with suture anchors. This technique creates double-mattress sutures which compress the fragment against its bone bed and restores better bony anatomy of the anterior glenoid rim with stable and non-tilting fixation that may improve healing.

  14. The Double-Pulley Anatomic Technique for Type II SLAP Lesion Repair.

    Science.gov (United States)

    Parnes, Nata; Ciani, Mario; Carr, Brian; Carey, Paul

    2015-10-01

    The annual incidence and number of repairs of SLAP lesions in the United States are constantly increasing. Surgical repairs of type II SLAP lesions have overall good success rates. However, a low satisfaction rate and low rate of return to preinjury level of play remain a challenge with elite overhead and throwing athletes. Recent anatomic studies suggest that current surgical techniques over-tension the biceps anchor and the superior labrum. These studies suggest that restoration of the normal anatomy will improve clinical outcomes and sports performance. We present a "double-pulley" technique for arthroscopic fixation of type II SLAP lesions. In this technique the normal anatomy is respected by preserving the mobility of the articular aspect of the superior labrum while reinforcing the biceps anchor and its posterior fibers medially.

  15. Modelling of the acoustic field of a multi-element HIFU array scattered by human ribs

    Energy Technology Data Exchange (ETDEWEB)

    Gelat, Pierre [National Physical Laboratory, Hampton Road, Teddington TW11 0LW (United Kingdom); Ter Haar, Gail [Therapeutic Ultrasound Group, Physics Department, Institute of Cancer Research, Sutton SM2 5NG (United Kingdom); Saffari, Nader, E-mail: Pierre.Gelat@npl.co.uk [Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom)

    2011-09-07

    The efficacy of high-intensity focused ultrasound (HIFU) for the treatment of a range of different cancers, including those of the liver, prostate and breast, has been demonstrated. As a non-invasive focused therapy, HIFU offers considerable advantages over techniques such as chemotherapy and surgical resection in terms of reduced risk of harmful side effects. Despite this, there are a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the rib cage to induce tissue necrosis in the required volume whilst minimizing the formation of side lobes. Multi-element random-phased arrays are currently showing great promise in overcoming the limitations of single-element transducers. Nevertheless, successful treatment of a patient with liver tumours requires a thorough understanding of the way in which the ultrasonic pressure field from a HIFU array is scattered by the rib cage. In order to address this, a boundary element approach based on a generalized minimal residual (GMRES) implementation of the Burton-Miller formulation was used in conjunction with phase conjugation techniques to focus the field of a 256-element random HIFU array behind human ribs at locations requiring intercostal and transcostal treatment. Simulations were carried out on a 3D mesh of quadratic pressure patches generated using CT scan anatomical data for adult ribs 9-12 on the right side. The methodology was validated on spherical and cylindrical scatterers. Field calculations were also carried out for idealized ribs, consisting of arrays of strip-like scatterers, demonstrating effects of splitting at the focus. This method has the advantage of fully accounting for the effect of scattering and diffraction in 3D under continuous wave excitation.

  16. Percutaneous aspiration biopsy in cervical spine lytic lesions. Indications and technique

    Energy Technology Data Exchange (ETDEWEB)

    Tampieri, D.; Weill, A.; Melanson, D.; Ethier, R. (Montreal Neurological Inst. and Hospital, PQ (Canada). Dept. of Neuroradiology)

    1991-02-01

    We describe the technique and the results of the percutaneous aspiration biopsy (PAB) in a series of 9 patients presenting with neck pain and different degrees of myelopathy, in whom the cervical spine X-ray demonstrated lytic lesions of unknown origin. PAB is a useful, relatively safe technique, and leads to histological diagnosis between metastatic and inflammatory processes. Furthermore, in inflammatory lesions with negative hemoculture, PAB may help in detecting the micro-organism responsible and therefore allow a better antibiotic treatment. (orig.).

  17. Simulations of lesion detection using a combined phased array LHMI-technique.

    Science.gov (United States)

    Heikkilä, Janne; Hynynen, Kullervo

    2008-11-01

    Ultrasound based elasticity imaging techniques have been developed during the past decades. Some of these techniques are based on an internal radiation force stimulation in which a transient or dynamic radiation force is produced by using a single or dual-frequency sonication. In addition, sonication and data acquisition can be implemented using combined or separate transducers. In this simulation study of lesion detection using localized harmonic motion imaging (LHMI), we used a combined phased array designed for simultaneous thermal ablation and lesion detection. In the sonication mode, a focused single-frequency amplitude-modulated sonication is used to induce harmonic motion and in the tracking mode, some of the array elements are used for pulse-echo tracking of the induced displacements. The results showed that the size of the lesion affected the induced displacement around the sonication point. The displacement tracking simulations demonstrated that these changes in the displacement distributions can be detected using only a few of the array elements in the tracking mode but the exact size of the lesion can not be detected accurately. The simulations also showed that two lesions having the radius of 2.5mm can be distinguished if distance between these lesions is at least 2.5mm.

  18. Correlation of p63 immunohistochemistry with histology and contrast enhanced MRI in characteristic lesions induced by minimally invasive thermal treatments in a dog prostate

    Science.gov (United States)

    Pascal, A.; Butts-Pauly, K.; Plata, J.; Sommer, G.; Daniel, B.; Bouley, D. M.

    2017-03-01

    Thermal ablation techniques are important tools to treat low grade tumors in the prostate gland. The use of Magnetic Resonance Imaging (MRI) has been an excellent tool to visualize and assess the thermally ablated areas in real time. In this study slides from dog prostates previously treated with cryoablation or High Intensity Focal Ultrasound (HIFU) were immunohistochemically stained with the biomarker p63, in order to determine if this marker would be helpful for differentiatiating between viable, sub lethally damaged and normal glands. Digitized slides were analyzed using Sedeen Viewer software, and compared with corresponding representative H&E slides and MR images. p63 staining in the cryoablated acute duration prostates was negative in the coagulation necrosis zone (region of interest subjected to the coldest temperatures). In acute duration HIFU treated prostates, the central heat-fixed zone (region of interest subjected to the hottest temperatures) still displayed + p63 staining. Cryoablated or HIFU subacute duration treated prostates were very hemorrhagic, but presented the same stain pattern in the treated areas as the acute duration prostates, and in chronic duration prostates, whether treated with cryo or HIFU, glands displayed robust p63 staining most prevalent in the outer edges of the lesion where there was extensive glandular regeneration. In conclusion, this study demonstrates the value of p63 IHC and its usefulness in detecting viable prostate basal cells in normal dog prostates following either cryoablation of HIFU. Our results suggest that the portions of the lesion with complete loss of p63 staining correspond well to the non-enhancing region in cryoablated prostates, as viewed with MRI. However, p63 staining in the heat-fixed zone in acute harvested HIFU treated prostates remains positive, suggesting either inadequate heat to destroy basal cells, or heat-fixation of the p63 antigen and false positive staining. Therefore p63 staining does not

  19. Temperature-dependent Physical Properties of a HIFU Blood Mimicking Fluid

    Science.gov (United States)

    Liu, Yunbo; Maruvada, Subha; King, Randy L.; Herman, Bruce A.; Wear, Keith A.

    2009-04-01

    A blood mimicking fluid (BMF) has been developed and characterized in a temperature dependent manner for high intensity focused ultrasound (HIFU) ablation devices. The BMF is based on a degassed and de-ionized water solution dispersed with low density polyethylene micro-spheres, nylon particles, gellan gum and glycerol. A broad range of physical parameters, including frequency dependent ultrasound attenuation, speed of sound, viscosity, thermal conductivity and diffusivity were characterized as a function of temperature (20° C to 70° C). The nonlinear parameter B/A and backscatter coefficient were also measured at room temperature. The attenuation coefficient is linearly proportional to the frequency (2 MHz-8 MHz) with a slope of about 0.2 dB cm-1 MHz-1 in the 20° C to 70° C range as has been reported for human blood. All the other temperature dependent physical parameters are also close to the reported values in human blood. These properties make the BMF a useful HIFU research tool for developing standardized exposimetry techniques, validating numerical models, and determining the safety and efficacy of HIFU ablation devices.

  20. PREVENTION OF DYSURIA AFTER HIFU THERAPY FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    A. Yu. Shestaev

    2014-07-01

    Full Text Available Objective: to identify factors for the development of dysuria and its prevention in patients with prostate cancer (PC after high-intensity focused ultrasound (HIFU therapy.Subjects and methods. In September 2008 to June 2013, the Clinic of Urology, S.M. Kirov Military Medical Academy, treated 98 patients, by performing HIFU sessions on an Ablatherm apparatus (EDAP, France. All the patients underwent transurethral resection of the prostate (TURP to reduce the volume of the ablated tissue. The patients were divided into 2 groups: 1 29 patients underwent TURP 3 days before HIFU therapy; 2 69 did this 1 month before major surgery. Each group was divided into 2 subgroups: 1 after ultrasound ablation, a urethral catheter was inserted for 10 days; 2 epicystostoma was applied, followed by its overlapping on day 3 postablation and spontaneous urination. The postoperative incidence of dysuria was estimated from subjective (complaints, voiding diary, and Inter-national Prostate Symptom Score and objective (uroflowmetry, small pelvic ultrasonography with determination of residual urine volume criteria.Results. In the patients who had undergone TURP one month before HIFU therapy, grades I–II urinary incontinence and urethral pros-tatic stricture occurred much less infrequently than in those who had undergone this maneuver 3 days prior to major surgery. Urinary in-continence and urethral prostatic stricture occurred 2-fold more frequently after TURP being carried out 3 days before HIFU therapy than after the urethral catheter being inserted. TURP performed one month before HIFU therapy showed no great difference in the incidence complications regardless of the type of bladder drainage.Conclusion. The short interval between TURP and HIFU therapy for PC increases the risk of postoperative dysuric events. The optimal time to perform TURP prior to HIFU therapy is 1 month.

  1. PREVENTION OF DYSURIA AFTER HIFU THERAPY FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    A. Yu. Shestaev

    2014-01-01

    Full Text Available Objective: to identify factors for the development of dysuria and its prevention in patients with prostate cancer (PC after high-intensity focused ultrasound (HIFU therapy.Subjects and methods. In September 2008 to June 2013, the Clinic of Urology, S.M. Kirov Military Medical Academy, treated 98 patients, by performing HIFU sessions on an Ablatherm apparatus (EDAP, France. All the patients underwent transurethral resection of the prostate (TURP to reduce the volume of the ablated tissue. The patients were divided into 2 groups: 1 29 patients underwent TURP 3 days before HIFU therapy; 2 69 did this 1 month before major surgery. Each group was divided into 2 subgroups: 1 after ultrasound ablation, a urethral catheter was inserted for 10 days; 2 epicystostoma was applied, followed by its overlapping on day 3 postablation and spontaneous urination. The postoperative incidence of dysuria was estimated from subjective (complaints, voiding diary, and Inter-national Prostate Symptom Score and objective (uroflowmetry, small pelvic ultrasonography with determination of residual urine volume criteria.Results. In the patients who had undergone TURP one month before HIFU therapy, grades I–II urinary incontinence and urethral pros-tatic stricture occurred much less infrequently than in those who had undergone this maneuver 3 days prior to major surgery. Urinary in-continence and urethral prostatic stricture occurred 2-fold more frequently after TURP being carried out 3 days before HIFU therapy than after the urethral catheter being inserted. TURP performed one month before HIFU therapy showed no great difference in the incidence complications regardless of the type of bladder drainage.Conclusion. The short interval between TURP and HIFU therapy for PC increases the risk of postoperative dysuric events. The optimal time to perform TURP prior to HIFU therapy is 1 month.

  2. A comparative study of the detectability of TMJ radiographic techniques for artificial mandibular condylar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hee Jeong; Jung, Yeon Hwa; Cho, Bong Hae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan(Korea, Republic of)

    1997-08-15

    The purpose of this study was to evaluate the detectability of various radiographic techniques for mandibular condylar lesions. Erosive lesion, osteophyte and flattening were formed on the artificial mandibular condyle, and panoramic, transcranial, transorbital radiography, lateral and frontal tomography were taken. The results were as follows; 1. The detectability for erosive lesions was superior in the order of frontal tomography (96%), lateral tomography (78%), transorbital (59%), transcranial (56%) and panoramic (48%) radiography. 2. The location of erosive lesion that showed the highest detectability was the medial third in panoramic, the lateral third in transcranial, the central portion of anteroposterior direction in transorbital, the central portion of mediolateral direction and the posterior third in lateral tomography. Frontal tomography disclosed all erosive lesions except one anterolateral lesion. 3. The detectability of osteophyte was 100% in lateral tomography, 78% in transcranial and 56% in panoramic radiography. 4. For flattening, lateral tomography showed the flattened condyle, but both panoramic and transcranial views showed only decreased bone density without the change of condylar shape.

  3. Blood coagulation using High Intensity Focused Ultrasound (HIFU)

    Science.gov (United States)

    Nguyen, Phuc V.; Oh, Junghwan; Kang, Hyun Wook

    2014-03-01

    High Intensity Focused Ultrasound (HIFU) technology provides a feasible method of achieving thermal coagulation during surgical procedures. One of the potential clinical benefits of HIFU can induce immediate hemostasis without suturing. The objective of this study was to investigate the efficiency of a HIFU system for blood coagulation on severe vascular injury. ngHIFU treatment was implemented immediately after bleeding in artery. The ultrasound probe was made of piezoelectric material, generating a central frequency of 2.0 MHz as well as an ellipsoidal focal spot of 2 mm in lateral dimension and 10 mm in axial dimension. Acoustic coagulation was employed on a perfused chicken artery model in vitro. A surgical incision (1 to 2 mm long) was made with a scapel on the arterial wall, and heparinized autologous blood was made to leak out from the incision with a syringe pump. A total of 5 femoral artery incisions was treated with the HIFU beam. The intensity of 4500 W/cm2 at the focus was applied for all treatments. Complete hemostasis was achieved in all treatments, along with the treatment times of 25 to 50 seconds. The estimated intraoperative blood loss was from 2 to 5 mL. The proposed HIFU system may provide an effective method for immediate blood coagulation for arteries and veins in clinical applications.

  4. Application of radiosurgical techniques to produce a primate model of brain lesions

    Directory of Open Access Journals (Sweden)

    Jun eKunimatsu

    2015-04-01

    Full Text Available Behavioral analysis of subjects with discrete brain lesions provides important information about the mechanisms of various brain functions. However, it is generally difficult to experimentally produce discrete lesions in deep brain structures. Here we show that a radiosurgical technique, which is used as an alternative treatment for brain tumors and vascular malformations, is applicable to create non-invasive lesions in experimental animals for the research in systems neuroscience. We delivered highly focused radiation (130–150 Gy at ISO center to the frontal eye field of macaque monkeys using a clinical linear accelerator (LINAC. The effects of irradiation were assessed by analyzing oculomotor performance along with magnetic resonance (MR images before and up to 8 months following irradiation. In parallel with tissue edema indicated by MR images, deficits in saccadic and smooth pursuit eye movements were observed during several days following irradiation. Although initial signs of oculomotor deficits disappeared within a month, damage to the tissue and impaired eye movements gradually developed during the course of the subsequent 6 months. Postmortem histological examinations showed necrosis and hemorrhages within a large area of the white matter and, to a lesser extent, in the adjacent gray matter, which was centered at the irradiated target. These results indicated that the LINAC system was useful for making brain lesions in experimental animals, while the suitable radiation parameters to generate more focused lesions need to be further explored. We propose the use of a radiosurgical technique for establishing animal models of brain lesions, and discuss the possible uses of this technique for functional neurosurgical treatments in humans.

  5. Techniques for cytologic sampling of pancreatic and bile duct lesions: The Papanicolaou Society of Cytopathology Guidelines.

    Science.gov (United States)

    Brugge, William R; De Witt, John; Klapman, Jason B; Ashfaq, Raheela; Shidham, Vinod; Chhieng, David; Kwon, Richard; Baloch, Zubair; Zarka, Matthew; Staerkel, Gregg

    2014-01-01

    The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology, including indications for endoscopic ultrasound guided fine-needle aspiration biopsy, techniques of the endoscopic retrograde cholangiopancreatography, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy management. All documents are based on the expertise of the authors, a review of literature, discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology website [www.papsociety.org]. This document presents the results of these discussions regarding the use of sampling techniques in the cytological diagnosis of biliary and pancreatic lesions. This document summarizes the current state of the art for techniques in acquiring cytology specimens from the biliary tree as well as solid and cystic lesions of the pancreas.

  6. Cost minimization analysis for combinations of sampling techniques in bronchoscopy of endobronchial lesions.

    Science.gov (United States)

    Roth, Kjetil; Hardie, Jon Andrew; Andreassen, Alf Henrik; Leh, Friedemann; Eagan, Tomas Mikal Lind

    2009-06-01

    The choice of sampling techniques in bronchoscopy with sampling from a visible lesion will depend on the expected diagnostic yields and the costs of the sampling techniques. The aim of this study was to determine the most economical combination of sampling techniques when approaching endobronchial visible lesions. A cost minimization analysis was performed. All bronchoscopies from 2003 and 2004 at Haukeland university hospital, Bergen, Norway, were reviewed retrospectively for diagnostic yields. 162 patients with endobronchial disease were included. Potential sampling techniques used were biopsy, brushing, endobronchial needle aspiration (EBNA) and washings. Costs were estimated based on registration of equipment costs and personnel costs. Sensitivity analyses were performed to determine threshold values. The combination of biopsy, brushing and EBNA was the most economical strategy with an average cost of Euro 893 (95% CI: 657, 1336). The cost of brushing had to be below Euro 83 and it had to increase the diagnostic yield more than 2.2%, for biopsy and brushing to be more economical than biopsy alone. The combination of biopsy, brushing and EBNA was more economical than biopsy and brushing when the cost of EBNA was below Euro 205 and the increase in diagnostic yield was above 5.2%. In the current study setting, biopsy, brushing and EBNA was the most economical combination of sampling techniques for endobronchial visible lesions.

  7. Alternative rubber dam isolation technique for the restoration of Class V cervical lesions.

    Science.gov (United States)

    Owens, Barry M

    2006-01-01

    This article describes an expedited, atraumatic technique of restoring cervical abrasion-erosion, abfraction or carious lesions using an alternative placement sequence of the dental rubber dam for adequate field isolation. As shown by this technique, the rubber dam retainer is modified and positioned on the tooth with subsequent placement of the dental dam material over theretainer and tooth. This technique saves time and provides good retraction of the gingival tissue and isolation of the cavity preparation from contamination (saliva, hemorrhage) that can potentially cause post-operative symptoms and possible restoration replacement.

  8. Contrast-enhanced magnetic resonance imaging of pulmonary lesions: Description of a technique aiming clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Radiology Department, German Cancer Research Center (Deutsches Krebsforschungszentrum – DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto, University of Sao Paulo, Avenida Bandeirantes 3900, Campus Universitario Monte Alegre, 14048 900 Ribeirao Preto, Sao Paulo (Brazil); Optazaite, Elzbieta, E-mail: optazaite@andrulis.eu [Diagnostic and Interventional Radiology with Nuclear Medicine, Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstraße 5, 69126 Heidelberg (Germany); Sommer, Gregor, E-mail: gregor.sommer@usb.ch [Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Safi, Seyer, E-mail: seyer.safi@gmail.com [Surgery Department, Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstraße 5, 69126 Heidelberg (Germany); Heussel, Claus Peter, E-mail: heussel@uni-heidelberg.de [Diagnostic and Interventional Radiology with Nuclear Medicine, Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstraße 5, 69126 Heidelberg (Germany); Translational Lung Research Center (TLRC), Member of the German Center for Lung Research (DZL), Im Neuenheimer Feld 350, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich, E-mail: hans-ulrich.kauczor@med.uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Translational Lung Research Center (TLRC), Member of the German Center for Lung Research (DZL), Im Neuenheimer Feld 350, 69120 Heidelberg (Germany); and others

    2015-01-15

    To propose a technique for evaluation of pulmonary lesions using contrast-enhanced MRI; to assess morphological patterns of enhancement and correlate quantitative analysis with histopathology. Material and methods: Thirty-six patients were prospectively studied. Volumetric-interpolated T1W images were obtained during consecutive breath holds after bolus triggered contrast injection. Volume coverage of first three acquisitions was limited (higher temporal resolution) and last acquisition obtained at 4th min. Two radiologists individually evaluated the patterns of enhancement. Region-of-interest-based signal intensity (SI)-time curves were created to assess quantitative parameters. Results: Readers agreed moderately to substantially concerning lesions’ enhancement pattern. SI-time curves could be created for all lesions. In comparison to benign, malignant lesions showed higher values of maximum enhancement, early peak, slope and 4th min enhancement. Early peak >15% showed 100% sensitivity to detect malignancy, maximum enhancement >40% showed 100% specificity. Conclusions: The proposed technique is robust, simple to perform and can be applied in clinical scenario. It allows visual evaluation of enhancement pattern/progression together with creation of SI-time curves and assessment of derived quantitative parameters. Perfusion analysis was highly sensitive to detect malignancy, in accordance to what is recommended by most recent guidelines on imaging evaluation of pulmonary lesions.

  9. Second harmonic generation microscopy is a novel technique for differential diagnosis of breast fibroepithelial lesions.

    Science.gov (United States)

    Tan, Wai Jin; Yan, Jie; Xu, Shuoyu; Thike, Aye Aye; Bay, Boon Huat; Yu, Hanry; Tan, Min-Han; Tan, Puay Hoon

    2015-12-01

    Breast fibroepithelial lesions, including fibroadenomas and phyllodes tumours, are commonly encountered in clinical practice. As histological differences between these two related entities may be subtle, resulting in a challenging differential diagnosis, pathological techniques to assist the differential diagnosis of these two entities are of high interest. An accurate diagnosis at biopsy is important given corresponding implications for clinical decision-making including surgical extent and monitoring. Second harmonic generation (SHG) microscopy is a recently developed optical imaging technique capable of robust, powerful and unbiased label-free direct detection of collagen fibril structure in tissue without the use of antibodies. We constructed tissue microarrays emulating limited materials on biopsy to investigate quantitative collagen signal in fibroepithelial lesions using SHG microscopy. Archived formalin-fixed paraffin-embedded materials of 47 fibroepithelial lesions (14 fibroadenomas and 33 phyllodes tumours) were evaluated. Higher collagen signal on SHG microscopy was observed in fibroadenomas than phyllodes tumours on SHG imaging (pmicroscopy for fibroadenoma classification was 71.4% and 84.4%, respectively. To corroborate these findings, we performed immunohistochemistry on tissue array sections using collagen I and III primary antibodies. Both collagen I and III immunohistochemical expressions were also significantly higher in fibroadenomas than in phyllodes tumours (pmicroscopy is a novel imaging approach that can aid the differential diagnosis of fibroepithelial lesions.

  10. Percutaneous SLAP lesion repair technique is an effective alternative to portal of Wilmington.

    Science.gov (United States)

    Galano, Gregory J; Ahmad, Christopher S; Bigliani, Louis; Levine, William

    2010-11-02

    Athletes with superior labral tear from anterior to posterior (SLAP) lesions place large demands on their rotator cuff and often have partial articular-sided rotator cuff tears as part of an internal impingement process. A percutaneous technique that facilitates SLAP repair may decrease the rotator cuff morbidity associated with establishment of the standard Wilmington portal. The current study reports the clinical outcome of patients with SLAP lesions treated with a percutaneous repair technique. Twenty-two patients with SLAP lesions underwent percutaneous repair. Mean patient age was 26.9 years. Standard posterior viewing and anterior working portals were used. Anchor placement and suture passing were performed with a 3-mm percutaneous and transtendinous approach to the superior labrum. Knot tying was performed via the standard anterior working portal. Clinical outcomes were assessed with validated shoulder evaluation instruments. Mean follow-up was 31.1 months (±6.6 months). Improvement of shoulder evaluation scores from pre- to postoperative were as follows: American Shoulder and Elbow Surgeons score improved from 49.5 to 83.6, visual analog scale improved from 5.4 to 1.5, and Simple Shoulder Score improved from 6.4 to 11.0. All were significant improvements (PSLAP lesion repair may minimize surgical morbidity to the rotator cuff and provides excellent results.

  11. Evaluate thermal lesion using Nakagami imaging for monitoring of high-intensity focused ultrasound

    Science.gov (United States)

    Zhang, Siyuan; Li, Chong; Zhou, Fanyu; Wang, Supin; Wan, Mingxi

    2017-03-01

    High-intensity focused ultrasound (HIFU) is currently being developed as a noninvasive technique for the treatment of cancer located in various tissues. Cavitation microbubbles (MBs) have been potential to aid treatment while the acoustic posterior shadowing effects of MBs influence the accuracy for defining the location and range of ablated thermal lesions during focused ultrasound surgery when using ultrasonic monitoring imaging. This work explored the feasibility of using ultrasonic Nakagami imaging to evaluate the ablated region induced by focused ultrasound exposures at different acoustic power levels in transparent tissue-mimicking phantoms.

  12. Dependence of Boiling Histotripsy Treatment Efficiency on HIFU Frequency and Focal Pressure Levels.

    Science.gov (United States)

    Khokhlova, Tatiana D; Haider, Yasser A; Maxwell, Adam D; Kreider, Wayne; Bailey, Michael R; Khokhlova, Vera A

    2017-09-01

    Boiling histotripsy (BH) is a high-intensity focused ultrasound (HIFU)-based method of mechanical tissue fractionation that utilizes millisecond-long bursts of HIFU shock waves to cause boiling at the focus in milliseconds. The subsequent interaction of the incoming shocks with the vapor bubble mechanically lyses surrounding tissue and cells. The acoustic parameter space for BH has been investigated previously and an inverse dependence between the HIFU frequency and the dimensions of a BH lesion has been observed. The primary goal of the present study was to investigate in more detail the ablation rate and reliability of BH in the frequency range relevant to treatment of deep abdominal tissue targets (1-2 MHz). The second goal was to investigate the effect of focal peak pressure levels and shock amplitude on BH lesion formation, given a constant duty factor, a constant ratio of the pulse duration to the time to reach boiling and a constant number of BH pulses. A custom-built 12-element sector array HIFU transducer with F-number = 1.05 was used in all experiments. BH pulses at 5 different frequencies (1, 1.2, 1.5, 1.7 and 1.9 MHz) were delivered to optically transparent polyacrylamide gel phantoms and ex vivo bovine liver and myocardium tissue to observe cavitation and boiling bubble activity with high-speed photography and B-mode ultrasound imaging, correspondingly. In gel phantoms, a cavitation bubble cloud was shown to form prefocally and to shield the focus in all exposures at 1 and 1.2 MHz and in the highest amplitude exposures at 1.5-1.7 MHz; shielding was not observed at 1.9 MHz. In ex vivo tissue, this shielding effect was observed in 25% of exposures when peak negative in situ pressure exceeded 10.2 MPa at 1 MHz and 14.5 MPa at 1.5 MHz. When shielding occurred, the exposures resulted in mild tissue disruption in the prefocal region, but not liquefaction. The dimensions of liquefied lesions followed the inverse proportionality trend with

  13. Comparison of QuadrapolarTM radiofrequency lesions produced by standard versus modified technique: an experimental model

    Directory of Open Access Journals (Sweden)

    Safakish R

    2017-06-01

    Full Text Available Ramin Safakish Allevio Pain Management Clinic, Toronto, ON, Canada Abstract: Lower back pain (LBP is a global public health issue and is associated with substantial financial costs and loss of quality of life. Over the years, different literature has provided different statistics regarding the causes of the back pain. The following statistic is the closest estimation regarding our patient population. The sacroiliac (SI joint pain is responsible for LBP in 18%–30% of individuals with LBP. Quadrapolar™ radiofrequency ablation, which involves ablation of the nerves of the SI joint using heat, is a commonly used treatment for SI joint pain. However, the standard Quadrapolar radiofrequency procedure is not always effective at ablating all the sensory nerves that cause the pain in the SI joint. One of the major limitations of the standard Quadrapolar radiofrequency procedure is that it produces small lesions of ~4 mm in diameter. Smaller lesions increase the likelihood of failure to ablate all nociceptive input. In this study, we compare the standard Quadrapolar radiofrequency ablation technique to a modified Quadrapolar ablation technique that has produced improved patient outcomes in our clinic. The methodology of the two techniques are compared. In addition, we compare results from an experimental model comparing the lesion sizes produced by the two techniques. Taken together, the findings from this study suggest that the modified Quadrapolar technique provides longer lasting relief for the back pain that is caused by SI joint dysfunction. A randomized controlled clinical trial is the next step required to quantify the difference in symptom relief and quality of life produced by the two techniques. Keywords: lower back pain, radiofrequency ablation, sacroiliac joint, Quadrapolar radiofrequency ablation

  14. DK crush technique: modified treatment of bifurcation lesions in coronary artery

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-liang; GE Jun-bo; YE Fei; ZHANG Jun-jie; ZHU Zhong-sheng; LIN Song; SHAN Shou-jie; LIU Zhi-zhong; LIU Yan; DUAN Bao-xiang

    2005-01-01

    @@ Bifurcation lesions are still technically challenging even in the era of modern stents.1 High incidence of restenosis both in main vessel and side branch limits the long-term prognosis although several kinds of techniques have been identified to be successful for coronary bifurcations.2-5 Reports have demonstrated the main reason for higher incidence of ostial side branch even though drug-eluting stent used in side vessel lies in that there were gaps in metal coverage and drug application.6-9 Therefore, new technique ensuring complete vessel scaffolding without gaps in drug delivery at the bifurcation is crush technique which is similar to other techniques including T- and Y- stenting still needing postdilatation of kissing balloon angioplasty to expand the stent fully in the ostial side branch and to prevent stent distortion in main vessel.10 As a result, kissing balloon angioplasty is a key step to improve the final result and to reduce the restenosis after stenting bifurcation lesions. However, kissing angioplasty is difficult to be underwent or impossible because operators usually fail to rewire two layers of metal strut, which would result in suboptimal stent deployment, a main reason of high incidence of restenosis, and acute- or-late-thrombosus. The present study reports modified DK crush technique improving success rate of kissing balloon angioplasty under the guidance of intravascular ultrasound (IVUS).

  15. Imaging techniques in the study of lipomatous neck lesions; Tecnicas de imagen en el estudio de las lesiones lipomatosas cervicales

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, M. M.; Herrero, C.; Garcia, M. J.; Sanchez-Lafuente, J. [Complejo Hospitalario Carlos Haya. Malaga (Spain)

    2001-07-01

    Lipomas of the neck are uncommon lesions. Those situated in deep locations and diffuse lipomatosis of the neck can be clinically mis diagnosed. We reviewed the 20 lipomatous neck lesions treated in our hospital over a 15-year period (1985-1999). Computed tomography was diagnostic in nearly 100% of cases and, this, is the method of choice for the detection and characterization of lipomatous tumors. It also provides data that aid in planning the surgical approach and enables the follow-up of clinically stable lesions that do not require surgical treatment. (Author) 11 refs.

  16. Application of a Novel Microvascular Imaging Technique in Breast Lesion Evaluation.

    Science.gov (United States)

    Yongfeng, Zhao; Ping, Zhou; Wengang, Liu; Yang, Shao; Shuangming, Tian

    2016-09-01

    Conventional power Doppler imaging (PDI) and the novel Superb Microvascular Imaging (SMI) technique were applied to observe the distribution of microvessels in 135 breast lesions, using semi-quantitative grading, penetrating vessel evaluation and flow distribution pattern to evaluate diagnostic efficacy. Compared with PDI, SMI detected more flow signals and details of microvessels. Further, when a centrally distributed branching or diffusing mode was used as a criterion for diagnosing malignancy, SMI improved diagnosis of breast masses. Sensitivity, specificity, positive predictive value and negative predictive value of SMI-assessed flow distribution were 85.4%, 92.6%, 83.3% and 93.5%, respectively, compared with 70.7%, 92.6%, 80.5% and 87.9% for PDI. We also found that flow distribution pattern analysis is superior to semi-quantitative grading and the penetrating vessel method in differentiating malignant breast lesions. Our work here further supports SMI as a novel and promising technique in visualizing microvasculature in breast lesions that may be of paramount use in initial diagnosis as well as follow-up assessment in various treatment regimes.

  17. Diagnostic Value of Hook Wire Localization Technique for Non-Palpable Breast Lesions

    Science.gov (United States)

    Demiral, Gokhan; Senol, Metin; Bayraktar, Baris; Ozturk, Hasan; Celik, Yahya; Boluk, Salih

    2016-01-01

    Background The aim of this study was to investigate the validity of hook wire localization biopsy for non-palpable breast lesions which were detected by ultrasonography (USG) or mammography (MMG). Methods In this retrospective study, USG or MMG-guided hook wire localization technique was performed on 83 patients who had non-palpable breast lesions. Then histopathological examination was performed on surgically removed specimens. All patients’ mammograms or ultrasonograms were categorized using Breast Imaging-Reporting and Data System (BI-RADS) classification. Results Radiologically, 27 (32.53%) patients were classified as BI-RADS 3, 49 (59.04%) BI-RADS 4, one (1.2%) BIRADS 5 and six (7.23%) BI-RADS 0. Histopathological results were benign in 68 (81.9%) and malignant in 15 (18.1%) patients. Twenty-seven patients were classified as BI-RADS 3 and definitive diagnoses for all were benign. Besides, 49 patients were classified as BI-RADS 4 and histopathologically 14 of them were reported as malignant, and 35 as benign. Sensitivity of MMG was 93% and specificity was 55%. For USG, the sensitivity was 100% and the specificity was 73%. Conclusion In early diagnosis of breast cancer, the validity of the imaging-guided hook wire localization biopsy of non-palpable breast lesions has been proved. The cooperation of surgeon, radiologist and pathologist increases the successfull results of hook wire localization technique. PMID:27081425

  18. Variational method for estimating the effects of continuously varying lenses in HIFU, sonography, and sonography-based cross-correlation methods.

    Science.gov (United States)

    Alaniz, Alex; Kallel, Faouzi; Hungerford, Ed; Ophir, Jonathan

    2002-01-01

    The effects of high intensity focused ultrasound (HIFU)-induced continuously varying thermal gradients on sound ray propagation were modeled theoretically. This modeling was based on Fermat's variational principle of least time for rays propagating in a continuously varying thermal gradient described by a radially symmetric heat equation. Such thermal lenses dynamically affect HIFU beam focusing, and simultaneously create ultrasonic geometric and intensity distortions and artifacts in monitoring devices. Techniques which are based upon ultrasonic cross-correlation methods, such as elastography and two-dimensional temperature estimation, also suffer distortion effects and generate artifacts.

  19. Prostate cancer transrectal HIFU ablation: detection of local recurrences using T2-weighted and dynamic contrast-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, Olivier; Lyonnet, Denis [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France); Universite de Lyon, Lyon (France); Universite de Lyon 1, Faculte de medecine Lyon Nord, Lyon (France); Inserm, U556, Lyon (France); Girouin, Nicolas; Glas, Ludivine; Ben Cheikh, Alexandre [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France); Universite de Lyon, Lyon (France); Universite de Lyon 1, Faculte de medecine Lyon Nord, Lyon (France); Gelet, Albert [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France); Inserm, U556, Lyon (France); Mege-Lechevallier, Florence [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Pathology, Lyon (France); Rabilloud, Muriel [Hospices Civils de Lyon, Department of Biostatistics, Lyon (France); Universite de Lyon 1, UMR CNRS, Laboratoire Biostatistiques-Sante, Pierre-Benite (France); Chapelon, Jean-Yves [Inserm, U556, Lyon (France)

    2010-01-15

    The objective was to evaluate T2-weighted (T2w) and dynamic contrast-enhanced (DCE) MRI in detecting local cancer recurrences after prostate high-intensity focused ultrasound (HIFU) ablation. Fifty-nine patients with biochemical recurrence after prostate HIFU ablation underwent T2-weighted and DCE MRI before transrectal biopsy. For each patient, biopsies were performed by two operators: operator 1 (blinded to MR results) performed random and colour Doppler-guided biopsies (''routine biopsies''); operator 2 obtained up to three cores per suspicious lesion on MRI (''targeted biopsies''). Seventy-seven suspicious lesions were detected on DCE images (n=52), T2w images (n=2) or both (n=23). Forty patients and 41 MR lesions were positive at biopsy. Of the 36 remaining MR lesions, 20 contained viable benign glands. Targeted biopsy detected more cancers than routine biopsy (36 versus 27 patients, p=0.0523). The mean percentages of positive cores per patient and of tumour invasion of the cores were significantly higher for targeted biopsies (p<0.0001). The odds ratios of the probability of finding viable cancer and viable prostate tissue (benign or malignant) at targeted versus routine biopsy were respectively 3.35 (95% CI 3.05-3.64) and 1.38 (95% CI 1.13-1.63). MRI combining T2-weighted and DCE images is a promising method for guiding post-HIFU biopsy towards areas containing recurrent cancer and viable prostate tissue. (orig.)

  20. Comparison of diagnostic performances among bronchoscopic sampling techniques in the diagnosis of peripheral pulmonary lesions.

    Science.gov (United States)

    Boonsarngsuk, Viboon; Kanoksil, Wasana; Laungdamerongchai, Sarangrat

    2015-04-01

    There are many sampling techniques dedicated to radial endobronchial ultrasound (R-EBUS) guided flexible bronchoscopy (FB). However, data regarding the diagnostic performances among bronchoscopic sampling techniques is limited. This study was conducted to compare the diagnostic yields among bronchoscopic sampling techniques in the diagnosis of peripheral pulmonary lesions (PPLs). A prospective study was conducted on 112 patients who were diagnosed with PPLs and underwent R-EBUS-guided FB between Oct 2012 and Sep 2014. Sampling techniques-including transbronchial biopsy (TBB), brushing cell block, brushing smear, rinsed fluid of brushing, and bronchoalveolar lavage (BAL)-were evaluated for the diagnosis. The mean diameter of the PPLs was 23.5±9.5 mm. The final diagnoses included 76 malignancies and 36 benign lesions. The overall diagnostic yield of R-EBUS-guided bronchoscopy was 80.4%; TBB gave the highest yield among the 112 specimens: 70.5%, 34.8%, 62.5%, 50.0% and 42.0% for TBB, brushing cell block, brushing smear, rinsed brushing fluid, and BAL fluid (BALF), respectively (Ptechniques should be performed together.

  1. Effect of ribs in HIFU beam path on formation of coagulative necrosis in goat liver

    Science.gov (United States)

    Li, Faqi; Gong, Xiaobo; Hu, Kai; Li, Chongyan; Wang, Zhibiao

    2006-05-01

    The motives of the work are to explore the effect of ribs in HIFU beam path on HIFU ablation goat liver. A model-JC Focused Ultrasound Tumor Therapeutic System was used. A 0.75 MHz focused transducer with 150mm aperture and 120mm focal length was used in all experiment. Acoustical power can be adjusted. 30 goats were divided into control group (HIFU beam through rib cage, HIFU alone), experiment group 1(HIFU beam through rib cage, HIFU combined with microbubble) and experiment group 2(Ribs in HIFU beam path were surgically removed, HIFU alone). 20 targeted regions at 5cm away from skin surface were applied for creating necrosis with linear scanning of 15mm length using HIFU in 3 groups. All animals were sacrificed two days later and exposed organs were dissected. After obtaining the maximal section, the volumes of the necrotic regions were measured, then to calculate Energy Efficiency Factor (EEF). Researched results showed that Ribs in HIFU beam path affected the formation of coagulative necrosis and enhanced EEF in control group. HIFU combined with microbubble could enhance the formation of coagulative necrosis and decrease EEF.

  2. Biomechanical Comparison of Arthroscopic Single- and Double-Row Repair Techniques for Acute Bony Bankart Lesions.

    Science.gov (United States)

    Spiegl, Ulrich J; Smith, Sean D; Todd, Jocelyn N; Coatney, Garrett A; Wijdicks, Coen A; Millett, Peter J

    2014-08-01

    Single- and double-row arthroscopic reconstruction techniques for acute bony Bankart lesions have been described in the literature. The double-row fixation technique would provide superior reduction and stability of a simulated bony Bankart lesion at time zero in a cadaveric model compared with the single-row technique. Controlled laboratory study. Testing was performed on 14 matched pairs of glenoids with simulated bony Bankart fractures with a defect width of 25% of the glenoid diameter. Half of the fractures were repaired with a double-row technique, while the contralateral glenoids were repaired with a single-row technique. The quality of fracture reduction was measured with a coordinate measuring machine. To determine the biomechanical stability of the repairs, specimens were preconditioned with 10 sinusoidal cycles between 5 and 25 N at 0.1 Hz and then pulled to failure in the anteromedial direction at a rate of 5 mm/min. Loads at 1 mm and 2 mm of fracture displacement were determined. The double-row technique required significantly higher forces to achieve fracture displacements of 1 mm (mean, 60.6 N; range, 39.0-93.3 N; P = .001) and 2 mm (mean, 94.4 N; range, 43.4-151.2 N; P = .004) than the single-row technique (1 mm: mean, 30.2 N; range, 14.0-54.1 N and 2 mm: mean, 63.7 N; range, 26.6-118.8 N). Significantly reduced fracture displacement was seen after double-row repair for both the unloaded condition (mean, 1.1 mm; range, 0.3-2.4 mm; P = .005) and in response to a 10-N anterior force applied to the defect (mean, 1.6 mm; range, 0.5-2.7 mm; P = .001) compared with single-row repair (unloaded: mean, 2.1 mm; range, 1.3-3.4 mm and loaded: mean, 3.4 mm; range, 1.9-4.7 mm). The double-row fixation technique resulted in improved fracture reduction and superior stability at time zero in this cadaveric model. This information may influence the surgical technique used to treat large osseous Bankart fractures and the postoperative rehabilitation protocols

  3. Management of Post-orthodontic White Spot Lesions and Subsequent Enamel Discoloration with Two Microabrasion Techniques

    Directory of Open Access Journals (Sweden)

    Arezoo Jahanbin

    2015-03-01

    Full Text Available Statement of the Problem: Demineralization of enamel adjacent to orthodontic appliances frequently occurs, commonly due to insufficient oral hygiene. Purpose: The aim of this study was to compare two microabrasion techniques on improving the white spot lesions as well as subsequent enamel discoloration. Materials and Method: Sixty extracted premolar teeth without caries and hypo-plasia were selected for this study. White spot lesions were artificially induced on the buccal surface of each tooth. Teeth were randomly assigned to three treatment groups, each treated with pumice powder as the control, microabrasion with 18% HCl, and microabrasion with 37% H3PO4. Subsequently, the three groups were daily immersed for five minutes in a tea-coffee solution for a period of one week. Colorimetric evaluation was done before and after formation of white spot lesions, after microabrasion, and after immersion in the colored solution; then the color differences (∆E were calculated. Statistical analysis was performed by multiple measurement analysis and the Tukey’s test. Results: This study showed that ∆E between the stages of white spot formation and microabrasion for H3PO4 was more than other groups and for the pumice powder group it was less than the others. Furthermore, there was a significant difference between ∆E of the three study groups (p= 0.017. Additionally, ∆E after placing the teeth in the colored solution and microabrasion was the highest for the HCl group and the lowest for the pumice powder group. There was also a significant difference between the three groups (p= 0.000. Conclusion: Pumice powder alone had similar effects as 18% HCl on removing the white spot lesions. Nevertheless, 18% HCl makes the enamel susceptible for subsequent color staining more than the other microabrasion methods.

  4. Adaptive technique for matching the spectral response in skin lesions' images

    Science.gov (United States)

    Pavlova, P.; Borisova, E.; Pavlova, E.; Avramov, L.

    2015-03-01

    The suggested technique is a subsequent stage for data obtaining from diffuse reflectance spectra and images of diseased tissue with a final aim of skin cancer diagnostics. Our previous work allows us to extract patterns for some types of skin cancer, as a ratio between spectra, obtained from healthy and diseased tissue in the range of 380 - 780 nm region. The authenticity of the patterns depends on the tested point into the area of lesion, and the resulting diagnose could also be fixed with some probability. In this work, two adaptations are implemented to localize pixels of the image lesion, where the reflectance spectrum corresponds to pattern. First adapts the standard to the personal patient and second - translates the spectrum white point basis to the relative white point of the image. Since the reflectance spectra and the image pixels are regarding to different white points, a correction of the compared colours is needed. The latest is done using a standard method for chromatic adaptation. The technique follows the steps below: -Calculation the colorimetric XYZ parameters for the initial white point, fixed by reflectance spectrum from healthy tissue; -Calculation the XYZ parameters for the distant white point on the base of image of nondiseased tissue; -Transformation the XYZ parameters for the test-spectrum by obtained matrix; -Finding the RGB values of the XYZ parameters for the test-spectrum according sRGB; Finally, the pixels of the lesion's image, corresponding to colour from the test-spectrum and particular diagnostic pattern are marked with a specific colour.

  5. [Achilles tendon plasty in inveterate lesions. Pérez Teuffer modified technique].

    Science.gov (United States)

    Martinez-Estrada, J G; Martinez, E F

    2014-01-01

    The purpose of this paper is to convey our experience with the technique used to treat chronic Achilles tendon lesions at ISSSTE "1 de Octubre" Regional Hospital. A prospective study with descriptive longitudinal follow-up was conducted in 30 patients with Achilles tendon rupture that occurred more than 10 days earlier. They were treated with the modified Perez-Teuffer technique at the Orthopedics and Trauma Service from March 2004 to March 2008. Plasty with transposition of the lateral peroneus brevis to the tendon stump was performed. The right side was affected in 70% of patients, mean age was 31.1 years, and males were predominant and accounted for 90%. Time elapsed since the lesion was 10-62 days with a mean of 26 days. We obtained excellent results in 90%, and good results in 10% of patients. One case had skin necrosis and limited mobility and two had pain. They were not considered as poor results as this did not interfere with the final functional results.

  6. A new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions

    Science.gov (United States)

    2014-01-01

    Background Quickly and accurately localizing small peripheral pulmonary lesions can avoid prolonged operative time and unplanned open thoracotomy. In this study, we aimed to introduce and evaluate a new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions. Methods Seventy four (74) patients with 80 peripheral pulmonary lesions methylene blue dye was injected to the virtually identified point according to the surface point, angle and depth previously determined by the simulator. The wedge resection of the marked lesion was performed under video-assisted thoracoscopic surgery (VATS) and the specimens were sent for immediate pathologic examination. According to pathology results, appropriate surgical procedures were decided and undertaken. Results The average lesion size was 10.4±3.5 mm (range: 4-17 mm) and the average distance to the pleural surface was 9.4±4.9 mm. Our preoperative localization procedure was successful in 75 of 80 (94%) lesions. Histological examination showed 28 benign lesions and 52 lung cancers. The shortest distance between the edges of the stain and lesion was 5.1±3.1 mm. Localization time was 17.4±2.3 min. All patients with malignant lesions subsequently underwent lobectomy and systematic lymph node dissection. No complications were observed in all participants. Conclusions The novel technique combining the preoperative virtual simulation and methylene blue staining techniques has a high success rate for localizing small peripheral pulmonary lesions, particularly for those tiny lesions which are difficult to visualise and palpate during VATS. PMID:24512571

  7. Safety and Efficacy of a Novel Technique in the Use of Fractional Flow Reserve in Complex Coronary Artery Lesions

    Directory of Open Access Journals (Sweden)

    Wen-Ming He

    2015-01-01

    Full Text Available Background: Fractional flow reserve (FFR has become an increasingly important index when making decisions with respect to revascularization of coronary artery stenosis. However, the pressure guidewire used in obtaining FFR measurements is difficult to control and manipulate in certain complex coronary artery lesions, resulting in increased fluoroscopy time and contrast dye usage. This study examined a novel (NOV technique for obtaining FFR measurements in hope of easing the difficulties associated with evaluating and treating complex coronary artery lesions. Methods: Fifty-six patients with complex coronary artery lesions were assigned to a conventional (CON FFR technique group or a NOV FFR technique group. The NOV technique involved the use of a balloon and wire exchange within the coronary artery. The fluoroscopy time, contrast dye usage, and FFR-related complications were assessed after completing the FFR measurement procedure for each patient. Results: The median time required for fluoroscopy in the NOV technique group was significantly less than that in the CON technique group; additionally, lesser amounts of contrast dye were used in the NOV technique group (both P 0.05. Conclusions: Compared to the CON technique used for measuring FFR, the new technique reduced the fluoroscopy time and amount of contrast dye used when evaluating complex coronary artery lesions. The new technique did not increase the risk of operation or decrease the success rate.

  8. Multi-parametric monitoring and assessment of high-intensity focused ultrasound (HIFU) boiling by harmonic motion imaging for focused ultrasound (HMIFU): an ex vivo feasibility study.

    Science.gov (United States)

    Hou, Gary Y; Marquet, Fabrice; Wang, Shutao; Konofagou, Elisa E

    2014-03-07

    Harmonic motion imaging for focused ultrasound (HMIFU) is a recently developed high-intensity focused ultrasound (HIFU) treatment monitoring method with feasibilities demonstrated in vitro and in vivo. Here, a multi-parametric study is performed to investigate both elastic and acoustics-independent viscoelastic tissue changes using the Harmonic Motion Imaging (HMI) displacement, axial compressive strain and change in relative phase shift during high energy HIFU treatment with tissue boiling. Forty three (n = 43) thermal lesions were formed in ex vivo canine liver specimens (n = 28). Two-dimensional (2D) transverse HMI displacement maps were also obtained before and after lesion formation. The same method was repeated in 10 s, 20 s and 30 s HIFU durations at three different acoustic powers of 8, 10, and 11 W, which were selected and verified as treatment parameters capable of inducing boiling using both thermocouple and passive cavitation detection (PCD) measurements. Although a steady decrease in the displacement, compressive strain, and relative change in the focal phase shift (Δϕ) were obtained in numerous cases, indicating an overall increase in relative stiffness, the study outcomes also showed that during boiling, a reverse lesion-to-background displacement contrast was detected, indicating potential change in tissue absorption, geometrical change and/or, mechanical gelatification or pulverization. Following treatment, corresponding 2D HMI displacement images of the thermal lesions also mapped consistent discrepancy in the lesion-to-background displacement contrast. Despite the expectedly chaotic changes in acoustic properties with boiling, the relative change in phase shift showed a consistent decrease, indicating its robustness to monitor biomechanical properties independent of the acoustic property changes throughout the HIFU treatment. In addition, the 2D HMI displacement images confirmed and indicated the increase in the thermal lesion size with

  9. Multi-parametric monitoring and assessment of High Intensity Focused Ultrasound (HIFU) boiling by Harmonic Motion Imaging for Focused Ultrasound (HMIFU): An ex vivo feasibility study

    Science.gov (United States)

    Hou, Gary Y.; Marquet, Fabrice; Wang, Shutao; Konofagou, Elisa E.

    2014-01-01

    Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a recently developed high-intensity focused ultrasound (HIFU) treatment monitoring method with feasibilities demonstrated in vitro and in vivo. Here, a multi-parametric study is performed to investigate both elastic and acoustics-independent viscoelastic tissue changes using the Harmonic Motion Imaging (HMI) displacement, axial compressive strain and change in relative phase-shift during high energy HIFU treatment with tissue boiling. Forty three (n=43) thermal lesions were formed in ex vivo canine liver specimens (n=28). Two dimensional (2D) transverse HMI displacement maps were also obtained before and after lesion formation. The same method was repeated in 10-s, 20-s and 30-s HIFU durations at three different acoustic powers of 8, 10, and 11W, which were selected and verified as treatment parameters capable of inducing boiling using both thermocouple and Passive Cavitation Detection (PCD) measurements. Although a steady decrease in the displacement, compressive strain, and relative change in the focal phase shift (Δφ) were obtained in numerous cases, indicating an overall increase in relative stiffness, the study outcomes also showed that during boiling, a reverse lesion-to-background displacement contrast was detected, indicating potential change in tissue absorption, geometrical change and/or, mechanical gelatification or pulverization. Following treatment, corresponding 2D HMI displacement images of the thermal lesions also mapped consistent discrepancy in the lesion-to-background displacement contrast. Despite unpredictable changes in acoustic properties with boiling, the relative change in phase shift showed a consistent decrease, indicating its robustness to monitor biomechanical properties independent of the acoustic property change throughout the HIFU treatment. In addition, the 2D HMI displacement images confirmed and indicated the increase in the thermal lesion size with treatment duration

  10. A fractal analysis of skin pigmented lesions using the novel tool of the variogram technique

    Energy Technology Data Exchange (ETDEWEB)

    Mastrolonardo, Mario [Department of Medical and Occupational Sciences, Unit of Dermatology, Azienda Ospedaliero-Universitaria ' Ospedali Riuniti' di Foggia (Italy)]. E-mail: mariomastrolonardo@libero.it; Conte, Elio [Department of Medical and Occupational Sciences, Unit of Dermatology, Azienda Ospedaliero-Universitaria ' Ospedali Riuniti' di Foggia (Italy); Department of Pharmacology and Human Physiology, TIRES-Center for Innovative Technology for Signal Detection and Processing, Bari University, 70100 Bari (Italy); Zbilut, Joseph P. [Department of Molecular Biophysics and Physiology, Rush University, Chicago, IL 60612 (United States)

    2006-06-15

    The incidence of the cutaneous malignant melanoma is increasing rapidly in the world [Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2000: Cancer incidence, mortality and prevalence worldwide, Version 1.0 IARC Cancer Base no. 5. Lyon: IARC Press, 2001]. The therapeutic address requires a method having high sensitivity and capability to diagnose such disease at an early stage. We introduce a new diagnostic method based on non-linear methodologies. In detail we suggest that fractal as well as noise and chaos dynamics are the most important components responsible for genetic instability of melanocytes. As consequence we introduce the new technique of the variogram and of fractal analysis extended to the whole regions of interest of skin in order to obtain parameters able to identify the malignant lesion. In a preliminary analysis, satisfactory results are reached.

  11. Novel bronchoscopic strategies for the diagnosis of peripheral lung lesions: present techniques and future directions.

    Science.gov (United States)

    Gilbert, Christopher; Akulian, Jason; Ortiz, Ricardo; Lee, Hans; Yarmus, Lonny

    2014-07-01

    The diagnosis of the peripheral lung lesion has been a long-standing clinical challenge--balancing accuracy with patient safety. With recent data revealing mortality benefits with lung cancer screening via low-dose computed tomography, now more than ever, clinicians will be challenged with the task of providing the means to provide a safe and minimally invasive method of obtaining accurate tissue diagnostics for the pulmonary nodule. In this review, we present available technologies to aid clinicians in attempts at minimally invasive techniques and the data supporting their use. In addition, we review novel tools under investigation that may further increase yield and provide additional benefit in obtaining an early diagnosis of lung cancer.

  12. Dosimetric comparison of three different treatment techniques in extensive scalp lesion irradiation.

    Science.gov (United States)

    Wojcicka, Jadwiga B; Lasher, Donette E; McAfee, Sandra S; Fortier, Gregory A

    2009-05-01

    This study compared lateral photon/electron plan (3DCRT), intensity modulated radiation therapy (IMRT) plan, and high dose rate (HDR) brachytherapy plan for total scalp irradiation. The techniques were planned on a patient with squamous cell carcinoma of the scalp for a prescribed dose of 60 Gy. Conformity indexes and dose volume histograms were used for the comparison. Clinical target volume coverage factors for 3DCRT, IMRT, and HDR were 0.976, 0.998, and 0.967, and Conformation Numbers were 0.532, 0.713, and 0.761, respectively. The dose gradient across the target was 59-136%, 91-129%, and 58-242% for 3DCRT, IMRT, and HDR techniques, respectively. The 3DCRT and IMRT techniques produced low optical structure doses. 3DCRT produced hotspots in the brain, while IMRT produced brain sparing. HDR produced the highest integral doses to the brain and optical structures. IMRT provided the best target dose homogeneity and coverage, and delivered clinically acceptable doses to normal structures. HDR produced the most conformal plan, but the total dose delivered is limited by doses to the brain and eyes. HDR is a clinically feasible alternative for less extensive lesions, lower prescription doses, and for patients who cannot lie on the treatment table.

  13. Photoacoustic detection and optical spectroscopy of high-intensity focused ultrasound-induced thermal lesions in biologic tissue

    Energy Technology Data Exchange (ETDEWEB)

    Alhamami, Mosa; Kolios, Michael C.; Tavakkoli, Jahan, E-mail: jtavakkoli@ryerson.ca [Department of Physics, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 (Canada)

    2014-05-15

    Purpose: The aims of this study are: (a) to investigate the capability of photoacoustic (PA) method in detecting high-intensity focused ultrasound (HIFU) treatments in muscle tissuesin vitro; and (b) to determine the optical properties of HIFU-treated and native tissues in order to assist in the interpretation of the observed contrast in PA detection of HIFU treatments. Methods: A single-element, spherically concaved HIFU transducer with a centre frequency of 1 MHz was utilized to create thermal lesions in chicken breast tissuesin vitro. To investigate the detectability of HIFU treatments photoacoustically, PA detection was performed at 720 and 845 nm on seven HIFU-treated tissue samples. Within each tissue sample, PA signals were acquired from 22 locations equally divided between two regions of interest within two volumes in tissue – a HIFU-treated volume and an untreated volume. Optical spectroscopy was then carried out on 10 HIFU-treated chicken breast specimens in the wavelength range of 500–900 nm, in 1-nm increments, using a spectrophotometer with an integrating sphere attachment. The authors’ optical spectroscopy raw data (total transmittance and diffuse reflectance) were used to obtain the optical absorption and reduced scattering coefficients of HIFU-induced thermal lesions and native tissues by employing the inverse adding-doubling method. The aforementioned interaction coefficients were subsequently used to calculate the effective attenuation coefficient and light penetration depth of HIFU-treated and native tissues in the wavelength range of 500–900 nm. Results: HIFU-treated tissues produced greater PA signals than native tissues at 720 and 845 nm. At 720 nm, the averaged ratio of the peak-to-peak PA signal amplitude of HIFU-treated tissue to that of native tissue was 3.68 ± 0.25 (mean ± standard error of the mean). At 845 nm, the averaged ratio of the peak-to-peak PA signal amplitude of HIFU-treated tissue to that of native tissue was 3.75

  14. Magnifying colonoscopy as a non-biopsy technique for differential diagnosis of non-neoplastic and neoplastic lesions

    Institute of Scientific and Technical Information of China (English)

    Shigeharu Kato; Kuang I Fu; Yasushi Sano; Takahiro Fujii; Yutaka Saito; Takahisa Matsuda; Ikuro Koba; Shigeaki Yoshida; Takahiro Fujimori

    2006-01-01

    AIM: To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps.METHODS: From June 1999 through March 2000, 180consecutive patients with 210 lesions diagnosed with a magnifying colonoscope (CF-200Z, Olympus Optical Co., Ltd., Tokyo, Japan) were enrolled. Magnification and chromoendoscopy with 0.2% indigo-carmine dye was applied to each lesion for mucosal crypt observation.Lesions showing types Ⅰ and Ⅱ crypt patterns were considered non-neoplastic and examined histologically by biopsy, whereas lesions showing types Ⅲ to Ⅴ crypt patterns were removed endoscopically or surgically.The correlation of endoscopic diagnosis and histologic diagnosis was then investigated.RESULTS: At endoscopy, 24 lesions showed a type Ⅰ or Ⅱ pit pattern, and 186 lesions showed type Ⅲ to Ⅴ pit patterns. With histologic examination, 26 lesions were diagnosed as non-neoplastic polyps, and 184lesions were diagnosed as neoplastic polyps. The overall diagnostic accuracy was 99.1% (208/210). The sensitivity and specificity were 92.3% (24/26) and 99.8%(184/186), respectively.CONCLUSION: Magnifying colonoscopy could be used as a non-biopsy technique for differentiating neoplastic and non-neoplastic polyps.

  15. Immune System Modulation with LOFU And HIFU Treatment of Prostate Cancer

    Science.gov (United States)

    Guha, C.; Huagang, Z.; Chen, W.; Carlosn, R.; Sanghvi, N. T.

    2011-09-01

    High intensity focused ultrasound (HIFU) results in instantaneous coagulative tissue necrosis. In contrast, "low" energy focused ultrasound (LOFU) induces membrane perturbation while maintaining cell viability. This report explores the tumor immunomodulatory roles of LOFU and HIFU combination treatment. We hypothesized that administration of repeated cycles of LOFU, followed by HIFU would release tumor-derived peptide-heat shock protein complexes in the blood and induce systemic tumor-specific immune response that would enhance tumor control of both local and systemic disease.

  16. HIFU Hemostasis of Liver Injuries Enhanced by Ultrasound Contrast Agents

    Science.gov (United States)

    Zderic, Vesna; Vaezy, Shahram; Brayman, Andrew A.; Matula, Thomas J.; O'Keefe, Grant E.; Crum, Lawrence A.

    2005-03-01

    Our objective was to investigate whether High-Intensity Focused Ultrasound (HIFU) hemostasis can be achieved faster in the presence of ultrasound contrast agents (UCA). Incisions (3 cm long and 0.5 cm deep) were made in surgically exposed rabbit liver. Optison at a concentration of 0.18 ml/kg was injected into the mesenteric vein, immediately before the incision was made. The HIFU applicator (frequency of 5.5 MHz, and intensity of 3,700 W/cm2) was scanned manually over the incision (at an approximate rate of 1 mm/s) until hemostasis was achieved. The times to complete hemostasis were measured and normalized with the initial blood loss. The hemostasis times were 59±23 s in the presence of Optison and 70±23 s without Optison. The presence of Optison produced a 37% reduction in the normalized hemostasis times (phemostasis of internal organ injuries.

  17. Combination of the transurethral resection and prostate HIFU ablation at treatment of the localized cancer

    Directory of Open Access Journals (Sweden)

    Popkov V.M.

    2014-09-01

    26 patients were included into HIFU and 74 group in group of the combined treatment (TURP+HIFU. Selection criteria for HIFU ablation were the localized cancer of a prostate concerning which earlier it wasn't carried out treatments, and level of a PSA at the time of statement of the diagnosis 15 ng/ml. All patients corresponding to these by criteria, were considered as candidates for treatment and inclusion in the analysis. The nadir and stability of PSA, the histologic conclusion, IPSS, quality of life and complication were estimated at time of postoperative supervision. Results: Statistically significant influence of a combination TURP+HIFU for the term of transurethral drainage of a bladder (a median of 40 days against 7 days, incontience frequency (15.4% against 6.9%, infections of urinary ways (47.9% against 11.4% and IPSS change during the postoperative period (on the average 8.91 against 3.37 is noted. During the short period of supervision it wasn't observed considerable changes in relation to efficiency: in HIFU group the frequency of repeated sessions made 25%, in TUR/HIFU group 4%. Conclusion: HIFU therapy is modern, minimum invasive method of a cancer therapy of a prostate. The combination of a transurethral resection and HIFU ablation significantly reduces the frequency of the complications connected with treatment. Maintaining the patient after combined TURP and HIFU ablation is comparable with maintaining the patient after usual TURP.

  18. Safety and Efficacy of a Novel Technique in the Use of Fractional Flow Reserve in Complex Coronary Artery Lesions

    Institute of Scientific and Technical Information of China (English)

    Wen-Ming He; Chang-Ling Li; Yong Sun; Zhong Zhou; Yi-Feng Mai

    2015-01-01

    Background:Fractional flow reserve (FFR) has become an increasingly important index when making decisions with respect to revascularization of coronary artery stenosis.However,the pressure guidewire used in obtaining FFR measurements is difficult to control and manipulate in certain complex coronary artery lesions,resulting in increased fluoroscopy time and contrast dye usage.This study examined a novel (NOV) technique for obtaining FFR measurements in hope of easing the difficulties associated with evaluating and treating complex coronary artery lesions.Methods:Fifty-six patients with complex coronary artery lesions were assigned to a conventional (CON) FFR technique group or a NOV FFR technique group.The NOV technique involved the use of a balloon and wire exchange within the coronary artery.The fluoroscopy time,contrast dye usage,and FFR-related complications were assessed after completing the FFR measurement procedure for each patient.Results:The median time required for fluoroscopy in the NOV technique group was significantly less than that in the CON technique group; additionally,lesser amounts of contrast dye were used in the NOV technique group (both P < 0.05).The NOV technique was successfully performed in thirty patients,without any FFR-related complications.However,the CON technique failed in three patients,including two who experienced coronary artery spasms (P > 0.05).Conclusions:Compared to the CON technique used for measuring FFR,the new technique reduced the fluoroscopy time and amount of contrast dye used when evaluating complex coronary artery lesions.The new technique did not increase the risk of operation or decrease the success rate.

  19. Comparison of the cytology technique and the frozen section results in intraoperative consultation of the breast lesions

    Directory of Open Access Journals (Sweden)

    "Haeri H

    2002-07-01

    Full Text Available The cytology study is effective and reliable technique in intraoperative consultation. This study was performed to evaluate the accuracy of the cytology study in intraoperative consultation of the breast lesions. 125 specimens of the breast lesions were examined and studied in Imam Khomeini Hospital during the years 1998-99. The sensitivity, specificity and accuracy for cytological method were 87.5% , 95%, 90.5% and for the frozen section 92.4%, 100% and 95.4% respectively. The false positive reports were 2% in the cytology technique and the most important source of error and false postivie reports was fibroadenoma in this method. By reviewing the results. It could be concluded that combination of these two techniques is beneficial and more reliable in intraoperative consultation resports of the breast lesions

  20. Development of Noninvasive Vascular Occlusion Method with HIFU

    Science.gov (United States)

    Senoo, Naohiko; Suzuki, Jun; Yoshinakaa, Kiyoshi; Deguchi, Juno; Takagia, Shu; Miyata, Tetsuro; Matsumotoa, Yoichiro

    2010-03-01

    HIFU treatment with microbubbles is investigated in the present study. It is well known that microbubbles have the potential to enhance the heating effect in an ultrasound field. In the present study, the heat produced by microbubble oscillation was used to occlude varicose veins. The heated area by HIFU irradiation was initially investigated with white-egg gel, which denatures at over 70° C. The heated area mainly depends on the frequency of the ultrasound, the intensity at focus, and the irradiation time. The attenuation coefficient was also measured in order to confirm that attenuation at the skin is such that HIFU energy can reach the vein. Then, we conducted an animal experiment. We completely dehaired a rabbit and washed the exposed skin with soap and degassed water in order to eliminate bubbles (which interfere with the passage of ultrasound) from the boundary face. The frequency of the ultrasound was 1.7 MHz. The intensity at focus was 1,800 W/cm2, and the irradiation time was 20 s. We chose the contrast agent Levovist® for the microbubbles, and set the void fraction (the ratio of total gas volume to liquid) in the blood vessel to 10-5. Levovist® was dissolved into normal saline and injected into the vein. The vein was clasped on one side using forceps and compressed in order to avoid thermal dissipation. Furthermore, hypodermic water was injected as coolant for skin. Then, the external jugular vein of rabbit was occluded. The capability of HIFU treatment to occlude lower extremity varicose veins was verified in the present study.

  1. In-office rapid volumetric ablation of uterine fibroids under ultrasound imaging guidance: Preclinical and early clinical experience with the Mirabilis transabdominal HIFU treatment system

    Science.gov (United States)

    Leal, José G. Garza; León, Ivan Hernandez; Sáenz, Lorena Castillo; Aguirre, Juan M. Aguilar; Lagos, Joel J. Islas; Parsons, Jessica E.; Darlington, Gregory P.; Lau, Michael P. H.

    2017-03-01

    Mirabilis Medica, Inc. (Bothell, WA, USA) has developed a high-intensity focused ultrasound (HIFU) system for producing rapid transabdominal volumetric ablation of uterine fibroids in an office-based setting. The Mirabilis HIFU Treatment System utilizes integrated ultrasound imaging guidance and short treatment times under 15 minutes. Treatment with the Mirabilis system is generally well tolerated using only oral analgesia without anesthesia or sedation. This paper summarizes certain technical aspects of the Mirabilis HIFU technology, the preclinical development process, and the results of the first in-human clinical study using the Mirabilis system. During preclinical studies, an in vivo transcutaneous porcine lower extremity model was used in a total of 180 adult swine to develop the HIFU treatment regimen parameters. Additionally, 108 excised human uteri with fibroids obtained from scheduled hysterectomies were treated in an ex vivo experimental setup and evaluated. These preclinical activities resulted in a HIFU treatment technique referred to as Mirabilis Shell Ablation, which enables rapid volumetric fibroid ablation by directing the HIFU energy to the outer perimeter of the target volume (the `shell') without insonating its core. This method results in efficient fibroid treatment through a synergistic combination of direct tissue ablation, cooperative heating effects, and indirect ischemic necrosis in the interior of the volume. After refining this technique and performing safety testing in the in vivo porcine model, a clinical pilot study was conducted to assess the initial safety and performance of the Mirabilis HIFU Treatment System for transabdominal treatment of uterine fibroids in eligible women who were scheduled to undergo hysterectomy following treatment with the device. A total of 37 women meeting certain eligibility criteria were treated at two clinical sites in Mexico. Twenty-nine (29) of these 37 women received only prophylactic sublingual

  2. Characterization of hepatocellular carcinoma (HCC) lesions using a novel CT-based volume perfusion (VPCT) technique

    Energy Technology Data Exchange (ETDEWEB)

    Kaufmann, S., E-mail: sascha.kaufmann@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Horger, T., E-mail: horger@ma.tum.de [Technische Universität München, Boltzmannstraße 3, 85748 Garching (Germany); Oelker, A., E-mail: oelker@ma.tum.de [Technische Universität München, Boltzmannstraße 3, 85748 Garching (Germany); Kloth, C., E-mail: christopher.kloth@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Nikolaou, K., E-mail: Konstantin.Nikolaou@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Schulze, M., E-mail: maximilian.schulze@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Horger, M., E-mail: marius.horger@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany)

    2015-06-15

    Highlights: • Quantification of perfusion with VPCT has great potential for functional imaging. • We present our preliminary results of perfusion parameters (Blood Flow, Blood Volume and kk-trans) of hepatocellular carcinoma (HCC) in terms of using VPCT and two different calculation methods, compare their results and look for correlation between tumor arterialization and lesion size. • VPCT can measure tumor volume perfusion non-invasively and enables quantification of the degree of HCC arterialization. Results are dependent on the technique used with best inter-method correlation for Blood Flow. • Tumor arterialization did not proved size-dependent. - Abstract: Objective: To characterize hepatocellular carcinoma (HCC) in terms of perfusion parameters using volume perfusion CT (VPCT) and two different calculation methods, compare their results, look for interobserver agreement of measurements and correlation between tumor arterialization and lesion size. Material and methods: This study was part of a prospective monitoring study in patients with HCC undergoing TACE, which was approved by the local Institutional Review Board. 79 HCC-patients (mean age, 64.7) with liver cirrhosis were enrolled. VPCT was performed for 40 s covering the involved liver (80 kV, 100/120 mAs) using 64 mm × 0.6 mm collimation, 26 consecutive volume measurements, 50 mL iodinated contrast IV and 5 mL/s flow rate. Mean/maximum blood flow (BF; ml/100 mL/min), blood volume (BV) and k-trans were determined both with the maximum slope + Patlak vs. deconvolution method. Additionally, the portal venous liver perfusion (PVP), the arterial liver perfusion (ALP) and the hepatic perfusion index (HPI) were determined for each tumor including size measurements. Interobserver agreement for all perfusion parameters was calculated using intraclass correlation coefficients (ICC). Results: The max. slope + Patlak method yielded: BFmean/max = 37.8/57 mL/100 g-tissue/′, BVmean/max = 9.8/11.1 mL/100 g

  3. Cytomorphological analysis in oral squamous cell carcinoma lesions and normal controls using rub and rinse technique

    Directory of Open Access Journals (Sweden)

    Shaila Mulki

    2014-01-01

    Full Text Available Context: Early diagnosis of oral cancer requires simple noninvasive screening tools. Aim: To analyze the cytomorphological features of keratinocytes in smears obtained from the oral mucosa of oral squamous cell carcinoma (OSCC lesions and normal controls using oral rub and rinse technique. Settings and Design: Oral smears were prepared using oral rub and rinse method in subjects with OSCC cases (n = 35 and apparently healthy normal controls (n = 35. They were subjected to cytomorphometric analysis. Materials and Methods : The smears prepared with the rinse method were stained with Papanicolaou stain. Quantitative assessment of nuclear diameter (ND, cytoplasmic diameter (CD, cellular area (CA, nuclear area (NA, and nuclear cytoplasmic ratio (N:C was carried out. Statistical Analysis Used: Unpaired Student′s t-test was used to compare the mean value between the groups. Results: There was a significant difference between ND, CD, CA, NA, and N: C of oral cancer cells and that of the normal controls. There was increase in the mean ND, NA, and N: C; and decrease in CA and CD of cancer subjects when compared to that of normal controls. Conclusion: Cytomorphometric analysis of keratinocytes obtained with oral rinse method can serve as a useful adjunct in the early diagnosis of OSCCs.

  4. The rigid curette technique for the application of fibrin bioadhesive during hip arthroscopy for articular cartilage lesions.

    Science.gov (United States)

    Asopa, Vipin; Singh, Parminder J

    2014-04-01

    Encouraging midterm results have recently been reported for the arthroscopic treatment of delaminating articular cartilage lesions at the capsulolabral junction of the hip joint using fibrin bioadhesive. The needle used to introduce the bioadhesive is long, flexible, and often difficult to position. We describe a novel technique for introducing the needle that allows accurate placement behind the delaminated articular cartilage pocket during hip arthroscopy.

  5. Treatment of Bankart lesions in traumatic anterior instability of the shoulder: a randomized controlled trial comparing arthroscopy and open techniques.

    Science.gov (United States)

    Archetti Netto, Nicola; Tamaoki, Marcel Jun Sugawara; Lenza, Mario; dos Santos, João Baptista Gomes; Matsumoto, Marcelo Hide; Faloppa, Flavio; Belloti, João Carlos

    2012-07-01

    The objective of this study was to compare the functional assessments of arthroscopy and open repair for treating Bankart lesion in traumatic anterior shoulder instability. Fifty adult patients, aged less than 40 years, with traumatic anterior shoulder instability and the presence of an isolated Bankart lesion confirmed by diagnostic arthroscopy were included in the study. They were randomly assigned to receive open or arthroscopic treatment of an isolated Bankart lesion. In all cases of both groups, the lesion was repaired with metallic suture anchors. The primary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. After a mean follow-up period of 37.5 months, 42 patients were evaluated. On the DASH scale, there was a statistically significant difference favorable to the patients treated with the arthroscopic technique, but without clinical relevance. There was no difference in the assessments by University of California, Los Angeles and Rowe scales. There was no statistically significant difference regarding complications and failures, as well as range of motion, for the 2 techniques. On the basis of this study, the open and arthroscopic techniques were effective in the treatment of traumatic anterior shoulder instability. The arthroscopic technique showed a lower index of functional limitation of the upper limb, as assessed by the DASH questionnaire; this, however, was not clinically relevant. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Optical coherence tomography assessment of a complex bifurcation lesion treated with double kissing Crush technique

    Science.gov (United States)

    Cai, Jin-Zan; Zhang, Yao-Jun; Xu, Tian; Zhu, Yong-Xiang; Mao, Chen-Yu; Bourantas, Christos V.; Crake, Tom; Chen, Shao-Liang

    2017-01-01

    Abstract The DEFINITION (Impact of the complexity of bifurcation lesions treated with drug-eluting stents) study has provided a novel classification to evaluate the complexity of coronary bifurcation lesion according to coronary angiography, but angiographic imaging due to its low resolution and inherited limitation may result in an inaccurate adjudication. We used optical coherence tomography (OCT) to further evaluate the coronary characteristics in a patient with “simple” bifurcation lesion which was classified by the DEFINITION criteria. However, a “complex” bifurcation lesion was defined and confirmed according to the OCT results. A double kissing Crush stenting approach was adopted to treat this “complex” case finally. The immediate and long-term angiographic and OCT results were excellent. OCT may be useful imaging modality to classify complexity of coronary bifurcation lesion and subsequently guide its treatment strategy. PMID:28072714

  7. Adaptive lesion formation using dual mode ultrasound array system

    Science.gov (United States)

    Liu, Dalong; Casper, Andrew; Haritonova, Alyona; Ebbini, Emad S.

    2017-03-01

    We present the results from an ultrasound-guided focused ultrasound platform designed to perform real-time monitoring and control of lesion formation. Real-time signal processing of echogenicity changes during lesion formation allows for identification of signature events indicative of tissue damage. The detection of these events triggers the cessation or the reduction of the exposure (intensity and/or time) to prevent overexposure. A dual mode ultrasound array (DMUA) is used for forming single- and multiple-focus patterns in a variety of tissues. The DMUA approach allows for inherent registration between the therapeutic and imaging coordinate systems providing instantaneous, spatially-accurate feedback on lesion formation dynamics. The beamformed RF data has been shown to have high sensitivity and specificity to tissue changes during lesion formation, including in vivo. In particular, the beamformed echo data from the DMUA is very sensitive to cavitation activity in response to HIFU in a variety of modes, e.g. boiling cavitation. This form of feedback is characterized by sudden increase in echogenicity that could occur within milliseconds of the application of HIFU (see http://youtu.be/No2wh-ceTLs for an example). The real-time beamforming and signal processing allowing the adaptive control of lesion formation is enabled by a high performance GPU platform (response time within 10 msec). We present results from a series of experiments in bovine cardiac tissue demonstrating the robustness and increased speed of volumetric lesion formation for a range of clinically-relevant exposures. Gross histology demonstrate clearly that adaptive lesion formation results in tissue damage consistent with the size of the focal spot and the raster scan in 3 dimensions. In contrast, uncontrolled volumetric lesions exhibit significant pre-focal buildup due to excessive exposure from multiple full-exposure HIFU shots. Stopping or reducing the HIFU exposure upon the detection of such an

  8. A feasibility study of soft embalmed human breast tissue for preclinical trials of HIFU- preliminary results

    Science.gov (United States)

    Joy, Joyce; Yang, Yang; Purdie, Colin; Eisma, Roos; Melzer, Andreas; Cochran, Sandy; Vinnicombe, Sarah

    2017-03-01

    Breast cancer is the commonest cancer in women in the UK, accounting for 30% of all new cancers in women, with an estimated 49,500 new cases in 20101. With the widespread negative publicity around over-diagnosis and over-treatment of low risk breast cancers, interest in the application of non-invasive treatments such as magnetic resonance imaging (MRI) guided high intensity focused ultrasound (HIFU) has increased. Development has begun of novel US transducers and platforms specifically designed for use with breast lesions, so as to improve the range of breast lesions that can be safely treated. However, before such transducers can be evaluated in patients in clinical trials, there is a need to establish their efficacy. A particular issue is the accuracy of temperature monitoring of FUS with MRI in the breast, since the presence of large amounts of surrounding fat can hinder temperature measurement. An appropriate anatomical model that imposes similar physical constraints to the breast and that responds to FUS in the same way would be extremely advantageous. The aim of this feasibility study is to explore the use of Thiel embalmed cadaveric tissue for these purposes. We report here the early results of laboratory-based experiments sonicating dissected breast samples from a Thiel embalmed soft human cadaver with high body mass index (BMI). A specially developed MRI compatible chamber and sample holder was developed to secure the sample and ensure reproducible sonications at the transducer focus. The efficacy of sonication was first studied with chicken breast and porcine tissue. The experiments were then repeated with the dissected fatty breast tissue samples from the soft-embalmed human cadavers. The sonicated Thiel breast tissue was examined histopathologically, which confirmed the absence of any discrete lesion. To investigate further, fresh chicken breast tissue was embalmed and the embalmed tissue was sonicated with the same parameters. The results confirmed the

  9. Evaluation of a Nonrigid Motion Compensation Technique Based on Spatiotemporal Features for Small Lesion Detection in Breast MRI

    Directory of Open Access Journals (Sweden)

    F. Steinbruecker

    2012-01-01

    the performance of a new nonrigid motion correction algorithm based on the optical flow method. For each of the small lesions, we extracted morphological and dynamical features describing both global and local shape, and kinetics behavior. In this paper, we compare the performance of each extracted feature set under consideration of several 2D or 3D motion compensation parameters for the differential diagnosis of enhancing lesions in breast MRI. Based on several simulation results, we determined the optimal motion compensation parameters. Our results have shown that motion compensation can improve the classification results. The results suggest that the computerized analysis system based on the non-rigid motion compensation technique and spatiotemporal features has the potential to increase the diagnostic accuracy of MRI mammography for small lesions and can be used as a basis for computer-aided diagnosis of breast cancer with MR mammography.

  10. Técnicas de biopsia para el diagnóstico de lesiones mamarias no palpables Biopsy techniques for the diagnosis of non-palpable mammary lesions

    Directory of Open Access Journals (Sweden)

    L. Pina

    2004-12-01

    (basically in cases of microcalcifications, echography (above all in the nodules, and magnetic resonance (for lesions not made visible through the previous systems. The next step is to select the most suitable biopsy technique. The most classical and reliable technique is the surgical biopsy with prior marking using a metallic harpoon, but, besides its high cost, it has the drawback of being an aggressive technique for the diagnosis of a benign pathology. Numerous systems of puncture have been developed as alternatives. Puncture with a fine needle is technically simple to carry out and can provide good results in the mammary nodules, but the existence of positive and negative false results has progressively limited its use. As an alternative, the systems of biopsy with a broad needle have made it possible to obtain multiple cylinders with a high diagnostic reliability, above all in the case of mammary nodules. However, their use in microcalcifications continues to show negative false results. The arrival of systems of vacuum-assisted biopsy has made it possible to obtain cylinders of greater quality, above all in cases of microcalcifications. Finally, the systems of percutaneous resection biopsy by means of cannulas with a diameter of 22mm make it possible to completely extract lesions of a size below that of the cannula, with a reliability similar to that of the surgical biopsy.

  11. The bony partial articular surface tendon avulsion lesion: an arthroscopic technique for fixation of the partially avulsed greater tuberosity fracture.

    Science.gov (United States)

    Bhatia, Deepak N; de Beer, Joe F; van Rooyen, Karin S

    2007-07-01

    The partial articular surface tendon avulsion (PASTA) is a common lesion that involves the supraspinatus tendon in most cases. We present an arthroscopic fixation technique for a previously undescribed lesion that may be considered a variant of the PASTA. The lesion involves a partial avulsion of the greater tuberosity with an intact deep insertion of the supraspinatus tendon into the fractured bone fragment and an intact superficial insertion of the supraspinatus into the unavulsed lateral aspect of the greater tuberosity: a "bony PASTA" lesion. The surgical technique involves the use of a 70 degree arthroscope to provide an "end-on" view of the pathology. A superior-medial transmuscular portal is used for anchor insertion and suture management; the portal avoids damage to the intact tendinous insertion of the supraspinatus, which can occur during transtendon anchor/screw insertion. Abduction of the arm to 50 degrees, after creation of the portal and passage of the cannula, permits an optimal "deadman" angle of anchor placement. An angled suture grasper is used to retrieve the 4 suture strands from the double-loaded suture anchor through the intact superficial and deep supraspinatus tendon fibers along the length of the fracture; these are tied as 2 mattress sutures over the tendon fibers in the subacromial space by use of sliding-locking knots. Adequacy of reduction is confirmed by intra-articular arthroscopic observation during movement of the extremity through its complete range of motion.

  12. Characterization of HIFU transducers designed for sonochemistry application: Acoustic streaming.

    Science.gov (United States)

    Hallez, L; Touyeras, F; Hihn, J-Y; Bailly, Y

    2016-03-01

    Cavitation distribution in a High Intensity Focused Ultrasound sonoreactors (HIFU) has been extensively described in the recent literature, including quantification by an optical method (Sonochemiluminescence SCL). The present paper provides complementary measurements through the study of acoustic streaming generated by the same kind of HIFU transducers. To this end, results of mass transfer measurements (electrodiffusional method) were compared to optical method ones (Particle Image Velocimetry). This last one was used in various configurations: with or without an electrode in the acoustic field in order to have the same perturbation of the wave propagation. Results show that the maximum velocity is not located at the focal but shifted near the transducer, and that this shift is greater for high powers. The two cavitation modes (stationary and moving bubbles) are greatly affect the hydrodynamic behavior of our sonoreactors: acoustic streaming and the fluid generated by bubble motion. The results obtained by electrochemical measurements show the same low hydrodynamic activity in the transducer vicinity, the same shift of the active focal toward the transducer, and the same absence of activity in the post-focal axial zone. The comparison with theoretical Eckart's velocities (acoustic streaming in non-cavitating media) confirms a very high activity at the "sonochemical focal", accounted for by wave distortion, which induced greater absorption coefficients. Moreover, the equivalent liquid velocities are one order of magnitude larger than the ones measured by PIV, confirming the enhancement of mass transfer by bubbles oscillation and collapse close to the surface, rather than from a pure streaming effect.

  13. Development of HIFU Therapy System for Lower Extremity Varicose Veins

    Science.gov (United States)

    Ota, Ryuhei; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2009-04-01

    High-intensity focused ultrasound (HIFU) treatment utilizing microbubbles was investigated in the present study. It is known that microbubbles have the potential to enhance the heating effects of an ultrasound field. In this study, the heat accompanying microbubble oscillation was used to occlude varicose veins. Alteration of veins was observed after ultrasound irradiation. Veins were resected by stripping. In this study, two vein conditions were adopted during HIFU irradiation; non-compressed and compressed. Compressing the vein was expected to improve occlusion by rubbing the altered intima under compressed conditions. The frequency of the ultrasound was 1.7 MHz, the intensity at the focus was 2800 W/cm2, and the irradiation time was 20 s. In this study, the contrast agent Levovist® was chosen as a microbubble source, and the void fraction (ratio of total gas volume to liquid) in the vein was fixed at 10-5. Under non-compressed conditions, changes were observed only at the adventitia of the vein anterior wall. In contrast, under compressed conditions, changes were observed from the intima to the adventitia of both the anterior and posterior walls, and they were partly stuck together. In addition, more experiments with hematoxylin-eosin staining suggested that the changes in the vein were more substantial under the latter conditions. From these results, it was confirmed that the vein was occluded more easily with vein compression.

  14. Evaluation of temperature rise in a tissue mimicking material during HIFU exposure

    Energy Technology Data Exchange (ETDEWEB)

    Maruvada, S; Liu, Y; Herman, B A; Harris, G R, E-mail: subha.maruvada@fda.hhs.gov [Food and Drug Administration, Center for Devices and Radiological Health, 10903 New Hampshire Ave., Bldg., Silver Spring, MD 20993 (United States)

    2011-02-01

    In pre-clinical testing it is essential to characterize clinical high intensity focused ultrasound (HIFU) devices using tissue-mimicking materials (TMMs) with well known characteristics, including temperature rise and cavitation properties. The purpose of this study was to monitor cavitation behavior and correlate its effect with temperature rise in a HIFU TMM containing an embedded thermocouple. A 75-{mu}m fine wire thermocouple was embedded in a hydrogel-based TMM previously developed for HIFU. HIFU at 1.1 and 3.3 MHz was focused at the thermocouple junction. Focal pressures from 1-11 MPa were applied and the temperature profiles were recorded. Three hydrophones were used to monitor cavitation activity during sonication. A hydrophone confocal with the HIFU transducer and a cylindrical hydrophone lateral to the HIFU beam were used as passive cavitation detectors for spectral analysis of signals, and a needle hydrophone placed beyond the HIFU focus was used to record changes in the pressure amplitude due to blockage by bubbles at or near the focus. B-mode imaging scans were employed to visualize bubble presence during sonication. In a separate measurement, schlieren imaging was used to monitor the change in field distribution behind the TMM. All hydrophone methods correlated well with cavitation in the TMM.

  15. Re-implant of the right coronary artery: a surgical technique for the treatment of ostial lesions

    Directory of Open Access Journals (Sweden)

    Bongiovani Hércules Lisboa

    2002-01-01

    Full Text Available Previously described surgical treatment for ostial coronary artery stenosis relied on either venous or arterial bypasses or ostial patch angioplasty. These surgical procedures are performed with bovine pericardium, saphenous vein or internal thoracic artery. We describe a technique of right coronary artery re-implantation into the aorta. The procedure was performed in four patients with right coronary artery ostial stenosis along with other left coronary artery lesions.

  16. Rehabilitation of children with lesions of the proximal humeral metaepiphysis using transosseous distraction osteosynthesis technique

    Directory of Open Access Journals (Sweden)

    Юрий Евгеньевич Гаркавенко

    2015-09-01

    Full Text Available We present an analysis of the treatment of 39 children with a shortening of the humerus after sustained osteomyelitis. Variants of lesions of the proximal humerus metaepiphysis are highlighted, and the differentiated approach to therapeutic measures depending on the identified changes resulted in a positive outcome.

  17. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique

    NARCIS (Netherlands)

    Kemoli, A.M.; van Amerongen, W.E.

    2011-01-01

    OBJECTIVE: To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. BASIC RESEARCH DESIGN: Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from

  18. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique

    NARCIS (Netherlands)

    Kemoli, A.M.; van Amerongen, W.E.

    2011-01-01

    OBJECTIVE: To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. BASIC RESEARCH DESIGN: Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from

  19. Image analysis of intracranial high perfusion lesion by whole brain one-stop imaging technique with 320 detector rows CT

    Directory of Open Access Journals (Sweden)

    Fei-zhou DU

    2014-03-01

    Full Text Available Objective  The perfusion and vascular architecture features were investigated and evaluated by use of one-stop imaging technique with 320 rows CT for exploring the clinical value of one-stop imaging technique in the diagnosis of intracranial lesions. Methods  The perfusion parameters and vascular architecture of intracranial high perfusion lesions of 52 patients were collected in General Hospital of Chengdu Command from Oct. 2010 to Apr. 2013, who were examined by one-stop imaging technique with 320 rows CT, were retrospectively analyzed. The perfusion values of normal contralateral cerebral tissue were used as control to analyze the perfusion and vascular architecture features of injured parts. Results  Of the 52 patients, there were 16 cases of subacute cerebral infarction, 9 cases of arteriovenous malformation, 7 cases of hemangioma, 12 cases of meningioma, and 8 cases of glioma. All the patients showed elevated CBV and/or CBF and different changes in mean transit time (MTT, time to peak (TTP and delay time (Delay. In the cases of subacute cerebral infarction, the parameters of MTT, TTP and Delay increased. In the cases of arteriovenous malformation, all the parameters decreased. In the cases of hemangioma, the MTT decreased, while TTP and Delay increased. In the cases of glioma, the TTP and Delay increased, while the change of MTT varied. Meanwhile, abnormality of vascular structures was found in all the cases by CT angiography. Conclusion  With whole brain perfusion and one-stop vascular imaging with 320 rows CT, the perfusion characteristics of intracranial lesions can be revealed completely, including blood supply and microcirculation changes in the lesions, and it may be of benefit in guiding the clinical diagnosis and treatment. DOI: 10.11855/j.issn.0577-7402.2014.03.10

  20. TU-EF-210-01: HIFU, Drug Delivery, and Immunotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ferrara, K. [University of California - Davis (United States)

    2015-06-15

    The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare.

  1. A New Model of Thermal Propagation in Human Tissue by Using HIFU Application

    CERN Document Server

    Hajian, Saeed Reza; Pouladian, Majid; Hemmasi, Gholam Reza

    2016-01-01

    In outside the body HIFU treatment that focused ultrasound beams hit severely with cancer tissue layer especially the soft one, at the time of passage of the body different layers as long as they want to reach tumor, put their own way components under mechanical and even thermal influence and they can cause skin lesions. To reduce this effect a specific mechanical model can be used that means body tissue is considered as a mechanical model, it is affected when passing sound mechanical waves through it and each layer has an average heat. Gradually sound intensity decreases through every layer passage, finally in one direction a decreased intensity sound reach tumor tissue. If sound propagated directions increase, countless waves with decreased intensity are gathered upon the tumor tissue that causes a lot of heat focus on tumor tissue. Depending on the kind and mechanical properties of the tissue, intensity of each sound wave when it passes through tissue can be controlled to reduce damages outside the tumor t...

  2. TREATMENT OF OSTEOCHONDRAL LESIONS OF THE TALUS BY MEANS OF THEARTHROSCOPY-ASSISTED MICROPERFORATION TECHNIQUE

    Science.gov (United States)

    de Lima, Everton; de Queiroz, Felipe; Lopes, Osmar Valadão; Spinelli, Leandro de Freitas

    2015-01-01

    Objective: To evaluate patients affected by osteochondral fractures of the talus who were treated surgically by means of arthroscopy-assisted microperforation. Methods: A retrospective study was carried out on 24 patients with osteochondral lesions of the talus who underwent microperforation assisted by videoarthroscopy of the ankle. They were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score system before and after the operation. Results: There were 19 men and 5 women, with a mean age of 35.3 years (minimum of 17 years and maximum of 54 years). The minimum follow-up was two years (maximum of 39 months). All the patients showed an improvement in AOFAS score after surgery, with an average improvement of around 22.5 points. Conclusion: Videoarthroscopy-assisted microperforation is a good option for treating osteochondral lesions of the talus and provides good functional results. PMID:27027076

  3. Modified watershed technique and post-processing for segmentation of skin lesions in dermoscopy images.

    Science.gov (United States)

    Wang, Hanzheng; Moss, Randy H; Chen, Xiaohe; Stanley, R Joe; Stoecker, William V; Celebi, M Emre; Malters, Joseph M; Grichnik, James M; Marghoob, Ashfaq A; Rabinovitz, Harold S; Menzies, Scott W; Szalapski, Thomas M

    2011-03-01

    In previous research, a watershed-based algorithm was shown to be useful for automatic lesion segmentation in dermoscopy images, and was tested on a set of 100 benign and malignant melanoma images with the average of three sets of dermatologist-drawn borders used as the ground truth, resulting in an overall error of 15.98%. In this study, to reduce the border detection errors, a neural network classifier was utilized to improve the first-pass watershed segmentation; a novel "edge object value (EOV) threshold" method was used to remove large light blobs near the lesion boundary; and a noise removal procedure was applied to reduce the peninsula-shaped false-positive areas. As a result, an overall error of 11.09% was achieved.

  4. Image similarity ranking of focal computed tomography liver lesions using a 2AFC technique

    Science.gov (United States)

    Faruque, Jessica; Antani, Sameer; Long, Rodney; Kim, Lauren; Thoma, George

    2016-03-01

    Content-based image retrieval (CBIR) for radiological images has experienced massive growth over the past two decades, and shows great potential as a tool for use in precision medicine. A recurring challenge in CBIR evaluation has been in obtaining reference sets of images from human viewers of the system. Our work seeks to determine the feasibility of creating a reference set from images ranked by similarity from human viewers of the images. We obtained 2 sets each of 10 images of CT focal liver lesions from a database of open-access publications with and without markings showing the region containing the lesions, respectively. We created 2 sets of all 45 pair-wise combinations of the images, and displayed them to 10 volunteers, of which 2 had medical training. We used a Two-Alternative Forced Choice (2AFC) paradigm to obtain complete rankings of similarity levels in these image pairs. Analysis showed that inter-reader agreement for rankings ranged from Tau=0.21-0.69 (median=0.37) for the image pairs without any markings, and Tau=0.21-0.57 (median=0.33) for the image pairs with markings. A comparison of the regions of interests drawn by the study participants outlining the lesions in images without markings showed that participants tended to agree on images containing a single focal lesion of a single density, and inter-reader agreement for image rankings in which the regions of interest agree ranged from Tau=0.39-0.85 (median=0.58). These results show that the use of image ranking using 2AFC may be a feasible method for creating reference sets for CBIR system validation.

  5. Identification of early cancerous lesion of esophagus with endoscopic images by hyperspectral image technique (Conference Presentation)

    Science.gov (United States)

    Huang, Shih-Wei; Chen, Shih-Hua; Chen, Weichung; Wu, I.-Chen; Wu, Ming Tsang; Kuo, Chie-Tong; Wang, Hsiang-Chen

    2016-03-01

    This study presents a method to identify early esophageal cancer within endoscope using hyperspectral imaging technology. The research samples are three kinds of endoscopic images including white light endoscopic, chromoendoscopic, and narrow-band endoscopic images with different stages of pathological changes (normal, dysplasia, dysplasia - esophageal cancer, and esophageal cancer). Research is divided into two parts: first, we analysis the reflectance spectra of endoscopic images with different stages to know the spectral responses by pathological changes. Second, we identified early cancerous lesion of esophagus by principal component analysis (PCA) of the reflectance spectra of endoscopic images. The results of this study show that the identification of early cancerous lesion is possible achieve from three kinds of images. In which the spectral characteristics of NBI endoscopy images of a gray area than those without the existence of the problem the first two, and the trend is very clear. Therefore, if simply to reflect differences in the degree of spectral identification, chromoendoscopic images are suitable samples. The best identification of early esophageal cancer is using the NBI endoscopic images. Based on the results, the use of hyperspectral imaging technology in the early endoscopic esophageal cancer lesion image recognition helps clinicians quickly diagnose. We hope for the future to have a relatively large amount of endoscopic image by establishing a hyperspectral imaging database system developed in this study, so the clinician can take this repository more efficiently preliminary diagnosis.

  6. Research on the positioning problem in HIFU surgery platform application

    Institute of Scientific and Technical Information of China (English)

    XIANG Lin-qing; GAO Xue-guan; XU Jian-bo; MA Pei-sun

    2006-01-01

    For describing the positioning process of High Intensity Focused Ultrasound (HIFU) Surgery Platform in the application in tumor treatment, a simplified representation of the shape and location of the positioning target tumor in the workspace of the platform by the Positioning Volume Ellipsoid is designed; and the Nearest Neighbor Search method is used to find the closest center point of the simplified ellipsoid tumor model in a selected patient body surface point set determined by the motion parameter of the platform. By the query result the goal positioning path configuration and an intermediate positioning path configuration for the positioning motion are determined for the positioning motion planning. Three new criterions using distance change between Positioning Volume Ellipsoid and the Ultrasound Focus Ellipsoid are proposed to evaluate the result of the whole positioning procedure.

  7. Osteochondritis dissecans of the capitellum: lesion size and pattern analysis using quantitative 3-dimensional computed tomography and mapping technique.

    Science.gov (United States)

    Bexkens, Rens; Oosterhoff, Jacobien H; Tsai, Tsung-Yuan; Doornberg, Job N; van den Bekerom, Michel P J; Eygendaal, Denise; Oh, Luke S

    2017-09-01

    The goals of this study were to evaluate the reliability of a quantitative 3-dimensional computed tomography (Q3DCT) technique for measurement of the capitellar osteochondritis dissecans (OCD) surface area, to analyze OCD distribution using a mapping technique, and to investigate associations between Q3DCT lesion quantification and demographic characteristics and/or clinical examination findings. We identified patients with capitellar OCD who presented to our orthopedic sports medicine practice between January 2001 and January 2016 and who had undergone a preoperative computed tomography scan (slice thickness ≤1.25 mm). A total of 17 patients with a median age of 15 years (range, 12-23 years) were included in this study. Three-dimensional polygon models were reconstructed after osseous structures were marked in 3 planes. Surface areas of the OCD lesion as well as the capitellum were measured. Observer agreement was assessed with the intraclass correlation coefficient (ICC). Heat maps were created to visualize OCD distribution. Measurements of the OCD surface area showed almost perfect intraobserver agreement (ICC, 0.99; confidence interval [CI], 0.98-0.99) and interobserver agreement (ICC, 0.93; CI, 0.86-0.97). Measurements of the capitellar surface area also showed almost perfect intraobserver agreement (ICC, 0.97;CI, 0.91-0.99) and interobserver agreement (ICC, 0.86; CI, 0.46-0.96). The median OCD surface area was 101 mm(2) (range, 49-217 mm(2)). On the basis of OCD heat mapping, the posterolateral zone of the capitellum was most frequently affected. OCDs in which the lateral wall was involved were associated with larger lesion size (P = .041), longer duration of symptoms (P = .030), and worse elbow extension (P = .013). The ability to quantify the capitellar OCD surface area and lesion location in a reliable manner using Q3DCT and a mapping technique should be considered when detailed knowledge of lesion size and location is desired

  8. Current technology and techniques in re-mineralization of white spot lesions: A systematic review

    Science.gov (United States)

    Podray, Susan S.

    White Spot lesions are a common iatrogenic occurrence on patients who are treated with fixed orthodontic appliances. There is a dynamic chemical interaction between enamel and saliva at the tooth surface that allow a lesion to have phase changes involving demineralization of enamel and reminerlization. This is due to calcium and phosphate dissolved in saliva that is deposited onto the tooth surface or removed depending on the surrounding pH. Caseinphosphopeptide-amorphous calcium phosphate (CPP-ACP) is gaining popularity in dentistry as a way to increase the available level of calcium and phosphate in plaque and saliva to improve the chemical gradient so that if favors reminerlization. The aim of our investigation is to search the available current literature and formulate a recommendation for use of CPP-ACP in orthodontics. Publications from the following electronic databases were searched: PubMed, Web of Science, Cochrane Library and Science Direct. Searches from August 2010 to April 1st 2012 were performed under the terms "MI Paste OR Recaldent OR caseinphosphopeptide-amorphous calcium phosphate OR CPP-ACP or tooth mousse". The searches yielded 155 articles, These were reviewed for relevance based on inclusion and exclusion criteria. Articles with inappropriate study design or no outcome measures at both baseline and end point were also excluded. 13 articles were deemed of relevance with a high quality study design and were included in this study for evaluation. The current literature suggests a preventative treatment regimen in which MI Paste Plus is used. It should be delivered once daily prior to bed after oral hygiene for 3 minutes in a fluoride tray, throughout orthodontic treatment. It should be recommended for high risk patients determined by poor oral hygiene, as seen by the inability to remove plaque from teeth and appliances. This protocol may prevent or assist in the remineralization of enamel white spot lesions during and after orthodontic treatment.

  9. Intra-operative Hemostasis of Punctured Femoral Artery Using HIFU: A Survival Study

    Science.gov (United States)

    Zderic, Vesna; Keshavarzi, Amid; Noble, Misty L.; Paun, Marla; Sharar, Sam R.; Crum, Lawrence A.; Martin, Roy W.; Vaezy, Shahram

    2005-03-01

    The objective was to investigate the long-term efficacy of hemostasis and healing of arteries after HIFU application. The femoral arteries of 22 adult rabbits were surgically exposed. Fifteen arteries were punctured with a needle and treated with HIFU, and 7 arteries were sham-treated (no puncture or HIFU was applied). The tip of the HIFU applicator was positioned on the bleeding site, and HIFU energy was applied until hemostasis was achieved. The focal intensity was approximately 3,000 W/cm2, at the resonant frequency of 9.6 MHz. Serial ultrasound images, blood and tissue samples were collected immediately and on days 1, 3, 7, 14, 28, and 60 after the treatment. Eleven of the arteries were patent after the treatment, and four arteries were occluded, as confirmed using Doppler imaging. One of the occluded arteries reopened at day 14. HIFU exposure time to achieve hemostasis was 27 ±17 seconds for patent arteries and 101±38 seconds for the occluded arteries. The blood flow velocities were not statistically different between HIFU-treated patent vessels and sham-treated vessels. The tunica adventitia and media, disrupted and coagulated immediately after the treatment, recovered to normal appearance within 28 days, with localized thinning of the tunica media observed up to day 60. Neo-intimal hyperplasia was observed in the arteries at days 14 and 28. HIFU produced an effective and long-term (up to 60 days) hemostasis of injured femoral arteries while preserving a normal blood flow and vessel wall structure in the majority of vessels.

  10. Study on Enhancement Effect of Cavitation Caused by HIFU Piezoelectricity Transducer

    Institute of Scientific and Technical Information of China (English)

    Xinnan Fan; Changping Zhu; Shichuan He; Minglei Shan; Jiacai Chen

    2006-01-01

    An orthogonal ultrasonic irradiation system consisting of HIFU with frequency at 1.05 MHz combined with ultrasound with frequency at 28 kHz was applied in this paper. Effect of cavitation was detected by pH-value measurement and conductance measurement. The result shows that the effect of cavitation caused by ultrasound with frequency at 28 kHz is greatly enhanced by HIFU piezoelectricity transducer with frequency at 1.05 MHz.

  11. Segmentation of tumor ultrasound image in HIFU therapy based on texture and boundary encoding.

    Science.gov (United States)

    Zhang, Dong; Xu, Menglong; Quan, Long; Yang, Yan; Qin, Qianqing; Zhu, Wenbin

    2015-03-07

    It is crucial in high intensity focused ultrasound (HIFU) therapy to detect the tumor precisely with less manual intervention for enhancing the therapy efficiency. Ultrasound image segmentation becomes a difficult task due to signal attenuation, speckle effect and shadows. This paper presents an unsupervised approach based on texture and boundary encoding customized for ultrasound image segmentation in HIFU therapy. The approach oversegments the ultrasound image into some small regions, which are merged by using the principle of minimum description length (MDL) afterwards. Small regions belonging to the same tumor are clustered as they preserve similar texture features. The mergence is completed by obtaining the shortest coding length from encoding textures and boundaries of these regions in the clustering process. The tumor region is finally selected from merged regions by a proposed algorithm without manual interaction. The performance of the method is tested on 50 uterine fibroid ultrasound images from HIFU guiding transducers. The segmentations are compared with manual delineations to verify its feasibility. The quantitative evaluation with HIFU images shows that the mean true positive of the approach is 93.53%, the mean false positive is 4.06%, the mean similarity is 89.92%, the mean norm Hausdorff distance is 3.62% and the mean norm maximum average distance is 0.57%. The experiments validate that the proposed method can achieve favorable segmentation without manual initialization and effectively handle the poor quality of the ultrasound guidance image in HIFU therapy, which indicates that the approach is applicable in HIFU therapy.

  12. A comparison of gray scale ultrasound and radionuclide imaging for the detection of focal hepatic lesions: open shutter technique.

    Science.gov (United States)

    Zatz, L M; Gouldin, J A; Hanley, G A

    1977-06-01

    A conventional B scan ultrasound unit was modified by the addition of a specially built logarithmic amplifier and a high resolution nonstorage oscilloscope, as suggested by Taylor and Carpenter. One hundred five consecutive patients submitted for radionuclide imaging of the liver were examined with ultrasound using a standardized scanning system. The ultrasound technique produced scans that were technically poor or inadequate in 37 per cent of the patients studied. In the studies in which there has been confirmation, the ultrasound diagnosis was accurate in 73 per cent and the radionuclide diagnosis was correct in 83 per cent. The combined accuracy of the two studies was 93 per cent. In 11 patients, ultrasound more clearly defined the lesions that were demonstrated by both techniques or demonstrated the nature of suspicious or equivocal areas on the radionuclide images. In 48 patients, the radionuclide scan imaged the liver more completely or demonstrated lesions more clearly than did the ultrasound examination. This specific approach to ultrasound gray scale imaging appears to be a valuable supplemental tool to radionuclide imaging, but at its present stage of development cannot replace it as a routine screening technique for hepatic disease.

  13. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

    2017-08-01

    To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

  14. Outcomes of the single-stent versus kissing-stents technique in asymmetric complex aortoiliac bifurcation lesions.

    Science.gov (United States)

    Suh, Yongsung; Ko, Young-Guk; Shin, Dong-Ho; Kim, Jung-Sun; Kim, Byeong-Keuk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo

    2015-07-01

    This study investigated the outcomes of single-stent vs kissing-stents techniques in asymmetric complex aortoiliac bifurcation (ACAB) lesions. We retrospectively investigated 80 consecutive patients (69 males, 66.6 ± 8.7 years) treated with a single stent and 30 patients (26 males, 67.1 ± 7.7 years) treated with kissing stents for ACAB between January 2005 and December 2012 from a single-center cohort. A ACAB lesion was defined as a symptomatic unilateral common iliac artery stenosis (>50%) combined with intermediate stenosis (30%-50%) in the contralateral common iliac artery ostium. The primary end point was the primary patency of the ACAB. The baseline clinical characteristics did not differ significantly between the single-stent and the kissing-stents group. Technical success was achieved in all patients. The single-stent group required fewer stents (1.3 ± 0.5 vs 2.3 ± 0.8; P kissing stents because of plaque shift to the contralateral side. The major complication rates were 8% in single-stent vs 13% in the kissing-stent group, which was similar (P = .399). At 3 years, the single-stent and kissing-stents group had similar rates of primary patency (89% vs 87%; P = .916) and target lesion revascularization-free survival (93% vs 87%; P = .462). The single-stent technique in ACAB was safe and showed midterm outcomes comparable with those of kissing stents. Considering the benefits, such as fewer stents, less bilateral femoral access, and the availability of contralateral access for future intervention, the single-stent technique may be an advantageous treatment option in ACAB. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  15. Esthetic improvement of white spot lesions and non-pitted fluorosis using resin infiltration technique: Series of four clinical cases

    Directory of Open Access Journals (Sweden)

    Neeraj Gugnani

    2014-01-01

    Full Text Available White opacities have always been a major concern of esthetics for patients and can have varying etiology. In general, white discolorations of enamel might be due to dental fluorosis, early caries (white spot lesions, developmental defects etc. Conventional treatment options available for such opacities include non-invasive and invasive approaches. Recently, a new "micro-invasive" technique has been introduced as an alternative therapeutic approach that improves such opacities esthetically, in a single sitting, is painless and exhibits no complications. This case series illustrates the use of resin infiltration to treat fluorosis stains and WSLs, exhibiting significant improvement in esthetics.

  16. [Identification of mutations associated with coronary artery lesion susceptibility in Kawasaki disease by targeted enrichment of genomic region sequencing technique].

    Science.gov (United States)

    Zhu, D Y; Song, S R; Xie, L J; Qiu, F; Yang, J; Xiao, T T; Huang, M

    2017-07-02

    Objective: To screen and identify the mutations in Kawasaki disease by targeted enrichment of genomic region sequencing technique and investigate susceptibility genes associated with coronary artery lesion. Method: This was a case-control study.A total of 114 patients diagnosed as Kawasaki disease treated in Shanghai Children's Hospital between December 2015 and November 2016 were studied and another 45 healthy children who were physically examined in outpatient department were enrolled as control group. Patients were divided into two groups based on the results of echocardiogram. Peripheral venous blood was obtained from patients and controls. Genomic DNA was extracted. SeqCap EZ Choice libraries were prepared by targeted enrichment of genomic region technology. Then the libraries were sequenced to identify susceptibility genes associated with coronary artery lesion in patients diagnosed as Kawasaki disease.Susceptible genes were identified by Burden test, Pearson chi-square test or Fisher's exact probability test. Result: There was statistically significant difference in TNFRSF11B(rs2073618)G>C(p.N3K)mutation and GG/GC/CC genotype between Kawasaki disease group and control group(χ(2)=15.52, P=0.00). There was statistically significant difference in TNFRSF13B(rs34562254)C>T(p.P251L)mutation(χ(2)=10.40, P=0.01)and LEFTY1(rs360057)T>G(p.D322A)mutation(χ(2)=8.505, P=0.01)between patients with coronary artery lesions and those without. Conclusion: Targeted enrichment of genomic region sequencing technology can be used to do primary screening for the susceptible genes associated with coronary artery lesions in Chinese Kawasaki patients and may provide theoretical basis for larger sample investigation of risk prediction score standard in Kawasaki disease.

  17. The rise of high intensity focused ultrasound (HIFU) non-invasive therapy for solid tumors%高强聚焦超声(HIFU)无创治疗肿瘤技术的崛起

    Institute of Scientific and Technical Information of China (English)

    冯若; 朱辉; 李发琪; 苏海兵; 陈迅

    2011-01-01

    20世纪40年代,美国学者首次提出了高强聚焦超声治疗技术的概念,并进行了初步的工程和临床研究.70、80年代间,治疗肿瘤的温热疗法曾盛行一时.90年代之后,高强聚焦超声外科肿瘤治疗技术在国际上重新崛起,我国率先推出了大型高强聚焦超声肿瘤治疗系统,并成功地应用于临床治疗乳腺癌、骨肿瘤、肝癌等多种实体肿瘤.迄今,该"JC型高强聚焦超声肿瘤治疗系统"已出口到英国、意大利、西班牙、日本、韩国等许多欧亚国家,在诸如欧洲肿瘤治疗中心等20多个医疗中心运行,治疗肿瘤患者达数万例.我国持续保持着引领世界超声无创治疗技术发展的领先地位.%In the 40 years of last centry American scientists put forward a concep of high intensity focused ultrasound (HIFU) therapeutic technique and had done some technical and clinical studies. Since 90 years the HIFU surgery technique treating tumors anew rised abruptly in the world. China firstly put out a comprehensive HIFU tumor treating sistem and successfully treated many solid tumors such as breast cancer, bone tumor, liver cancer etc.. Now the treating sistem has already exported to England, Italy,Spain, Japan, Colea etc. and treated tens thousands tumor patients. In the field of noninvasive ultrasound treating tumor technique China has continually kept the leading position in the world.

  18. Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions.

    Science.gov (United States)

    Chakrabarti, Sudipta; Datta, Alok Sobhan; Hira, Michael

    2012-01-01

    Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

  19. The "bony Bankart bridge" procedure: a new arthroscopic technique for reduction and internal fixation of a bony Bankart lesion.

    Science.gov (United States)

    Millett, Peter J; Braun, Sepp

    2009-01-01

    Arthroscopic treatment of bony Bankart lesions can be challenging. We present a new easy and reproducible technique for arthroscopic reduction and suture anchor fixation of bony Bankart fragments. A suture anchor is placed medially to the fracture on the glenoid neck, and its sutures are passed around the bony fragment through the soft tissue including the inferior glenohumeral ligament complex. The sutures of this anchor are loaded in a second anchor that is placed on the glenoid face. This creates a nontilting 2-point fixation that compresses the fragment into its bed. By use of the standard technique, additional suture anchors are used superiorly and inferiorly to the bony Bankart piece to repair the labrum and shift the joint capsule. We call this the "bony Bankart bridge" procedure.

  20. A Study of the Potential to Detect Caries Lesions at the White-Spot Stage Using V(Z) Technique

    Science.gov (United States)

    Bakulin, E. Y.; Denisova, L. A.; Maev, R. Gr.

    Current wide-spread methods of non-destructive methods of caries diagnostics, such as X-ray techniques, do not provide the possibility to efficiently detect enamel caries lesions at the beginning ("white-spot") stage, when the tooth tissue is only slightly altered and no loss of the tissue occurs. Therefore, it is of paramount importance to develop new, more sensitive methods of caries diagnostics. In this paper, certain aspects of the ultrasonic approach to the problem are discussed - in particular, detection of the enamel's surface caries at the white-spot stage with a focused ultrasonic sensor positioned in front of the caries lesion (without cross-sectioning the tooth). Theoretical model using V(z) approach for layered media was applied to perform computer simulations resulting in V(z) curves for the different parameters of carious tissue and the degree of degradation. The curves were analyzed and it was shown that, comparing to a short-pulse/echo technique, V(z) approach provides much better distinction between sound and carious enamel and even makes possible to evaluate the degree of demineralization.

  1. Coronary bifurcation lesions treated with double kissing crush technique compared to classical crush technique: serial intravascular ultrasound analysis

    Institute of Scientific and Technical Information of China (English)

    SHAN Shou-jie; YE Fei; LIU Zhi-zhong; TIAN Nai-liang; ZHANG Jun-jie; HEN Shao-liang

    2013-01-01

    Background The double kissing (DK) crush technique is a modified version of the crush technique.It is specifically designed to increase the success rate of the final kissing balloon post-dilatation,but its efficacy and safety remain unclear.Methods Data were obtained from the DKCRUSH-I trial,a prospective,randomized,multi-center study to evaluate safety and efficacy.Post-procedural and eight-month follow-up intravascular ultrasound (IVUS) analysis was available in 61 cases.Volumetric analysis using Simpson's method within the Taxus stent,and cross-sectional analysis at the five sites of the main vessel (MV) and three sites of the side branch (SB) were performed.Impact of the bifurcation angle on stent expansion at the carina was also evaluated.Results Stent expansion in the SB ostium was significantly less in the classical crush group ((53.81±13.51)%) than in the DK crush group ((72.27±11.46)%) (P=-0.04).For the MV,the incidence of incomplete crush was 41.9% in the DK group and 70.0% in the classical group (P=-0.03).The percentage of neointimal area at the ostium had a tendency to be smaller in the DK group compared with the classical group ((16.4±19.2)% vs.(22.8±27.1)%,P=-0.06).The optimal threshold of post-procedural minimum stent area (MSA) to predict follow-up minimum lumen area (MLA) <4.0 mm2 at the SB ostium was 4.55 mm2,yielding an area under the curve of 0.80 (95% confidence interval:0.61 to 0.92).Conclusion Our data suggest that the DK crush technique is associated with improved quality of the final kissing balloon inflation (FKBI) and had smaller optimal cutoff value of post-procedural MSA at the SB ostium.

  2. Coronary bifurcation lesions treated with double kissing crush technique compared to classical crush technique: serial intravascular ultrasound analysis.

    Science.gov (United States)

    Shan, Shou-Jie; Ye, Fei; Liu, Zhi-Zhong; Tian, Nai-Liang; Zhang, Jun-Jie; Chen, Shao-Liang

    2013-04-01

    The double kissing (DK) crush technique is a modified version of the crush technique. It is specifically designed to increase the success rate of the final kissing balloon post-dilatation, but its efficacy and safety remain unclear. Data were obtained from the DKCRUSH-I trial, a prospective, randomized, multi-center study to evaluate safety and efficacy. Post-procedural and eight-month follow-up intravascular ultrasound (IVUS) analysis was available in 61 cases. Volumetric analysis using Simpson's method within the Taxus stent, and cross-sectional analysis at the five sites of the main vessel (MV) and three sites of the side branch (SB) were performed. Impact of the bifurcation angle on stent expansion at the carina was also evaluated. Stent expansion in the SB ostium was significantly less in the classical crush group ((53.81 ± 13.51)%) than in the DK crush group ((72.27 ± 11.46)%) (P = 0.04). For the MV, the incidence of incomplete crush was 41.9% in the DK group and 70.0% in the classical group (P = 0.03). The percentage of neointimal area at the ostium had a tendency to be smaller in the DK group compared with the classical group ((16.4 ± 19.2)% vs. (22.8 ± 27.1)%, P = 0.06). The optimal threshold of post-procedural minimum stent area (MSA) to predict follow-up minimum lumen area (MLA) kissing balloon inflation (FKBI) and had smaller optimal cutoff value of post-procedural MSA at the SB ostium.

  3. Recanalization of Chronic Total Occlusion Lesions: A Critical Appraisal of Current Devices and Techniques

    Science.gov (United States)

    2016-01-01

    Chronic Total Occlusion (CTO) has been considered as one of the “final frontier” in interventional cardiology. Until recently, the patients with CTO are often managed surgically or medically due to lack of published evidence of clinical benefits and lower success rate of percutaneous recanalization of CTO. However, the introduction of enhanced guidewires, microcatheters combined with novel specialized devices and techniques reduce the number of unapproachable CTO. In this review article, current techniques and devices of percutaneous recanalization of CTO have been systematically summarized, which may help budding interventional cardiologists to theoretically understand these complex procedures and to deliver safe and effective percutaneous management of CTO to the patients. PMID:27790503

  4. High-intensity focused ultrasound (HIFU) using Sonablate{trade mark, serif} devices for the treatment of localized prostate cancer: 13-year experience

    Science.gov (United States)

    Uchida, Toyoaki; Tomonaga, Tetsuro; Shoji, Sunao; Kim, Hakushi; Nagata, Yoshihiro

    2012-11-01

    To report on the long-term results of high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. Eight hundred and eighty-four men with prostate cancer treated with Sonablate® (SB) devices were included. All patients were followed for more than 2 years. The patients were divided into three groups: in the first group, 419 patients were treated with SB200/500 from 1999 to 2006; in the second group, 263 patients were treated with SB 500 ver. 4 from 2005 to 2009: in the third group, 202 patients were treated with SB 500 TCM from 2007 up to present. Biochemical failure was defined according to the Phoenix definition (PSA nadir + 2 ng/ml). The mean age, PSA, Gleason score, operation time, and follow-up period in each group were 68, 66 and 67 years, 11.2, 9.7 and 9.3 ng/ml, 6.2, 6.6 and 6.7, 167, 101 and 106 min, and 56, 48 and 36 months, respectively. The biochemical disease-free rate (bDFR) in each group at 5 years was, respectively, 54%, 61% and 84%, and was 50% at 10 years in the SB200/500 group (prisk groups in all patients at 10 years were 72% and 58%, 44%, respectively (prisk groups in the SB500 TCM group at 5 years were 97%, 83%, and 74% (p=0.0056). The negative prostate biopsy rates in 3 groups were 81%, 92% and 88%, respectively. As post HIFU complications, urethral stricture, acute epididymitis and urinary incontinence were noted in 18.0%, 6.2% and 1.9%, respectively. Rectourethral fistula was occurred in 0.6% in the first HIFU cases, Postoperative erectile dysfunction was noted in 27% of patients at 2 years after HIFU. HIFU therapy appears to be minimally invasive, efficacious, and safe for patients with localized prostate cancer. Technological advances as well as cultural and economic vectors have caused a shift from to minimally invasive techniques.

  5. Nanoparticle-enhanced synergistic HIFU ablation and transarterial chemoembolization for efficient cancer therapy

    Science.gov (United States)

    You, Yufeng; Wang, Zhigang; Ran, Haitao; Zheng, Yuanyi; Wang, Dong; Xu, Jinshun; Wang, Zhibiao; Chen, Yu; Li, Pan

    2016-02-01

    High-intensity focused ultrasound (HIFU) is being generally explored as a non-invasive therapeutic modality to treat solid tumors. However, the clinical use of HIFU for large and deep tumor-ablation applications such as hepatocellular carcinoma (HCC) is currently entangled with long treatment duration and high operating energy. This critical issue can be potentially resolved by the introduction of HIFU synergistic agents (SAs). Traditional SAs such as microbubbles and microparticles face the problem of large size, short cycle time, damage to mononuclear phagocytic system and unsatisfactory targeting efficiency. In this work, we have developed a facile and versatile nanoparticle-based HIFU synergistic cancer surgery enhanced by transarterial chemoembolization for high-efficiency HCC treatment based on elaborately designed Fe3O4-PFH/PLGA nanocapsules. Multifunctional Fe3O4-PFH/PLGA nanocapsules were administrated into tumor tissues via transarterial injection combined with Lipiodol to achieve high tumor accumulation because transarterial chemoembolization by Lipiodol could block the blood vessels. The high synergistic HIFU ablation effect was successfully achieved against HCC tumors based on the phase-transformation performance of the perfluorohexane (PFH) inner core in the composite nanocapsules, as systematically demonstrated in VX2 liver tumor xenograft in rabbits. Multifunctional Fe3O4-PFH/PLGA nanocapsules were also demonstrated as efficient contrast agents for ultrasound, magnetic resonance and photoacoustic tri-modality imagings, potentially applicable for imaging-guided HIFU synergistic surgery. Therefore, the elaborate integration of traditional transarterial chemoembolization with recently developed nanoparticle-enhanced HIFU cancer surgery could efficiently enhance the HCC cancer treatment outcome, initiating a new and efficient therapeutic protocol/modality for clinic cancer treatment.

  6. Radiosurgery of small skull-base lesions. No advantage for intensity-modulated stereotactic radiosurgery versus conformal arc technique

    Energy Technology Data Exchange (ETDEWEB)

    Ernst-Stecken, A.; Sauer, R.; Grabenbauer, G. [Dept. of Radiation Therapy and Novalis Shaped Beam Surgery Center, Univ. of Erlangen-Nuremberg, Erlangen (Germany); Lambrecht, U.; Mueller, R. [Dept. of Radiation Therapy and Novalis Shaped Beam Surgery Center, Univ. of Erlangen-Nuremberg, Erlangen (Germany); Div. of Medical Physics, Dept. of Radiation Therapy, Univ. of Erlangen-Nuremberg, Erlangen (Germany); Ganslandt, O.; Fahlbusch, R. [Dept. of Neurosurgery, Univ. of Erlangen-Nuremberg, Erlangen (Germany)

    2005-05-01

    Background and purpose: intensity-modulated stereotactic radiotherapy (IMSRT) has shown the ability to conform the dose to concavities and to better avoid critical organs for large tumors. Given the availability of an electronically driven micro-multileaf collimator, both intensity-modulated stereotactic radiosurgery (IMSRS) and dynamic conformal arc (DCA) technique (DCA) can be performed at the Novalis Shaped Beam Surgery Center, University of Erlangen-Nuremberg, Germany, since 12/2002. This study evaluates both techniques in small skull-base tumors treated with radiosurgery. Material and methods: between 12/2002 and 04/2004, a total of 109 radiosurgical procedures were performed in 77 patients, equally distributed between patients with acoustic neuroma (AN), pituitary adenoma (PA) and meningeoma (M). Six index patients (n = 2 AN, n = 1 PA, n = 3 M) routinely planned for dynamic arc stereotactic radiosurgery were replanned using the IMSRS approach (BrainScan, BrainLAB, Heimstetten, Germany). The RTOG radiosurgery quality assurance guidelines, isodose volumes, doses to organs at risk (OAR), and dose delivery criteria were compared. Results: DCA was superior to IMSRS for homogeneity and coverage. IMSRS could keep the high-dose-irradiated volumes (90% isodose volume) lower than DCA in the PA and AN with very small volumes, but all other lower dose volumes were larger for IMSRS. Dose maxima to OAR were higher for IMSRS. Treatment delivery time for IMSRS would clearly exceed treatment time for DCA by a factor of 2-3. The integral absorbed dose to the brain was much higher in the IMSRS than in the DCA approach (factor 2-3). Conclusion: RTOG radiosurgery guidelines were best met by the DCA rather than IMSRS approach for the treatment of small skull-base lesions. The IMSRS approach will increase the time for planning, dose delivery and integral dose to the brain. Thus, IMSRT techniques are recommended for fractionated stereotactic radiotherapy to larger volumes rather

  7. Endoscopic lysis of bladder scar associated with Hunner's lesions: A new technique

    Directory of Open Access Journals (Sweden)

    Sonia Bahlani

    2015-01-01

    Conclusion: Patients with IC/BPS may be severely debilitated by a clinically significant decrease in their bladder capacity, especially in the face of HL. The use of the holmium laser to incise regions of scar and bladder wall tethering may produce a clinically significant and durable increase in bladder capacity. The use of this technique as a means of treating bladder scarring poses an excellent adjunct to existing treatment strategies.

  8. Comparison of Mandibular Surgical Techniques for Accessing Cranial Base Vascular Lesions

    OpenAIRE

    Devlin, Michael A.; Hoffmann, Keith D.; Johnson, Walter D.

    2003-01-01

    This study compared mandibular distraction and vertical ramus osteotomy in terms of their effectiveness at increasing access to the cranial base and distal internal carotid artery. Five fresh–frozen cadavers were used to obtain a total of ten cranial base exposures. The following two techniques were evaluated on each of the ten exposures: (1) anterior distraction of the mandible without violation of the temporomandibular joint capsule, and (2) vertical ramus osteotomy of the mandible with dis...

  9. A COMPARATIVE ANALYSIS OF SINGLE AND COMBINATION FEATURE EXTRACTION TECHNIQUES FOR DETECTING CERVICAL CANCER LESIONS

    Directory of Open Access Journals (Sweden)

    S. Pradeep Kumar Kenny

    2016-02-01

    Full Text Available Cervical cancer is the third most common form of cancer affecting women especially in third world countries. The predominant reason for such alarming rate of death is primarily due to lack of awareness and proper health care. As they say, prevention is better than cure, a better strategy has to be put in place to screen a large number of women so that an early diagnosis can help in saving their lives. One such strategy is to implement an automated system. For an automated system to function properly a proper set of features have to be extracted so that the cancer cell can be detected efficiently. In this paper we compare the performances of detecting a cancer cell using a single feature versus a combination feature set technique to see which will suit the automated system in terms of higher detection rate. For this each cell is segmented using multiscale morphological watershed segmentation technique and a series of features are extracted. This process is performed on 967 images and the data extracted is subjected to data mining techniques to determine which feature is best for which stage of cancer. The results thus obtained clearly show a higher percentage of success for combination feature set with 100% accurate detection rate.

  10. Imaging of bone tumors and tumor-like lesions. Techniques and applications

    Energy Technology Data Exchange (ETDEWEB)

    Davies, A. Mark [Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom). MRI Dept.; Sundaram, Murali [Cleveland Clinic Foundation, Cleveland, OH (United States). Section of Musculoskeletal Radiology, Imaging Inst.; James, Steven L.J. (eds.) [Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham (United Kingdom). Imaging Dept.

    2009-07-01

    This is a comprehensive textbook that provides a detailed description of the imaging techniques and findings in patients with benign and malignant bone tumors. In the first part of the book, the various techniques and procedures employed for imaging bone tumors are discussed in detail. Individual chapters are devoted to MRI, CT, nuclear medicine, and interventional procedures. The second part of the book gives an authoritative review of the role of these imaging techniques in diagnosis, surgical staging, biopsy, and assessment of response to therapy. The third part of the book covers the imaging features of each major tumor subtype, with separate chapters on osteogenic tumors, cartilaginous tumors, etc. The final part of the book reviews the imaging features of bone tumors at particular anatomical sites such as the spine, ribs, pelvis, and scapula. Each chapter is written by an acknowledged expert in the field, and a wealth of illustrative material is included. This book will be of great value to musculoskeletal and general radiologists, orthopedic surgeons, and oncologists. (orig.)

  11. Calibration of HIFU intensity fields measured using an infra-red camera

    Science.gov (United States)

    Shaw, A.; Khokhlova, V.; Bobkova, S.; Gavrilov, L.; Hand, J.

    2011-02-01

    A trend in HIFU technologies is to use 2D phased arrays that offer electronic steering of a single focus and formation of patterns of multiple foci. Conventional methods to characterize array fields using scanned hydrophone would be prohibitively slow given the potentially large number of focusing conditions. An alternative technique for rapid qualitative assessment of intensity distributions was recently developed. The method is based on infrared camera measurements of the temperature rises induced by low amplitude short ultrasonic bursts in a thin absorber. Here, the method is extended to estimate the absolute values of intensity in a field of a 2D 1-MHz randomized phased array. Two approaches were implemented. In the first approach it was assumed that the measured temperature rise at the surface of the absorber is proportional to the free field intensity. The second approach correlated the temperature rise measured in an absorber and calculated from the modelled acoustic field and the heat transfer equation. Corresponding correction factors between the free field intensity and temperature was obtained and introduced in the conversion of temperature images to intensity. Free field distributions in water and focusing through ribs were recorded and simulated. Good correlation between the measured and modeled results in both spatial distributions and the absolute values of intensity was demonstrated.

  12. A new experimental study on noninvasive thermometry in HIFU

    Institute of Scientific and Technical Information of China (English)

    侯珍秀; 徐祯祥; 金长善

    2002-01-01

    The measurement of temperature at the heated point is very important and difficult for the treatmentof tumor using HIFU( High intensity focused ultrasound). According to the theory that the gray scale value va-ries with the ultrasound transmitting through different tissues at different temperatures, a set of experiment e-quipment was designed to describe the temperature field in tissues by using the characteristics of the ultrasonicimage, and an experiment was carried out with fresh liver and muscle tissues of pigs in a temperature arrange of26 ℃ to 64 ℃. The statistical curve of the experiment demonstrates: ( 1 ) The gray scales vary in accordancewith the changes in the temperature of tissue and it is feasible to measure the temperature at the heated point bymaking use of the gray scale variations; (2) Non-linearity is the characteristics of temperature changes and thegray scale of tissues at different temperature phases. Moreover, the gray scale varies from up to down phase atthe same temperature phase; ( 3 ) The gray scale for the same temperature range varies with different tissues. Anexperimented formula is proposed for the measurement of fresh liver and muscle tissues of pigs.

  13. Dual-window subscapularis-sparing approach: a new surgical technique for combined reconstruction of a glenoid bone defect or bankart lesion associated with a HAGL lesion in anterior shoulder instability.

    Science.gov (United States)

    Bhatia, Deepak N

    2012-03-01

    Combined bankart lesion and humeral avulsion of glenohumeral ligament lesion (HAGL) is a well-described pathologic complex in anterior shoulder instability; open surgical approaches with and without arthroscopic assistance have been suggested for simultaneous 1-stage repair of these lesions. Presence of a significant glenoid bone defect (inverted-pear glenoid) adds to the complexity of the problem and necessitates a bony reconstruction procedure. Open surgical approaches described for management of this combined lesion complex in anterior shoulder instability necessitate a subscapularis-cutting approach; suboptimal healing of the tenotomized subscapularis and subsequent delayed rehabilitation predisposes to late subscapularis dysfunction, and this compromises clinical outcomes. This study describes a new surgical technique that utilizes a dual-window approach through the subscapularis muscle; the dual window enables access to the glenoid and humeral lesions without the need for a subscapularis tenotomy. The approach can be used to perform a congruent-arc Latarjet procedure (for glenoid bone defects) or a Bankart repair (for capsulolabral lesions), in combination with a HAGL repair. Preliminary arthroscopy is essential to identify significant bone defects and HAGL lesions. The dual-window approach for reconstruction of the lesions involves (1) a lateral "subscapularis-sparing" window to identify and repair the HAGL lesion; (2) a medial "subscapularis muscle-splitting" window to perform either a glenoid capsulolabral reconstruction or a congruent-arc Latarjet procedure; and (3) a balanced inferior capsular shift and lateralization procedure of the glenohumeral capsule. Technical tips and guidelines to avoid complications are discussed, and a rehabilitation protocol is presented.

  14. An Ultrasound Imaging-Guided Robotic HIFU Ablation Experimental System and Accuracy Evaluations

    Directory of Open Access Journals (Sweden)

    Chih Yu An

    2017-01-01

    Full Text Available In recent years, noninvasive thermal treatment by using high-intensity focused ultrasound (HIFU has high potential in tumor treatment. The goal of this research is to develop an ultrasound imaging-guided robotic HIFU ablation system for tumor treatment. The system integrates the technologies of ultrasound image-assisted guidance, robotic positioning control, and HIFU treatment planning. With the assistance of ultrasound image guidance technology, the tumor size and location can be determined from ultrasound images as well as the robotic arm can be controlled to position the HIFU transducer to focus on the target tumor. After the development of the system, several experiments were conducted to measure the positioning accuracy of this system. The results show that the average positioning error is 1.01 mm with a standard deviation 0.34, and HIFU ablation accuracy is 1.32 mm with a standard deviation 0.58, which means this system is confirmed with its possibility and accuracy.

  15. A continuous tri-phase transition effect for HIFU-mediated intravenous drug delivery.

    Science.gov (United States)

    Zhang, Kun; Chen, Hangrong; Li, Faqi; Wang, Qi; Zheng, Shuguang; Xu, Huixiong; Ma, Ming; Jia, Xiaoqing; Chen, Yu; Mou, Juan; Wang, Xia; Shi, Jianlin

    2014-07-01

    Aiming at substantially enhanced efficacy and biosafety of clinical HIFU therapy, a natural solid medium, L-menthol (LM), characteristic of mild and controllable "solid-liquid-gas" (SLG) tri-phase transition, was adopted, instead of those conventional explosive liquid-gas (LG) bi-phase transitional media, in constructing a multifunctional theranostic system. Owing to the continuous and controllable characteristics of SLG tri-phase transition, such a novel tri-phase transition-based theranostic system has been demonstrated of the repeatedly enhanced HIFU efficacy ex vivo and in vivo under once intravenous injection and the significantly improved treatment precision, controllability and biosafety when comparing to the traditional bi-phase transition medium, perfluorohexane (PFH), thus promising great application potential in clinical HIFU treatment. Moreover, this theranostic system has been demonstrated a long blood-circulation lifetime and continuous accumulation in tumor in 24 h, which is very beneficial for the enhanced tumor ablation in vivo along with SLG tri-phase transition. More importantly, after loading multiple model drugs and real drug, such a theranostic system presents a HIFU-mediated temperature-responsive drug release property, and depending on the versatile miscibility of LM, co-loadings with hydrophobic and hydrophilic drugs are also achieved, which provides the possibility of synergistic treatment combining HIFU therapy and chemotherapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Sonablate-500TM Transrectal High-intensity Focused Ultrasound (HIFU) for Benign Prostatic Hyperplasia Patients

    Institute of Scientific and Technical Information of China (English)

    L(U) Jun; HU Weilie; WANG Wei; ZHANG Yuanfeng; CHEN Zhaoyang; YE Zhangqun

    2007-01-01

    To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH), serial studies were conducted in 150 BPH pa- tients before and 30 min, 1, 2, 6 and 12 month(s) after Sonablate-500TM HIFU treatment. A sili- con-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score (IPSS), quality of life (QOL), uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month(s) (P<0.01). Maximum urine flow rate (6.0 to 17.2 mL/s, P<0.01), PVR (75.0 to 30.3,P<0.01) and prostatic volume (65.0 to 38.1 mL, P<0.05) were significantly improved 12 months after the operation. Recurrent urinary retention (n=2) and urethrorectal fistula (n=1) occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 rain. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.

  17. A novel approach to identify non-palpable breast lesions combining fluorescent liposomes and magnetic resonance-guided high intensity focused ultrasound-triggered release

    NARCIS (Netherlands)

    Oerlemans, Chris; Nijsen, Frank; van Amersfoort, Miranda; van Bloois, Louis; Heijman, Edwin; Luijten, Peter; Mali, Willem; Storm, Gert

    2011-01-01

    The combination of fluorescein-containing liposomes (FCL) and magnetic resonance-guided high intensity focused ultrasound (MR-HIFU)-triggered release is a promising approach for lesion demarcation and more efficient removal of non-palpable breast lesions. Exposure of FCL to ablation temperatures (60

  18. PSA nadir as a predictive factor for biochemical disease-free survival and overall survival following whole-gland salvage HIFU following radiotherapy failure

    NARCIS (Netherlands)

    Shah, T T; Peters, M; Kanthabalan, A; McCartan, N; Fatola, Y; van der Voort van Zyp, J; van Vulpen, M; Freeman, A; Moore, C M; Arya, M; Emberton, M; Ahmed, H U

    2016-01-01

    BACKGROUND: Treatment options for radio-recurrent prostate cancer are either androgen-deprivation therapy or salvage prostatectomy. Whole-gland high-intensity focussed ultrasound (HIFU) might have a role in this setting. METHODS: An independent HIFU registry collated consecutive cases of HIFU. Betwe

  19. A specific closed percutaneous technique for reduction of Jeffery type II lesion.

    Science.gov (United States)

    Chotel, Franck; Sailhan, Frédéric; Martin, Jean-Noël; Filipe, Georges; Pem, Rajkumar; Garnier, Emmanuelle; Berard, Jerôme

    2006-09-01

    Open reduction is commonly recommended in Jeffery type II fractures. Attempts to reduce these fractures percutaneously were reported as unsafe and unreliable. We revisited this technique and used a specific percutaneous reduction that turned out to be successful in two cases. Instead of lifting the radial head as described in leverage maneuver, we use a pushing-back procedure to reduce the fracture. The maneuver aims at suppressing the capitellum interposition between the head fragment and the metaphysis by reproducing the reversed trajectory of trauma. This reduction is made possible because of the posterior periosteal attachment of the radial head. A few weeks after the procedure, the two patients remained painless, recovered a complete range of motion in prono-supination and returned to sports. In these two cases, the procedure used led to a prompt recovery and provided a much better outcome than described with the classic open approach.

  20. MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hye Young [Department of Radiology, Gyeongsang National University Hospital, Jinju 660-702 (Korea, Republic of); Kim, Sun Mi; Jang, Mijung; Yun, Bo La [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Kim, Sung-Won; Kang, Eunyoung [Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Park, So Yeon [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Ko, Eun Sook [Department of Radiology, Samsung Medical Center, Seoul 135-710 (Korea, Republic of)

    2013-07-01

    To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.

  1. Imaging technique for real-time temperature monitoring during cryotherapy of lesions

    Science.gov (United States)

    Petrova, Elena; Liopo, Anton; Nadvoretskiy, Vyacheslav; Ermilov, Sergey

    2016-11-01

    Noninvasive real-time temperature imaging during thermal therapies is able to significantly improve clinical outcomes. An optoacoustic (OA) temperature monitoring method is proposed for noninvasive real-time thermometry of vascularized tissue during cryotherapy. The universal temperature-dependent optoacoustic response (ThOR) of red blood cells (RBCs) is employed to convert reconstructed OA images to temperature maps. To obtain the temperature calibration curve for intensity-normalized OA images, we measured ThOR of 10 porcine blood samples in the range of temperatures from 40°C to -16°C and analyzed the data for single measurement variations. The nonlinearity (ΔTmax) and the temperature of zero OA response (T0) of the calibration curve were found equal to 11.4±0.1°C and -13.8±0.1°C, respectively. The morphology of RBCs was examined before and after the data collection confirming cellular integrity and intracellular compartmentalization of hemoglobin. For temperatures below 0°C, which are of particular interest for cryotherapy, the accuracy of a single temperature measurement was ±1°C, which is consistent with the clinical requirements. Validation of the proposed OA temperature imaging technique was performed for slow and fast cooling of blood samples embedded in tissue-mimicking phantoms.

  2. Treatment Plan Technique and Quality for Single-Isocenter Stereotactic Ablative Radiotherapy of Multiple Lung Lesions with Volumetric-Modulated Arc Therapy or Intensity-Modulated Radiosurgery

    OpenAIRE

    Quan, Kimmen; Xu, Karen M.; Lalonde, Ron; Horne, Zachary D.; BERNARD, MARK E.; McCoy, Chuck; Clump, David A.; Steven A Burton; Dwight E Heron

    2015-01-01

    The aim of this study is to provide a practical approach to the planning technique and evaluation of plan quality for the multi-lesion, single-isocenter stereotactic ablative radiotherapy (SABR) of the lung. Eleven patients with two or more lung lesions underwent single-isocenter volumetric-modulated arc therapy (VMAT) radiosurgery or IMRS. All plans were normalized to the target maximum dose. For each plan, all targets were treated to the same dose. Plan conformity and dose gradient were max...

  3. Treatment plan technique and quality for single-isocenter stereotactic ablative radiotherapy of multiple lung lesions with volumetric modulated arc therapy or intensity-modulated radiosurgery

    OpenAIRE

    Kimmen eQuan; Karen Mann Xu; Ron eLalonde; Horne, Zachary D.; BERNARD, MARK E.; Chuck eMcCoy; David Anthony Clump; Steven eBurton; Dwight E Heron

    2015-01-01

    Purpose: The aim is to provide a practical approach to the planning technique and evaluation of plan quality for the multi-lesion, single-isocenter stereotactic ablative radiotherapy (SABR) of the lung. Methods and Materials: Eleven patients with 2 or more lung lesions underwent single-isocenter VMAT radiosurgery or IMRS. All plans were normalized to the target maximum dose. For each plan, all targets were treated to the same dose. Plan conformity and dose gradient were maximized with dose...

  4. Contrast Agent Ultrasonography before and after HIFU Treatment of Parathyroid Glands

    Science.gov (United States)

    Kovatcheva, Roussanka; Arnaud, Françoise; Lacoste, François

    2010-03-01

    OBJECTIVES: To observe changes in the parathyroid tissue treated by extracorporeal HIFU. MATERIAL AND METHODS: 5 patients were treated for primary hyperparathyroidism by thermally ablating enlarged parathyroid glands using an external HIFU applicator. The treated glands were visualized with B-Mode and contrast enhanced ultrasonography (CEUS) before, 1 week and 4 weeks post HIFU. Serum iPTH, calcium, and phosphorus levels were monitored before and after the treatment. RESULTS: The initial results showed a correlation between contrast agent uptake of treated parathyroid tissue, the reduction of volume of the gland and the decrease of iPTH levels. CONCLUSIONS These results show it is possible to use CEUS to monitor the thermal ablation of parathyroid glands.

  5. Strategy of high efficiency and refined high-intensity focused ultrasound and ultrasound monitoring imaging of thermal lesion and cavitation

    Science.gov (United States)

    Wan, Mingxi; Zhang, Siyuan; Lu, Mingzhu; Hu, Hong; Jing, Bowen; Liu, Runna; Zhong, Hui

    2017-03-01

    We proposed that high efficiency high-intensity focused ultrasound (HIFU) could be achieved by using a splitting transducer with various frequencies and focusing patterns, and explored the feasibility of using ultrafast active cavitation imaging (UACI), pulse inversion (PI) sub-harmonic cavitation imaging and bubble wavelet transform imaging for monitoring of cavitation during HIFU, as well as the ultrasonic B-mode images, differential integrated backscatter (IBS) images, Nakagami images and elastography for monitoring HIFU-induced lesion. The use of HIFU splitting transducer had the potential to increase the size of the thermal lesion in a shorter duration and may improve the ablation efficiency of HIFU and would shorten the exposure duration significantly. The spatial-temporal evolution of residual cavitation bubbles at the tissue-water interface was obtained by UACI and the results showed that the UACI had a frame rate high enough to capture the transient behavior of the cavitation bubbles. The experiments demonstrated that comparing with normal sub-harmonic and PI harmonic images, PI sub-harmonic images had higher sensitivity and CTR, which was conducive to showing cavitation bubbles. The CTR would be further improved by combining PI ultrafast plane wave transmitting with cavitation bubble wavelet transform.

  6. A Pulsatile Flow Phantom for Image-Guided HIFU Hemostasis of Blood Vessels

    Science.gov (United States)

    Greaby, Robyn; Vaezy, Shahram

    2005-03-01

    A pulsatile flow phantom for studying ultrasound image-guided acoustic hemostasis in a controlled environment has been developed. An ex vivo porcine carotid artery was attached to the phantom and embedded in a visually and ultrasonically transparent gel. Heparinized porcine blood was pumped through the phantom. Power-Doppler and B-mode ultrasound were used to remotely target the HIFU focus to the site of a needle puncture. In nine trials, complete hemostasis was achieved after an average HIFU application of 55 +/- 34 seconds. The vessels remained patent after treatment. With this phantom, it will be possible to do controlled studies of ultrasound image-guided acoustic hemostasis.

  7. Angiographic and clinical outcomes after implantation of drug eluting stents in bifurcation lesions with crush or kissing stent technique.

    Science.gov (United States)

    Cheema, Asim N; Jolly, Sanjit S; Burstein, Jason M; Sharieff, Waseem; Mohammad, Atif; Yeoh, Eunice; Mancini, G B John; Cantor, Warren J; Kutryk, Michael J B; Strauss, Bradley H; Chisholm, Robert J

    2013-04-01

    Long-term outcome after bifurcation stenting with drug-eluting stents (DES) for obstructive coronary artery disease is poorly understood. In this study, we report 6-9-month angiographic follow-up and long-term clinical outcomes after implantation of drug-eluting stents by crush and kissing stent technique for coronary bifurcation lesions. Consecutive patients undergoing bifurcation stenting with DES by crush or kissing stent technique were enrolled in a prospective registry. Angiographic follow-up was obtained at 6-9 months and clinical follow-up completed for a median of 38 months. A total of 86 patients participated in the study. Bifurcation stenting by crush technique was performed in 73 (85%) and by kissing stent in 13 (15%) patients. Stenting of left main bifurcation was applied in 24 (28%) patients. Angiographic follow-up was completed in 75 (87%) patients and showed restenosis in the main for 8 (11%) and side branch for 20 (27%) patients. Clinical follow-up was available for a median duration of 38 months. During follow-up, 2 (2%) patients died, 4 (5%) experienced myocardial infarction (MI), and 11 (13%) underwent target vessel revascularization (TVR) with an overall major adverse cardiac event (MACE) rate of 16%. In left main cohort, angiographic restenosis occurred in 9 (37%) patients, and 3 (12%) patients required TVR. There were no deaths or stent thrombosis. A comparison of crush and kissing stent technique showed significantly higher angiographic restenosis with crush (26% vs 13% in kissing stent patients, P = 0.046) and 95% of restenosis in crush group involved ostium of the side branch. There was no difference in clinical outcomes between the crush and kissing stent groups. Final kissing balloon dilatation (FKB) was successful in 65 (89%) patients in the crush group and associated with a significant reduction in MACE (8% in FKB successful vs 37% in FKB unsuccessful, P = 0.04) during follow-up. Bifurcation stenting with crush or kissing stent

  8. An MR-compliant phased-array HIFU transducer with augmented steering range, dedicated to abdominal thermotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Auboiroux, Vincent [Inserm, U556, Lyon, F-69003 (France); Dumont, Erik [Image Guided Therapy, Pessac, Bordeaux (France); Petrusca, Lorena; Salomir, Rares [Faculty of Medicine, University of Geneva (Switzerland); Viallon, Magalie, E-mail: vincent.auboiroux@unige.ch [Radiology Department, University Hospital of Geneva, Geneva (Switzerland)

    2011-06-21

    A novel architecture for a phased-array high intensity focused ultrasound (HIFU) device was investigated, aiming to increase the capabilities of electronic steering without reducing the size of the elementary emitters. The principal medical application expected to benefit from these developments is the time-effective sonication of large tumours in moving organs. The underlying principle consists of dividing the full array of transducers into multiple sub-arrays of different resonance frequencies, with the reorientation of these individual emitters, such that each sub-array can focus within a given spatial zone. To enable magnetic resonance (MR) compatibility of the device and the number of output channels from the RF generator to be halved, a passive spectral multiplexing technique was used, consisting of parallel wiring of frequency-shifted paired piezoceramic emitters with intrinsic narrow-band response. Two families of 64 emitters (circular, 5 mm diameter) were mounted, with optimum efficiency at 0.96 and 1.03 MHz, respectively. Two different prototypes of the HIFU device were built and tested, each incorporating the same two families of emitters, but differing in the shape of the rapid prototyping plastic support that accommodated the transducers (spherical cap with radius of curvature/aperture of 130 mm/150 mm and, respectively, 80 mm/110 mm). Acoustic measurements, MR-acoustic radiation force imaging (ex vivo) and MR-thermometry (ex vivo and in vivo) were used for the characterization of the prototypes. Experimental results demonstrated an augmentation of the steering range by 80% along one preferentially chosen axis, compared to a classic spherical array of the same total number of elements. The electric power density provided to the piezoceramic transducers exceeded 50 W cm{sup -2} CW, without circulation of coolant water. Another important advantage of the current approach is the versatility of reshaping the array at low cost.

  9. Radioguided localisation of impalpable breast lesions using 99m-Technetium macroaggregated albumin: Lessons learnt during introduction of a new technique to guide preoperative localisation

    Energy Technology Data Exchange (ETDEWEB)

    Landman, Joanne [Department of Nuclear Medicine, Royal Perth Hospital, Perth, Western Australia (Australia); Kulawansa, Sagarika [Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia (Australia); McCarthy, Michael; Troedson, Russell [Department of Nuclear Medicine, Royal Perth Hospital, Perth, Western Australia (Australia); Phillips, Michael [Western Australian Institute for Medical Research, University of Western Australia, Perth, Western Australia (Australia); Tinning, Jill [The Multidisciplinary Breast Service, Royal Perth Hospital, Perth, Western Australia (Australia); Taylor, Donna, E-mail: Donna.Taylor@health.wa.gov.au [Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia (Australia); School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of Nuclear Medicine, Royal Perth Hospital, Perth, Western Australia (Australia)

    2015-03-15

    Preoperative wire-guided localisation (WGL) of impalpable breast lesions is widely used but can be technically difficult. Risks include wire migration, inaccurate placement, and inadequate surgical margins. Research shows that radioguided occult lesion localisation (ROLL) is quicker, easier, and can improve surgical and cosmetic outcomes. An audited introduction of ROLL was conducted to validate the technique as a feasible alternative to WGL. Fifty patients with single impalpable lesions and biopsy proven malignancy or indeterminate histology underwent WGL followed by intralesional radiopharmaceutical injection of 99m-Technetium macroaggregated albumin. Postprocedural mammography was performed to demonstrate wire position, and scintigraphy to evaluate radiopharmaceutical migration. Lymphoscintigraphy and intraoperative sentinel node biopsy were performed if indicated, followed by lesion localisation and excision using a gamma probe. Specimen imaging was performed, with immediate reexcision for visibly inadequate margins. Accurate localisation was achieved in 86% of patients with ROLL compared to 72% with WGL. All lesions were successfully removed, with clear margins in 71.8% of malignant lesions. Reexcision and intraoperative sentinel node localisation rates were equivalent to preaudit figures for WGL. ROLL was easy to perform and problems were infrequent. Inaccurate radiopharmaceutical placement necessitating WGL occurred in four patients. Minor radiopharmaceutical migration was common, but precluded using ROLL in only two cases. ROLL is effective, simple, inexpensive, and easily learnt; however, preoperative confirmation of correct radiopharmaceutical placement using mammography and the gamma probe is important to help ensure successful lesion removal. Insertion of a backup hookwire is recommended during the initial introduction of ROLL.

  10. [Usefulness of systematic chromoendoscopy with a double dye staining technique for the detection of dysplasia in patients with premalignant gastric lesions].

    Science.gov (United States)

    Yep-Gamarra, Víctor; Díaz-Vélez, Cristian; Araujo, Isis; Ginès, Àngels; Fernández-Esparrach, Gloria

    2016-02-01

    Premalignant gastric lesions have an increased risk to develop gastric cancer. To evaluate the usefulness of systematic endoscopy that includes chromoendoscopy with a double dye staining technique for the detection of dysplasia in patients with premalignant gastric lesions. This longitudinal, prospective study was performed in patients with gastric atrophy, intestinal metaplasia or dysplasia who were referred for endoscopy less than 6 months after the initial diagnosis. The second endoscopy was performed in three phases: phase 1, exhaustive and systematic review of the mucosa with photographic documentation and biopsies of suspicious areas; phase 2, chromoendoscopy with a double dye staining technique using acetic acid 1.2% and indigo carmine 0.5%; phase 3, topographic mapping and random biopsies. A total of 50 patients were included. Nine (18%) had atrophic gastritis, 38 (76%) had intestinal metaplasia, and 3 (6%) had low-grade dysplasia. Systematic endoscopy with chromoendoscopy using a double dye staining technique detected more patients with dysplasia (9 versus 3, plesions (6 vs. 3, p=NS). In one patient, initial low-grade dysplasia was not detected again in the systematic endoscopy, giving a global endoscopic performance for the detection of lesions of 92%. Patients with premalignant gastric lesions have synchronous lesions with greater histological severity, which are detected when systematic endoscopy is conducted with indigo carmine dye added to acetic acid. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  11. [Semiotics of lesions of the cerebral venous collectors on application of noninvasive techniques of x-ray diagnosis].

    Science.gov (United States)

    Semenov, S; Abalmasov, V

    2001-01-01

    The study included application of a complex of the noninvasive diagnostic techniques such as MR tomography, MR venography, duplex scanning of the internal jugular veins, and transcranial Doppler sonography. The authors provide a detailed description of the semiotics of the MR signs of cerebral venous collector lesion in patients with thrombosis, extravasal compression, aneurysms, and developmental anomalies. Present the quantitative ultrasound parameters of hemodynamics in the efferent vessels of the brain accessible to inspections describe the effect of spontaneous echo-opacification in the internal jugular veins, which is assumed to be a predictor of thrombosis. Intravenous injection of magnevist resulted in an appreciable refinement of visualization of small dural sinuses at MR venography thereby allowing for the diagnosis of their thrombosis. It is suggested that the use of the entire complex of the x-ray modalities under consideration may lead to a more complete and noninvasive evaluation of the nature of cerebral venous insufficiency and of the degree of hemodynamic significance. Moreover, this will make it possible to outline approaches to therapeutic or surgical correction of the disease.

  12. Significant skin burns may occur with the use of a water balloon in HIFU treatment

    Science.gov (United States)

    Ritchie, Robert; Collin, Jamie; Wu, Feng; Coussios, Constantin; Leslie, Tom; Cranston, David

    2012-10-01

    HIFU is a minimally-invasive therapy suitable for treating selected intra-abdominal tumors. Treatment is safe although skin burns may occur due to pre-focal heating. HIFU treatment of a renal transplant tumor located in the left lower abdomen was undertaken in our centre. Treatment was performed prone, requiring displacement of the abdominal wall away from the treatment field using a water balloon, constructed of natural rubber latex and filled with degassed water. Intra-operatively, ultrasound imaging and physical examination of the skin directly over the focal region was normal. Immediately post-operative, a full-thickness skin burn was evident at the periphery of the balloon location, outside the expected HIFU path. Three possibilities may account for this complication. Firstly, the water balloon may have acted as a lens, focusing the HIFU to a neo-focus off axis. Secondly, air bubbles may have been entrapped between the balloon and the skin, causing heating at the interface. Finally, heating of the isolated water within the balloon may have been sufficient to cause burning. In this case, the placement of a water balloon caused a significant skin burn. Care should be taken in their use as burns, situated off axis, may occur even if the overlying skin appears normal.

  13. A study of three-dimensional tumor figure creating and treatment trail in HIFU

    Institute of Scientific and Technical Information of China (English)

    HOU zhen-xiu; ZHAO Yong-ping; CHEN Xin-liang; CHEN Shi-zhe; JIN Chang-shan

    2006-01-01

    This paper introduces a method in which a series of parallel B-ultrasonic tumor section images is recombined into a three-dimensional picture in HIFU (High Intensity Focus Ultrasonic) therapy. The experiments show that the recombining three-dimensional tumor is anastomose with the trim size, that the method is usable and accurate in the operation. It has a certain consulting value.

  14. A new HIFU probe for the treatment of the superficial venous insufficiency and varicose veins

    Science.gov (United States)

    Pichardo, Samuel; Curiel, Laura; Milleret, René; Pichot, Olivier; Lacoste, François; Chapelon, Jean-Yves

    2006-05-01

    A previous work showed the feasibility of inducing a localized partial shrinkage of venous tissues with High Intensity Focused Ultrasound (HIFU). A partial shrinkage of the vein wall is proposed to correct the valvular dysfunction on the saphenous vein that is responsible of the superficial venous insufficiency and varicose veins. In the present study, a new real-time imaging HIFU probe is presented which is suited for this type of treatment. The probe is composed of two HIFU elements that focus sound uniformly over a line of 7 mm-length. Geometry of the HIFU elements was calculated by numerical optimization and allows positioning of the focal line 15 mm in-depth from the skin. The probe is compatible with commercial imaging devices used currently in vascular medicine. Once coupled with an imaging probe, the imaging system shows the central perpendicular plan to the focal line. A validation of the compatibility with a commercial ultrasound imaging system was achieved using a precise model fabricated by stereo-lithography. Construction of the probe is underway.

  15. Follow-up of bone lesions in an experimental multiple myeloma mouse model: Description of an in vivo technique using radiography dedicated for mammography

    NARCIS (Netherlands)

    Vanderkerken, K.; Goes, E.; Raeve, H. de; Radl, J.; Camp, B. van

    1996-01-01

    The evolution of bone lesions in transplantable C57BL/KaLwRij 5T mouse myeloma (MM) has been followed in vivo. Mice were anaesthetised and a radiograph of the pelvis and hind legs was performed by a radiograph dedicated for mammography. This is the first description of an in vivo technique under

  16. Evidence for a new mechanism behind HIFU-triggered release from liposomes.

    Science.gov (United States)

    Oerlemans, Chris; Deckers, Roel; Storm, Gert; Hennink, Wim E; Nijsen, J Frank W

    2013-06-28

    A promising approach for local drug delivery is high-intensity focused ultrasound (HIFU)-triggered release of drugs from stimuli-responsive nanoparticles such as liposomes. The aim of this study was to investigate whether another release mechanism is involved with HIFU-triggered release from liposomes beside cavitation and temperature. Furthermore, it was studied whether this new release mechanism allows the release of lipophilic compounds. Therefore, both a lipophilic (Nile red) and a hydrophilic (fluorescein) compound were loaded into thermosensitive (TSL) or non-thermosensitive liposomes (NTSL) and the liposomes were subjected both to continuous wave (CW)- and pulsed wave (PW)-HIFU. The mean liposome size varied from 97 to 139 nm with a polydispersity index (PDI)≤0.06 for the different formulations. The Tm of the phospholipid bilayer of the TSL was around 42°C. Approximately 80% of fluorescein was released within 15 min from TSL at temperatures≥42°C. In contrast, no fluorescein release from NTSL and NR release from both TSL and NTSL was observed at temperatures up to 60 °C. CW-HIFU exposure of TSL resulted in rapid temperature elevation up to 52°C and subsequently almost quantitative fluorescein release. Fluorescein release from NTSL was also substantial (~64% after 16 min at 20 W). Surprisingly, CW-HIFU exposure (20W for 16 min) resulted in the release of NR from TSL (~66% of the loaded amount), and this was even higher from NTSL (~78%). PW-HIFU exposure did not result in temperatures above the Tm of TSL. However, nearly 85% of fluorescein was released from TSL after 32 min at 20W of PW-HIFU exposure, whereas the release from NTSL was around 27%. Interestingly, NR release from NTSL was~30% after 2 min PW-HIFU exposure and increased to~70% after 32 min. Furthermore, addition of microbubbles to the liposomes prior to PW-HIFU exposure did not result in more release, which suggests that cavitation can be excluded as the main mechanism responsible for the

  17. The effect of pulsed HIFU on the porosity and permeability of collagen gels: An in vitro study

    Science.gov (United States)

    Vipulanandan, Geethanjali; O'Neill, Brian E.

    2012-10-01

    Pulsed HIFU is hypothesized to alter permeability of the extracellular matrix by altering the collagen network. In this study, the ability of HIFU to disrupt the extracellular matrix, particularly Type I collagen, in vitro, was investigated in order to enhance the drug delivery to highly collagenous tumors. This was tested in vitro in two ways, first using dye penetration, and second, by confocal reflection microscopy. Based on the analyses, it was concluded that there was at least a three-fold increase in porosity of the collagen gels after HIFU treatment.

  18. Automated analysis of non-mass-enhancing lesions in breast MRI based on morphological, kinetic, and spatio-temporal moments and joint segmentation-motion compensation technique

    Science.gov (United States)

    Hoffmann, Sebastian; Shutler, Jamie D.; Lobbes, Marc; Burgeth, Bernhard; Meyer-Bäse, Anke

    2013-12-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) represents an established method for the detection and diagnosis of breast lesions. While mass-like enhancing lesions can be easily categorized according to the Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon, a majority of diagnostically challenging lesions, the so called non-mass-like enhancing lesions, remain both qualitatively as well as quantitatively difficult to analyze. Thus, the evaluation of kinetic and/or morphological characteristics of non-masses represents a challenging task for an automated analysis and is of crucial importance for advancing current computer-aided diagnosis (CAD) systems. Compared to the well-characterized mass-enhancing lesions, non-masses have no well-defined and blurred tumor borders and a kinetic behavior that is not easily generalizable and thus discriminative for malignant and benign non-masses. To overcome these difficulties and pave the way for novel CAD systems for non-masses, we will evaluate several kinetic and morphological descriptors separately and a novel technique, the Zernike velocity moments, to capture the joint spatio-temporal behavior of these lesions, and additionally consider the impact of non-rigid motion compensation on a correct diagnosis.

  19. Modeling of high-intensity focused ultrasound-induced lesions in the presence of cavitation bubbles

    Science.gov (United States)

    Chavrier; Chapelon; Gelet; Cathignol

    2000-07-01

    The classical "Bio Heat Transfer Equation (BHTE)" model is adapted to take into account the effects of oscillating microbubbles that occur naturally in the tissue during high-intensity focused ultrasound (HIFU) treatment. First, the Gilmore-Akulichev model is used to quantify the acoustic pressure scattered by microbubbles submitted to HIFU. Because this scattered pressure is not monochromatic, the concept of harmonic attenuation is introduced and a global attenuation coefficient is estimated for bubble-filled tissues. The first results show that this global attenuation coefficient varies significantly with respect to several parameters such as the frequency and the density of microbubbles in the medium, but also with respect to the incident acoustic pressure which thus becomes a transcendental function. Under these conditions, a layer-by-layer modeling, in the direction of propagation, is proposed to calculate the ultrasonic beam. Finally, the BHTE is solved and the HIFU-induced lesions are estimated by the calculation of the thermal dose. Using this model, it can be observed first that, when the firing power increases, the lesion develops clearly in the direction of the transducer, with a shape agreeing with in vivo experimentation. Next, it is observed that the lesion can be significantly modified in size and position, if an interface (skin or inner wall) is simulated as a zone with multiple cavitation nuclei. With a firing power increase, it is also shown how a secondary lesion can appear at the interface and how, beyond a certain threshold, this lesion develops at the main lesion expense. Finally, a better in-depth homogeneity of lesions is observed when the acoustic frequency of HIFU is increased.

  20. Effects of oxytocin on high intensity focused ultrasound (HIFU) ablation of adenomysis: A prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xin [State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Zou, Min; Zhang, Cai [Department of Obstetrics and Gynecology, Chongqing Haifu Hospital, Chongqing 401121 (China); He, Jia [Department of Obstetrics and Gynecology, Suining Central Hospital, Sichuan 629000 (China); Mao, Shihua [Department of Obstetrics and Gynecology, Three Gorges Central Hospital, Chongqing 404000 (China); Wu, Qingrong [Department of Obstetrics and Gynecology, Fuling Central Hospital, Chongqing 408099 (China); He, Min [State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Department of Obstetrics and Gynecology, Suining Central Hospital, Sichuan 629000 (China); Wang, Jian [Department of Obstetrics and Gynecology, Chongqing Haifu Hospital, Chongqing 401121 (China); Department of Obstetrics and Gynecology, Three Gorges Central Hospital, Chongqing 404000 (China); Zhang, Ruitao [Department of Obstetrics and Gynecology, Chongqing Haifu Hospital, Chongqing 401121 (China); Department of Obstetrics and Gynecology, Fuling Central Hospital, Chongqing 408099 (China); Zhang, Lian, E-mail: lianwzhang@yahoo.com [State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Department of Obstetrics and Gynecology, Chongqing Haifu Hospital, Chongqing 401121 (China)

    2014-09-15

    Objective: To investigate the effects of oxytocin on high-intensity focused ultrasound (HIFU) ablation for the treatment of adenomyosis. Materials and methods: Eighty-six patients with adenomyosis from three hospitals were randomly assigned to the oxytocin group or control group for HIFU treatment. During HIFU treatment, 80 units of oxytocin was added in 500 ml of 0.9% normal saline running at the rate of 2 ml/min (0.32 U/min) in the oxytocin group, while 0.9% normal saline was used in the control group. Both patients and HIFU operators were blinded to oxytocin or saline application. Treatment results, adverse effects were compared. Results: When using oxytocin, the non-perfused volume (NPV) ratio was 80.7 ± 11.6%, the energy-efficiency factor (EEF) was 8.1 ± 9.9 J/mm{sup 3}, and the sonication time required to ablate 1 cm{sup 3} was 30.0 ± 36.0 s/cm{sup 3}. When not using oxytocin, the non-perfused volume ratio was 70.8 ± 16.7%, the EEF was 15.8 ± 19.6 J/mm{sup 3}, and the sonication time required to ablate 1 cm{sup 3} was 58.2 ± 72.7 S/cm{sup 3}. Significant difference in the NPV ratio, EEF, and the sonication time required to ablate 1 cm{sup 3} between the two groups was observed. No oxytocin related adverse effects occurred. Conclusion: Oxytocin could significantly decrease the energy for ablating adenomyosis with HIFU, safely enhance the treatment efficiency.

  1. MRI Technique in the Diagnosis of Cervical Cystic Lesions%上颈部囊性病变的MRI分析

    Institute of Scientific and Technical Information of China (English)

    杨宁; 刘丽辉

    2014-01-01

    目的:探讨MRI检查在上颈部囊性病变中的诊断价值。方法:36例上颈部囊性肿物,术前行穿刺检查和MRI检查以明确囊液性质、嚢肿范围、来源及信号强度。根据囊液性质及MRI检查特点,决定手术方法,术后病理确诊。结果:穿刺囊液为蛋清样黏液23例,为淡黄色水样液体6例,为灰色脓汁样液体5例。另有2例患者不配合未能行穿刺检查。MRI检查T1低信号、T2高信号且囊肿有“尾状征”与口底关系密切者25例,诊断为潜突型舌下腺囊肿,采用口内入路摘除舌下腺,其余11例采用颈部入路。术后病理证实潜突型舌下腺囊肿25例,淋巴管瘤6例,鳃裂囊肿5例。所有术后病理确诊与术前诊断相符,随访3~36月,未见有患者复发。结论:上颈部囊性病变术前MRI检查,有助于术前明确诊断,以正确指导手术,避免盲目颈部探查手术。%Objective: To explore the diagnostic value of MRI technique applied for cervical cystic lesions. Method: 36 cases with cervical cystic lesions were checked preoperatively by puncture examination and/or MRI. Results: There were 23 cases with the cystic fluid like egg white, 6 cases with pale yellow watery fluid and 5 cases with gray pus-like fluid. Another 2 patients didn't complete puncture examination because of poor cooperation. 25 MRI images clearly showed the cystic wall was originated from the ipsilateral sublingual gland, 11 patients without correct preoperative diagnosis by MRI. The patients with low signal T1 and hyperintensity signal T2 and "tail syndrome" in MRI were subject to using intraoral approach to remove the sublingual gland. There was no patient of recurrence within 3 to 36 months follow-up. The postop-erative pathology confirmed the preoperative diagnosis. Conclusion:MRI examination can clearly show the travel and ori-gin sites of cystic lesions of the neck and contribute to get correct diagnosis preoperatively.

  2. Radiation-force-based estimation of acoustic attenuation using harmonic motion imaging (HMI) in phantoms and in vitro livers before and after HIFU ablation.

    Science.gov (United States)

    Chen, Jiangang; Hou, Gary Y; Marquet, Fabrice; Han, Yang; Camarena, Francisco; Konofagou, Elisa

    2015-10-07

    Acoustic attenuation represents the energy loss of the propagating wave through biological tissues and plays a significant role in both therapeutic and diagnostic ultrasound applications. Estimation of acoustic attenuation remains challenging but critical for tissue characterization. In this study, an attenuation estimation approach was developed using the radiation-force-based method of harmonic motion imaging (HMI). 2D tissue displacement maps were acquired by moving the transducer in a raster-scan format. A linear regression model was applied on the logarithm of the HMI displacements at different depths in order to estimate the acoustic attenuation. Commercially available phantoms with known attenuations (n = 5) and in vitro canine livers (n = 3) were tested, as well as HIFU lesions in in vitro canine livers (n = 5). Results demonstrated that attenuations obtained from the phantoms showed a good correlation (R² = 0.976) with the independently obtained values reported by the manufacturer with an estimation error (compared to the values independently measured) varying within the range of 15-35%. The estimated attenuation in the in vitro canine livers was equal to 0.32   ±   0.03 dB cm(-1) MHz(-1), which is in good agreement with the existing literature. The attenuation in HIFU lesions was found to be higher (0.58   ±   0.06 dB cm(-1) MHz(-1)) than that in normal tissues, also in agreement with the results from previous publications. Future potential applications of the proposed method include estimation of attenuation in pathological tissues before and after thermal ablation.

  3. Data for spatial analysis of growth anomaly lesions on Montipora capitata coral colonies using 3D reconstruction techniques

    Directory of Open Access Journals (Sweden)

    John H.R. Burns

    2016-12-01

    Full Text Available Ten annotated 3D reconstructions of Montipora capitata coral colonies contain x,y,z coordinates for all growth anomaly (GA lesions affecting these corals. The 3D reconstructions are available as Virtual Reality Modeling Language (VRML files, and the GA lesions coordinates are in accompanying text files. The VRML models and GA lesion coordinates can be spatially analyzed using Matlab. Matlab scripts are provided for three spatial statistical procedures in order to assess clustering of the GA lesions across the coral colony surfaces in a 3D framework: Ripley׳s K, Moran׳s I, and the Kolmogorov–Smirnov test. Please see the research article, “Investigating the spatial distribution of Growth Anomalies affecting Montipora capitata corals in a 3-dimensional framework” (J.H.R. Burns, T. Alexandrov, E. Ovchinnikova, R.D. Gates, M. Takabayashi, 2016 [1], for further interpretation and discussion of the data.

  4. Effect of hydrodynamic cavitation in the tissue erosion by pulsed high-intensity focused ultrasound (pHIFU)

    Science.gov (United States)

    Zhou, Yufeng; Gao, Xiaobin Wilson

    2016-09-01

    High-intensity focused ultrasound (HIFU) is emerging as an effective therapeutic modality in clinics. Besides the thermal ablation, tissue disintegration is also possible because of the interaction between the distorted HIFU bursts and either bubble cloud or boiling bubble. Hydrodynamic cavitation is another type of cavitation and has been employed widely in industry, but its role in mechanical erosion to tissue is not clearly known. In this study, the bubble dynamics immediately after the termination of HIFU exposure in the transparent gel phantom was captured by high-speed photography, from which the bubble displacement towards the transducer and the changes of bubble size was quantitatively determined. The characteristics of hydrodynamic cavitation due to the release of the acoustic radiation force and relaxation of compressed surrounding medium were found to associate with the number of pulses delivered and HIFU parameters (i.e. pulse duration and pulse repetition frequency). Because of the initial big bubble (~1 mm), large bubble expansion (up to 1.76 folds), and quick bubble motion (up to ~1 m s-1) hydrodynamic cavitation is significant after HIFU exposure and may lead to mechanical erosion. The shielding effect of residual tiny bubbles would reduce the acoustic energy delivered to the pre-existing bubble at the focus and, subsequently, the hydrodynamic cavitation effect. Tadpole shape of mechanical erosion in ex vivo porcine kidney samples was similar to the contour of bubble dynamics in the gel. Liquefied tissue was observed to emit towards the transducer through the punctured tissue after HIFU exposure in the sonography. In summary, the release of HIFU exposure-induced hydrodynamic cavitation produces significant bubble expansion and motion, which may be another important mechanism of tissue erosion. Understanding its mechanism and optimizing the outcome would broaden and enhance HIFU applications.

  5. Ultrasound imaging and evaluation of lesion induced by High Intensity Focused Ultrasound

    Institute of Scientific and Technical Information of China (English)

    ZHONG Hui; WAN Mingxi; JIANG Yifeng; WANG Supin

    2006-01-01

    The present study was to investigate the differential imaging method for detecting HIFU (High Intensity Focused Ultrasound)-induced lesions and the estimation of variation of attenuation for lesion evaluation with log spectral difference algorithm. Experiment results of bovine muscle and liver in vitro were acquired. Several algorithms for lesion detection - Absolute Difference (AD), Sum Absolute Differences (SAD) and Sum Squared Differences (SSD) - were analyzed with several window sizes and threshold values. Then three attenuation parameters were compared to evaluate the degree of tissue damage. It was found that variation of the mean attenuation △(α) was an effective parameter to evaluate lesions.

  6. Elemental concentration in normal skin and fibroepithelial polip lesions by synchrotron radiation total reflection X-ray fluorescence technique

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Julio C.A.C.R.; Canellas, Catarine G.L.; Lopes, Ricardo T., E-mail: ricardo@lin.ufrj.br, E-mail: jcorsini@lin.ufrj.br [Nuclear Laboratory Instrumentation/COPPE, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Anjos, Marcelino J., E-mail: marcelin@lin.ufrj.br [Physics Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    In this work, the concentrations of trace elements were measured in acrochordon, a skin lesion also known as skin tag or fibroepithelial polyp, as well as in normal skin from the same patient. The samples were analysed by Synchrotron Radiation Total Reflection X- ray Fluorescence (SRTXRF) in the Synchrotron Light National Laboratory (LNLS) in Campinas/Sao Paulo-Brazil. The collection of lesion and healthy skin samples, including papillary dermis and epidermis, has involved 17 patients. It was evaluated the presence of P, S, Cl, K, Ca, Cr, Mn, Fe, Cu, Zn, Br and Rb in the paired samples, which were compared, and significant differences were found in some of them. (author)

  7. Clinical Outcome of Double Kissing Crush Versus Provisional Stenting of Coronary Artery Bifurcation Lesions: The 5-Year Follow-Up Results From a Randomized and Multicenter DKCRUSH-II Study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions).

    Science.gov (United States)

    Chen, Shao-Liang; Santoso, Teguh; Zhang, Jun-Jie; Ye, Fei; Xu, Ya-Wei; Fu, Qiang; Kan, Jing; Zhang, Feng-Fu; Zhou, Yong; Xie, Du-Jiang; Kwan, Tak W

    2017-02-01

    Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years. The primary end point was the occurrence of a major adverse cardiac event at 5 years. Patients were classified by simple and complex bifurcation lesions according to the DEFINITION criteria (Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents). At 5 years, the major adverse cardiac event rate (23.8%) in the provisional stenting group was insignificantly different to that of the double kissing group (15.7%; P=0.051). However, the difference in the target lesion revascularization rate between 2 groups was sustained through the 5-year follow-up (16.2% versus 8.6%; P=0.027). The definite and probable stent thrombosis rate was 2.7% in each group (P=1.0). Complex bifurcation was associated with a higher rate of target lesion revascularization (21.6%) at 5 years compared with 11.1% in patients with a simple bifurcation (P=0.037), with an extremely high rate in the provisional stenting group (36.8% versus 12.5%, P=0.005) mainly because of final kissing balloon inflation (19.4% versus 5.2%; P=0.036). The double kissing crush stenting technique for coronary bifurcation lesions is associated with a lower rate of target lesion revascularization. The optimal stenting approach based on the lesions' complexity may improve the revascularization for patients with complex bifurcations. URL: http://www.chictr.org. Unique

  8. A Split-and-Merge-Based Uterine Fibroid Ultrasound Image Segmentation Method in HIFU Therapy.

    Directory of Open Access Journals (Sweden)

    Menglong Xu

    Full Text Available High-intensity focused ultrasound (HIFU therapy has been used to treat uterine fibroids widely and successfully. Uterine fibroid segmentation plays an important role in positioning the target region for HIFU therapy. Presently, it is completed by physicians manually, reducing the efficiency of therapy. Thus, computer-aided segmentation of uterine fibroids benefits the improvement of therapy efficiency. Recently, most computer-aided ultrasound segmentation methods have been based on the framework of contour evolution, such as snakes and level sets. These methods can achieve good performance, although they need an initial contour that influences segmentation results. It is difficult to obtain the initial contour automatically; thus, the initial contour is always obtained manually in many segmentation methods. A split-and-merge-based uterine fibroid segmentation method, which needs no initial contour to ensure less manual intervention, is proposed in this paper. The method first splits the image into many small homogeneous regions called superpixels. A new feature representation method based on texture histogram is employed to characterize each superpixel. Next, the superpixels are merged according to their similarities, which are measured by integrating their Quadratic-Chi texture histogram distances with their space adjacency. Multi-way Ncut is used as the merging criterion, and an adaptive scheme is incorporated to decrease manual intervention further. The method is implemented using Matlab on a personal computer (PC platform with Intel Pentium Dual-Core CPU E5700. The method is validated on forty-two ultrasound images acquired from HIFU therapy. The average running time is 9.54 s. Statistical results showed that SI reaches a value as high as 87.58%, and normHD is 5.18% on average. It has been demonstrated that the proposed method is appropriate for segmentation of uterine fibroids in HIFU pre-treatment imaging and planning.

  9. Diffusion-weighted magnetic resonance imaging of breast lesions: the influence of different fat-suppression techniques on quantitative measurements and their reproducibility

    Energy Technology Data Exchange (ETDEWEB)

    Muertz, P.; Tsesarskiy, M.; Kowal, A.; Traeber, F.; Willinek, W.A.; Leutner, C.C.; Schmiedel, A.; Schild, H.H. [University of Bonn, Department of Radiology, Bonn (Germany); Gieseke, J. [University of Bonn, Department of Radiology, Bonn (Germany); Philips Healthcare, Best (Netherlands)

    2014-10-15

    The aim of this study was to evaluate the influence of different fat-suppression techniques on quantitative measurements and their reproducibility when applied to diffusion-weighted imaging (DWI) of breast lesions. Twenty-five patients with different types of breast lesions were examined on a clinical 1.5-T magnetic resonance imaging (MRI) system. Two diffusion-weighted sequences with different fat-suppression methods were applied: one with spectral presaturation by inversion recovery (SPIR), and one with short-TI inversion recovery (STIR). The acquisition of both sequence variants was repeated with modified shim volume. Lesion-to-background contrast (LBC), apparent diffusion coefficients (ADC) ADC(0,1000) and ADC(50,1000), and their coefficients of variation (CV) were determined. In four patients, the image quality of DWI with SPIR was insufficient. In the other 21 patients, 46 regions of interest (ROI), including 11 malignant and 35 benign lesions, were analysed. The LBC, ADC(0,1000) and ADC(50,1000) values, which did not differ between initial and repeated measurements, were significantly higher for STIR than for SPIR. The mean CV improved from 10.8 % to 4.0 % (P = 0.0047) for LBC, from 6.3 % to 2.9 % (P = 0.0041) for ADC(0,1000), and from 6.3 % to 2.6 % (P = 0.0049) for ADC(50,1000). For STIR compared to SPIR fat suppression, improved lesion conspicuity, higher ADC values, and better measurement reproducibility were found in breast DWI. circle Quality of fat suppression influences quantitative DWI breast lesion measurements. circle In breast DWI, STIR fat suppression worked more reliably than SPIR. (orig.)

  10. Numerical study on the effective heating due to inertial cavitation in microbubble-enhanced HIFU therapy

    Science.gov (United States)

    Okita, Kohei; Sugiyama, Kazuyasu; Takagi, Shu; Matsumoto, Yoichiro

    2015-10-01

    The enhancement of heating due to inertial cavitation was focused in high-intensity focused ultrasound (HIFU) therapy. The influences of the rectified diffusion on microbubble-enhanced HIFU were examined numerically. A bubble dynamics equation in consideration of the spherical shell bubble and the elasticity of surrounding tissue was employed. Mass and heat transfer between the surrounding medium and the bubble were considered. The basic equations were discretized by finite difference method. The mixture phase and bubbles are coupled by the Euler-Lagrange method to take into account the interaction between ultrasound and bubbles. The mass transfer rate of gas from the surrounding medium to the bubble was examined as function of the initial bubble radius and the driving pressure amplitude. As the results, the pressure required to bubble growth was decreases with increasing the initial bubble radius. Thus, the injection of microbubble reduces the cavitation threshold pressure. On the other hand, the influence of the rectified diffusion on the triggered HIFU therapy which generates cavitation bubbles by high-intensity burst and induces the localized heating owing to cavitation bubble oscillation by low-intensity continuous waves. The calculation showed that the localized heating was enhanced by the increase of the equilibrium bubble size due to the rectified diffusion.

  11. Processing ultrasound backscatter to monitor high-intensity focused ultrasound (HIFU) therapy

    Science.gov (United States)

    Kaczkowski, Peter J.; Anand, Ajay; Bailey, Michael R.

    2005-09-01

    The development of new noninvasive surgical methods such as HIFU for the treatment of cancer and internal bleeding requires simultaneous development of new sensing approaches to guide, monitor, and assess the therapy. Ultrasound imaging using echo amplitude has long been used to map tissue morphology for diagnostic interpretation by the clinician. New quantitative ultrasonic methods that rely on amplitude and phase processing for tissue characterization are being developed for monitoring of ablative therapy. We have been developing the use of full wave ultrasound backscattering for real-time temperature estimation, and to image changes in tissue backscatter spectrum as therapy progresses. Both approaches rely on differential processing of the backscatter signal in time, and precise measurement of phase differences. Noise and artifacts from motion and nonstationary speckle statistics are addressed by constraining inversions for tissue parameters with physical models. We present results of HIFU experiments with static point and scanned HIFU exposures in which temperature rise can be accurately mapped using a new heat transfer equation (HTE) model-constrained inverse approach. We also present results of a recently developed spectral imaging method that elucidates microbubble-mediated nonlinearity not visible as a change in backscatter amplitude. [Work supported by Army MRMC.

  12. Flat-Panel Detector—Based Volume Computed Tomography: A Novel 3D Imaging Technique to Monitor Osteolytic Bone Lesions in a Mouse Tumor Metastasis Model

    Directory of Open Access Journals (Sweden)

    Jeannine Missbach-Guentner

    2007-09-01

    Full Text Available Skeletal metastasis is an important cause of mortality in patients with breast cancer. Hence, animal models, in combination with various imaging techniques, are in high demand for preclinical assessment of novel therapies. We evaluated the applicability of flat-panel volume computed tomography (fpVCT to noninvasive detection of osteolytic bone metastases that develop in severe immunodeficient mice after intracardial injection of MDA-MB-231 breast cancer cells. A single fpVCT scan at 200-wm isotropic resolution was employed to detect osteolysis within the entire skeleton. Osteolytic lesions identified by fpVCT correlated with Faxitron X-ray analysis and were subsequently confirmed by histopathological examination. Isotropic three-dimensional image data sets obtained by fpVCT were the basis for the precise visualization of the extent of the lesion within the cortical bone and for the measurement of bone loss. Furthermore, fpVCT imaging allows continuous monitoring of growth kinetics for each metastatic site and visualization of lesions in more complex regions of the skeleton, such as the skull. Our findings suggest that fpVCT is a powerful tool that can be used to monitor the occurrence and progression of osteolytic lesions in vivo and can be further developed to monitor responses to antimetastatic therapies over the course of the disease.

  13. [Transduodenal ampullectomy: an useful alternative for the treatment of Vater's ampulla lesions. Case reports of an unfrecuent surgical technique].

    Science.gov (United States)

    Targarona Modena, Javier; Rosamedina, Jose Luis; Garatea, Rafael; Romero, Cesar; Lora, Alfonso; Contardo, Carlos; Mantila, Lidia; Yabar, Alejandro; Montoya, Eduardo

    2005-01-01

    The Vater's ampulla neoplasias are not very frequent lesions. The ampullectomy consists on the total resection of the Vater's ampulla and part of the duodenal wall with the later reconstruction and anastomosis of the common bile duct and the Wirsung's duct to the duodenum. The local resection of the ampulla is an alternative to the duodenopancreatectomy that has to be taken into account, especially in benign lesions as in the case of adenomas of the Vater's ampulla. Here we describe two cases one with adenoma of the Vater's ampulla, with a high degree dysplasia, who first underwent an ampullectomy and finally ended up in a duodenopancreatectomy due to the infiltration of the adenoma into the edge of section and other case of Lymphangioma of Vater's ampulla with no infiltration in the edge of section.

  14. A modified sentinel node and occult lesion localization (SNOLL) technique in non-palpable breast cancer: a pilot study

    OpenAIRE

    Follacchio, Giulia Anna; Monteleone, Francesco; Anibaldi, Paolo; De Vincentis, Giuseppe; Iacobelli, Silvia; Merola, Raffaele; D’Orazi, Valerio; Monti, Massimo; Pasta, Vittorio

    2015-01-01

    Background The spread of mammographic screening programs has allowed an increasing amount of early breast cancer diagnosis. A modern approach to non-palpable breast lesions requires an accurate intraoperative localization, in order to achieve a complete surgical resection. In addiction, the assessment of lymph node status is mandatory as it represents a major prognostic factor in these patients. The aim of this study is to evaluate the reliability of a modified technical approach using a sing...

  15. Optical mammography: a new technique for visualizing breast lesions in women presenting non palpable BIRADS 4-5 imaging findings: preliminary results with radiologic-pathologic correlation.

    Science.gov (United States)

    Athanasiou, Alexandra; Vanel, Daniel; Fournier, Laure; Balleyguier, Corinne

    2007-02-28

    The purpose of this prospective study is to determine the diagnostic accuracy of near-infrared breast optical absorption imaging in patients with Breast Imaging Reporting and Data System (BIRADS) 4-5 non-palpable lesions scheduled for biopsy, using pathology after core or excisional biopsy as a reference. The patient's breast was positioned onto a panel of red light-emitting diodes (640 nm). A soft membrane was inflated to exert a uniform pressure on the breast. Transmitted light was detected using a CCD camera. The entire acquisition sequence took 1 minute. Image processing generated dynamic images displayed in colour scale, to reveal time-dependent changes in the transmitted light intensity caused by the pressure change. Dynamic curves were classified in two categories: consistently decreasing intensity suspicious for malignancy, and sinusoidal increasing intensity considered as benign. Seventy-eight women consulting for non-palpable breast lesions were initially included in the study. An imaging-histology correlation was obtained for seventy-two patients, the remaining six patients were excluded for technical optical scan reasons. We experienced an overall sensitivity of 73% and specificity of 38%, the false negative results being mainly small size (<10 mm) infiltrating malignant lesions and ductal carcinoma in situ (DCIS). False positive results were seen in benign proliferative lesions. Dynamic optical breast imaging is a novel, low-cost, non-invasive technique yielding a new type of information about the physiology of breast lesions. Absorption is due to haemoglobin and its products, therefore reflecting the angiogenic status of breast tumours.

  16. Optical mammography: a new technique for visualizing breast lesions in women presenting non palpable BIRADS 4–5 imaging findings: preliminary results with radiologic–pathologic correlation

    Science.gov (United States)

    Vanel, Daniel; Fournier, Laure; Balleyguier, Corinne

    2007-01-01

    The purpose of this prospective study is to determine the diagnostic accuracy of near-infrared breast optical absorption imaging in patients with Breast Imaging Reporting and Data System (BIRADS) 4–5 non-palpable lesions scheduled for biopsy, using pathology after core or excisional biopsy as a reference. The patient's breast was positioned onto a panel of red light-emitting diodes (640 nm). A soft membrane was inflated to exert a uniform pressure on the breast. Transmitted light was detected using a CCD camera. The entire acquisition sequence took 1 minute. Image processing generated dynamic images displayed in colour scale, to reveal time-dependent changes in the transmitted light intensity caused by the pressure change. Dynamic curves were classified in two categories: consistently decreasing intensity suspicious for malignancy, and sinusoidal increasing intensity considered as benign. Seventy-eight women consulting for non-palpable breast lesions were initially included in the study. An imaging–histology correlation was obtained for seventy-two patients, the remaining six patients were excluded for technical optical scan reasons. We experienced an overall sensitivity of 73% and specificity of 38%, the false negative results being mainly small size (<10 mm) infiltrating malignant lesions and ductal carcinoma in situ (DCIS). False positive results were seen in benign proliferative lesions. Dynamic optical breast imaging is a novel, low-cost, non-invasive technique yielding a new type of information about the physiology of breast lesions. Absorption is due to haemoglobin and its products, therefore reflecting the angiogenic status of breast tumours. PMID:17339139

  17. Increasing the HIFU ablation rate through an MRI-guided sonication strategy using shock waves : feasibility in the in vivo porcine liver

    NARCIS (Netherlands)

    Ramaekers, P; de Greef, M; van Breugel, J M M; Moonen, C T W; Ries, M

    2016-01-01

    This study investigated whether an MR-guided pulsed HIFU ablation strategy could be implemented under clinical conditions, using a transducer designed for uterine fibroid ablation, to obtain an ablation rate that is sufficiently high for clinical abdominal HIFU therapy in highly perfused organs. A p

  18. Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique

    Energy Technology Data Exchange (ETDEWEB)

    Anzidei, Michele; Argiro, Renato; Porfiri, Andrea; Boni, Fabrizio; Zaccagna, Fulvio; Napoli, Alessandro; Leonardi, Andrea; Bezzi, Mario; Catalano, Carlo [University of Rome, Department of Radiological, Oncological and Anatomopathological Sciences - Radiology - Sapienza, Rome (Italy); Anile, Marco; Venuta, Federico [University of Rome, Department of Thoracic Surgery - Sapienza, Rome (Italy); Vitolo, Domenico [University of Rome, Department of Radiological, Oncological and Anatomopathological Sciences - Pathology - Sapienza, Rome (Italy); Saba, Luca [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, Monserrato (Italy); Longo, Flavia [University of Rome, Department of Radiological, Oncological and Anatomopathological Sciences - Oncology - Sapienza, Rome (Italy)

    2015-05-01

    Evaluate the performance of a robotic system for CT-guided lung biopsy in comparison to the conventional manual technique. One hundred patients referred for CT-guided lung biopsy were randomly assigned to group A (robot-assisted procedure) or group B (conventional procedure). Size, distance from entry point and position in lung of target lesions were evaluated to assess homogeneity differences between the two groups. Procedure duration, dose length product (DLP), precision of needle positioning, diagnostic performance of the biopsy and rate of complications were evaluated to assess the clinical performance of the robotic system as compared to the conventional technique. All biopsies were successfully performed. The size (p = 0.41), distance from entry point (p = 0.86) and position in lung (p = 0.32) of target lesions were similar in both groups (p = 0.05). Procedure duration and radiation dose were significantly reduced in group A as compared to group B (p = 0.001). Precision of needle positioning, diagnostic performance of the biopsy and rate of complications were similar in both groups (p = 0.05). Robot-assisted CT-guided lung biopsy can be performed safely and with high diagnostic accuracy, reducing procedure duration and radiation dose in comparison to the conventional manual technique. (orig.)

  19. Closing the gap between oral hygiene and minimally invasive dentistry: a review on the resin infiltration technique of incipient (proximal) enamel lesions.

    Science.gov (United States)

    Kielbassa, Andrej M; Muller, Jan; Gernhardt, Christian R

    2009-09-01

    Dental caries on (proximal) tooth surfaces is still a problem in many industrialized countries. The objectives of this review were to present the scientific basis and the principles of the resin infiltration concept, to discuss the inherent clinical applications, and to describe how these backgrounds can be integrated into the concept of minimal intervention dentistry. Data were identified by searches of the Cochrane Registers, Medline, and Scopus. Articles published in English and German through December 2008 were selected, and most up-to-date or relevant references were chosen. Cross-referencing of significant articles identified additionally relevant articles written in other languages and those of historical value. A total of 23 in vitro studies (focusing on penetration depths or demineralization prevention) were found, and 3 clinical studies (involving 122 subjects) could be retrieved; these studies were not comparable. With an increased understanding of the caries process, it is now recognized that demineralized but noncavitated enamel lesions can be arrested or remineralized in many situations. The clinical research evidence on the resin infiltration technique currently is of moderate extent to reach any decisive conclusions; however, based on available laboratory and clinical studies, it seems convincing that resin infiltration of enamel lesions should reduce (or even stop) the progress of white spot lesions. Combining this ultraconservative restorative approach (which is considered microinvasive) with a substantial caries remineralization program may provide therapeutic benefits and significantly reduce both long-term restorative needs and costs, thus complementing the concept of minimal intervention dentistry.

  20. Treatment plan technique and quality for single-isocenter stereotactic ablative radiotherapy of multiple lung lesions with volumetric modulated arc therapy or intensity-modulated radiosurgery

    Directory of Open Access Journals (Sweden)

    Kimmen eQuan

    2015-10-01

    Full Text Available Purpose: The aim is to provide a practical approach to the planning technique and evaluation of plan quality for the multi-lesion, single-isocenter stereotactic ablative radiotherapy (SABR of the lung. Methods and Materials: Eleven patients with 2 or more lung lesions underwent single-isocenter VMAT radiosurgery or IMRS. All plans were normalized to the target maximum dose. For each plan, all targets were treated to the same dose. Plan conformity and dose gradient were maximized with dose control tuning structures surrounding targets. For comparison, multi-isocenter plans were retrospectively created for 4 patients. Conformity index (CI, homogeneity index (HI, gradient index (GI and gradient distance (GD were calculated for each plan. V5, V10, and V20 of the lung and organs at risk (OARs were collected. Treatment time and total monitor units (MUs were also recorded. Results: One patient had 4 lesions and the remainder had 2 lesions. Six patients received VMAT and 5 patients received IMRS. For those treated with VMAT, two patients received 3-arc VMAT and four received 2-arc VMAT. For those treated with IMRS, two patients were treated with 10 and 11 beams, respectively, and the rest received 12 beams. Prescription doses ranged from 30 to 54 Gy in 3 to 5 fractions. The median prescribed isodose line was 84% (range: 80-86%. The median maximum dose was 57.1 Gy (range: 35.7-65.1 Gy. The mean combined PTV was 49.57 cm3 (range: 14.90 - 87.38 cm3. For single-isocenter plans, the median CI was 1.15 (range: 0.97-1.53. The median HI was 1.19 (range: 1.16-1.28. The median GI was 4.60 (range: 4.16-7.37. The median maximum radiation dose (Dmax to total lung was 55.6 Gy (range: 35.7-62.0 Gy. The median mean radiation dose to the lung (Dmean was 4.2 Gy (range: 1.1-9.3 Gy. The median lung V5 was 18.7% (range: 3.8-41.3%. There was no significant difference in CI, HI, GI, GD, V5, V10 and V20 (lung, heart, trachea, esophagus, and spinal cord between single

  1. Treatment Plan Technique and Quality for Single-Isocenter Stereotactic Ablative Radiotherapy of Multiple Lung Lesions with Volumetric-Modulated Arc Therapy or Intensity-Modulated Radiosurgery.

    Science.gov (United States)

    Quan, Kimmen; Xu, Karen M; Lalonde, Ron; Horne, Zachary D; Bernard, Mark E; McCoy, Chuck; Clump, David A; Burton, Steven A; Heron, Dwight E

    2015-01-01

    The aim of this study is to provide a practical approach to the planning technique and evaluation of plan quality for the multi-lesion, single-isocenter stereotactic ablative radiotherapy (SABR) of the lung. Eleven patients with two or more lung lesions underwent single-isocenter volumetric-modulated arc therapy (VMAT) radiosurgery or IMRS. All plans were normalized to the target maximum dose. For each plan, all targets were treated to the same dose. Plan conformity and dose gradient were maximized with dose-control tuning structures surrounding targets. For comparison, multi-isocenter plans were retrospectively created for four patients. Conformity index (CI), homogeneity index (HI), gradient index (GI), and gradient distance (GD) were calculated for each plan. V5, V10, and V20 of the lung and organs at risk (OARs) were collected. Treatment time and total monitor units (MUs) were also recorded. One patient had four lesions and the remainder had two lesions. Six patients received VMAT and five patients received intensity-modulated radiosurgery (IMRS). For those treated with VMAT, two patients received 3-arc VMAT and four received 2-arc VMAT. For those treated with IMRS, two patients were treated with 10 and 11 beams, respectively, and the rest received 12 beams. Prescription doses ranged from 30 to 54 Gy in three to five fractions. The median prescribed isodose line was 84% (range: 80-86%). The median maximum dose was 57.1 Gy (range: 35.7-65.1 Gy). The mean combined PTV was 49.57 cm(3) (range: 14.90-87.38 cm(3)). For single-isocenter plans, the median CI was 1.15 (range: 0.97-1.53). The median HI was 1.19 (range: 1.16-1.28). The median GI was 4.60 (range: 4.16-7.37). The median maximum radiation dose (Dmax) to total lung was 55.6 Gy (range: 35.7-62.0 Gy). The median mean radiation dose to the lung (Dmean) was 4.2 Gy (range: 1.1-9.3 Gy). The median lung V5 was 18.7% (range: 3.8-41.3%). There was no significant difference in CI, HI, GI, GD, V5, V10

  2. Debridement of cartilage lesions before autologous chondrocyte implantation by open or transarthroscopic techniques: a comparative study using post-mortem materials.

    Science.gov (United States)

    Drobnic, M; Radosavljevic, D; Cör, A; Brittberg, M; Strazar, K

    2010-04-01

    We compared the quality of debridement of chondral lesions performed by four arthroscopic (SH, shaver; CU, curette; SHCU, shaver and curette; BP, bipolar electrodes) and one open technique (OPEN, scalpel and curette) which are used prior to autologous chondrocyte implantation (ACI). The ex vivo simulation of all five techniques was carried out on six juvenile equine stifle joints. The OPEN, SH and SHCU techniques were tested on knees harvested from six adult human cadavers. The most vertical walls with the least adjacent damage to cartilage were obtained with the OPEN technique. The CU and SHCU methods gave inferior, but still acceptable results whereas the SH technique alone resulted in a crater-like defect and the BP method undermined the cartilage wall. The subchondral bone was severely violated in all the equine samples which might have been peculiar to this model. The predominant depth of the debridement in the adult human samples was at the level of the calcified cartilage. Some minor penetrations of the subchondral end-plate were induced regardless of the instrumentation used. Our study suggests that not all routine arthroscopic instruments are suitable for the preparation of a defect for ACI. We have shown that the preferred debridement technique is either open or arthroscopically-assisted manual curettage. The use of juvenile equine stifles was not appropriate for the study of the cartilage-subchondral bone interface.

  3. T2-based temperature monitoring in abdominal fat during HIFU treatment of patients with uterine fibroids

    Science.gov (United States)

    Ozhinsky, Eugene; Kohi, Maureen; Ghanouni, Pejman; Rieke, Viola

    2017-03-01

    In this study, we have implemented T2-based monitoring of near-field heating in patients undergoing HIFU ablation of uterine fibroids using Insightec ExAblate system. In certain areas, near-field heating can reach 18°C and the tissue may experience sustained heating of more than 10°C for the period of 2 hours or more. This indicates a cumulative thermal dose that may cause necrosis. Our results show the feasibility and importance of measuring near-field heating in subcutaneous fat.

  4. Comparison of cervical cell morphology using two different cytology techniques for early detection of pre-cancerous lesions.

    Science.gov (United States)

    Moosa, Najla Yussuf; Khattak, Nuzhat; Alam, Muhammad Irfan; Sher, Alam; Shah, Walayat; Mobashar, Shumaila; Alam, Muhammad Imran; Javid, Asima

    2014-01-01

    Cervical cancer is an issue of foremost importance globally, specifically affecting the developing nations. Significant advances have taken place with regard to diagnosis of cervical cancer, especially with screening. Appropriate screening measures can thus reduce the incidence of cervical cancer. The most desirable screening technique should be less invasive, easy to perform, cost-effective and cover a wide range of diagnostic icons. Manual liquid based cytology (MLBC) can be considered as one of the suitable technique for screening with the above-mentioned benefits. The aim of the current study was to compare two cervical screening techniques on the basis of different morphological parameters and staining parameters by using modified acetic acid Pap staining to see the possibility of reducing time economy involved in conventional Pap staining (CPS). The study was conducted on a total 88 cases and all were analyzed with both MLBC and CPS. Forty eight cases that were regarded as satisfactory on the basis of Bethesda system by both methods were further recruited for investigation. Their morphological parameters and staining quality were compared and scored according to a scoring system defined in the study. Quality indices was calculated for both staining procedures and smear techniques.

  5. Slow-pull and different conventional suction techniques in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid lesions using 22-gauge needles.

    Science.gov (United States)

    Chen, Jia-Ying; Ding, Qing-Yu; Lv, Yang; Guo, Wen; Zhi, Fa-Chao; Liu, Si-De; Cheng, Tian-Ming

    2016-10-21

    To evaluate the cytological diagnostic capacity and sample quality of the slow-pull technique and compare them with different suction techniques. From July 2010 to December 2015, 102 patients with pancreatic solid lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with 22-gauge needles were retrospectively evaluated. EUS-FNA diagnosis was based on a cytological examination, and final diagnosis was based on a comprehensive standard of cytological diagnosis, surgical pathology and clinical or imaging follow-up. Cytological specimens were characterized for cellularity and blood contamination. The cytological diagnostic capacity and sample quality of the slow-pull technique and suction techniques with 5-mL/10-mL/20-mL syringes were analyzed. Of all of the EUS-FNA procedures, the slow-pull technique and suction techniques with 5-mL/10-mL/20-mL syringes were used in 31, 19, 34 and 18 procedures, respectively. There were significant differences between these four suction techniques in terms of cytological diagnostic accuracy (90.3% vs 63.2% vs 58.8% vs 55.6%, P = 0.019), sensitivity (88.2% vs 41.7% vs 40.0% vs 36.4%, P = 0.009) and blood contamination (score ≥ 2 for 29.0% vs 52.6% vs 70.6% vs 72.2%, P = 0.003). The accuracy and sensitivity of the slow-pull technique were significantly higher than those of the suction techniques using 5-mL (P = 0.03, P = 0.014), 10-mL (P = 0.005; P = 0.006) and 20-mL syringes (P = 0.01, P = 0.01). Blood contamination was significantly lower in the slow-pull technique than in the suction techniques with 10-mL (P = 0.001) and 20-mL syringes (P = 0.007). The slow-pull technique may increase the cytological diagnostic accuracy and sensitivity with slight blood contamination during EUS-FNA when using 22-gauge needles for solid pancreatic masses.

  6. Exfoliative cytology as a tool for monitoring pre-malignant and malignant lesions based on combined stains and morphometry techniques.

    Science.gov (United States)

    Gonzalez Segura, Ignacio; Secchi, Dante; Carrica, Andres; Barello, Rosario; Arbelo, Dario; Burgos, Adriana; Brunotto, Mabel; Zarate, Ana M

    2015-03-01

    Prevention and early diagnosis have the greatest potential for public health and are the most effective method in the long-term to control oral cancer. The aim was to apply PAP staining together with AgNOR staining and morphometric analysis in oral exfoliative cytology, to determine the sensitivity and specificity of these methods in the detection of malignant changes for the purposes of both initial population monitoring and follow-up. AgNOR, Papanicolau, and morphometric tests were conducted in samples of patients with oral cancer, oral potentially malignant disorders and controls (opposite side of lesions). Specificity and sensitivity values for each stain method and the curve under ROC area were estimated. The diagnostic variables which allowed greatest accuracy in identifying malignancy relative to the healthy control were cluster (76.92%), satellite (75.64%), and total (90%). The diagnosis was seen to be associated with PAP and total AgNOR, total AgNOR and PAP, total AgNOR and satellites and clusters, and total AgNOR nuclear area/cytoplasmic area ratio. The total number of AgNOR is a reliable marker for detecting neoplastic cells; this method increases sensitivity and specificity by decreasing the likelihood of false negatives or positives, as the accuracy obtained was 90%. It is also a low-cost, non-invasive, simple methodology that can be recommended to help the early detection of oral cancer and monitoring of patients with a first diagnosis of cancer. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. First Experience Of Application Of High-Intensity Focused Ultrasonic Ablation (Hifu In Prostate Cancer Treatment

    Directory of Open Access Journals (Sweden)

    A.V. Stativko

    2009-12-01

    Full Text Available The scientific article points out that 40 sessions of HIFU prostate ablation have been performed for estimation of clinical efficiency. Average frequency of influences presents 628±164 impulses; average volume of tissues subjected to influence during one procedure is 33,8±16,3 smi (132 % of prostate volume; average operation time constitutes 150 minutes (from 90 to 200 minutes. During the operation no complications have been occurred. In the first days after the session of HIFU there was a peak of PSA increase and then during 1,5-3 months there was decrease to the lowest index. Minimal PSA level was reached in 10-12 weeks after treatment and it constituted from 0,04 till 1,1 ngml depending on the disease state. Reduction of prostate volume occurred in average from the 30th day of postoperative period and lasted for 6 months, reaching in average 50 % from initial volume. Postoperative period varied from 10 till 16 days and constituted in average 12±0,8 days. Thus application of high-intensity focused ultrasonic ablation allows treating successfully various stages of prostate cancer with minimal number of side-effects and makes possible the early estimation of treatment efficiency

  8. A History of the Sonocare CST-100: The First FDA-approved HIFU Device

    Science.gov (United States)

    Muratore, Robert

    2006-05-01

    The Sonocare CST-100 Therapeutic Ultrasound System, designed for the treatment of glaucoma, was developed in the 1980s and became the first high intensity focused ultrasound (HIFU) device to receive Food and Drug Administration approval. The system arose from studies done by F.L. Lizzi, Eng.Sc.D., of Riverside Research Institute and D.J. Coleman, M.D., of Cornell Medical Center/New York Hospital on the safety of ultrasound diagnosis of the eye. As safety limits were probed, therapeutic regimes were discovered. Optimization of operational parameters, clinical experience, and engineering design came together through a spin-off company, Sonocare, Inc., formed to produce and market the ophthalmic device. Various precedents were set during the approval process, including the acceptance by the FDA of radiation momentum imparted to an absorber as a measure of acoustic power. Many devices were sold, but the laser industry, grandfathered into the therapeutic field, eventually out-marketed Sonocare. The CST-100 remains as a model of elegant industrial design, and existing units are used daily in HIFU laboratory experiments.

  9. Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique.

    Science.gov (United States)

    Anzidei, Michele; Argirò, Renato; Porfiri, Andrea; Boni, Fabrizio; Anile, Marco; Zaccagna, Fulvio; Vitolo, Domenico; Saba, Luca; Napoli, Alessandro; Leonardi, Andrea; Longo, Flavia; Venuta, Federico; Bezzi, Mario; Catalano, Carlo

    2015-05-01

    Evaluate the performance of a robotic system for CT-guided lung biopsy in comparison to the conventional manual technique. One hundred patients referred for CT-guided lung biopsy were randomly assigned to group A (robot-assisted procedure) or group B (conventional procedure). Size, distance from entry point and position in lung of target lesions were evaluated to assess homogeneity differences between the two groups. Procedure duration, dose length product (DLP), precision of needle positioning, diagnostic performance of the biopsy and rate of complications were evaluated to assess the clinical performance of the robotic system as compared to the conventional technique. All biopsies were successfully performed. The size (p = 0.41), distance from entry point (p = 0.86) and position in lung (p = 0.32) of target lesions were similar in both groups (p = 0.05). Procedure duration and radiation dose were significantly reduced in group A as compared to group B (p = 0.001). Precision of needle positioning, diagnostic performance of the biopsy and rate of complications were similar in both groups (p = 0.05). Robot-assisted CT-guided lung biopsy can be performed safely and with high diagnostic accuracy, reducing procedure duration and radiation dose in comparison to the conventional manual technique. • CT-guided biopsy is the main procedure to obtain diagnosis in lung tumours. • The robotic device facilitates percutaneous needle placement under CT guidance. • Robot-assisted CT-guided lung biopsy reduces procedure duration and radiation dose.

  10. Monitoring of thermal therapy based on shear modulus changes: II. Shear wave imaging of thermal lesions.

    Science.gov (United States)

    Arnal, Bastien; Pernot, Mathieu; Tanter, Mickael

    2011-08-01

    The clinical applicability of high-intensity focused ultrasound (HIFU) for noninvasive therapy is currently hampered by the lack of robust and real-time monitoring of tissue damage during treatment. The goal of this study is to show that the estimation of local tissue elasticity from shear wave imaging (SWI) can lead to a precise mapping of the lesion. HIFU treatment and monitoring were respectively performed using a confocal setup consisting of a 2.5-MHz single element transducer focused at 34 mm on ex vivo samples and an 8-MHz ultrasound diagnostic probe. Ultrasound-based strain imaging was combined with shear wave imaging on the same device. The SWI sequences consisted of 2 successive shear waves induced at different lateral positions. Each wave was created with pushing beams of 100 μs at 3 depths. The shear wave propagation was acquired at 17,000 frames/s, from which the elasticity map was recovered. HIFU sonications were interleaved with fast imaging acquisitions, allowing a duty cycle of more than 90%. Thus, elasticity and strain mapping was achieved every 3 s, leading to real-time monitoring of the treatment. When thermal damage occurs, tissue stiffness was found to increase up to 4-fold and strain imaging showed strong shrinkages that blur the temperature information. We show that strain imaging elastograms are not easy to interpret for accurate lesion characterization, but SWI provides a quantitative mapping of the thermal lesion. Moreover, the concept of shear wave thermometry (SWT) developed in the companion paper allows mapping temperature with the same method. Combined SWT and shear wave imaging can map the lesion stiffening and temperature outside the lesion, which could be used to predict the eventual lesion growth by thermal dose calculation. Finally, SWI is shown to be robust to motion and reliable in vivo on sheep muscle.

  11. Initial investigation of a novel noninvasive weight loss therapy using MRI-Guided high intensity focused ultrasound (MR-HIFU) of visceral fat.

    Science.gov (United States)

    Winter, Patrick M; Lanier, Matthew; Partanen, Ari; Dumoulin, Charles

    2016-07-01

    MRI-guided high intensity focused ultrasound (MR-HIFU) allows noninvasive heating of deep tissues. Specifically targeting visceral fat deposits with MR-HIFU could offer an effective therapy for reversing the development of obesity, diabetes, and metabolic syndrome. Overweight rats received either MR-HIFU of visceral fat, sham treatment, no treatment, or ex vivo temperature calibration. Conventional MR thermometry methods are not effective in fat tissue. Therefore, the T2 of fat was used to estimate heating in adipose tissue. HIFU treated rats lost 7.5% of their body weight 10 days after HIFU, compared with 1.9% weight loss in sham animals (P = 0.008) and 1.3% weight increase in untreated animals (P = 0.004). Additionally, the abdominal fat volume in treated animals decreased by 8.2 mL 7 days after treatment (P = 0.002). The T2 of fat at 1.5 Tesla increased by 3.3 ms per °C. The fat T2 was 103.3 ms before HIFU, but increased to 128.7 ms (P = 0.0005) after HIFU at 70 watts for 16 s and to 131.9 ms (P = 0.0005) after HIFU at 100 watts for 16 s. These experiments demonstrate that MR-HIFU of visceral fat could provide a safe, effective, and noninvasive weight loss therapy for combating obesity and the subsequent medical complications. Magn Reson Med 76:282-289, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  12. A framework for the correction of slow physiological drifts during MR-guided HIFU therapies : Proof of concept

    NARCIS (Netherlands)

    Zachiu, Cornel; de Senneville, Baudouin Denis; Moonen, Chrit; Ries, Mario

    2015-01-01

    Purpose: While respiratory motion compensation for magnetic resonance (MR)-guided high intensity focused ultrasound (HIFU) interventions has been extensively studied, the influence of slow physiological motion due to, for example, peristaltic activity, has so far been largely neglected. During lengt

  13. Validation of a gating technique for radiotherapy treatment of injuries affected by respiratory motion; Validacion de una atecnica de gating para el tratamiento con radioterapia externa de lesiones afectadas por el movimiento respiratorio

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Ortega, J.; Castro Tejero, P.

    2011-07-01

    The use of gating techniques for the treatment of lesions that are involved respiratory motion may bring an increase in the dose administered. tumors and decreased the dose to adjacent healthy organs. In the study presented shows the steps taken to validate the respiratory gating technique using the RPM system (Real-time Position Management) from Varian. (Author)

  14. Microindentation hardness and calcium/phosphorus ratio of dentin following excavation of dental caries lesions with different techniques.

    Science.gov (United States)

    Katirci, Gunseli; Ermis, R Banu

    2016-01-01

    The aim of this in vitro study was to evaluate the microindentation hardness and chemical composition of residual dentin left at the cavity bottom following removal of carious dentin using the Carisolv chemomechanical and Er:YAG laser caries excavation methods in comparison with the conventional tungsten-carbide bur excavation. Sixty-nine extracted permanent teeth with occlusal dentin caries were assigned into three groups according to caries removal technique. Carious dentin excavation was guided by tactile method and a caries-staining dye. In stereomicroscope images (100×) of the samples, the presence or absence of residual caries was defined. The Knoop hardness value of the cavity floor was determined and atomic analysis of treated cavities was performed by energy dispersive X-ray spectroscopy. The Knoop hardness value of residual dentin left at the cavity bottom was lower (One-way ANOVA, Dunnett-C, p carious dentin was higher after Carisolv excavation than those obtained after conventional and laser excavations (Kruskal-Wallis, Mann-Whitney U, p  0.05). The results indicated that Er:YAG laser was more comparable to conventional bur excavation than chemomechanical method in the efficacy of caries removal with regard to microindentation hardness of remaining dentin and both Carisolv gel and Er:YAG laser did not alter chemical composition of residual dentin in the treated cavities.

  15. Spatiotemporal filtering of MR-temperature artifacts arising from bowel motion during transurethral MR-HIFU

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, Alain, E-mail: aschmitt@sri.utoronto.ca [Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada); Mougenot, Charles [Philips Healthcare, 281 Hillmount Road, Markham, Ontario L6C 2S3 (Canada); Chopra, Rajiv [Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canadaand Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9061 (United States)

    2014-11-01

    Purpose: Transurethral MR-HIFU is a minimally invasive image-guided treatment for localized prostate cancer that enables precise targeting of tissue within the gland. The treatment is performed within a clinical MRI to obtain real-time MR thermometry used as an active feedback to control the spatial heating pattern in the prostate and to monitor for potential damage to surrounding tissues. This requires that the MR thermometry measurements are an accurate representation of the true tissue temperature. The proton resonance frequency shift thermometry method used is sensitive to tissue motion and changes in the local magnetic susceptibility that can be caused by the motion of air bubbles in the rectum, which can impact the performance of transurethral MR-HIFU in these regions of the gland. Methods: A method is proposed for filtering of temperature artifacts based on the temporal variance of the temperature, using empirical and dynamic positional knowledge of the ultrasonic heating beam, and an estimation of the measurement noise. A two-step correction strategy is introduced which eliminates artifact-detected temperature variations while keeping the noise level low through spatial averaging. Results: The filter has been evaluated by postprocessing data from five human transurethral ultrasound treatments. The two-step correction process led to reduced final temperature standard deviation in the prostate and rectum areas where the artifact was located, without negatively affecting areas distal to the artifact. The performance of the filter was also found to be consistent across all six of the data sets evaluated. The evaluation of the detection criterion parameter M determined that a value of M = 3 achieves a conservative filter with minimal loss of spatial resolution during the process. Conclusions: The filter was able to remove most artifacts due to the presence of moving air bubbles in the rectum during transurethral MR-HIFU. A quantitative estimation of the filter

  16. Modeling pressure distribution and heat in the body tissue and extract the relationship between them in order to improve treatment planning in HIFU

    CERN Document Server

    Hajian, Saeed Reza; Pouladian, Majid; Hemmasi, Gholam Reza

    2016-01-01

    In high intensity focused ultrasound (HIFU) systems using non-ionizing methods in cancer treatment, if the device is applied to the body externally, the HIFU beam can damage nearby healthy tissues and burn skin due to lack of knowledge about the viscoelastic properties of patient tissue and failure to consider the physical properties of tissue in treatment planning. Addressing this problem by using various methods, such as MRI or ultrasound, elastography can effectively measure visco-elastic properties of tissue and fits within the pattern of stimulation and total treatment planning. In this paper, in a linear path of HIFU propagation, and by considering the smallest part of the path, including voxel with three mechanical elements of mass, spring and damper, which represents the properties of viscoelasticity of tissue, by creating waves of HIFU in the wire environment of MATLAB mechanics and stimulating these elements, pressure and heat transfer due to stimulation in the hypothetical voxel was obtained. Throu...

  17. High-Intensity Focused Ultrasound (HIFU) Using Sonablate® Devices for the Treatment of Benign Prostatic Hyperplasia and Localized Prostate Cancer: 18-year experience

    Science.gov (United States)

    Uchida, Toyoaki

    2011-09-01

    From 1993 to 2010, we have treated 156 patients benign prostatic hyperplasia (BPH) and 1,052 patients localized prostate cancer high-intensity focused ultrasound (HIFU). Four different HIFU devices, SonablateR-200, SonablateR-500, SonablateR-500 version 4 and Sonablate® TCM, have been used for this study. Clinical outcome of HIFU for BPH did not show any superior effects to transurethral resection of the prostate, laser surgery or transurethral vapolization of the prostate. However, HIFU appears to be a safe and minimally invasive therapy for patients with localized prostate cancer, especially low- and intermediate-risk patients. The rate of clinical outcome has significantly improved over the years due to technical improvements in the device.

  18. Interference-free ultrasound imaging during HIFU therapy, using software tools

    Science.gov (United States)

    Vaezy, Shahram (Inventor); Held, Robert (Inventor); Sikdar, Siddhartha (Inventor); Managuli, Ravi (Inventor); Zderic, Vesna (Inventor)

    2010-01-01

    Disclosed herein is a method for obtaining a composite interference-free ultrasound image when non-imaging ultrasound waves would otherwise interfere with ultrasound imaging. A conventional ultrasound imaging system is used to collect frames of ultrasound image data in the presence of non-imaging ultrasound waves, such as high-intensity focused ultrasound (HIFU). The frames are directed to a processor that analyzes the frames to identify portions of the frame that are interference-free. Interference-free portions of a plurality of different ultrasound image frames are combined to generate a single composite interference-free ultrasound image that is displayed to a user. In this approach, a frequency of the non-imaging ultrasound waves is offset relative to a frequency of the ultrasound imaging waves, such that the interference introduced by the non-imaging ultrasound waves appears in a different portion of the frames.

  19. [Managing focal incidental renal lesions].

    Science.gov (United States)

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

  20. Variations of bubble cavitation and temperature elevation during lesion formation by high-intensity focused ultrasound.

    Science.gov (United States)

    Zhou, Yufeng; Gao, Xiaobin Wilson

    2013-08-01

    High-intensity focused ultrasound (HIFU) is emerging as an effective therapeutic modality in both thermal ablations for solid tumor/cancer and soft-tissue fragmentation. Mechanical and thermal effects, which play an important role in the HIFU treatment simultaneously, are dependent on the operating parameters and may vary with the progress of therapy. Mechanical erosion in the shape of a "squid," a "dumbbell" lesion with both mechanical and thermal lesions, or a "tadpole" lesion with mechanical erosion at the center and thermal necrosis on the boundary in the transparent gel phantom could be produced correspondingly with the pulse duration of 5-30 ms, which is much longer than histotripsy burst but shorter than the time for tissue boiling, and pulse repetition frequency (PRF) of 0.2-5 Hz. Meanwhile, variations of bubble cavitation (both inertial and stable cavitation) and temperature elevation in the focal region (i.e., z = -2.5, 0, and 2.5 mm) were measured by passive cavitation detection (PCD) and thermocouples during the therapeutic procedure, respectively. Stable cavitation increased with the pulse duration, PRF, and the number of pulses delivered. However, inertial cavitation was found to increase initially and then decrease with long pulse duration and high PRF. Temperature in the pre-focal region is always higher than those at the focal and post-focal position in all tests. Great variations of PCD signals and temperature elevation are due to the generation and persistence of large bubble, which is resistant to collapse and occurs with the increase of pulse duration and PRF. Similar lesion pattern and variations were also observed in ex vivo porcine kidneys. Hyperechoes in the B-mode ultrasound image were comparable to the shape and size of lesions in the dissected tissue. Thermal lesion volume increased with the increase of pulse duration and PRF, but mechanical erosion reached its maximum volume with the pulse duration of 20 ms and PRF of 1

  1. DUAL-FOCUS THERAPEUTIC ULTRASOUND TRANSDUCER FOR PRODUCTION OF BROAD TISSUE LESIONS

    Science.gov (United States)

    Jeong, Jong Seob; Cannata, Jonathan M.; Shung, K. Kirk

    2011-01-01

    In noninvasive high-intensity focused ultrasound (HIFU) treatment, formation of a large tissue lesion per sonication is desirable for reducing the overall treatment time. The goal of this study is to show the feasibility of enlarging tissue lesion size with a dual-focus therapeutic ultrasound transducer (DFTUT) by increasing the depth-of-focus (DOF). The proposed transducer consists of a disc- and an annular-type element of different radii of curvatures to produce two focal zones. To increase focal depth and to maintain uniform beamwidth of the elongated DOF, each element transmits ultrasound of a different center frequency: the inner element at a higher frequency for near field focusing and the outer element at a lower frequency for far field focusing. By activating two elements at the same time with a single transmitter capable of generating a dual-frequency mixed signal, the overall DOF of the proposed transducer may be extended considerably. A prototype transducer composed of a 4.1 MHz inner element and a 2.7 MHz outer element was fabricated to obtain preliminary experimental results. The feasibility the proposed technique was demonstrated through sound field, temperature and thermal dose simulations. The performance of the prototype transducer was verified by hydrophone measurements and tissue ablation experiments on a beef liver specimen. When several factors affecting the length and the uniformity of elongated DOF of the DFTUT are optimized, the proposed therapeutic ultrasound transducer design may increase the size of ablated tissues in the axial direction and, thus, decreasing the treatment time for a large volume of malignant tissues especially deep-seated targets. PMID:20870346

  2. Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MRgHIFU) for Treatment of Symptomatic Uterine Fibroids: An Economic Analysis

    Science.gov (United States)

    Babashov, V; Palimaka, S; Blackhouse, G; O'Reilly, D

    2015-01-01

    Background Uterine fibroids, or leiomyomas, are the most common benign tumours in women of childbearing age. Some women experience symptoms (e.g., heavy bleeding) that require aggressive forms of treatment such as uterine artery embolization (UAE), myomectomy, magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU), and even hysterectomy. It is important to note that hysterectomy is not appropriate for women who desire future childbearing. Objectives The objective of this analysis was to evaluate the cost-effectiveness and budgetary impact of implementing MRgHIFU as a treatment option for symptomatic uterine fibroids in premenopausal women for whom drugs have been ineffective. Review Methods We performed an original cost-effectiveness analysis to assess the long-term costs and effects of MRgHIFU compared with hysterectomy, myomectomy, and UAE as a strategy for treating symptomatic uterine fibroids in premenopausal women aged 40 to 51 years. We explored a number of scenarios, e.g., comparing MRgHIFU with uterine-preserving procedures only, considering MRgHIFU-eligible patients only, and eliminating UAE as a treatment option. In addition, we performed a one-year budget impact analysis, using data from Ontario administrative sources. Four scenarios were explored in the budgetary impact analysis: MRgHIFU funded at 2 centres MRgHIFU funded at 2 centres and replacing only uterine-preserving procedures MRgHIFU funded at 6 centres MRgHIFU funded at 6 centres and replacing only uterine-preserving procedures Analyses were conducted from the Ontario public payer perspective. Results The base case determined that the uterine artery embolization (UAE) treatment strategy was the cost-effective option at commonly accepted willingness-to-pay values. Compared with hysterectomy, UAE was calculated as having an incremental cost-effectiveness ratio (ICER) of $46,480 per quality-adjusted life-year (QALY) gained. The MRgHIFU strategy was extendedly dominated by a

  3. Drift correction for accurate PRF-shift MR thermometry during mild hyperthermia treatments with MR-HIFU.

    Science.gov (United States)

    Bing, Chenchen; Staruch, Robert M; Tillander, Matti; Köhler, Max O; Mougenot, Charles; Ylihautala, Mika; Laetsch, Theodore W; Chopra, Rajiv

    2016-09-01

    There is growing interest in performing hyperthermia treatments with clinical magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) therapy systems designed for tissue ablation. During hyperthermia treatment, however, due to the narrow therapeutic window (41-45 °C), careful evaluation of the accuracy of proton resonant frequency (PRF) shift MR thermometry for these types of exposures is required. The purpose of this study was to evaluate the accuracy of MR thermometry using a clinical MR-HIFU system equipped with a hyperthermia treatment algorithm. Mild heating was performed in a tissue-mimicking phantom with implanted temperature sensors using the clinical MR-HIFU system. The influence of image-acquisition settings and post-acquisition correction algorithms on the accuracy of temperature measurements was investigated. The ability to achieve uniform heating for up to 40 min was evaluated in rabbit experiments. Automatic centre-frequency adjustments prior to image-acquisition corrected the image-shifts in the order of 0.1 mm/min. Zero- and first-order phase variations were observed over time, supporting the use of a combined drift correction algorithm. The temperature accuracy achieved using both centre-frequency adjustment and the combined drift correction algorithm was 0.57° ± 0.58 °C in the heated region and 0.54° ± 0.42 °C in the unheated region. Accurate temperature monitoring of hyperthermia exposures using PRF shift MR thermometry is possible through careful implementation of image-acquisition settings and drift correction algorithms. For the evaluated clinical MR-HIFU system, centre-frequency adjustment eliminated image shifts, and a combined drift correction algorithm achieved temperature measurements with an acceptable accuracy for monitoring and controlling hyperthermia exposures.

  4. Experimental Validation of a Novel MRI-Compatible HIFU Device for the Treatment of Superficial Venous Insufficiency

    Science.gov (United States)

    Salomir, Rares; Pichardo, Samuel; Petrusca, Lorena; Angel, Yves; Lacoste, François; Chapelon, Jean-Yves

    2007-05-01

    A novel High Intensity Focused Ultrasound (HIFU) probe has been designed for minimally-invasive treatment of valvular dysfunction in the saphenous vein, which is known to be the cause of superficial venous insufficiency (SVI) and varicose veins. Treating SVI with HIFU is possible, since venous tissue undergoes localized partial shrinkage when subjected to high temperature elevation. In a previous study in vitro we demonstrated that diameter shrinkage should be sufficient to restore valvular function, as this is done in the more aggressive approach known as external valvuloplasty. Numerical optimization using fast simulations of pressure field have led to a non-spherically shaped probe design with two HIFU elements that focus ultrasound uniformly over a line of length 7 mm, at a depth of 15 mm from the skin. A MR-compatible prototype of the probe has been constructed and this was characterized 1). by electroacustical mapping of the pressure field in water, and 2). by fast, high resolution MR thermal mapping ex vivo on fresh meat samples. Results were in good agreement with those predicted by an analytical approach and numerical simulations. Available experimental data suggest that a short sonication (less than 10 sec duration) should permit sufficient temperature elevation to obtain vein shrinkage. Further studies will be performed on surgically excised samples of human veins under MR thermal mapping in order to determine the optimal sonication parameters (duration and power level).

  5. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study.

    Science.gov (United States)

    Sawant, Ajinkya; Chunawalla, Yusuf; Morawala, Abdul; S Kanchan, Nupur; Jain, Kapil; Talathi, Rohan

    2017-01-01

    less time-consuming custom-made post in treating mutilated maxillary anteriors. Sawant A, Chunawalla Y, Morawala A, Kanchan NS, Jain K, Talathi R. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study. Int J Clin Pediatr Dent 2017;10(2):126-130.

  6. Diagnostic accuracies of endoscopic ultrasound-guided fine-needle aspiration with distinct negative pressure suction techniques in solid lesions: A retrospective study

    Science.gov (United States)

    Wang, Ronghua; Wang, Jinlin; Li, Yawen; Duan, Yaqi; Wu, Xiaoli; Cheng, Bin

    2017-01-01

    Endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) is highly accurate in obtaining specific diagnoses for various diseases. The present study aimed to evaluate the diagnostic yields, accuracies and sampling adequacies, of slow-pull, 5 ml suction and 10 ml suction techniques in EUS-FNA of solid lesions. The present study was a retrospective comparative study, which was performed in tertiary academic centers, recognized for their expertise in EUS and EUS-guided FNA. The present study involved 149 patients who underwent EUS-FNA of solid masses. A total of 34 (22.8%), 37 (24.8%) and 78 (52.4%) patients underwent EUS-FNA with slow-pull, 5 ml suction and 10 ml suction techniques, respectively. The EUS-FNA cytology and histology results were compared with those from the gold standard of surgical histopathology [hematoxylin-eosin staining; immunohistochemical test of cluster of differentiation (CD) 79a, CD20 and flow cytometry test] or long-term clinical follow-up. The present retrospective comparative study demonstrated that the diagnostic yields and accuracies of EUS-FNA with slow-pull (86.1%) were significantly superior to those achieved with 5 ml suction (83.3%) or 10 ml suction (69.9%; Psuction group were adequate for histological diagnosis. By contrast, 70.6 (24/34) and 85.9% (67/78) of samples from the slow-pull and 10 ml suction groups were adequate for histological diagnosis, respectively. The samples obtained using 10 ml suction contained more blood compared with those obtained via slow-pull and 5 ml suction (P=0.0056; χ2 test). No complications were noted in any of the three groups. The samples that were obtained for histopathological diagnosis using 5 ml suction were superior to those obtained using slow-pull or 10 ml suction. Additional multi-central prospective studies in which EUS-FNA is performed with variable negative pressures are required to improve the defining of the diagnostic roles of those techniques. PMID:28521473

  7. Lesiones laborales

    OpenAIRE

    2015-01-01

    Las lesiones laborales se producen por un esfuerzo repetitivo, cuando un exceso de presión se ejerce sobre una parte del cuerpo provocando lesiones óseas, articulares, musculares y daños en los tejidos. Los accidentes laborales también pueden producir una lesión en el organismo y esto sumado a diversos factores es un problema para la reinserción laboral de los trabajadores de la energía eléctrica. Objetivo: Establecer cuáles son las lesiones más frecuentes que afectan a los ...

  8. Case Report: Use of reinforced buccal mucosa graft over gracilis muscle flap in management of post high intensity focused ultrasound (HIFU) rectourethral fistula

    Science.gov (United States)

    Jai, Shrikant; Ganpule, Arvind; Singh, Abhishek; Vijaykumar, Mohankumar; Bopaiah, Vinod; Sabnis, Ravindra; Desai, Mahesh

    2017-01-01

    High intensity focused ultrasound (HIFU) has come forward as alternative treatment for carcinoma of the prostate. Though minimally invasive,HIFUhas potential side effects. Urethrorectal fistula is one such rare side effect. Management of these fistulas has been described by Vanni et al. This case report describes points of technique that will help successful management of resilient rectourethral fistula. Urinary and faecal diversion in the form of suprapubic catheter and colostomy is vital. Adequate time between stoma formation, fistula closure and then finally stoma closure is needed. Lithotomy position and perineal approach gives best exposure to the fistula. The rectum should be dissected 2cm above the fistula; this aids in tension free closure of the rectal defect. Similarly buccal mucosal graft was used on the urethra to achieve tension free closure. A good vascular pedicle gracilis muscle flap is used to interpose between the two repairs. This not only provides a physical barrier but also provides a vascular bed for BMG uptake. Perfect haemostasis is essential, as any collection may become a site of infection thus compromising results.  We strongly recommend rectourethral fistula be directly repaired with gracilis muscle flap with reinforced buccal mucosa graft without attempting any less invasive repairs because the “first chance is the best chance”. PMID:28299181

  9. A framework for the correction of slow physiological drifts during MR-guided HIFU therapies: Proof of concept

    Energy Technology Data Exchange (ETDEWEB)

    Zachiu, Cornel, E-mail: C.Zachiu@umcutrecht.nl; Moonen, Chrit; Ries, Mario [Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX (Netherlands); Denis de Senneville, Baudouin [Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX (Netherlands); Mathematical Institute of Bordeaux, University of Bordeaux, Talence Cedex 33405 (France)

    2015-07-15

    Purpose: While respiratory motion compensation for magnetic resonance (MR)-guided high intensity focused ultrasound (HIFU) interventions has been extensively studied, the influence of slow physiological motion due to, for example, peristaltic activity, has so far been largely neglected. During lengthy interventions, the magnitude of the latter can exceed acceptable therapeutic margins. The goal of the present study is to exploit the episodic workflow of these therapies to implement a motion correction strategy for slow varying drifts of the target area and organs at risk over the entire duration of the intervention. Methods: The therapeutic workflow of a MR-guided HIFU intervention is in practice often episodic: Bursts of energy delivery are interleaved with periods of inactivity, allowing the effects of the beam on healthy tissues to recede and/or during which the plan of the intervention is reoptimized. These periods usually last for at least several minutes. It is at this time scale that organ drifts due to slow physiological motion become significant. In order to capture these drifts, the authors propose the integration of 3D MR scans in the therapy workflow during the inactivity intervals. Displacements were estimated using an optical flow algorithm applied on the 3D acquired images. A preliminary study was conducted on ten healthy volunteers. For each volunteer, 3D MR images of the abdomen were acquired at regular intervals of 10 min over a total duration of 80 min. Motion analysis was restricted to the liver and kidneys. For validating the compatibility of the proposed motion correction strategy with the workflow of a MR-guided HIFU therapy, an in vivo experiment on a porcine liver was conducted. A volumetric HIFU ablation was completed over a time span of 2 h. A 3D image was acquired before the first sonication, as well as after each sonication. Results: Following the volunteer study, drifts larger than 8 mm for the liver and 5 mm for the kidneys prove that

  10. Comparison of Treatment Outcomes of Arthroscopic Bankart Lesion Repair with Open Bristow-Latarjet Technique in Patients with Anterior Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Mohsen Mardani-Kivi

    2012-12-01

    Full Text Available Background & Objectives: Over 150 different surgical techniques for treatment of anterior shoulder instability has been suggested that there is no consensus in the orthopedics. This study seeks to compare treatment outcomes of arthroscopic Bankart lesion repair methods with Bristow - Latarjet open surgical technique in patients with anterior shoulder instability.   Methods: In this cross-sectional study all patients with recurrent shoulder dislocation from 2009-2011 was divided into two groups, arthroscopic Bankart treatment (28 cases and open Bristow - Latarjet (26 cases that all were treated by one orthopedic surgeon. Patients were visited in 2,4,6,8 weeks also in the third and sixth month post-op .The visual analog scale (VAS for patient satisfaction and Walsch-duplay and Rowe score for functional outcomes of treatment were used in six months follow up. These three criteria were analyzed again after recalling the patients.   Results: Mean age of 54 patients was 29.46±9.16 years and mean follow-up duration was 23.28 ± 6.2 months. Scores of patients in both groups were not statistically different after analyzing the functional outcomes of treatment by Walsch-duplay and Rowe score after six months and final follow-up. Scores of patients by Walsch-duplay measurement in arthroscopic Bankart and Bristow-Latarjet groups were 98.03±4.37 and 97.88±4.51 respectively and by Rowe index were 97.32±5.52 vs. 97.88±4.51at final follow-up. No recurrence was observed in both groups in final follow up. Patient satisfaction in Bankart and operation groups were 9.4 ±0.68 and 9.47±0.58 (p= 0.69.   Conclusion: In anterior shoulder instability, minimally invasive Arthroscopic Bankart procedures almost equal to open Bristow-Latarjet method with regards to shoulder stability, recurrence rate, and range of motion.

  11. Qualitative research of the relationship between occurrence time of coagulation necrosis and cavitation during HIFU exposures%HIFU辐照离体牛眼晶状体致凝固性坏死出现时间与空化关系的定性研究

    Institute of Scientific and Technical Information of China (English)

    王琦; 王静; 李雅芬; 李发琪; 艾慧坚; 钟明松; 王智彪

    2013-01-01

    Objective: To study the relationship between occurrence time of coagulation necrosis and cavitation during HTFU exposures qualitatively. Methods: The bovine lens were exposed to HIFU with various parameters (100w - 6s, 200w - 3s, 300w - 2s and 600w - ls) after fixed using a homemade bracket. The high - speed photography device was used to record the formation process of coagulation necrosis in the bovine lens. Acoustic emissions were also detected by a passive cavitation detection (PCD) system and then processed with a program which was written on Lab VIEW previously. The lens after irradiations were observed and photographed. Results: Coagulation necrosis were observed in all bovine lens during HIFU exposures while the occurrence time differentiated. The mean appear time of coagulation necrosis in bovine lens was 1.921, 1.109, 0.627and 0.240 s respectively after HIFU with the acoustic powers of 100, 200, 300 and 600 W. Under naked eye, the volumes and shapes of lesions were similar after all exposures with different powers and times. Cavitation behaviors were detected during 200, 300 and 600 W acoustic powers HIFU irradiations, and the greater power, the more severe cavitation. Conclusions: Coagulation necrosis in the bovine lens were affected by cavitation during HIFU exposures, and the more severe cavitation, the shorter the occurrence time of coagulation necrosis.%目的:研究高强度聚焦超声(high intensity fcused ultrasound,HIFU)辐照离体牛眼睛所致热凝固性坏死出现的时间与空化的关系.方法:使用自制支架固定牛眼晶状体,使用不同辐照参数(100w-6s、200w-3s、300w-2s、600w-1s)的HIFU辐照离体牛眼晶状体,辐照过程中使用高速摄影系统摄录晶状体中凝固性坏死的形成过程,并用被动空化检测(passive cavitation detection,PCD)系统对辐照中牛眼晶状体中发出的声散射信号(acoustic emissions)进行检测后在LabVIEW开发平台上编程对其量化分析.辐照结束后,观

  12. Investigation of techniques to quantify in vivo lesion volume based on comparison of water apparent diffusion coefficient (ADC) maps with histology in focal cerebral ischemia of rats.

    Science.gov (United States)

    Kazemi, Mark; Silva, Matthew D; Li, Fuhai; Fisher, Marc; Sotak, Christopher H

    2004-06-01

    Stroke lesion-volume estimates derived from calculated water apparent diffusion coefficient (ADC) maps provide a quantitative surrogate end-point for investigating the efficacy of drug treatment or studying the temporal evolution of cerebral ischemia. Methodology is described for estimating ischemic lesion volumes in a rat model of permanent middle cerebral artery occlusion (MCAO) based on absolute and percent-reduction threshold values of the water ADC at 3 h post-MCAO. Volume estimates derived from average ADC (ADC(av)) maps were compared with those derived from post-mortem histological sections. Optimum ADC thresholds were established as those that provided the best correlation and one-to-one correspondence between ADC- and histologically derived lesion-volume estimates. At 3 h post-MCAO, an absolute-ADC(av) threshold of 47 x 10(-5) mm(2)/s (corresponding to a 33% reduction in ADC(av) based on a contralateral hemisphere comparison) provided the most accurate estimate of percent hemispheric lesion volume (%HLV). Experimental and data analysis issues for improving and validating the usefulness of DWI as a surrogate endpoint for the quantification of ischemic lesion volume are discussed.

  13. Skirt followed by trouser stenting technique: True anatomical preservation of coronary Y-shaped bifurcation lesions while using "vanishing" bioresorbable scaffolds: A report of two cases.

    Science.gov (United States)

    Elabbassi, Wael; Al Nooryani, Arif

    2016-11-03

    We report on two cases in which Y-shaped coronary bifurcations were treated with the use of Bioresorbable scaffolds. The first case was of a 50-year-old man with NSTEMI. Coronary angiography showed stenosis involving a Y-shaped bifurcation of proximal to mid LAD and diagonal. The lesion was wired using two 0.14 BMW guide wires, followed by serial pre-dilatation of LAD and Diagonal branch. The stent into proximal LAD was deployed first as a skirt (3.5 × 12 BVS). Stent was post-dilated. A second 2.5 × 28 BVS was deployed into diagonal branch, protruding backwards; along with a 2.0 × 15 SC balloon continuing into the mid LAD. Both balloons where pulled back proximally and re-inflated. The technique was repeated in reversed order for stenting the mid LAD using the third BVS (3.0 × 18 BVS). Finally two NC balloons where used to post-dilate both legs of the newly-formed trouser. The result was checked by OCT. The second case was that of a 62-year-old man with chest pain and NSTEMI. He had a history of previous PCI to LCx using bare metal stent. Coronary angiogram showed severe in-stent restenosis in mid LCX, extending into two large obtuse marginal branches. After wiring both OMs, serial pre-dilatation was done with two NC 2.5 × 20 balloons, followed by initial stenting of mid LCx inside old stent, as the proximal segment of bifurcation, using a 3.5 × 12 BVS, followed by implanting a 2.5 × 28 BVS into OM2 and 2.5 × 18 into OM1. At 6 months a clinical follow up via telephone contact revealed no recurrence of chest pain in both cases and no further intervention required.

  14. 高强聚焦超声(HIFU)加热活体组织中的温度分布%Temperature distribution in vivo tissues heated by high intensity focused ultrasound(HIFU)

    Institute of Scientific and Technical Information of China (English)

    钱祖文

    2010-01-01

    在高强聚焦超声(HIFU)加热的情况下,利用多针射频(RF)测温装置测量活体组织内的温度分布,结果表明,温度梯度依赖于局部温度,温度越商,梯度越大.此外,本文还研究了血流对温度梯度的影响,结果似乎证实了理论预测,即血流(或血液灌注)减缓了温度(梯度)的变化.

  15. Pink lesions.

    Science.gov (United States)

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  16. Long-Term Clinical Outcomes of Final Kissing Ballooning in Coronary Bifurcation Lesions Treated With the 1-Stent Technique: Results From the COBIS II Registry (Korean Coronary Bifurcation Stenting Registry).

    Science.gov (United States)

    Yu, Cheol Woong; Yang, Jeong Hoon; Song, Young Bin; Hahn, Joo-Yong; Choi, Seung-Hyuk; Choi, Jin-Ho; Lee, Hyun Jong; Oh, Ju Hyeon; Koo, Bon-Kwon; Rha, Seung Woon; Jeong, Jin-Ok; Jeong, Myung-Ho; Yoon, Jung Han; Jang, Yangsoo; Tahk, Seung-Jea; Kim, Hyo-Soo; Gwon, Hyeon-Cheol

    2015-08-24

    This study investigated the impact of final kissing ballooning (FKB) after main vessel (MV) stenting on outcomes in patients with coronary bifurcation lesions after application of the 1-stent technique. Although FKB has been established as the standard method for bifurcation lesions treated with a 2-stent strategy, its efficacy in a 1-stent approach is highly controversial. This study enrolled 1,901 patients with a bifurcation lesion with a side branch diameter ≥2.3 mm, treated solely with the 1-stent technique using a drug-eluting stent from 18 centers in Korea between January 1, 2003 and December 31, 2009. The primary outcome was major adverse cardiac events (MACE)-cardiac death, myocardial infarction, or target lesion revascularization. Propensity score-matching analysis was also performed. FKB was performed in 620 patients and the post minimal lumen diameter of the MV and side branch was larger in the FKB group than in the non-FKB group. During follow-up (median 36 months), the incidence of MACE (adjusted hazard ratio [HR]: 0.68, 95% confidence interval [CI]: 0.46 to 0.99; p = 0.048) was lower in the FKB group than the non-FKB group. After propensity score matching (545 pairs), the FKB group had a lower incidence of MACE (adjusted HR: 0.50, 95% CI: 0.30 to 0.85; p = 0.01), and target lesion revascularization in the MV (adjusted HR: 0.51, 95% CI: 0.28 to 0.93; p = 0.03) and both vessels (adjusted HR: 0.47, 95% CI: 0.25 to 0.90; p = 0.02) than in the non-FKB group. In coronary bifurcation lesions, we demonstrated that the 1-stent technique with FKB was associated with a favorable long-term clinical outcome, mainly driven by the reduction of target lesion revascularization in the MV or both vessels as a result of an increase in minimal lumen diameter. (Korean Coronary Bifurcation Stenting Registry II [COBIS II]: NCT01642992). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Arthroscopic Bankart repair combined with remplissage technique for the treatment of anterior shoulder instability with engaging Hill-Sachs lesion: a report of 49 cases with a minimum 2-year follow-up.

    Science.gov (United States)

    Zhu, Yi-Ming; Lu, Yi; Zhang, Jin; Shen, Jie-Wei; Jiang, Chun-Yan

    2011-08-01

    Engaging Hill-Sachs lesions are known to be a risk factor for recurrence dislocation after arthroscopic repair in patients with anterior shoulder instability. For a large engaging Hill-Sachs lesion, arthroscopic remplissage is a solution. Arthroscopic Bankart repair combined with the Hill-Sachs remplissage technique can achieve good results without significant impairment of shoulder function. Case Series; Level of evidence, 4. Forty-nine consecutive patients who underwent arthroscopic Bankart repair and Hill-Sachs remplissage for anterior shoulder instability were followed up for a mean duration of 29.0 months (range, 24-35 months). There were 42 males and 7 females with a mean age of 28.4 years (range, 16.7-54.7 years). All patients had diagnosed traumatic unidirectional anterior shoulder instability with a bony lesion of glenoid and an engaging Hill-Sachs lesion. Physical examination, radiographs, and magnetic resonance imaging were performed during postoperative follow-up. The American Shoulder and Elbow Surgeons (ASES) score, Constant score, and Rowe score were used to evaluate shoulder function. The active forward elevation increased a mean of 8.0° (range, -10° to 80°) postoperatively. However, the patients lost 1.9° (range, -40° to 30°) of external rotation to the side. Significant improvement was detected with regard to the ASES score (84.7 vs 96.0, P lesion was shown by magnetic resonance imaging. Arthroscopic Bankart repair combined with Hill-Sachs remplissage can restore shoulder stability without significant impairment of shoulder function in patients with engaging Hill-Sachs lesions.

  18. Parasellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruscalleda, J. [Hospital Sant Pau, Radiology Department, Neuroradiology, Barcelona (Spain)

    2005-03-01

    The sellar and parasellar region is an anatomically complex area that represents a crucial crossroad of important adjacent structures, e.g. orbits, cavernous sinus and its content, polygon of Willis, hypothalamus through the pituitary stalk and dural reflections forming the diaphragm sellae and the walls of the cavernous sinuses. Although the cavernous sinus represents the most relevant parasellar structure, from the practical and clinical point of view all the structures that surround the sella turcica can be included in the parasellar region. CT and, mainly, MRI are the imaging modalities to study and characterise the normal anatomy and the majority of processes in this region. We present a practical short review of the most relevant CT and MRI characteristics, such as location, nature of contrast enhancement and presence of cystic components, together with clinical findings, which permit differentiation of the most frequent and less common lesions found in the parasellar region. Learning objectives: A short review of the anatomy and clinical symptoms related to the parasellar region. Radiological characterisation, mainly by MRI, of the many lesions that alter the structure and function of sellar and parasellar anatomy. Description of the MRI features that permit differentiation among less common lesions. (orig.)

  19. HematoPorphyrin Monomethyl Ether polymer contrast agent for ultrasound/photoacoustic dual-modality imaging-guided synergistic high intensity focused ultrasound (HIFU) therapy

    Science.gov (United States)

    Yan, Sijing; LU, Min; Ding, Xiaoya; Chen, Fei; He, Xuemei; Xu, Chunyan; Zhou, Hang; Wang, Qi; Hao, Lan; Zou, Jianzhong

    2016-01-01

    This study is to prepare a hematoporphyrin monomethyl ether (HMME)-loaded poly(lactic-co-glycolic acid) (PLGA) microcapsules (HMME/PLGA), which could not only function as efficient contrast agent for ultrasound (US)/photoacoustic (PA) imaging, but also as a synergistic agent for high intensity focused ultrasound (HIFU) ablation. Sonosensitizer HMME nanoparticles were integrated into PLGA microcapsules with the double emulsion evaporation method. After characterization, the cell-killing and cell proliferation-inhibiting effects of HMME/PLGA microcapsules on ovarian cancer SKOV3 cells were assessed. The US/PA imaging-enhancing effects and synergistic effects on HIFU were evaluated both in vitro and in vivo. HMME/PLGA microcapsules were highly dispersed with well-defined spherical morphology (357 ± 0.72 nm in diameter, PDI = 0.932). Encapsulation efficiency and drug-loading efficiency were 58.33 ± 0.95% and 4.73 ± 0.15%, respectively. The HMME/PLGA microcapsules remarkably killed the SKOV3 cells and inhibited the cell proliferation, significantly enhanced the US/PA imaging results and greatly enhanced the HIFU ablation effects on ovarian cancer in nude mice by the HMME-mediated sono-dynamic chemistry therapy (SDT). HMME/PLGA microcapsules represent a potential multifunctional contrast agent for HIFU diagnosis and treatment, which might provide a novel strategy for the highly efficient imaging-guided non-invasive HIFU synergistic therapy for cancers by SDT in clinic. PMID:27535093

  20. Experimental Study on the Effect of High-intensity Focused Ultrasound (HIFU) Using Sonablate-500 in the Ablation of Canine Prostate

    Institute of Scientific and Technical Information of China (English)

    LU Jun; YE Zhangqun; WANG Wei; CHEN Zhaoyang; ZHANG Yuanfeng; HU Weilie

    2007-01-01

    To investigate the safety, feasibility and effectiveness of transrectal high-intensity focused ultrasound (HIFU) in the ablation of canine prostate, 20 dogs were divided randomly into 5 groups.Sixteen canine prostates were treated with the third-generation transrectal HIFU device (Sonablate-500 TM). Transrectal ultrasound images of the prostate and prostatic urethra were observed preoperatively and postoperatively. Serial study was performed 30 min, 30 days, 60 days and 180 days after the therapy. The rectum, periprostatic tissues, and prostate were excised en bloc and the tissues were fixed for gross and histological analysis. Our results showed that the average maximal diameter of prostatic urethra was 0.59±0.11 cm before the operation and 2.57±0.98 cm 60 days after the operation. The volume of prostate was 6.5±3.12 cm3 before the treatment while the volume was 4.13±0.23 cm3 60 days after the treatment and the differences were statistically significant (P<0.05).Histologically, there was a clear demarcation between the necrotic area of the treated tissues and the unaffected surrounding tissues. All the necrotic tissues in the targeted zone broke off and the prostatic urethra became cavitary 60 days later. The more frequent complications were urinary retention and frequency and hematuria. No rectal injury occurred during the treatment. It is concluded that the third-generation transrectal HIFU is capable of destroying prostatic tissue, substantially increasing the width of the prostatic urethra without causing injury to the adjacent tissues. The risk of postoperative complications associated with HIFU was low. HIFU may become a safe, effective and minimally invasive alternative for the treatment of prostatic diseases..

  1. HematoPorphyrin Monomethyl Ether polymer contrast agent for ultrasound/photoacoustic dual-modality imaging-guided synergistic high intensity focused ultrasound (HIFU) therapy

    Science.gov (United States)

    Yan, Sijing; Lu, Min; Ding, Xiaoya; Chen, Fei; He, Xuemei; Xu, Chunyan; Zhou, Hang; Wang, Qi; Hao, Lan; Zou, Jianzhong

    2016-08-01

    This study is to prepare a hematoporphyrin monomethyl ether (HMME)-loaded poly(lactic-co-glycolic acid) (PLGA) microcapsules (HMME/PLGA), which could not only function as efficient contrast agent for ultrasound (US)/photoacoustic (PA) imaging, but also as a synergistic agent for high intensity focused ultrasound (HIFU) ablation. Sonosensitizer HMME nanoparticles were integrated into PLGA microcapsules with the double emulsion evaporation method. After characterization, the cell-killing and cell proliferation-inhibiting effects of HMME/PLGA microcapsules on ovarian cancer SKOV3 cells were assessed. The US/PA imaging-enhancing effects and synergistic effects on HIFU were evaluated both in vitro and in vivo. HMME/PLGA microcapsules were highly dispersed with well-defined spherical morphology (357 ± 0.72 nm in diameter, PDI = 0.932). Encapsulation efficiency and drug-loading efficiency were 58.33 ± 0.95% and 4.73 ± 0.15%, respectively. The HMME/PLGA microcapsules remarkably killed the SKOV3 cells and inhibited the cell proliferation, significantly enhanced the US/PA imaging results and greatly enhanced the HIFU ablation effects on ovarian cancer in nude mice by the HMME-mediated sono-dynamic chemistry therapy (SDT). HMME/PLGA microcapsules represent a potential multifunctional contrast agent for HIFU diagnosis and treatment, which might provide a novel strategy for the highly efficient imaging-guided non-invasive HIFU synergistic therapy for cancers by SDT in clinic.

  2. HISTOMORPHOLOGICAL SPECTRUM OF BREAST LESIONS

    Directory of Open Access Journals (Sweden)

    Kiran H. S

    2016-07-01

    Full Text Available BACKGROUND Cancer of the breast is the second most common cause of cancer in women. Benign or malignant lesions presenting as mass in the breast causes anxiety to the patients and the family members. AIMS AND OBJECTIVES OF THE STUDY 1. To classify different types of lesions of breast, both benign and malignant. 2. Histomorphological study of various types of benign and malignant breast lesions. 3. To study spectrum of lesions associated with benign and malignant breast diseases. SETTING AND DESIGN All the breast biopsies, lumpectomies, and mastectomy specimens presenting to Department of Pathology of our institution between June 2012 to June 2014. MATERIALS AND METHODS A sample size of 100 cases are included in this study. Clinical details are taken from records. The specimens of breast sent to the Department of Pathology are processed by routine histopathological techniques. Histopathological features are studied on haematoxylin and eosin-stained sections. STATISTICAL ANALYSIS Statistically, the test of proportion is used to obtain the frequency of all lesions. Chi-square test, which is used to find the association between the spectrum of lesions showed a p value of 0.0438 and hence the study was considered significant. RESULTS In our study, out of 100 cases, malignant breast lesions constituted the majority of the lesions comprising of 49 cases (49%, followed by benign lesions comprising 46 cases (46% and the inflammatory lesions comprising 5 cases (5%. Among benign lesions, fibrocystic disease was the predominant lesion comprising of 39 cases (41%, followed by fibroadenoma comprising 26 cases (28%, which is followed by 13 cases (14% of fibrocystic disease with columnar cell change and 8 cases (9% of sclerosing adenosis. Among malignant lesions, invasive ductal carcinoma (NST type was the most common lesion comprising 31 cases (61% followed by 11 cases (21% of invasive lobular carcinoma. Invasive papillary carcinoma and medullary carcinoma

  3. Imaging inflammatory acne: lesion detection and tracking

    Science.gov (United States)

    Cula, Gabriela O.; Bargo, Paulo R.; Kollias, Nikiforos

    2010-02-01

    It is known that effectiveness of acne treatment increases when the lesions are detected earlier, before they could progress into mature wound-like lesions, which lead to scarring and discoloration. However, little is known about the evolution of acne from early signs until after the lesion heals. In this work we computationally characterize the evolution of inflammatory acne lesions, based on analyzing cross-polarized images that document acne-prone facial skin over time. Taking skin images over time, and being able to follow skin features in these images present serious challenges, due to change in the appearance of skin, difficulty in repositioning the subject, involuntary movement such as breathing. A computational technique for automatic detection of lesions by separating the background normal skin from the acne lesions, based on fitting Gaussian distributions to the intensity histograms, is presented. In order to track and quantify the evolution of lesions, in terms of the degree of progress or regress, we designed a study to capture facial skin images from an acne-prone young individual, followed over the course of 3 different time points. Based on the behavior of the lesions between two consecutive time points, the automatically detected lesions are classified in four categories: new lesions, resolved lesions (i.e. lesions that disappear completely), lesions that are progressing, and lesions that are regressing (i.e. lesions in the process of healing). The classification our methods achieve correlates well with visual inspection of a trained human grader.

  4. Mechanisms and clinical significance of quality of final kissing balloon inflation in patients with true bifurcation lesions treated by crush stenting technique

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jun-jie; CHEN Shao-liang; YE Fei; YANG Song; KAN Jing; LIU Yue-qiang; ZHOU Yong; SUN Xue-wen; ZHANG Ai-ping; WANG Xin; CHEN Jack

    2009-01-01

    Background The mechanisms responsible for the occurrence of a kissing unsatisfied (KUS) result after classical crush stenting remain unclear. The present study aimed at analyzing the mechanisms and clinical significance of KUS. Methods Two hundred and thirteen patients with true bifurcation lesions treated with classical crush stenting and final kissing balloon inflation (FKBI) were assigned to upper, middle, and lower groups according to the position of the side branch re-wiring assessed by visual estimation, quantitative coronary analysis (QCA) and intravascular ultrasound (IVUS). Angiographic follow-up was indexed at 12 months.Results The upper group was characterized by a larger bifurcation angle of 55.53°±95.25° (P=0.030) and a longer procedural time (42.43±93.92) minutes (P=0.015). The overall rate of KUS by visual estimation was 10.48%, with 5.4% in the upper group, 3.9% in middle group, and 36.1% in lower group (P <0.001). For the diagnosis of KUS, visual inspection demonstrated a good correlation with both QCA and IVUS. Smaller stent diameter was the main reason for KUS in the upper group, while extra-stent side wire location, or re-wire in a low position was the main mechanism attributed to KUS in the lower group. The Lower group had more restenosis, with most restenotic lesions at a lower position of the side branch ostium. KUS (HR 1.652, 95% Cl 1.332-2.088, P <0.001) and re-wiring position (HR 2.341, 95% Cl 1.780-4.329, P <0.001) were two independent predictors of side branch restenosis. Re-wiring position (OR 0.458, 95%Cl 0.336-0.874, P=0.001) and side stent expansion (OR 3.122, 95%Cl 2.883-5.061, P=0.014) were factors predicting the findings of KUS.Conclusions Side wire outside side stents resulted in more KUS and restenosis. Different restenotic lesion types reflected individual mechanisms contributing to the development of plaque proliferation.

  5. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dumont, Clemens [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Georg-August-Universitaet, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Lerzer, Sebastian; Tezval, Mohammad; Stuermer, Klaus Michael [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Vafa, Morad Ali; Lotz, Joachim [University Medical Center Goettingen, Department of Diagnostic Radiology and Interventional Radiology, Goettingen (Germany); Dechent, Peter [University Medical Center Goettingen, MR-Research in Neurology and Psychiatry, Department of Cognitive Neurology, Goettingen (Germany)

    2014-10-15

    To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). A total of 20 CMC I joints of 14 asymptomatic volunteers (6 x both sides) and 28 CMC I joints of 22 patients (6 x both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb - extension and abduction - to evaluate the ligaments and dorsal subluxation of MC I. (orig.)

  6. Improved intercostal HIFU ablation using a phased array transducer based on Fermat's spiral and Voronoi tessellation: A numerical evaluation.

    Science.gov (United States)

    Ramaekers, Pascal; Ries, Mario; Moonen, Chrit T W; de Greef, Martijn

    2017-03-01

    A major complication for abdominal High Intensity Focused Ultrasound (HIFU) applications is the obstruction of the acoustic beam path by the thoracic cage, which absorbs and reflects the ultrasonic energy leading to undesired overheating of healthy tissues in the pre-focal area. Prior work has investigated the determination of optimized transducer apodization laws, which allow for a reduced rib exposure whilst (partially) restoring focal point intensity through power compensation. Although such methods provide an excellent means of reducing rib exposure, they generally increase the local energy density in the pre-focal area, which similarly can lead to undesired overheating. Therefore, this numerical study aimed at evaluating whether a novel transducer design could provide improvement for intercostal HIFU applications, in particular with respect to the pre-focal area. A combination of acoustic and thermal simulations was used to evaluate 2 mono-element transducers, 2 clinical phased array transducers, and 4 novel transducers based on Fermat's Spiral (FS), two of which were Voronoi-tessellated (VTFS). Binary apodizations were determined for the phased array transducers using a collision detection algorithm. A tissue geometry was modeled to represent an intercostal HIFU sonication in the liver at 30 and 50 mm behind the ribs, including subsequent layers of gel pad, skin, subcutaneous fat, muscle, and liver tissue. Acoustic simulations were then conducted using propagation of the angular spectrum of plane waves (ASPW). The results of these simulations were used to evaluate pre-focal intensity levels. Subsequently, a finite difference scheme based on the Pennes bioheat equation was used for thermal simulations. The results of these simulations were used to calculate both the energy density in the pre-focal skin, fat, and muscle layers, as well as the energy exposure of the ribs. The acoustic simulations showed that for a sonication in a single point without

  7. 11C choline PET guided salvage radiotherapy with volumetric modulation arc therapy and hypofractionation for recurrent prostate cancer after HIFU failure: preliminary results of tolerability and acute toxicity.

    Science.gov (United States)

    Alongi, Filippo; Liardo, Rocco L E; Iftode, Cristina; Lopci, Egesta; Villa, Elisa; Comito, Tiziana; Tozzi, Angelo; Navarria, Pierina; Ascolese, Anna M; Mancosu, Pietro; Tomatis, Stefano; Bellorofonte, Carlo; Arturo, Chiti; Scorsetti, Marta

    2014-10-01

    The purpose of this work was to evaluate tolerance, feasibility and acute toxicity in patients undergoing salvage radiotherapy after high-intensity focused ultrasound (HIFU) failure. From 2005 to 2011 a total of 15 patients were treated with HIFU as primary radical treatment. Between July 2011 and February 2013, all 15 patients presented biochemical relapse after HIFU and 11C choline PET documenting intrapostatic-only failure. Salvage EBRT was performed with moderate hypofractionation schedule in 28 fractions with volumetric modulation arc therapy (VMAT). Genito-urinary (GU) and rectal and bowel toxicity were scored by common terminology criteria for adverse events version 4 (CTCAE V.4) scale. Biochemical response was assessed by ASTRO Phoenix criteria. Median age of patients was 67 years (range: 53-85). The median Gleason score was 7 (range: 6-9). The median prostate specific antigen (PSA) at the time of biochemical relapse after HIFU was 5.2 ng/mL (range: 2-64.2). Seven of the 15 patients received androgen deprivation therapy (ADT) started after HIFU failure, interrupted before 11C choline PET and radiotherapy. Median prescribed dose was 71.4 Gy (range: 71.4-74.2 Gy) in 28 fractions. No radiation related major upper gastrointestinal (GI), rectal and GU toxicity were experienced. GU, acute grade 1 and grade 2 toxicities were recorded in 7/15 and 4/15 respectively; bowel acute grade 1 and grade 2 toxicities in 4/15 and 1/15; rectal acute grade 1 and grade 2 toxicities in 3/15 and 2/15 respectively. No grade 3 or greater acute or late toxicities occurred. Biochemical control was assessed in 12/15 (80%) patients. With a median follow up of 12 months, three out of 15 patients, with biochemical relapse, showed lymph-nodal recurrence. Our early clinical results and biochemical data confirm the feasibility and show a good tolerance of the 11C choline PET guided salvage radiation therapy after HIFU failure. The findings of low acute toxicity is encouraging, but longer

  8. PET/CT-guided percutaneous biopsy of FDG-avid metastatic bone lesions in patients with advanced lung cancer: a safe and effective technique

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Wei; Hao, Bing; Chen, Hao-jun; Zhao, Long; Luo, Zuo-ming; Wu, Hua; Sun, Long [The First Affiliated Hospital of Xiamen University, Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, Xiamen (China)

    2017-01-15

    {sup 18}F-FDG PET/CT should be performed before a diagnostic biopsy site is chosen in patients with a high clinical suspicion of aggressive, advanced tumour. The aim of this study was to evaluate the safety and efficacy of {sup 18}F-FDG PET/CT in guiding biopsy of bone metastases in patients with advanced lung cancer. PET/CT-guided percutaneous core biopsies were performed in 51 consecutive patients with suspected lung cancer and {sup 18}F-FDG-avid bone lesions after whole-body {sup 18}F-FDG PET/CT scans. Generally, one tissue sample was obtained from each patient. The final diagnoses were established on the basis of the histology results. The histopathological and molecular testing results were systematically evaluated. A total of 53 samples were obtained for histological examination or molecular testing as a second biopsy was required in two patients in whom the pathological diagnosis was unclear following the first biopsy. The pathological diagnosis and lung cancer classification were confirmed in 48 patients. The epidermal growth factor receptor mutation status was determined in 23 biopsies, and the mutation rate was 30.4 % (7/23). The anaplastic lymphoma kinase mutation status was determined in 19 biopsies, and the mutation rate was 31.6 % (6/19). Two of the 51 biopsies were positive for non-Hodgkin's lymphoma and one was positive for metastatic renal cell carcinoma. The first-time diagnostic success rate of biopsy was 96.1 % (49/51) and the overall diagnostic success rate and sensitivity were 100 %. All 51 patients were eventually confirmed as having stage IV disease. No serious complications were encountered and the average biopsy time was 30 min. PET/CT-guided percutaneous biopsy of {sup 18}F-FDG-avid bone metastases is an effective and safe method that yields a high diagnostic success rate in the evaluation of hypermetabolic bone lesions in patients with suspected advanced lung cancer. (orig.)

  9. Real-time monitoring of high-intensity focused ultrasound thermal therapy using the manifold learning method.

    Science.gov (United States)

    Rangraz, Parisa; Behnam, Hamid; Sobhebidari, Pooya; Tavakkoli, Jahan

    2014-12-01

    High-intensity focused ultrasound (HIFU) induces thermal lesions by increasing the tissue temperature in a tight focal region. The main ultrasound imaging techniques currently used to monitor HIFU treatment are standard pulse-echo B-mode ultrasound imaging, ultrasound temperature estimation and elastography-based methods. The present study was carried out on ex vivo animal tissue samples, in which backscattered radiofrequency (RF) signals were acquired in real time at time instances before, during and after HIFU treatment. The manifold learning algorithm, a non-linear dimensionality reduction method, was applied to RF signals whichconstruct B-mode images to detect the HIFU-induced changes among the image frames obtained during HIFU treatment. In this approach, the embedded non-linear information in the region of interest of sequential images is represented in a 2-D manifold with the Isomap algorithm, and each image is depicted as a point on the reconstructed manifold. Four distinct regions are chosen in the manifold corresponding to the four phases of HIFU treatment (before HIFU treatment, during HIFU treatment, immediately after HIFU treatment and 10-min after HIFU treatment). It was found that disorganization of the points is achieved by increasing the acoustic power, and if the thermal lesion has been formed, the regions of points related to pre- and post-HIFU significantly differ. Moreover, the manifold embedding was repeated on 2-D moving windows in RF data envelopes related to pre- and post-HIFU exposure data frames. It was concluded that if mean values of the points related to pre- and post-exposure frames in the reconstructed manifold are estimated, and if the Euclidean distance between these two mean values is calculated and the sliding window is moved and this procedure is repeated for the whole image, a new image based on the Euclidean distance can be formed in which the HIFU thermal lesion is detectable.

  10. Revisión clínica de diez técnicas tradicionales para cobertura de lesiones en punta de dedo Clinical review of ten traditional techniques for finger tip injuries coverage

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2007-09-01

    Full Text Available Las amputaciones de punta de dedo son lesiones muy comunes para las que se han descrito numerosas técnicas reconstructivas. El manejo de estas heridas supone, con frecuencia, un problema difícil para el cirujano que no dispone de medios para la realización de intervenciones microquirúrgicas. En estos casos, las técnicas convencionales de cobertura, que han probado su eficacia y sencillez, pueden aportar soluciones adecuadas a cada paciente si son correctamente empleadas. Los injertos de piel, colgajos de avance V-Y, las diferentes modalidades de colgajos de dedos cruzados, los colgajos inguinales, colgajos homodigitales de pedículo retrógrado y anterógrado, son algunas de las técnicas desarrolladas en este estudio. El correcto manejo de las técnicas tradicionales, cuyo empleo sigue hoy vigente en muchos Servicios de Urgencias del mundo, se presenta como un recurso eficaz para resolver las más diversas lesiones de punta de dedo.Fingertip amputations are very common injuries and a lot of reconstructive methods have been described to treat them. The management of these wounds frequently supposes a complex problem for surgeons without resources for microsurgical applications. In these cases, conventional coverage techniques, that have proven their effectiveness and simplicity, can be appropriate solutions to each patient if they are correctly employed. Skin grafts, advancement V-Y flaps, different modalities of cross-finger flaps, groin flaps, homodigital direct and reverse pedicle flaps, are some of the techniques developed in this study. Correct management of these traditional techniques, are today effective in many Emergency Services all over the world, and represent an effective resource to solve most of finger tip injuries.

  11. Cavitation and the relationship between cavitation, echo and the thermal effects of HIFU treatment%高强度聚焦超声治疗中的空化及其与回声、热效应之间的关系

    Institute of Scientific and Technical Information of China (English)

    陈杰; 易华容; 王彬; 李发琪

    2009-01-01

    High intensity focused ultrasound (HIFU) is a new and exciting medical treatment. Cavitation is the focus in the field of HIFU research. Cavitation and the relationship between cavitation, echo and the thermal effects of HIFU treatment were reviewed in this article.%高强度聚焦超声(HIFU)正在成为医学上一种新兴的治疗技术.HIFU治疗中的空化一直是HIFU研究中的热点问题.本文介绍HIFU治疗中的空化及其与回声、热效应之间的关系.

  12. Experimental investigation of thermal effects in HIFU-based external valvuloplasty with a non-spherical transducer, using high-resolution MR thermometry

    Science.gov (United States)

    Petrusca, Lorena; Salomir, Rares; Milleret, Réné; Pichot, Olivier; Rata, Mihaela; Cotton, François; Chapelon, Jean-Yves

    2009-09-01

    Real-time image-guided extracorporeal high intensity focused ultrasound (HIFU) has been suggested for minimally invasive treatment of valvular dysfunction in the saphenous vein. Local application of heat on the perimeter of the valve zone was previously reported to induce a partial shrinkage of the collagen, which may correct valvular function. In our study, a novel MR compatible HIFU device has been investigated. This device is based on a non-spherical geometry, with two active elements that create a focusing line which is orthogonal to the beam main axis, aiming to cover the valve longitudinally. The prototype performance was characterized by electro-acoustical measurements of the pressure field and by high-resolution MR thermometry. Pressure and thermal fields were found in good agreement with the theoretical predictions. To investigate the therapeutic potential, fresh samples of excised human veins were filled with an agarose gel, embedded in porcine muscle and exposed to HIFU. The power level applied during a fixed duration of 30 s was varied such that the absolute temperature at focus ranged between 52 °C and 83 °C. Targeting was achieved under MR guidance using a MR compatible XZ positioning system. A dedicated waterproof miniature loop coil was specifically built to achieve high-resolution MRI image-based targeting (0.25 mm × 0.25 mm × 3 mm voxel) and thermometry (0.4 mm × 0.4 mm × 4 mm voxel). The vein wall was clearly identified on MR images before and after HIFU treatment. The thermal buildup created by the non-spherical transducer could be characterized from MR thermometry data. Shrinkage of the vein wall (above 65 °C) was determined by absolute temperature and was not a cumulative thermal dose effect.

  13. Experimental investigation of thermal effects in HIFU-based external valvuloplasty with a non-spherical transducer, using high-resolution MR thermometry

    Energy Technology Data Exchange (ETDEWEB)

    Petrusca, Lorena; Salomir, Rares; Milleret, Rene; Pichot, Olivier; Rata, Mihaela; Chapelon, Jean-Yves [Inserm, U556, and Universite de Lyon, Lyon, F-69003 (France); Cotton, Francois [Universite Claude Bernard Lyon 1, Lyon, F-69003 (France)], E-mail: lorena.petrusca@inserm.fr

    2009-09-07

    Real-time image-guided extracorporeal high intensity focused ultrasound (HIFU) has been suggested for minimally invasive treatment of valvular dysfunction in the saphenous vein. Local application of heat on the perimeter of the valve zone was previously reported to induce a partial shrinkage of the collagen, which may correct valvular function. In our study, a novel MR compatible HIFU device has been investigated. This device is based on a non-spherical geometry, with two active elements that create a focusing line which is orthogonal to the beam main axis, aiming to cover the valve longitudinally. The prototype performance was characterized by electro-acoustical measurements of the pressure field and by high-resolution MR thermometry. Pressure and thermal fields were found in good agreement with the theoretical predictions. To investigate the therapeutic potential, fresh samples of excised human veins were filled with an agarose gel, embedded in porcine muscle and exposed to HIFU. The power level applied during a fixed duration of 30 s was varied such that the absolute temperature at focus ranged between 52 deg. C and 83 deg. C. Targeting was achieved under MR guidance using a MR compatible XZ positioning system. A dedicated waterproof miniature loop coil was specifically built to achieve high-resolution MRI image-based targeting (0.25 mm x 0.25 mm x 3 mm voxel) and thermometry (0.4 mm x 0.4 mm x 4 mm voxel). The vein wall was clearly identified on MR images before and after HIFU treatment. The thermal buildup created by the non-spherical transducer could be characterized from MR thermometry data. Shrinkage of the vein wall (above 65 deg. C) was determined by absolute temperature and was not a cumulative thermal dose effect.

  14. Non-invasive MR-guided HIFU Therapy of TSC-Associated Renal Angiomyolipomas

    Science.gov (United States)

    2013-07-01

    associated renal angiomyolipomas. TSC is a genetic tumor predisposition syndrome characterized by the growth of lesions in multiple organ systems...shows the experimental system we developed for thermal ablation in phantoms and animals during the first year of this project. This setup allows the...make a reasonable argument that J1(kR) ∼ 1/k for k large (I’m getting abit on a limb with this one . . .) and thus have |A| ∼ vk. From the picture

  15. MR thermometry analysis program for laser- or high-intensity focused ultrasound (HIFU)-induced heating at a clinical MR scanner

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ju; Jeong, Ki Young; Oh, Seung Jae; Park, Eun Hae; Lee, Young Han; Suh, Jin Suck [Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Hong [National Cancer Center, Goyang (Korea, Republic of)

    2014-12-15

    Magnetic resonance (MR) thermometry is a noninvasive method for monitoring local temperature change during thermal therapy. In this study, a MR temperature analysis program was established for a laser with gold nanorods (GNRs) and high-intensity focused ultrasound (HIFU)-induced heating MR thermometry. The MR temperature map was reconstructed using the water proton resonance frequency (PRF) method. The temperature-sensitive phase difference was acquired by using complex number subtraction instead of direct phase subtraction in order to avoid another phase unwrapping process. A temperature map-analyzing program was developed and implemented in IDL (Interactive Data Language) for effective temperature monitoring. This one program was applied to two different heating devices at a clinical MR scanner. All images were acquired with the fast spoiled gradient echo (fSPGR) pulse sequence on a 3.0 T GE Discovery MR750 scanner with an 8-channel knee array coil or with a home-built small surface coil. The analyzed temperature values were confirmed by using values simultaneously measured with an optical temperature probe (R{sup 2} = 0.996). The temperature change in small samples induced by a laser or by HIFU was analyzed by using a raw data, that consisted of complex numbers. This study shows that our MR thermometry analysis program can be used for thermal therapy study with a laser or HIFU at a clinical MR scanner. It can also be applied to temperature monitoring for any other thermal therapy based on the PRF method.

  16. Temperature elevation by HIFU in ex vivo porcine muscle: MRI measurement and simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Solovchuk, Maxim A., E-mail: solovchuk@gmail.com [Center for Advanced Study in Theoretical Sciences (CASTS), National Taiwan University, Taipei 10617, Taiwan (China); Hwang, San Chao; Chang, Hsu [Medical Engineering Research Division, National Health Research Institute, Miaoli 35053, Taiwan (China); Thiriet, Marc [Sorbonne Universités, UPMC Univ Paris 06, UMR 7598, Laboratoire Jacques-Louis Lions, F-75005, Paris (France); Sheu, Tony W. H., E-mail: twhsheu@ntu.edu.tw [Department of Engineering Science and Ocean Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei 10617, Taiwan, Republic of China and Center for Advanced Study in Theoretical Sciences (CASTS), National Taiwan University, Taipei 10617, Taiwan (China)

    2014-05-15

    Purpose: High-intensity focused ultrasound is a rapidly developing medical technology with a large number of potential clinical applications. Computational model can play a pivotal role in the planning and optimization of the treatment based on the patient's image. Nonlinear propagation effects can significantly affect the temperature elevation and should be taken into account. In order to investigate the importance of nonlinear propagation effects, nonlinear Westervelt equation was solved. Weak nonlinear propagation effects were studied. The purpose of this study was to investigate the correlation between the predicted and measured temperature elevations and lesion in a porcine muscle. Methods: The investigated single-element transducer has a focal length of 12 cm, an aperture of 8 cm, and frequency of 1.08 MHz. Porcine muscle was heated for 30 s by focused ultrasound transducer with an acoustic power in the range of 24–56 W. The theoretical model consists of nonlinear Westervelt equation with relaxation effects being taken into account and Pennes bioheat equation. Results: Excellent agreement between the measured and simulated temperature rises was found. For peak temperatures above 85–90 °C “preboiling” or cavitation activity appears and lesion distortion starts, causing small discrepancy between the measured and simulated temperature rises. From the measurements and simulations, it was shown that distortion of the lesion was caused by the “preboiling” activity. Conclusions: The present study demonstrated that for peak temperatures below 85–90 °C numerical simulation results are in excellent agreement with the experimental data in three dimensions. Both temperature rise and lesion size can be well predicted. Due to nonlinear effect the temperature in the focal region can be increased compared with the linear case. The current magnetic resonance imaging (MRI) resolution is not sufficient. Due to the inevitable averaging the measured

  17. Simulation of high-intensity focused ultrasound lesions in presence of boiling.

    Science.gov (United States)

    Grisey, Anthony; Yon, Sylvain; Letort, Véronique; Lafitte, Pauline

    2016-01-01

    The lesions induced by high-intensity focused ultrasound (HIFU) thermal ablations are particularly difficult to simulate due to the complexity of the involved phenomena. In particular, boiling has a strong influence on the lesion shape. Thus, it must be accounted for if it happens during the pulses to be modeled. However, no acoustic model enables the simulation of the resulting wave scattering. Therefore, we propose an equivalent model for the heat deposition pattern in the presence of boiling. Firstly, the acoustic field is simulated with k-Wave and the heat source term is calculated. Then, a thermal model is designed, including the equivalent model for boiling. It is rigorously calibrated and validated through the use of diversified ex vivo and in vivo data, including usually unexploited data types related to the bubble clouds. The proposed model enabled to efficiently simulate unitary pulses properties, including the sizes of the lesions, their morphology, the boiling onset time, and the influence of the boiling onset time on the lesions sizes. In this article, the whole procedure of model design, calibration, and validation is discussed. In addition to depicting the creative use of data, our modeling approach focuses on the understanding of the mechanisms influencing the shape of the lesion. Further work is required to study the influence of the remaining bubble clouds in the context of pulse groups.

  18. Progress in prevention and treatment of skin lesions caused by the treatment of liver cancer by high intensity focused ultrasound%高强度聚焦超声治疗肝癌中皮肤损伤防治进展

    Institute of Scientific and Technical Information of China (English)

    白愿; 陈锦云

    2016-01-01

    Liver cancer is one of the most common malignant tumour,High intensity focused ultrasound (HIFU) as a new type of treatment,is capable of ablating the tumor tissue safely,precisely,and efficiently without damaging the peripheral normal tissue,thus it’s more and more widely used in the treatment of malignant tumor.However, in clinical practice, medical workers found that there are some complications and adverse reactions in the treatment of liver cancer with HIFU, among which the skin lesions are more common.This paper reviews the progress in prevention and treatment of skin lesions caused by the treatment of liver cancer by HIFU.%肝癌是常见的恶性肿瘤,高强度聚焦超声(HIFU)作为一种新型治疗手段。因其具有无创性、安全性、有效性、无放射性等优点,使其在恶性肿瘤的临床治疗中日趋常见。然而在临床实践中,HIFU治疗肝癌也出现一些并发症及不良反应,其中以皮肤损伤较为多见,本文就HIFU治疗肝癌皮肤损伤的发生机理、临床表现及预防治疗做一综述。

  19. Pediatric Knee Osteochondritis Dissecans Lesions.

    Science.gov (United States)

    Cruz, Aristides I; Shea, Kevin G; Ganley, Theodore J

    2016-10-01

    Osteochondritis dissecans (OCD) can cause knee pain and dysfunction in children. The etiology of OCD remains unclear; theories on causes include inflammation, ischemia, ossification abnormalities, genetic factors, and repetitive microtrauma. Most OCD lesions in skeletally immature patients will heal with nonoperative treatment. The success of nonoperative treatment decreases once patients reach skeletal maturity. The goals of surgical treatment include maintenance of articular cartilage congruity, rigid fixation of unstable fragments, and repair of osteochondral defects with cells or tissues that can adequately replace lost or deficient cartilage. Unsalvageable OCD lesions can be treated with various surgical techniques.

  20. Bone marrow lesions: A systematic diagnostic approach

    Directory of Open Access Journals (Sweden)

    Filippo Del Grande

    2014-01-01

    Full Text Available Bone marrow lesions on magnetic resonance (MR imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI, to achieve accurate final diagnosis has been highlighted.

  1. Cardiac shear-wave elastography using a transesophageal transducer: application to the mapping of thermal lesions in ultrasound transesophageal cardiac ablation.

    Science.gov (United States)

    Kwiecinski, Wojciech; Bessière, Francis; Colas, Elodie Constanciel; N'Djin, W Apoutou; Tanter, Mickaël; Lafon, Cyril; Pernot, Mathieu

    2015-10-21

    Heart rhythm disorders, such as atrial fibrillation or ventricular tachycardia can be treated by catheter-based thermal ablation. However, clinically available systems based on radio-frequency or cryothermal ablation suffer from limited energy penetration and the lack of lesion's extent monitoring. An ultrasound-guided transesophageal device has recently successfully been used to perform High-Intensity Focused Ultrasound (HIFU) ablation in targeted regions of the heart in vivo. In this study we investigate the feasibility of a dual therapy and imaging approach on the same transesophageal device. We demonstrate in vivo that quantitative cardiac shear-wave elastography (SWE) can be performed with the device and we show on ex vivo samples that transesophageal SWE can map the extent of the HIFU lesions. First, SWE was validated with the transesophageal endoscope in one sheep in vivo. The stiffness of normal atrial and ventricular tissues has been assessed during the cardiac cycle (n = 11) and mapped (n = 7). Second, HIFU ablation has been performed with the therapy-imaging transesophageal device in ex vivo chicken breast samples (n  =  3), then atrial (left, n = 2) and ventricular (left n = 1, right n = 1) porcine heart tissues. SWE provided stiffness maps of the tissues before and after ablation. Areas of the lesions were obtained by tissue color change with gross pathology and compared to SWE. During the cardiac cycle stiffness varied from 0.5   ±   0.1 kPa to 6.0   ±   0.3 kPa in the atrium and from 1.3   ±   0.3 kPa to 13.5   ±   9.1 kPa in the ventricles. The thermal lesions were visible on all SWE maps performed after ablation. Shear modulus of the ablated zones increased to 16.3   ±   5.5 kPa (versus 4.4   ±   1.6 kPa before ablation) in the chicken breast, to 30.3   ±   10.3 kPa (versus 12.2   ±   4.3 kPa) in the atria and to 73.8

  2. Unique psoriatic lesion versus multiple lesions

    Directory of Open Access Journals (Sweden)

    Anca Chiriac

    2014-10-01

    Full Text Available Aim: To evaluate the number of lesions of psoriasis and to find risk factors for multiple lesions. Material and Methods: 1,236 patients (male 54.13%, female 45.87% with psoriasis were seen over a period of 8 years in an Outpatient Clinic. Patients filled out questionnaires containing age at onset, number of lesions and location at the beginning of the disease, gender, type and localization of psoriasis at the time of clinical examination, psoriasis family history, previous treatment, comorbidities, and social status. Results: The number of psoriasis lesions correlates with: onset age of psoriasis (F=8.902, p=0.0029; age at the moment of clinical examination (F=8.902, p=0.0029; residence in rural area (χ2=8.589, p=0.00338, 95%CI; alcohol intake (χ2=16.47, p=0.00005, 95%CI; smoking (χ2=8.408, p=0.00373, 95%CI; occupation: workers/pupils/students (χ2=14.11, p=0.0069, 95%CI. Conclusions: There is a correlation between number of psoriatic lesions and some factors. Multiple lesions were observed in older patients, smokers and drinkers, coming from rural area and social active (workers and pupils/students. No correlation was statistically proved between number of lesions and gender, comorbidities and family history of psoriasis.

  3. Report on research of calculus fragmentation by HIFU-induced cavitation in Tsinghua University: 1. Effects of tissue-mimicking phantom

    Science.gov (United States)

    Zuo, Z. G.; Liu, S. H.

    2012-11-01

    Study of the acoustic attenuation through human tissues was carried out, in order to accurately evaluate the damaging power of the generated cavitation cloud. Tissue phantom was made, with acoustic properties (acoustic speed and acoustic attenuation factor) similar to human tissues. Preliminary results show that, with the increase of intensity and acting time of the HIFU acoustic waves, the depths of the craters increase rapidly, while the radii of the craters increase mildly. Mass loss of the artificial stones in phantom is less than in water (about 50%), indicating considerable energy dissipation in tissues.

  4. [Galeazzi lesion in children and adults: the undiagnosed lesion].

    Science.gov (United States)

    Maman, Eran; Dekel, Shmuel; Steinberg, Ely

    2002-07-01

    Unrecognized Galeazzi fracture dislocation of the wrist (distal radius fracture with radioulnar joint disruption) may lead to a high incidence of permanent functional disability and chronic pain. A high index of suspicion, early recognition, and acute treatment of distal radioulnar joint (DRUJ) instability will avoid chronic problems. This review examines the clinical presentation, diagnostic techniques, management and prognosis in children and in adults for this type of lesion.

  5. Study on Clinical Application of of the Dual Energy Technique of Dual Source CT in Kidney Lesions%肾脏占位性病变中双源CT双能量技术的应用研究

    Institute of Scientific and Technical Information of China (English)

    马海鸿; 赵波; 周应恩

    2016-01-01

    目的:探究双源CT双能量技术在肾脏占位性病变的临床应用价值。方法选择2012年1月至2014年8月在新疆喀什地区第二人民医院接受治疗的肾脏占位性病变患者78例。分别采用常规CT扫描和双源CT双能量技术的增强扫描。将双源CT增强扫描结果记为观察组,常规CT扫描记为对照组。对比两组扫描图像及CT值,以及辐射剂量。结果观察组所收集的图像92.31%(72/78)的病患大部分能清晰显示,满足医师的诊断要求。并且观察组在各个部位扫描得到的CT值与对照组无显著差异且SNR显著高于对照组,而辐射剂量中的CTDIvoII、DLY以及ED均显著低于对照组。差异均有统计学意义(均P<0.05)。结论采用双源CT双能量技术对肾脏占位性病变进行诊断的图像质量较好,能满足检查的需要。此外,扫描结果中CT值可观、噪声比较低,而且辐射剂量非常低。在临床上具有较高的应用价值,值得推广应用。%Objective To explore the technique of dual source dual energy CT lesions clinical application value in the kidney. Methods 78 cases of renal occupying lesionsin was in the Second People's Hospital of Xinjiang Kashi Region for treatment From January 2012 to August 2014. Enhanced scan were used routine CT scan and dual energy technique of dual source CT. The dual source CT scan results recorded in the observation group, routine CT scan as control group, compared the two groups of images and the CT value, and the radiation dose. Results In the observation group, 92.31%(72/78) the patients of the collected most of the image display, to meet the requirements of medical diagnosis. And the observation group in each part of scanning CT value had no significant difference with control group and SNR was significantly higher than that of control group, and the radiation dose of CTDIvoII, DLY and ED were significantly lower than those of the control group. The differences

  6. Novel use of noninvasive high-intensity focused ultrasonography for intercostal nerve neurolysis in a swine model.

    Science.gov (United States)

    Gulati, Amitabh; Loh, Jeffrey; Gutta, Narendra B; Ezell, Paula C; Monette, Sébastien; Erinjeri, Joseph P; Maybody, Majid; Solomon, Stephen

    2014-01-01

    High-intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique. High-intensity focused ultrasound has been used in small-animal models to lesion neural tissue selectively. This study aimed to evaluate the efficacy of HIFU in a large-animal model for ablation of nerves similar in size to human nerves. Twelve acute magnetic resonance-guided HIFU ablation lesions were created in intercostal nerves in a swine model. In a second pig, as a control, 4 radiofrequency ablation and 4 alcohol lesions were performed on intercostal nerves under ultrasound guidance. Preprocedural and postprocedural magnetic resonance imaging was then performed to evaluate radiologically the lesion size created by HIFU. Animals were euthanized 1 hour postprocedure, and necropsy was performed to collect tissue samples for histopathologic analysis. On gross and histological examination of the intercostal nerve, acute HIFU nerve lesions showed evidence of well-demarcated, acute, focally extensive thermal necrosis. Four intercostal nerves ablated with HIFU were sent for histopathologic analysis, with 2 of 4 lesions showing pathologic damage to the intercostal nerve. Similar results were shown with radiofrequency ablation technique, whereas the intercostal nerves appeared histologically intact with alcohol ablation. High-intensity focused ultrasound may be used as a noninvasive neurolytic technique in swine. High-intensity focused ultrasound may have potential as a neuroablation technique for patients with chronic and cancer pain.

  7. Arthroscopic Repair of Posterior Bony Bankart Lesion and Subscapularis Remplissage

    OpenAIRE

    Luedke, Colten; Tolan, Stefan J.; Tokish, John M.

    2017-01-01

    Posterior shoulder instability with glenoid bone loss has only a fraction of the prevalence of anterior instability. Unlike the latter, there is a paucity of literature regarding the treatment of posterior bony Bankart lesions and even less with concomitant reverse Hill-Sachs lesions. This combination of pathology leads to a difficult situation regarding treatment options. We present our technique for arthroscopic repair of a posterior bony Bankart lesion and reverse Hill-Sachs lesion. The im...

  8. Research on the lesion segmentation of breast tumor MR images based on FCM-DS theory

    Science.gov (United States)

    Zhang, Liangbin; Ma, Wenjun; Shen, Xing; Li, Yuehua; Zhu, Yuemin; Chen, Li; Zhang, Su

    2017-03-01

    Magnetic resonance imaging (MRI) plays an important role in the treatment of breast tumor by high intensity focused ultrasound (HIFU). The doctors evaluate the scale, distribution and the statement of benign or malignancy of breast tumor by analyzing variety modalities of MRI, such as the T2, DWI and DCE images for making accurate preoperative treatment plan and evaluating the effect of the operation. This paper presents a method of lesion segmentation of breast tumor based on FCM-DS theory. Fuzzy c-means clustering (FCM) algorithm combined with Dempster-Shafer (DS) theory is used to process the uncertainty of information, segmenting the lesion areas on DWI and DCE modalities of MRI and reducing the scale of the uncertain parts. Experiment results show that FCM-DS can fuse the DWI and DCE images to achieve accurate segmentation and display the statement of benign or malignancy of lesion area by Time-Intensity Curve (TIC), which could be beneficial in making preoperative treatment plan and evaluating the effect of the therapy.

  9. Ghost cell lesions

    Directory of Open Access Journals (Sweden)

    E Rajesh

    2015-01-01

    Full Text Available Ghost cells have been a controversy for a long time. Ghost cell is a swollen/enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. This article review about the origin, nature and significance of ghost cells in different neoplasms.

  10. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S

    2009-01-01

    in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee...... the activity of primary coronal and root lesions reliably and accurately at one examination by using the combined information obtained from a range of indicators--such as visual appearance, location of the lesion, tactile sensation during probing and gingival health....

  11. Supraorbital eyebrow approach to skull base lesions

    Directory of Open Access Journals (Sweden)

    Fernandes Yvens Barbosa

    2002-01-01

    Full Text Available We report our experience with a supraorbital eyebrow minicraniotomy. This technique is suitable to lesions situated in the region of the anterior fossa, suprasellar cisterns, parasellar region and Sylvian fissure. A 50 mm incision in the eyebrow and a supraorbital minicraniotomy is performed. Sixteem patients harboring different lesions were operated on with good postoperative and cosmetic results. We conclude that this approach is safe and useful in selected cases.

  12. Cone-beam computed tomography versus digital periapical radiography in the detection of artificially created periapical lesions: A pilot study of the diagnostic accuracy of endodontists using both techniques

    Energy Technology Data Exchange (ETDEWEB)

    Campello, Abdrea Fagundes; Goncalves, Lucio Souza; Marques, Fabio vidal [Faculty of Dentistry, Estacio de Sa University, Rio de Janeiro (Brazil); Guedes, Fabio Ribeiro [Faculty of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro (Brazil)

    2017-03-15

    The aim of this study was to compare the diagnostic accuracy of previously trained endodontists in the detection of artificially created periapical lesions using cone-beam computed tomography (CBCT) and digital periapical radiography (DPR). An ex vivo model using dry skulls was used, in which simulated apical lesions were created and then progressively enlarged using no.1/2, no.2, no.4, and no.6 round burs. A total of 11 teeth were included in the study, and 110 images were obtained with CBCT and with an intraoral digital periapical radiographic sensor (Instrumentarium dental, Tuusula, Finland) initially and after each bur was used. Specificity and sensitivity were calculated. All images were evaluated by 10 previously trained, certified endodontists. Agreement was calculated using the kappa coefficient. The accuracy of each method in detecting apical lesions was calculated using the chi-square test. The kappa coefficient between examiners showed low agreement (range, 0.17-0.64). No statistical difference was found between CBCT and DPR in teeth without apical lesions (P=.15). The accuracy for CBCT was significantly higher than for DPR in all corresponding simulated lesions (P<.001). The correct diagnostic rate for CBCT ranged between 56.9% and 73.6%. The greatest difference between CBCT and DPR was seen in the maxillary teeth (CBCT, 71.4%; DPR, 28.6%; P<.01) and multi-rooted teeth (CBCT, 83.3%; DPR, 33.3%; P<.01). CBCT allowed higher accuracy than DPR in detecting simulated lesions for all simulated lesions tested. Endodontists need to be properly trained in interpreting CBCT scans to achieve higher diagnostic accuracy.

  13. Cone-beam computed tomography versus digital periapical radiography in the detection of artificially created periapical lesions: A pilot study of the diagnostic accuracy of endodontists using both techniques

    Science.gov (United States)

    Campello, Andrea Fagundes; Gonçalves, Lucio Souza; Guedes, Fábio Ribeiro

    2017-01-01

    Purpose The aim of this study was to compare the diagnostic accuracy of previously trained endodontists in the detection of artificially created periapical lesions using cone-beam computed tomography (CBCT) and digital periapical radiography (DPR). Materials and Methods An ex vivo model using dry skulls was used, in which simulated apical lesions were created and then progressively enlarged using #1/2, #2, #4, and #6 round burs. A total of 11 teeth were included in the study, and 110 images were obtained with CBCT and with an intraoral digital periapical radiographic sensor (Instrumentarium dental, Tuusula, Finland) initially and after each bur was used. Specificity and sensitivity were calculated. All images were evaluated by 10 previously trained, certified endodontists. Agreement was calculated using the kappa coefficient. The accuracy of each method in detecting apical lesions was calculated using the chi-square test. Results The kappa coefficient between examiners showed low agreement (range, 0.17-0.64). No statistical difference was found between CBCT and DPR in teeth without apical lesions (P=.15). The accuracy for CBCT was significantly higher than for DPR in all corresponding simulated lesions (P<.001). The correct diagnostic rate for CBCT ranged between 56.9% and 73.6%. The greatest difference between CBCT and DPR was seen in the maxillary teeth (CBCT, 71.4%; DPR, 28.6%; P<.01) and multi-rooted teeth (CBCT, 83.3%; DPR, 33.3%; P<.01). Conclusion CBCT allowed higher accuracy than DPR in detecting simulated lesions for all simulated lesions tested. Endodontists need to be properly trained in interpreting CBCT scans to achieve higher diagnostic accuracy. PMID:28361026

  14. Intraosseous osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Adler, C.P.; Wenz, W.

    1981-10-01

    Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

  15. Pain in osteochondral lesions.

    Science.gov (United States)

    Wiewiorski, Martin; Pagenstert, Geert; Rasch, Helmut; Jacob, Augustinus Ludwig; Valderrabano, Victor

    2011-04-01

    Pain is the key symptom of patients suffering from osteochondral lesions (OCLs) of the ankle joint. Routine radiographic imaging methods for diagnosis and staging of OCL fail to visualize the pain-inducing focus within the joint. SPECT-CT (Single-photon emission computed tomography-computed tomography) is a new hybrid imaging technique allowing exact digital fusion of scintigraphic and computer tomographic images. This allows precise localization and size determination of an OCL within the joint. Using this novel imaging method, we conducted a study to evaluate the correlation between pathological uptake within an OCL and pain experienced by patients suffering from this condition; 15 patients were assessed in the orthopaedic ambulatory clinic for unilateral OCL of the ankle joint. Pain status was measured with the Visual Analogue Scale (VAS). A SPECT-CT was performed. All patients underwent CT-guided ankle injection with a local anesthetic and iodine contrast medium. The VAS score assessed immediately postinfiltration was compared with the preinterventional VAS score obtained in the outpatient clinic. Pain relief was defined as a reduction of the VAS score to ≤50% of the preinterventional score, if expected immediately after infiltration. Pain relief was found in all 15 patients. The results of our study show that there is a highly significant correlation between pain and pathological uptake seen on SPECT-CT, indicating that pathologically remodeled bone tissue is an important contributor to pain in OCL. Adequate addressing of involved bone tissue needs to be taken into consideration when choosing a surgical treatment method.

  16. Common conjunctival lesions

    African Journals Online (AJOL)

    ocular appearance. is discussion does not attempt to classify lesions, but only highlights ... magnifying glass. Examine what you can see and evert the upper ... look at the cornea and feel for pre-auricular and submandibular lymph nodes.

  17. Oropharynx lesion biopsy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003850.htm Oropharynx lesion biopsy To use the sharing features on this ... Department of Otolaryngology - Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. ...

  18. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Schwendicke, F; Frencken, J E; Bjørndal, L

    2016-01-01

    caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal...... or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal...... health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health...

  19. Unusual benign breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Porter, G.J.R. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)]. E-mail: gporter@ncht.trent.nhs.uk; Evans, A.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Lee, A.H.S. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Hamilton, L.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); James, J.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)

    2006-07-15

    The purpose of this article is to show examples of the radiological (mammography and/or ultrasound) and pathological appearances of unusual benign breast lesions. The conditions covered are granular cell tumours, fibromatosis, nodular fasciitis, myofibroblastomas, haemangiomas, neurofibromas, and leiomyomas. The article includes the first published description of the ultrasound appearance of a myofibroblastoma. Knowledge of these appearances may help confirm or refute radiological-pathological concordance of percutaneous biopsy results during multidisciplinary assessment of these lesions and aid patient management.

  20. Magnetic-resonance-guided biopsy of focal liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Ethan A. [University of Michigan Health System, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Grove, Jason J. [University of Michigan Health System, Division of Interventional Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Der Spek, Abraham F.L.V. [University of Michigan Health System, Department of Anesthesiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Jarboe, Marcus D. [University of Michigan Health System, Division of Interventional Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); University of Michigan Health System, Section of Pediatric Surgery, C.S. Mott Children' s Hospital, Department of Surgery, Ann Arbor, MI (United States)

    2017-05-15

    Image-guided biopsy techniques are widely used in clinical practice. Commonly used methods employ either ultrasound (US) or computed tomography (CT) for image guidance. In certain patients, US or CT guidance may be suboptimal, or even impossible, because of artifacts, suboptimal lesion visualization, or both. We recently began performing magnetic resonance (MR)-guided biopsy of focal liver lesions in select pediatric patients with lesions that are not well visualized by US or CT. This report describes our experience performing MR-guided biopsy of focal liver lesions, with case examples to illustrate innovative techniques and novel aspects of these procedures. (orig.)

  1. Andersson Lesion in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

    2004-04-01

    Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

  2. Neurovestibular Compensation following Ototoxic Lesion and Labyrinthectomy

    Directory of Open Access Journals (Sweden)

    Yazdanshenas, Hamed

    2016-03-01

    Full Text Available Introduction Unilateral labyrinthectomy and intra-tympanic gentamycin have been employed in the treatment of Ménière's disease, but the efficacy of these techniques has not been well established. Objective The objective of this study is to measure the time course of recovery from a unilateral labyrinthectomy either after ipsilateral topical treatment with gentamicin to the inner ear or without the previous insult. Methods Twenty-nine adult Mongolian gerbils were randomized into two experimental groups. Group 1 (n = 17 received a right ear gentamicin drug-induced lesion by unilateral labyrinthectomy (UL. Group 2 (n = 12 only received a right unilateral labyrinthectomy lesion. We measured the horizontal vestibulo-ocular responses in gerbils before and after the lesion. The gerbils received an angular acceleration stimulus and their eye movements were recorded. Results The gentamicin lesion resulted in a quicker recovery. Experimental groups underwent a similar time course of recovery. Statistical analysis showed no significant difference between the two groups. Both groups displayed adaptation to the lesion by day 21, but long-term compensation did not completely revert to the original pre-lesion state. Conclusions In a lesion requiring both static and dynamic compensation as in UL, the need for a static compensation may alter pre-existing compensation from a previous dynamic insult and require a new compensation. A previous lesion and adaptation is not preserved for a second lesion and the subject has to re-compensate. Therefore, surgical treatment in Meniere's disease such as UL can be considered without prior gentamicin treatment. Static and dynamic compensations do not appear to be as independent as previous studies have suggested.

  3. Scintigraphic localization of bone lesions during surgery

    Energy Technology Data Exchange (ETDEWEB)

    Harcke, H.T.; MacEwen, G.D.; Conway, J.J.; Tachdjian, M.O.; Dias, L.S.; Noble, H.B.; Weiss, S.

    1985-03-01

    Nuclear medicine provides several methods for increasing the accuracy of surgical removal of bone lesions with focally increased uptake. In this paper, three intraoperative procedures are discussed: remote control by imaging, intraoperative control by imaging, and intraoperative control by scintillation probe. All techniques require preoperative injection of bone imaging tracer. Remote operative control calls for a gamma camera to mark the skin over the lesion prior to surgery, providing optimal preoperative localization and imaging of the excised lesion to ensure complete removal. Intraoperative control procedures require that a portable camera or a scintillation probe be used in the operating room; these permit direct monitoring of localization and resection. Our experience with 18 procedures performed on 15 patients suggests that these techniques are worthy of continued use.

  4. Meniscal Ramp Lesions

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  5. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Innes, N P T; Frencken, J E; Bjørndal, L

    2016-01-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current...... managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical...... manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm...

  6. Efficient Driving of Piezoelectric Transducers Using a Biaxial Driving Technique.

    Directory of Open Access Journals (Sweden)

    Samuel Pichardo

    Full Text Available Efficient driving of piezoelectric materials is desirable when operating transducers for biomedical applications such as high intensity focused ultrasound (HIFU or ultrasound imaging. More efficient operation reduces the electric power required to produce the desired bioeffect or contrast. Our preliminary work [Cole et al. Journal of Physics: Condensed Matter. 2014;26(13:135901.] suggested that driving transducers by applying orthogonal electric fields can significantly reduce the coercivity that opposes ferroelectric switching. We present here the experimental validation of this biaxial driving technique using piezoelectric ceramics typically used in HIFU. A set of narrow-band transducers was fabricated with two sets of electrodes placed in an orthogonal configuration (following the propagation and the lateral mode. The geometry of the ceramic was chosen to have a resonance frequency similar for the propagation and the lateral mode. The average (± s.d. resonance frequency of the samples was 465.1 (± 1.5 kHz. Experiments were conducted in which each pair of electrodes was driven independently and measurements of effective acoustic power were obtained using the radiation force method. The efficiency (acoustic/electric power of the biaxial driving method was compared to the results obtained when driving the ceramic using electrodes placed only in the pole direction. Our results indicate that the biaxial method increases efficiency from 50% to 125% relative to the using a single electric field.

  7. Lesiones deportivas Sports injuries

    OpenAIRE

    2007-01-01

    El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participa...

  8. Dynamics of and diagnostic methods for detecting small carious lesions

    NARCIS (Netherlands)

    Pine, CM; tenBosch, JJ

    1996-01-01

    This paper reviews and discusses the dynamics of carious lesions and diagnostic methods for their detection. Summary data are presented on progression rates of differing lesion types with differing initial severity. Among the non-invasive techniques, fibre-optic transillumination, used appropriately

  9. Traumatic plexus lesion.

    NARCIS (Netherlands)

    Dongen, R.T.M. van; Cohen, S.P.; Kleef, M. van; Mekhail, N.; Huygen, F.

    2011-01-01

    Pain, motor, and sensory deficits characterize patients with a traumatic lesion of the brachial plexus. Frequently, more severe injuries co-exist that require immediate surgical attention. Early rehabilitation and physical therapy are the cornerstones of treatment. Pharmacological management can be

  10. Immunopathology of skin lesions

    Directory of Open Access Journals (Sweden)

    Khan Nazoora

    2001-09-01

    Full Text Available A study was conducted on 130 patients suffering from skin lesions which included psoriasis, lichen planus, DLE, pemphigus, vitiligo and alopecia areata. Forty age-and-sex-matched healthy individuals served as control. Serum IgG, IgM, and circulating immune complexes (CIC were estimated. Significant increase in serum IgG (1937.2 ± 1030.43 mg% and IgM (232.12 ± 136.98 mg% was observed in all the skin lesions when compared with controls except in lichen planus where they were significantly lowered, values being 580.61± 77.35 mg% and 66.88 ± 6.59mg% respectively. CIC levels were significantly raised (P<0.00 1 in various skin lesions (40.49±23.29 when compared with controls (17.68± 3.21, but no significance was observed in lichen planus( 17.72 ± 4.28. Serum IgG, IgM and CIC were statistically significantly altered depending on the extent of the lesion and lowered significantly to almost normal values following treatment, thereby confirming the role of immunity in the pathogenesis of these skin disorders.

  11. Genital lesions following bestiality

    Directory of Open Access Journals (Sweden)

    Mittal A

    2000-01-01

    Full Text Available A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution.

  12. White matter lesion progression

    DEFF Research Database (Denmark)

    Hofer, Edith; Cavalieri, Margherita; Bis, Joshua C;

    2015-01-01

    BACKGROUND AND PURPOSE: White matter lesion (WML) progression on magnetic resonance imaging is related to cognitive decline and stroke, but its determinants besides baseline WML burden are largely unknown. Here, we estimated heritability of WML progression, and sought common genetic variants...

  13. Morel-Lavallee lesion

    Institute of Scientific and Technical Information of China (English)

    Li Hui; Zhang Fangjie; Lei Guanghua

    2014-01-01

    Objective To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity.Familiarization may decrease missed diagnoses and misdiagnoses.It could also help steer the clinician to the proper treatment choice.Data sources A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords:Morel-Lavallee lesion,closed degloving injury,concealed degloving injury,Morel-Lavallee effusion,Morel-Lavallee hematoma,posttraumatic pseudocyst,posttraumatic soft tissue cyst.Study selection Chinese and English language literatures relevant to the subject were collected.Their references were also reviewed.Results Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury.It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia.Apart from the classic location over the region of the greater trochanter,MLLs have been described in other parts of the body.The natural history of MLL has not yet been established.The lesion may decrease in volume,remain stable,enlarge progressively or show a recurrent pattern.Diagnosis of MLL was often missed or delayed.Ultrasonography,computed tomography,and magnetic resonance imaging have great value in the diagnosis of MLL.Treatment of MLL has included compression,local aspiration,open debridement,and sclerodesis.No standard treatment has been established.Conclusions A diagnosis of MLL should be suspected when a soft,fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury.Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis.Treatment decisions should base on association with fractures,the condition of the lesion,symptom and desire of the patient.

  14. Focal cerebral lesions and painting abilities.

    Science.gov (United States)

    Mazzucchi, Anna; Sinforiani, Elena; Boller, François

    2013-01-01

    Focal lesions such as strokes significantly affect painting production in the vast majority of artists. In particular, painters, when they resume painting, show changes in their painting style. In exceptional cases, there may be an apparent improvement in style, but in most cases, the changes represent nothing short of deterioration. This, however, varies according to the hemisphere affected. Painters with left-hemisphere lesions tend to show an inability to deal adequately with perspective and also tend to use simplified colors with fewer nuances. One often witnesses an evolution toward simpler, often "naïve" techniques, and at times rigid geometric repetitive features. Painters with right-hemisphere lesions also become unable to represent tridimensionality. In addition, their figures are often drawn in very summary fashion, with lack of coordination between volumes and space and a chromatic impoverishment; their main problem, however, is visuospatial, leading to neglect of the left side of the canvas.

  15. Lesiones en el deporte

    Directory of Open Access Journals (Sweden)

    Rubio Gimeno, Silvio

    2000-02-01

    Full Text Available Not available

    El incremento de la actividad física y del deporte, en las sociedades llamadas desarrolladas, ha traído consigo beneficios claros para la salud, reflejados en diferentes indicadores de salud. Simultáneamente, el deporte de competición obliga a una dedicación diaria a intensidad de entrenamiento, con objeto de obtener los elevados requerimientos físicos que exige la competición. Todo ello ha traído consigo la aparición de numerosas lesiones, fundamentalmente del sistema músculo- esquelético.
    Se exponen en este trabajo consideraciones históricas, la epidemiología de la lesión deportiva y se describen, concisamente, algunas de las lesiones más habituales y significativas que afectan a músculos, tendones y sistema esquelético.

  16. Meniscal Ramp Lesions

    OpenAIRE

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, ...

  17. Human brain lesion-deficit inference remapped.

    Science.gov (United States)

    Mah, Yee-Haur; Husain, Masud; Rees, Geraint; Nachev, Parashkev

    2014-09-01

    . Positively, we show that novel machine learning techniques employing high-dimensional inference can nonetheless accurately converge on the true locus. We conclude that current inferences about human brain function and deficits based on lesion mapping must be re-evaluated with methodology that adequately captures the high-dimensional structure of lesion data. © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain.

  18. Numerical Simulation of Focal Shape of Annular HIFU Transducer%环状HIFU换能器焦域形态的数值模拟研究

    Institute of Scientific and Technical Information of China (English)

    张樯; 许坚毅; 冯若; 王耀俊; 王芷龙; 王智彪

    2001-01-01

    Objective andMethods:The numerical simulation of the focal shape of an annular HIFU transducer and its relation to the designed parameters has been studied.Results and Conclusions:Our simulations show that in order to improve the focal shape,the outer diameter of the annulus must be as large but the radius of acoustic lens must be as small as possible.The focal region is found to become smaller with increase of frequency.%目的与方法:对环状HIFU换能器焦域形态与其设计参数之间的关系进行了数值模拟研究。结果与结论:为了改善椭球焦域长短轴之比,环状外径应尽量取大,声透镜半径应尽量取小;且随频率增高,焦域变小,但其形状几乎不变。

  19. An unexpected lumbar lesion

    Directory of Open Access Journals (Sweden)

    Laura Beard

    2016-01-01

    Full Text Available This case report details an interesting case of suspected spinal bifida in an obstetric patient who presented for an elective cesarean section. A large scarred/dimpled area, surrounded by significant hair growth in the region of the lumbar spine had been missed in multiple antenatal and preoperative assessments and was recognized on the day of the surgery as the patient was being prepared for spinal anesthesia. The patient was uncertain regarding the pathology of the lesion, and all investigations relating to this had been undertaken in Pakistan where she lived as a child. General anesthesia was undertaken because magnetic resonance imaging had not been performed and tethering of the spinal cord could not be ruled out clinically. The patient suffered from significant blood loss intra and postoperatively, requiring a two unit blood transfusion. She was discharged after 5 days in the hospital. This case highlights the need for thorough examination in all obstetric patients presenting to the preoperative clinic, focusing on the airway, vascular access, and lumbar spine. Patients may not always disclose certain information due to a lack of understanding, embarrassment, forgetfulness, or language barriers. Significant aspects of their care may have been undertaken abroad and access to these notes is often limited. Preoperative detection of the lesion would have allowed further investigation and imaging of the lesion and enabled more comprehensive discussions with the patient regarding anesthetic options and risk.

  20. Aplicabilidade da técnica de cell block na avaliação citológica do conteúdo de lesões de aspecto cístico dos maxilares Applicability of cell block technique for cytological evaluation of biological material collected from maxillary cystic lesions

    Directory of Open Access Journals (Sweden)

    Grasieli de Oliveira Ramos

    2012-04-01

    Full Text Available INTRODUÇÃO: A busca por novos métodos que auxiliem e simplifiquem de maneira eficaz o diagnóstico de lesões maxilares, cistos e tumores, objetiva beneficiar os pacientes e facilitar a atuação dos profissionais da área de diagnóstico bucal. Além dos dados clínicos, radiográficos e histopatológicos classicamente utilizados nos protocolos de investigação das lesões maxilares, a adaptação de técnicas já consagradas na medicina pode ser de grande valia. A técnica de cell block se propõe a auxiliar nesse processo, pois consiste na análise citológica de materiais, efusões e líquidos, coletados de lesões passíveis de punção aspirativa, como cistos e tumores císticos dos maxilares. OBJETIVO: Demonstrar a aplicabilidade da técnica de cell block para avaliação citológica de material biológico coletado a partir de lesões císticas dos maxilares. RESULTADOS: Das 20 lesões, das quais o conteúdo foi processado pela técnica, a avaliação citológica de cinco casos de tumores odontogênicos ceratocísticos (TOCs demonstrou a presença predominante de ceratina, sempre com áreas de paraceratina. Nos demais casos (cinco cistos dentígeros, cinco cistos radiculares e cinco cistos residuais foi observada a presença de hemácias, células inflamatórias e fendas de cristais de colesterol. CONCLUSÃO: A avaliação citológica, a partir da técnica de cell block, foi útil no estabelecimento do diagnóstico diferencial entre TOC e demais lesões estudadas, cistos radicular, residual e dentígero.INTRODUCTION: The search for new methods that aid and optimize the diagnosis of cystic and tumoral maxillary lesions aims to benefit both patients and professionals from oral diagnosis. In addition to clinical, radiographic and histological findings traditionally used in research protocol for maxillary lesions, the adaptation of widely used medical techniques may be very helpful. The cell block procedure streamlines this process

  1. Venocentric lesions: an MRI marker of MS?

    Directory of Open Access Journals (Sweden)

    Matthew P. Quinn

    2013-07-01

    Full Text Available From the earliest descriptions of MS, the venocentric characteristic of plaques was noted. Recently, numerous MRI studies have proposed this finding as a prospective biomarker for MS, which might aid in differentiating MS from other diseases with similar MRI findings. High field MRI studies have shown that penetrating veins can be detected in most MS lesions using T2* weighted or susceptibility weighted imaging. Future studies must address the feasibility of imaging such veins in a clinically practical context. The specificity of this biomarker has been studied only in a limited capacity. Results in microangiopathic lesions are conflicting, whereas asymptomatic white matter hyperintensities as well as lesions of NMO are less frequently venocentric compared to MS plaques. Prospective studies have shown that the presence of venocentric lesions at an early clinical presentation is highly predictive of future MS diagnosis. This is very promising, but work remains to be done to confirm or exclude lesions of common MS mimics, such as ADEM, as venocentric. A number of technical challenges must be addressed before the introduction of this technique as a complementary tool in current diagnostic procedures.

  2. 逆向技术在冠状动脉慢性完全闭塞病变介入治疗中的应用%The application of retrograde technique in the interventional treatment for chronic total coronary occlusion(CTO) lesions

    Institute of Scientific and Technical Information of China (English)

    左梅; 黎军德; 吴栋梁; 李阳; 王芝荣; 李新国

    2011-01-01

    Objectives: To evaluate the feasibility and security of applying retrograde technique in the interventional treatment for chronic total coronary occlusion(CTO) lesions. Methods:We elected 3 cases of chronic total coronary occlusion (CTO) patients confirmed by coronary angiography (CAG) via radial artery which all exist collateral circulations with another coronary artery at the distal portion whose coronary angiographies (CAG) suggested the images developed from distal to proximal portion . During the interventional operations, as the previously failed antegrade double guiding catheters, microcatheters and different special Guidings for chronic total coronary occlusion (CTO) and accuratelypercutaneous coronary intervention (PCI) , we tried to get through the occlusion lesions by the retrograde combined application of controlling directions of the guides wires, then performed balloon dilatation anchoring through antegrade guiding catheter and retrograde balloon dilatation, implanted and expanded sents successfully, when antegrade guide wire passed the lesion. Results:Percutaneous coronary intervention (PCI) have been performed successfully for 3 cases of chronic total coronary occlusion (CTO) patients, without coronary dissection and perforation. Conclusions:The retrograde technique is an ideal technique in the interventional treatment for chronic total coronary occlusion (CTO) lesions%目的:评价逆向技术在慢性冠状动脉完全闭塞病变(CTO)介入治疗中应用的可行性及安全性.方法:3例经造影证实的CTO,均有另一支冠状动脉向远端血管提供良好侧枝循环,造影时CTO血管由远及近逆向显影.正向技术失败后,使用双指引导管法,逆向联合应用微导管和不同CTO专用导丝,导丝通过CTO病变后,继续进入正向指引导管内进行球囊扩张锚定,行逆向球囊扩张,正向导丝通过病变,植入支架.结果:3例成功通过逆向技术植入支架,术中无冠状动脉夹层及穿孔并发

  3. Laser therapy of pigmented lesions: pro and contra.

    Science.gov (United States)

    Bukvić Mokos, Zrinka; Lipozenčić, Jasna; Ceović, Romana; Stulhofer Buzina, Daška; Kostović, Krešimir

    2010-01-01

    Although frequently performed, laser removal of pigmented lesions still contains certain controversial issues. Epidermal pigmented lesions include solar lentigines, ephelides, café au lait macules and seborrheic keratoses. Dermal lesions include melanocytic nevi, blue nevi, drug induced hyperpigmentation and nevus of Ota and Ito. Some lesions exhibit both an epidermal and dermal component like Becker's nevus, postinflammatory hyperpigmentations, melasma and nevus spilus. Due to the wide absorption spectrum of melanin (500-1100 nm), several laser systems are effective in removal of pigmented lesions. These lasers include the pigmented lesion pulsed dye laser (510 nm), the Q-switched ruby laser (694 nm), the Q-switched alexandrite laser (755 nm) and the Q-switched Nd:YAG laser (1064 nm), which can be frequency-doubled to produce visible green light with a wavelength of 532 nm. The results of laser therapy are usually successful. However, there are still many controversies regarding the use of lasers in treating certain pigmented lesions. Actually, the essential question in removing pigmented lesions with lasers is whether the lesion has atypical features or has a malignant potential. Dermoscopy, used as a routine first-level diagnostic technique, is helpful in most cases. If there is any doubt whether the lesion is benign, then a biopsy for histologic evaluation is obligatory.

  4. An updated histological classification system for multiple sclerosis lesions.

    Science.gov (United States)

    Kuhlmann, Tanja; Ludwin, Samuel; Prat, Alexandre; Antel, Jack; Brück, Wolfgang; Lassmann, Hans

    2017-01-01

    subdivided into the early and late demyelinating lesions. The former is defined by the presence in macrophages of major and small molecular weight myelin proteins, such as cyclic nucleotide diphosphoesterase (CNP), myelin oligodendrocyte glycoprotein (MOG), or myelin-associated protein (MAG), whereas macrophages in the latter demonstrate merely the presence of the major myelin proteins MBP or PLP. We discuss the histological features and staining techniques required to classify MS lesions, and, in addition, describe the histological hallmarks of cortical pathology and diffuse white matter changes, as well as of remyelination.

  5. O valor da ressonância magnética na detecção de nódulos hepáticos utilizando-se diversas técnicas ponderadas em T2: existe consenso? The value of magnetic resonance imaging for the detection of focal liver lesions using different T-2 weighted techniques: is there a consensus?

    Directory of Open Access Journals (Sweden)

    Glaucia Andrade e Silva Palácio

    2002-11-01

    Full Text Available Desde o início da década de 80 a ressonância magnética vem sendo utilizada para o estudo do abdome e principalmente na detecção de nódulos hepáticos. As imagens ponderadas em T2 são as que trouxeram maior benefício quando comparadas à tomografia computadorizada com contraste. Inúmeras técnicas e seqüências de ressonância magnética ponderadas em T2 surgiram desde então, na tentativa de aumentar a eficácia diagnóstica, com menores tempos de exame. Neste sentido, foram publicados inúmeros trabalhos demonstrando a utilidade de seqüências rápidas e ultra-rápidas, com e sem supressão de gordura, em apnéia, com sincronizador respiratório e com bobinas de sinergia, entre outros avanços tecnológicos. No entanto, não há um consenso sobre qual a técnica mais apropriada e sensível para a detecção de lesões hepáticas focais. Neste artigo fazemos uma revisão bibliográfica e análise crítica das diversas técnicas de imagens ponderadas em T2, no que diz respeito às suas sensibilidades na detecção de nódulos hepáticos.Since the early 1980's several magnetic resonance imaging pulse sequences have been developed in order to determine the optimum imaging technique for the detection and characterization of hepatic lesions. T2-weighted images play an important role in the evaluation of the liver and present equal or greater sensitivity than enhanced computed tomography for the detection of liver lesions. New techniques for obtaining T-2 weighted images have been developed in the attempt to optimize the method. These techniques have improved the image quality by shortening examination time, reducing motion artifacts, and improving contrast-to-noise ratio. The effectiveness of the different techniques (fat suppression, breath-hold, respiratory-triggered and phased-array coils has been tested in many comparative studies, although the results are controversial. In this article we review the literature and discuss the several

  6. Acute periodontal lesions.

    Science.gov (United States)

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  7. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo;

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  8. Otoendoscopic treatment of hidden lesions in otomastoiditis

    Institute of Scientific and Technical Information of China (English)

    LIU Yang; SUN Jian-jun; LIN Yong-sheng; ZHAO Dan-heng; ZHAO Jing; LEI Fei

    2010-01-01

    Background Surgical treatments for chronic suppurative and cholesteatoma otitis media have been discussed for several decades, but recurrences still occur because of the complex dissection required and hidden lesions associated with otomastoiditis. This study investigated the technology and strategy behind the use of otoendoscopic-assisted otosurgery.Methods We reported on hidden lesions in 32 ears of patients with otomastoiditis between November 2006 and January 2009. All the patients were treated with the aid of an otoendoscope. The advantages of otoendoscopy, including multi-angle light scattering, aperture illumination, and magnification of the local operative field, were utilized in otologic microsurgery, and otoendoscopic operative techniques were introduced for operative sites such as the epitympanum, aditus of the antrum, facial recess, sinus tympani and the mastoid tip.Results All patients were followed up from 3 months to 2 years after surgery. All patients recovered well within 3 months following surgery, except for one case of epithelialization of the mastoid cavity occurring 6 months after surgery for cholesteatoma on the cerebellar surface and another case with Bezold's abscess, hyperplastic granulation tissue developed at the antrum.Conclusions Otoendoscopy can overcome the technical deficiency of rectilinearity of the visual axis associated with otomicroscopic illumination, which presents a problem when dealing with otomastoiditis lesions in hidden areas. This technique allows such lesions within the complex three-dimensional structure to be visualized and cleaned. Otoendoscopy thus has significant potential for improving the quality of surgery and reducing the risk of postoperative recurrence.

  9. A disappearing neonatal skin lesion.

    LENUS (Irish Health Repository)

    Hawkes, Colin Patrick

    2012-01-31

    A preterm baby girl was noted at birth to have a firm, raised, non-tender skin lesion located over her right hip. She developed three similar smaller lesions on her ear, buttock and right knee. All lesions had resolved by 2 months of age.

  10. MR-Guided High-Intensity Focused Ultrasound Ablation of Breast Cancer with a Dedicated Breast Platform

    Energy Technology Data Exchange (ETDEWEB)

    Merckel, Laura G., E-mail: L.G.Merckel-2@umcutrecht.nl [University Medical Center Utrecht, Department of Radiology (Netherlands); Bartels, Lambertus W., E-mail: W.Bartels@umcutrecht.nl [University Medical Center Utrecht, Image Sciences Institute (Netherlands); Koehler, Max O., E-mail: max.kohler@philips.com [Philips Healthcare (Finland); Bongard, H. J. G. Desiree van den, E-mail: D.vandenBongard@umcutrecht.nl [University Medical Center Utrecht, Department of Radiotherapy (Netherlands); Deckers, Roel, E-mail: R.Deckers-2@umcutrecht.nl [University Medical Center Utrecht, Image Sciences Institute (Netherlands); Mali, Willem P. Th. M., E-mail: W.Mali@umcutrecht.nl [University Medical Center Utrecht, Department of Radiology (Netherlands); Binkert, Christoph A., E-mail: Christoph.Binkert@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland); Moonen, Chrit T., E-mail: C.Moonen@umcutrecht.nl [University Medical Center Utrecht, Image Sciences Institute (Netherlands); Gilhuijs, Kenneth G. A., E-mail: K.G.A.Gilhuijs@umcutrecht.nl; Bosch, Maurice A. A. J. van den, E-mail: mbosch@umcutrecht.nl [University Medical Center Utrecht, Department of Radiology (Netherlands)

    2013-04-15

    Optimizing the treatment of breast cancer remains a major topic of interest. In current clinical practice, breast-conserving therapy is the standard of care for patients with localized breast cancer. Technological developments have fueled interest in less invasive breast cancer treatment. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a completely noninvasive ablation technique. Focused beams of ultrasound are used for ablation of the target lesion without disrupting the skin and subcutaneous tissues in the beam path. MRI is an excellent imaging method for tumor targeting, treatment monitoring, and evaluation of treatment results. The combination of HIFU and MR imaging offers an opportunity for image-guided ablation of breast cancer. Previous studies of MR-HIFU in breast cancer patients reported a limited efficacy, which hampered the clinical translation of this technique. These prior studies were performed without an MR-HIFU system specifically developed for breast cancer treatment. In this article, a novel and dedicated MR-HIFU breast platform is presented. This system has been designed for safe and effective MR-HIFU ablation of breast cancer. Furthermore, both clinical and technical challenges are discussed, which have to be solved before MR-HIFU ablation of breast cancer can be implemented in routine clinical practice.

  11. Lesiones deportivas Sports injuries

    Directory of Open Access Journals (Sweden)

    Isabel Cristina Gallego Ching

    2007-04-01

    Full Text Available El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participantes o tasas por horas de juego o por número de partidos jugados. Las tasas varían entre 1,7 y 53 lesiones por 1.000 horas de práctica deportiva, entre 0,8 y 90,9 por 1.000 horas de entrenamiento, entre 3,1 y 54,8 por 1.000 horas de competición y de 6,1 a 10,9 por 100 juegos. La gran variación entre las tasas de incidencia se explica por las diferencias existentes entre los deportes, los países, el nivel competitivo, las edades y la metodología empleada en los estudios. Se ha definido la lesión deportiva como la que ocurre cuando los atletas están expuestos a la práctica del deporte y se produce alteración o daño de un tejido, afectando el funcionamiento de la estructura. Los deportes de contacto generan mayor riesgo de presentar lesiones; se destacan al respecto los siguientes: fútbol, rugby, baloncesto, balonmano, artes marciales y jockey. Las lesiones ocurren con mayor probabilidad en las competencias que en el entrenamiento. Stress generated by sports practice has increased the probability that athletes suffer from acute and chronic injuries. Worldwide, there have been many different investigations concerning the incidence of sport injuries. The different ways in which results have been presented makes it difficult to compare among them. Rates of sports injuries vary between 1.7 and 53 per 1.000 hours of sports practice; 0.8 and 90.9 per 1.000 hours of training; 3.1 and 54.8 per 1.000 hours of competition, and 6.1 and 10.9 per 100

  12. The radio-pathological correlation of spleen lesions; Correlacion radioanatomopatologica de la lesion esplenica

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, I.; Cespedes, M.; Camacho, F. I. [Hosptial Virgen de la Salud. Toledo (Spain)

    1999-07-01

    To review the spectrum of spleen lesions, by correlating the radiologic images with the anatomopathological findings. A retrospective study was carried out on 180 patients with splenic lesions, whose diagnosis had been confirmed by the anatomopathological unit. The iconography was studied, distinguishing between the following categories: inflammatory/infectious pathology, cystic and vascular lesions, benign diffuse infiltration illnesses, tumours and development abnormalities. We showed the distribution of the lesions observed in our series and the correlation of the radiologic images with those of the pathologic study of the most significant ones. The current imaging methods allow for a reliable diagnostic approach to the splenic processes, however, the anatomopathological correlation, when possible, has been proven o be very useful. Currently computed tomography is still the technique chosen to evaluate the spleen, especially due to its availability. The arrival of the helical computed tomography has significantly improved the characterisation and the detection of lesions. magnetic resonance imaging (MRI) has proved to be especially useful for small lesions and for some diffuse infiltrations, such as hemochromatosis. (Author) 36 refs.

  13. Klatskin-Like Lesions

    Directory of Open Access Journals (Sweden)

    M. P. Senthil Kumar

    2012-01-01

    Full Text Available Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5–15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature.

  14. Klatskin-like lesions.

    Science.gov (United States)

    Senthil Kumar, M P; Marudanayagam, R

    2012-01-01

    Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5-15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature.

  15. Lesiones en el deporte

    OpenAIRE

    2000-01-01

    Not available

    El incremento de la actividad física y del deporte, en las sociedades llamadas desarrolladas, ha traído consigo beneficios claros para la salud, reflejados en diferentes indicadores de salud. Simultáneamente, el deporte de competición obliga a una dedicación diaria a intensidad de entrenamiento, con objeto de obtener los elevados requerimientos físicos que exige la competición. Todo ello ha traído consigo la aparición de numerosas lesiones, fundamentalmen...

  16. Atrichia with Papular Lesions

    OpenAIRE

    Bansal, Manish; Manchanda, Kajal; Lamba, Sachin; Pandey, SS

    2011-01-01

    Atrichia with papular lesions (APL) is a rare autosomal recessive form of irreversible alopecia with onset at few months of age with papular keratin cysts over the body. It is associated with mutation in the Zinc finger domain of the human hairless gene on chromosome region 8p12. An eleven-year-old male presented with extensive alopecia starting at six months of age refractory to the treatment along with keratotic papules on the face and trunk. Biopsy from a papule showed mid-dermal keratin c...

  17. Lesiones en corredores amateurs

    OpenAIRE

    Natale, Vanesa

    2011-01-01

    Se realizó un estudio tomando como muestra a 100 corredores amateurs de la ciudad de Mar del Plata, en la cual el objetivo general fue determinar cuáles son las patologías más frecuentes en corredores. Correr no es solo un deporte en si mismo sino que tiene elementos de otras actividades deportivas, es decir, que las lesiones de los corredores también son comunes en otros tipos de deportes. El número de deportistas aumenta diariamente y al mismo tiempo aumentan el número de per...

  18. Cystic Lesions of the Mediastinum.

    Science.gov (United States)

    Vargas, Daniel; Suby-Long, Thomas; Restrepo, Carlos S

    2016-06-01

    Cystic lesions are commonly seen in the mediastinum, and they may arise from virtually any organ. The vast majority of these lesions are benign and result in no symptoms. When large, cysts may produce symptoms related to compression of adjacent structures. The most common mediastinal cysts are pericardial and foregut duplication cysts. Both computed tomography and magnetic resonance are routinely used to evaluate these lesions. Although computed tomography offers superior spatial resolution, magnetic resonance is useful in differentiating cysts that contain proteinaceous material from solid lesions. Occasionally, cysts arise from solid lesions, such as thymoma or teratoma. Although cysts are alike in appearance, location helps narrowing the differential diagnoses.

  19. Transanal endoscopic microsurgery for the treatment of uncommon rectal lesions.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Rubio-Gil, Francisco; Ortega-Ruiz, Sofía; Blesa-Sierra, Isabel; Álvarez-García, Antonio; Jorge-Cerrudo, Jaime; Vidaña-Márquez, Elisabet; Belda-Lozano, Ricardo; Reina-Duarte, Ángel

    Transanal endoscopic microsurgery (TEM) was developed as a less aggressive alternative treatment for rectal lesions (mainly adenomas and adenocarcinomas). However, its use for other rectal lesions has become more frequent, trying to reduce the morbidity associated with more invasive techniques. The aim of this study is to describe our experience in the use of TEM in other rectal lesions. Retrospective and descriptive study including patients operated with TEM (from June 2008 to December 2016) for the treatment of rectal lesions different from adenomas or adenocarcinomas. Among the 138 patients treated by TEM in our department, 10 patients were operated on for rectal lesions other than adenomas or adenocarcinomas. Rectal lesions were 3neuroendocrine tumours, a neuroendocrine tumour metastasis, a rectal stenosis, a cloacogenic polyp, an endometrioma, a retrorrectal tumour, a presacral abscess and a lesion in the rectovaginal septum. Mean operative time was 72min and postoperative stay was 4.2 days. Only one patient needed a reoperation, due to rectal bleeding. TEM could be a useful tool for the treatment of rectal lesions different from adenomas or adenocarcinomas, potentially decreasing the morbidity associated with more aggressive surgical techniques. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. [Bony Bankart lesions].

    Science.gov (United States)

    Spiegl, U J; Braun, S; Euler, S A; Warth, R J; Millett, P J

    2014-12-01

    Fractures of the anteroinferior glenoid rim, termed bony Bankart lesions, have been reported to occur in up to 22% of first time anterior shoulder dislocations. The primary goal of treatment is to create a stable glenohumeral joint and a good shoulder function. Options for therapeutic intervention are largely dependent on the chronicity of the lesion, the activity level of the patient and postreduction fracture characteristics, such as the size, location and number of fracture fragments. Non-operative treatment can be successful for small, acute fractures, which are anatomically reduced after shoulder reduction. However, in patients with a high risk profile for recurrent instability initial Bankart repair is recommended. Additionally, bony fixation is recommended for acute fractures that involve more than 15-20% of the inferior glenoid diameter. On the other hand chronic fractures are generally managed on a case-by-case basis depending on the amount of fragment resorption and bony erosion of the anterior glenoid with high recurrence rates under conservative therapy. When significant bone loss of the anterior glenoid is present, anatomical (e.g. iliac crest bone graft and osteoarticular allograft) or non-anatomical (e.g. Latarjet and Bristow) reconstruction of the anterior glenoid is often indicated.

  1. Evaluation of direct radiographic magnification (DIMA) in the early detection of inflammatory rheumatic lesions. Comparison with the high-resolution conventional technique. Wertigkeit der direktradiographischen Vergroesserung (DIMA) bei der Fruehdetektion entzuendlich-rheumatischer Laesionen. Vergleichende Evaluation mit hochaufloesender konventioneller Aufnahmetechnik

    Energy Technology Data Exchange (ETDEWEB)

    Link, T.M. (Westfaelische Wilhelms-Universitaet Muenster (Germany). Institut fuer Klinische Radiologie); Fiebich, M. (Westfaelische Wilhelms-Universitaet Muenster (Germany). Institut fuer Klinische Radiologie); Gaubitz, M. (Westfaelische Wilhelms-Universitaet Muenster (Germany). Medizinische Klinik und Poliklinik B); Krause, F. (Westfaelische Wilhelms-Universitaet Muenster (Germany). Institut fuer Klinische Radiologie); Vestring, T. (Westfaelische Wilhelms-Universitaet Muenster (Germany). Institut fuer Klinische Radiologie); Schneider, M. (Westfaelische Wilhelms-Universitaet Muenster (Germany). Medizinische Klinik und Poliklinik B); Peters, P.E. (Westfaelische Wilhelms-Universitaet Muenster (Germany). Institut fuer Klinische Radiologie)

    1994-07-01

    Rheumatological joint disorders were examined with mammographic film-screen combinations and high-definition microfocal magnification radiography. Our objective was to evaluate the potentials of magnification radiography in diagnosing arthritis by means of interobserver and ROC analysis. The microfocal X-ray unit had a spot size of 20-130 [mu]m; 5-fold magnification was performed. Digital luminescence radiography was employed; digital image processing included simulation of conventional technique and edge enhancement. Eighty radiographs were obtained with conventional and magnification technique. All films were analyzed by five readers. Anatomical and pathological structures were evaluated. The percentage of uncertain findings in magnification radiography was lower compared to conventional radiographs (14% to 26%); in 8% (compared to 19%) the diagnosis of erosions was uncertain. Additionally ROC analysis was carried out. Magnification radiography was significantly (p < 0.03) better than the conventional films. (orig.)

  2. Automated detection of multiple sclerosis lesions in serial brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Llado, Xavier; Ganiler, Onur; Oliver, Arnau; Marti, Robert; Freixenet, Jordi [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Valls, Laia [Dr. Josep Trueta University Hospital, Department of Radiology, Girona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain); Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Department of Radiology, Barcelona (Spain)

    2012-08-15

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  3. Combination treatment of HIFU and rehabilitation on phantom limb pain after amputation%聚焦超声联合常规康复治疗对截肢后幻肢痛的疗效

    Institute of Scientific and Technical Information of China (English)

    唐映; 刘杰文; 许晓光

    2015-01-01

    目的:探讨聚焦超声联合常规康复对幻肢痛的治疗效果。方法将32例存在幻肢痛的患者分为治疗组和对照组,各16例,治疗组采用聚焦超声联合常规康复治疗,对照组单纯采用常规康复方法治疗。治疗30天后,以简明McGill疼痛问卷表评分作为评价指标,观察两组治疗效果。结果治疗组总有效率93.8%,对照组总有效率56.3%,两组比较差异有显著性意义(P<0.05);两组治疗前与治疗后SF-MPQ评分比较,差异均有显著性意义(P<0.05);治疗后组间SF-MPQ评分比较,差异有显著性意义(P<0.05)。结论聚焦超声和常规康复治疗联合运用对幻肢痛有很好的疗效。%Objective To study the effect of high intensity focus ultrasound ( HIFU) and rehabilitation treatment on phan-tom limb pain.Methods With randomized and controlled clinical research method, 32 cases of phantom limb pain were randomly divided into study group ( HIFU and rehabilitation therapy) and control group ( Rehabilitation therapy) with 16 patients in each group.After 30 days of treatment, a concise questionnaire SF-MPQ score was used as the evaluation in-dex of the therapeutic effect.Results The total effective rate of treatment group was 93.8%, compared to 56.3 % in the control group (P<0.05).The SF-MPQ score were significantly different before and after the treatment in both study group and control group (P<0.05).Comparison of SF-MPQ score between the two groups after treatment indicated sig-nificant difference (P<0.05).Conclusion HIFU and rehabilitation treatment have a good efficacy on limb pain.The combination of HIFU and rehabilitation treatment presents better results.

  4. Comparison of centrifuged liquid based cytology method with conventional brush cytology in oral lesions

    OpenAIRE

    Nidhi Dwivedi; Akhil Agarwal; Vineet Raj; Bina Kashyap; Shaleen Chandra

    2012-01-01

    Background: Exfoliative cytology is the study of cells that are shed or scrapped off from mucosal surfaces. Centrifuged Liquid based cytology is a modified technique employed in the present study. Aims: To compare the utility of centrifuged liquid based cytology with conventional cytology in oral lesions after staining with Papanicolaou (PAP) stain. Materials and Methods: 50 cases of oral lesions comprising of normal mucosa (n=14), hyperkeratotic lesions (n=17), ulcerated lesions (n=7) and at...

  5. Automated Detection of Red Lesions Using Superpixel Multichannel Multifeature

    Science.gov (United States)

    Wu, Chengdong

    2017-01-01

    Red lesions can be regarded as one of the earliest lesions in diabetic retinopathy (DR) and automatic detection of red lesions plays a critical role in diabetic retinopathy diagnosis. In this paper, a novel superpixel Multichannel Multifeature (MCMF) classification approach is proposed for red lesion detection. In this paper, firstly, a new candidate extraction method based on superpixel is proposed. Then, these candidates are characterized by multichannel features, as well as the contextual feature. Next, FDA classifier is introduced to classify the red lesions among the candidates. Finally, a postprocessing technique based on multiscale blood vessels detection is modified for removing nonlesions appearing as red. Experiments on publicly available DiaretDB1 database are conducted to verify the effectiveness of our proposed method. PMID:28512511

  6. [Ramp lesions : Tips and tricks in diagnostics and therapy].

    Science.gov (United States)

    Seil, R; Hoffmann, A; Scheffler, S; Theisen, D; Mouton, C; Pape, D

    2017-09-14

    There is an increasing biomechanical and anatomical understanding of the different types of meniscal lesions. Lesions of the posterior part of the medial meniscus in the meniscosynovial area have recently received increased attention. They generally occur in association with anterior cruciate ligament (ACL) injuries. They are often missed ("hidden lesions") due to the fact that they cannot be seen by routine anterior arthroscopic inspection. Furthermore, meniscosynovial lesions play a role in anteroposterior knee laxity and, as such, they may be a cause of failure of ACL reconstruction or of postoperative persistent laxity. Little information is available regarding their cause with respect to injury mechanism, natural history, biomechanical implications, healing potential and treatment options. This article presents an overview of the currently available knowledge of these ramp lesions, their possible pathomechanism, classification, biomechanical relevance as well as repair techniques.

  7. Management of cervical spinal lesions in rheumatoid arthritis.

    Science.gov (United States)

    Yonenobu, Kazuo; Oda, Takenori

    2004-01-01

    We review the management of cervical spinal lesions in rheumatoid arthritis. Surgical treatment for cervical lesions presents several potential problems, such as spinal cord injury during surgery, prolonged and painful postoperative immobilization, poor outcome incompatible with surgical invasiveness, and a high failure rate of arthrodesis. The introduction of spinal instrumentation techniques to surgery for cervical lesions has solved some of these problems. Rigid spinal fixation using screws, rods, and wires has made surgery more reliable, and has freed patients from painful postoperative immobilization methods such as the Halo vest. However, the effects of surgical treatment have not been clearly examined using methods of evidence-based medicine. There is a need for clinical studies of treatment for cervical lesions, in order to help establish better methods for the management of cervical spinal lesions.

  8. Thalamic Lesions: A Radiological Review

    Directory of Open Access Journals (Sweden)

    Dimitri Renard

    2014-01-01

    Full Text Available Background. Thalamic lesions are seen in a multitude of disorders including vascular diseases, metabolic disorders, inflammatory diseases, trauma, tumours, and infections. In some diseases, thalamic involvement is typical and sometimes isolated, while in other diseases thalamic lesions are observed only occasionally (often in the presence of other typical extrathalamic lesions. Summary. In this review, we will mainly discuss the MRI characteristics of thalamic lesions. Identification of the origin of the thalamic lesion depends on the exact localisation inside the thalamus, the presence of extrathalamic lesions, the signal changes on different MRI sequences, the evolution of the radiological abnormalities over time, the history and clinical state of the patient, and other radiological and nonradiological examinations.

  9. Spectroscopic Detection of Caries Lesions

    OpenAIRE

    Mika Ruohonen; Katri Palo; Jarmo Alander

    2013-01-01

    Background. A caries lesion causes changes in the optical properties of the affected tissue. Currently a caries lesion can be detected only at a relatively late stage of development. Caries diagnosis also suffers from high interobserver variance. Methods. This is a pilot study to test the suitability of an optical diffuse reflectance spectroscopy for caries diagnosis. Reflectance visible/near-infrared spectroscopy (VIS/NIRS) was used to measure caries lesions and healthy enamel on extracted h...

  10. MALIGNANCY IN LARGE COLORECTAL LESIONS

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Oliveira dos SANTOS

    2014-09-01

    Full Text Available Context The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion Objectives To evaluate the malignancy of colorectal lesions ≥20 mm. Methods Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed Results The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm. Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3% lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5% and IV (53.9% pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma, with no difference in morphology and site. Only one lesion (1.3% invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001. The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.

  11. Radio-induced brain lesions

    Directory of Open Access Journals (Sweden)

    Gorgan Mircea Radu

    2014-03-01

    Full Text Available Introduction : Radiotherapy, an important tool in multimodal oncologic treatment, can cause radio-induced brain lesion development after a long period of time following irradiation.

  12. Arthroscopic Repair of Posterior Bony Bankart Lesion and Subscapularis Remplissage.

    Science.gov (United States)

    Luedke, Colten; Tolan, Stefan J; Tokish, John M

    2017-06-01

    Posterior shoulder instability with glenoid bone loss has only a fraction of the prevalence of anterior instability. Unlike the latter, there is a paucity of literature regarding the treatment of posterior bony Bankart lesions and even less with concomitant reverse Hill-Sachs lesions. This combination of pathology leads to a difficult situation regarding treatment options. We present our technique for arthroscopic repair of a posterior bony Bankart lesion and reverse Hill-Sachs lesion. The importance of proper portal placement cannot be overstated. By use of the lateral position and strategically placed portals, the posterior bony Bankart lesion and attached labral complex were appropriately mobilized. We reduced the glenoid bone, with the attached capsulolabral complex, to the glenoid rim and performed fixation using a knotless suture anchor. We then placed 2 double-loaded suture anchors into the reverse Hill-Sachs lesion. The sutures were passed creating horizontal mattress configurations that were tied at the end of the procedure, effectively externalizing the humeral head defect. Our technique results in satisfactory fragment reduction, as well as appropriate capsular tension, and effectively prevents the reverse Hill-Sachs lesion from engaging.

  13. Traumatic lesions of internal saphenous nerve and branches.

    Science.gov (United States)

    Rodrigues, Flávio Freinkel; Skartz, Issac; Dozza, Diego Cassol; Moscovici, Maurício; Suchmacher, Mendel

    2009-09-01

    To show a rare lesion that sometimes simulates vascular disorder of the lower extremities. Three patients were operated and the follow-up period was eight months, the surgical technique was neurotomy of the infrapatellar and descendent branches. In two cases there were almost total pain resolution, and in other case improvement only. Surgical treatment yields good results in this type of internal saphenous nerve lesion, and could be useful as an alternative to conservative treatment.

  14. Incipient caries lesions: from concept to actual treatment approaches

    OpenAIRE

    Araújo, Diana; Alencar, Marina; Freitas, Maria Cristina; Azevedo, Larissa; Atta, Maria; Wang, Linda

    2014-01-01

    The concepts introduced by the Minimally Invasive Dentistry (MID) allowed the rising of new conservative treatment and assessment system for caries lesions’ classification.  In this context, the approaches of the incipient caries lesions surpass the use of only traditional restorative techniques. The aim of this study was to review the new caries classifications criteria (ICDAS and CAST), the importance of the early diagnosis of caries lesions and the clinical procedures for treatment in MID.

  15. Undefeatable coronary lesion.

    Science.gov (United States)

    Farman, Muhammad Tariq; Sial, Jawaid Akbar; Khan, Naveed Ullah; Masood, Tariq; Saghir, Tahir

    2011-02-01

    We report a case in which a calcification in mid left anterior descending (LAD) artery was not apparent initially on angiogram and stenting was done after inappropriate predilation resulting in underexpansion of stent. High pressure inflation, buddy wire technique, scoring and cutting balloon inflation failed to achieve the full expansion of stent.

  16. "Hybrid" lesion of the maxilla

    Directory of Open Access Journals (Sweden)

    S Sankaranarayanan

    2011-01-01

    Full Text Available Juvenile ossifying fibroma is an uncommon benign but aggressive fibroosseous lesion that affects the craniofacial skeleton. Their distinct clinical and histopathological features warrant the lesion to be considered as a separate entity from other fibro-osseous group of lesions such as fibrous dysplasia and cemento ossifying fibroma. Concomitant development of secondary aneurysmal bone cyst may rarely occur, which makes the lesion more aggressive and difficult to treat. We report a case of a 6 year old girl who was diagnosed with aneurysmal bone cyst during her earlier presentation at a private hospital and was treated for the same. The lesion recurred within 6 months. The second incisional biopsy specimen revealed features of trabecular variant of juvenile ossifying fibroma along with areas of aneurysmal bone cyst.

  17. Dynamic observation of repigmentation in vitiligo lesions after narrow-band ultraviolet B phototherapy by using an adhesive tape stripping technique%胶带粘贴法观察窄谱中波紫外线治疗后白癜风皮损的复色

    Institute of Scientific and Technical Information of China (English)

    汪凯凡; 汪宇; 陆洪光

    2012-01-01

    目的 探讨窄谱中波紫外线(NB-UVB)治疗前后照射区浅表角质层细胞中黑素颗粒的变化.方法 使用胶带粘贴法对接受NB-UVB治疗的白癜风皮损进行浅表角质层细胞取样,银氨染色后观察细胞中黑素颗粒形态、分布、颜色的变化,使用Image-Pro Plus6.0显微图像分析软件计算细胞内黑素颗粒面积百分比,使用SPSS11.5对数据进行统计分析.结果 治疗前白斑区仍残存少量含黑素颗粒的浅表角质层细胞.治疗前黑素颗粒面积百分比为(5.31±4.12)%,治疗10次后为(6.24±2.65)%,治疗20次后为(10.14±5.73)%,治疗30次后为(13.05±6.17)%,方差分析显示,治疗前、治疗10次、治疗20次、治疗30次后黑素颗粒面积百分比差异有统计学意义(F=4.334,P< 0.05),经两两比较分析,治疗30次后细胞内黑素颗粒面积百分比相对治疗前及治疗10次后均增高(P值均< 0.01).皮损复色区新生黑素颗粒染色后形态、颜色与治疗前周边正常肤色区有所不同.结论 用浅表角质层细胞胶带粘贴法可以客观评估NBUVB治疗白癜风的复色过程.%Objective To observe the changes of melanin granules in superficial corneocytes in vitiligo lesions after irradiation with narrow-band ultraviolet B (NB-UVB) by using an adhesive tape stripping technique.Methods Vitiligo lesions were selected from 6 patients and irradiated with NB-UVB every other day for 31 sessions.Superficial corneocytes were obtained by an adhesive tape stripping technique from the vitiligo lesions and perilesional normal skin before every treatment.The morphology,distribution and color of melanin granules were observed after Masson-Fontana silver staining.The percentage of area occupied by melanin granules in superficial corneocytes were calculated by using the Image-Pro Plus 6.0 software.Statistical analysis was conducted by the SPSS11.5 software.Results There were still a few superficial corneocytes containing melanin granules

  18. Lesiones debido a un rayo

    OpenAIRE

    Soraia Oliveira; Andriy Bal

    2012-01-01

    Lesiones debido a un rayo Mujer de 72 años, fue admitida en urgências con dolor abdominal y lipotimia después de ser golpeada por un rayo mientras abría una ventana. En la exploracion presentaba lesiones, localizadas en el tronco, dolorosas a la palpación. Las lesiones abdominales en forma de estrella eran muy sugestivas de imágenes de Lichtenberg (figura A), mientras en la región pélvica (figura B) y en la nalga derecha (figura C) eran más lineales y compatibles con quemaduras de pri...

  19. Factitious lesions of the hand

    Directory of Open Access Journals (Sweden)

    Ricardo Kaempf de Oliveira

    2013-08-01

    Full Text Available OBJECTIVE: The presence of a lesion with atypical presentation, obscure clinical history, which does not improve with classic treatments, shall raise the red flag of the medical team. In such cases, the hypothesis of a factitious lesion shall be considered. Many times the correct diagnosis on the initial assessment may avoid high-cost diagnostic tests, unnecessary treatments, and time consumption of the medical team. We present here two classic cases of factitious lesions that, similar to those described in the literature, is difficult to diagnose and difficult to treat.

  20. PHAEOHYPHOMYCOSIS: CUTANEOUS, SUBCUTANEOUS, NASOPHARYNGEAL LESIONS

    Directory of Open Access Journals (Sweden)

    M. Rasoolinejad

    1999-06-01

    Full Text Available Phaeohyphomycosis is an amalgam of clinical diseases caused by a wide variety of dematiaceous fungi. We are reporting on a 16 year-old patient from Amol with subcutaneous cervical nodes and nasopharyngeal lesions of phaeohypho"nmycosis that were confirmed by pathological examination, direct smear, and culture. After treatment with an oral triazole (Itraconazole for 4 months, all nodes and lesions disappeared and treatment was stopped A new lesion appeared on his chest wall 8 months, therapy with itraconazole was restarted and commuted for a long time.

  1. Automated measurement of local white matter lesion volume

    DEFF Research Database (Denmark)

    van der Lijn, Fedde; Verhaaren, Benjamin F. J.; Ikram, M. Arfan;

    2012-01-01

    . The method was also compared to two commonly used techniques to assess the periventricular and subcortical lesion load. The main finding was that high blood pressure was primarily associated with lesion load in the vascular watershed area that forms the border between the periventricular and subcortical...... regions. It explains the associations found for both the periventricular and subcortical load computed for the same data, and that were reported in the literature. But the proposed method can localize the region of association with greater precision than techniques that distinguish between periventricular...

  2. Evidence for immunosurveillance in intestinal premalignant lesions.

    Science.gov (United States)

    Karlsson, M; Lindberg, K; Karlén, P; Ost, A; Thörn, M; Winqvist, O; Eberhardson, M

    2010-05-01

    The immunosurveillance theory argues that the immune system recognizes tumour-specific antigens expressed by transformed cells, which results in the destruction of cancer precursors before they become clinically manifest. As a model for the development of cancer, we set out to study premalignant lesions and immune responses in sentinel lymph nodes from patients with long-standing ulcerative colitis and progression of mucosal dysplasia. Mesenteric lymph nodes draining dysplastic and normal intestinal segments were identified by sentinel node technique during surgery in 13 patients with ulcerative colitis who were subjected to colectomy because of intestinal dysplasia. T cells were extracted from the lymph nodes and analysed by flow cytometry, and lymphocyte proliferation assays were set up in the presence of extracts from dysplastic and normal intestinal mucosa. Increase in CD4/CD8 ratio was observed in sentinel lymph nodes draining dysplastic epithelium compared to normal mucosa. The increase in CD4(+) T cells in relation to CD8(+) T cells correlated with the degree of dysplasia reflected by a significant increase in the ratio against low-grade dysplasia compared to indefinite dysplastic lesions. The T-cell response was specific to antigens from dysplastic epithelial lining as seen in proliferation assays. The observation suggests an important surveillance role for the immune system against premalignant intestinal lesions in patients with long-standing ulcerative colitis.

  3. Speckle tracking and speckle content based composite strain imaging for solid and fluid filled lesions.

    Science.gov (United States)

    Rabbi, Md Shifat-E; Hasan, Md Kamrul

    2017-02-01

    Strain imaging though for solid lesions provides an effective way for determining their pathologic condition by displaying the tissue stiffness contrast, for fluid filled lesions such an imaging is yet an open problem. In this paper, we propose a novel speckle content based strain imaging technique for visualization and classification of fluid filled lesions in elastography after automatic identification of the presence of fluid filled lesions. Speckle content based strain, defined as a function of speckle density based on the relationship between strain and speckle density, gives an indirect strain value for fluid filled lesions. To measure the speckle density of the fluid filled lesions, two new criteria based on oscillation count of the windowed radio frequency signal and local variance of the normalized B-mode image are used. An improved speckle tracking technique is also proposed for strain imaging of the solid lesions and background. A wavelet-based integration technique is then proposed for combining the strain images from these two techniques for visualizing both the solid and fluid filled lesions from a common framework. The final output of our algorithm is a high quality composite strain image which can effectively visualize both solid and fluid filled breast lesions in addition to the speckle content of the fluid filled lesions for their discrimination. The performance of our algorithm is evaluated using the in vivo patient data and compared with recently reported techniques. The results show that both the solid and fluid filled lesions can be better visualized using our technique and the fluid filled lesions can be classified with good accuracy. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. [Color Doppler sonography of focal abdominal lesions].

    Science.gov (United States)

    Licanin, Zoran; Lincender, Lidija; Djurović, V; Salihefendić, Nizama; Smajlović, Fahrudin

    2004-01-01

    Color Doppler sonography (CDS--spectral, color and power), harmonic imaging techniques (THI, PHI), possibility of 3D analysis of picture, usage of contrast agents, have raised the values of ultrasound as a diagnostic method to a very high level. THI--non-linear gray scale modality, is based on the processing of higher reflected frequencies, that has improved a picture resolution, which is presented with less artifacts and limiting effects of obesity and gases. Ultrasound contrast agents improve analysis of micro and macro circulation of the examined area, and with the assessment of velocity of supply in ROI (wash in), distribution and time of signal weakening (wash out), are significantly increasing diagnostic value of ultrasound. Besides the anatomical and topographic presentation of examined region (color, power), Color Doppler sonography gives us haemodynamic-functional information on vascularisation of that region, as well as on pathologic vascularisation if present. Avascular aspect of a focal pathologic lesion corresponds to a cyst or haematoma, while coloration and positive spectral curve discover that anechogenic lesions actually represents aneurysms, pseudoaneurysms or AVF. In local inflammatory lesion, abscess in an acute phase, CDS shows first increased, and then decreased central perfusion, while in a chronic phase, a pericapsular vascularisation is present. Contribution of CDS in differentiation of hepatic tumors (hemangioma, HCC and metastasis) is very significant. Central color dots along the peripheral blood vessels and the blush phenomenon are characteristics of capillary hemangioma, peritumoral vascular ring "basket" of HCC, and "detour" sign of metastasis. The central artery, RI from 0.45 to 0.60 and radial spreading characterize FNH. Hepatic adenoma is characterized by an intratumoral vein, and rarely by a vascular hallo. Further on, blood velocity in tumor defined by Color Doppler, distinguishes malignant from benign lesion, where 40 cm/s is a

  5. Assessing burn depth in tattooed burn lesions with LASCA Imaging.

    Science.gov (United States)

    Krezdorn, N; Limbourg, A; Paprottka, F J; Könneker; Ipaktchi, R; Vogt, P M

    2016-09-30

    Tattoos are on the rise, and so are patients with tattooed burn lesions. A proper assessment with regard to burn depth is often impeded by the tattoo dye. Laser speckle contrast analysis (LASCA) is a technique that evaluates burn lesions via relative perfusion analysis. We assessed the effect of tattoo skin pigmentation on LASCA perfusion imaging in a multicolour tattooed patient. Depth of burn lesions in multi-coloured tattooed and untattooed skin was assessed using LASCA. Relative perfusion was measured in perfusion units (PU) and compared to various pigment colours, then correlated with the clinical evaluation of the lesion. Superficial partial thickness burn (SPTB) lesions showed significantly elevated perfusion units (PU) compared to normal skin; deep partial thickness burns showed decreased PU levels. PU of various tattoo pigments to normal skin showed either significantly lower values (blue, red, pink) or significantly increased values (black) whereas orange and yellow pigment showed values comparable to normal skin. In SPTB, black and blue pigment showed reduced perfusion; yellow pigment was similar to normal SPTB burn. Deep partial thickness burn (DPTB) lesions in tattoos did not show significant differences to normal DPTB lesions for black, green and red. Tattoo pigments alter the results of perfusion patterns assessed with LASCA both in normal and burned skin. Yellow pigments do not seem to interfere with LASCA assessment. However proper determination of burn depth both in SPTB and DPTB by LASCA is limited by the heterogenic alterations of the various pigment colours.

  6. TU-EF-210-03: Real-Time Ablation Monitoring and Lesion Quantification Using Harmonic Motion Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Konofagou, E. [Columbia University (United States)

    2015-06-15

    The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare.

  7. Benign breast lesions in Kano

    African Journals Online (AJOL)

    Background; Non-malignant diseases of the breast have assumed increased importance ... This was followed by fibroadenoma accounting for 28.8% with a mean age of 21 ... relevance of this study. ... benign breast lesion in Kano accounting.

  8. Electrocautery for Precancerous Anal Lesions

    Science.gov (United States)

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  9. Lesions of the avian pancreas.

    Science.gov (United States)

    Schmidt, Robert E; Reavill, Drury R

    2014-01-01

    Although not well described, occasional reports of avian exocrine and endocrine pancreatic disease are available. This article describes the lesions associated with common diseases of the avian pancreas reported in the literature and/or seen by the authors.

  10. Space Occupying Lesions in the Liver

    Directory of Open Access Journals (Sweden)

    Nasser Ebrahimi Daryani

    2009-01-01

    of HCC include poorly-defined margins and coarse, irregular internal echoes. Small tumors are often hypoechoic. "nMagnetic resonance imaging: On MRI, HCC appears as a high intensity pattern on T2-weighted images, and a low intensity pattern on T1-weighted images. "nBENIGN FOCAL LESIONS: "nCysts: "nUltrasound—Ultrasound features that are specific for a cyst include a well-defined thin wall and increased through-transmission. "nMagnetic resonance imaging—MRI shows hepatic cysts as well-defined lesions with very high signal intensity on T2-weighted images. "nCavernous Hemangioma: "nUltrasound: Ultrasound typically reveals a well-demarcated homogeneous hyperechoic mass. The hemangioma may be hypo-echoic in patients with fatty infiltration of the liver due to the bright signal from the surrounding parenchyma. "nMagnetic resonance imaging: The typical MRI appearance is a smooth, well-demarcated homogeneous mass that has low-signal intensity on T1-weighted images and is hyper-intense on T2-weighted images. "nHepatic Adenoma: "nUltrasound: The lesions are often large and in the right lobe of the liver. Adenomas are usually hyperechoic in relation to the surrounding liver parenchyma. Magnetic resonance imaging—Lesions often have increased T1-weighted signal intensity as a result of lipid, and the central hemorrhage is often detected with this imaging technique.  

  11. Pediatric sellar and suprasellar lesions.

    Science.gov (United States)

    Schroeder, Jason W; Vezina, L Gilbert

    2011-03-01

    Masses arising in the sella turcica and the suprasellar region are common in children. The type and frequency of the various lesions encountered in childhood differ from the adult presentation. This article reviews the embryology of the pituitary gland and its normal appearance in childhood as well as the imaging and clinical findings of the common and some of the uncommon lesions arising in the sella turcica, the pituitary stalk, the suprasellar cistern and the lower third ventricle in the pediatric population.

  12. HIFU经颅治疗中降低颅骨声压的仿真研究%Simulation Study on Reducing Acoustic Pressure on Skull During HIFU Transcranial Therapy

    Institute of Scientific and Technical Information of China (English)

    王意喆; 张千; 周文征; 菅喜岐

    2014-01-01

    During the transcranial therapy by using high-intensity focused ultrasound ( HIFU) , the hot spot with a peak acoustic pressure and a high temperature rise might be induced on the skull, which can injure the skull and the surrounding tissue. In this paper, the approximation of the Westervelt formula and Pennes bio-heat conduction e-quation were applied to the simulation model which was based on spherical eight annular phased array transducer and CT data of a human skull and combined with time reversal method in order to analyze and discuss the acoustic pres-sure and temperature distribution of transcranial HIFU. The results show that, when the acoustic pressure and temper-ature of the hot spot in skull were reduced, it can focus at the target region through the skull. In this simulation mod-el, it reduced the acoustic pressure and temperature of hot spot in the one-dimensional focusing range of the spherical eight annular phased array transducer.%研究颅骨超声治疗声压和温度预测问题,高强度聚焦超声( high-intensity focused ultrasound, HIFU)经颅脑肿瘤治疗中,由于在颅骨处可能形成声压和温度较高的热点,引起颅骨及周边组织损伤。为解决上述问题,利用Westervelt声传播方程近似式及Pennes生物热传导方程,以凹球面八圆环相控换能器和人体头颅CT数据建立的仿真模型为例,结合时间反转法,分析讨论经颅HIFU形成的声压场和温度场。研究结果表明,降低热点声压及温升的同时可实现在颅内目标靶区中聚焦;在该数值仿真模型中,在凹球面八圆环相控换能器的一维可变焦范围内均可实现颅内聚焦和颅骨热点处声压和温升的降低。

  13. Tratamiento no quirúrgico de lesiones periapicales Non-surgical treatment of periapical lesions

    Directory of Open Access Journals (Sweden)

    Pedro Pablo Ferro Benítez

    2005-08-01

    decrease of the periapical lesions was evaluated in both groups 3 and 6 months after the beginning of the treatment. No statistically significant differences were observed. The same occurred in the evaluation of the periapical osteal repair 9 months after initiating the treatment. The results were satisfactory with both techniques. The active participation of calcium hydroxide in the repair of periapical lesions independently of its association with camphorated paramonochlorophenol was proved.

  14. Lesions of the clitoris: a review.

    Science.gov (United States)

    Heller, Debra S

    2015-01-01

    The clitoris may become involved by vulvar lesions. There are also lesions arising from the clitoris. A familiarity with these lesions is necessary for the high index of suspicion needed for their diagnosis.

  15. Simulation of spiculated breast lesions

    Science.gov (United States)

    Elangovan, Premkumar; Alrehily, Faisal; Pinto, R. Ferrari; Rashidnasab, Alaleh; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2016-03-01

    Virtual clinical trials are a promising new approach increasingly used for the evaluation and comparison of breast imaging modalities. A key component in such an assessment paradigm is the use of simulated pathology, in particular, simulation of lesions. Breast mass lesions can be generally classified into two categories based on their appearance; nonspiculated masses and spiculated masses. In our previous work, we have successfully simulated non-spiculated masses using a fractal growth process known as diffusion limited aggregation. In this new work, we have extended the DLA model to simulate spiculated lesions by using features extracted from patient DBT images containing spiculated lesions. The features extracted included spicule length, width, curvature and distribution. This information was used to simulate realistic looking spicules which were attached to the surface of a DLA mass to produce a spiculated mass. A batch of simulated spiculated masses was inserted into normal patient images and presented to an experienced radiologist for review. The study yielded promising results with the radiologist rating 60% of simulated lesions in 2D and 50% of simulated lesions in DBT as realistic.

  16. Border preserving skin lesion segmentation

    Science.gov (United States)

    Kamali, Mostafa; Samei, Golnoosh

    2008-03-01

    Melanoma is a fatal cancer with a growing incident rate. However it could be cured if diagnosed in early stages. The first step in detecting melanoma is the separation of skin lesion from healthy skin. There are particular features associated with a malignant lesion whose successful detection relies upon accurately extracted borders. We propose a two step approach. First, we apply K-means clustering method (to 3D RGB space) that extracts relatively accurate borders. In the second step we perform an extra refining step for detecting the fading area around some lesions as accurately as possible. Our method has a number of novelties. Firstly as the clustering method is directly applied to the 3D color space, we do not overlook the dependencies between different color channels. In addition, it is capable of extracting fine lesion borders up to pixel level in spite of the difficulties associated with fading areas around the lesion. Performing clustering in different color spaces reveals that 3D RGB color space is preferred. The application of the proposed algorithm to an extensive data-base of skin lesions shows that its performance is superior to that of existing methods both in terms of accuracy and computational complexity.

  17. Premalignant Lesions in the Kidney

    Directory of Open Access Journals (Sweden)

    Ziva Kirkali

    2001-01-01

    Full Text Available Renal cell carcinoma (RCC is the most malignant urologic disease. Different lesions, such as dysplasia in the tubules adjacent to RCC, atypical hyperplasia in the cyst epithelium of von Hippel-Lindau syndrome, and adenoma have been described for a number of years as possible premalignant changes or precursor lesions of RCC. In two recent papers, kidneys adjacent to RCC or removed from other causes were analyzed, and dysplastic lesions were identified and defined in detail. Currently renal intraepithelial neoplasia (RIN is the proposed term for classification. The criteria for a lesion to be defined as premalignant are (1 morphological similarity; (2 spatial association; (3 development of microinvasive carcinoma; (4 higher frequency, severity, and extent then invasive carcinoma; (5 progression to invasive cancer; and (6 similar genetic alterations. RIN resembles the neoplastic cells of RCC. There is spatial association. Progression to invasive carcinoma is described in experimental cancer models, and in some human renal tumors. Similar molecular alterations are found in some putative premalignant changes. The treatment for RCC is radical or partial nephrectomy. Preneoplastic lesions may remain in the renal remnant in patients treated by partial nephrectomy and may be the source of local recurrences. RIN seems to be a biologic precursor of some RCCs and warrants further investigation. Interpretation and reporting of these lesions would reveal important resources for the biological nature and clinical significance. The management of RIN diagnosed in a renal biopsy and partial nephrectomy needs to be answered.

  18. Unusual lesions of the mediastinum

    Directory of Open Access Journals (Sweden)

    Fatima Shamsuddin

    2015-01-01

    Full Text Available Objectives: To study unusual lesions in the mediastinum, which do not originate from the thymus, lymph nodes, neural tissues or germ cells, and tissues that normally engender pathologic lesions in the mediastinum. Materials and Methods: Of the 65 cases seen, 12 unusual lesion were encountered in a 5½ year period from 2006 to 2011. Results: Two cases of nodular colloid goiter and one each of the mediastinal cyst, undifferentiated carcinoma, and Langerhans cell histiocytosis (LCH affected the anterosuperior mediastinum. In the middle mediastinum, one case each of the mesothelioma, malignant gastrointestinal stromal tumor (GIST, squamous cell carcinoma (SCC, solitary fibrous tumor (SFT, and pleomorphic sarcoma (PS was seen. One case of meningeal melanocytoma (Mme and primary pleural liposarcoma (PL involved the posterior mediastinum. Persistent disease was seen in LCH after 2 years. Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year. Conclusion: The cases of primary and SCC, LCH, melanocytoma, liposarcoma and PS, and GIST are unexpected and very rarely have paradigms in the mediastinum. Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location. A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.

  19. TU-B-210-00: MR-Guided Focused Ultrasound Therapy in Oncology

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

  20. Non-local means inpainting of MS lesions in longitudinal image processing

    Directory of Open Access Journals (Sweden)

    Nicolas eGuizard

    2015-12-01

    Full Text Available In medical imaging, multiple sclerosis (MS lesions can lead to confounding effects in automatic morphometric processing tools such as registration, segmentation and cortical extraction and subsequently alter individual longitudinal measurements. Multiple magnetic resonance imaging (MRI inpainting techniques have been proposed to decrease the impact of MS lesions in medical image processing, however, most of these methods make the assumption that lesions only affect white matter. Here, we propose a method to fill lesion regions using the patch-based non-local mean (NLM strategy. The method consists of a hierarchical concentric filling strategy after identification of the lesion region. The lesion is filled iteratively, based on the surrounding tissue intensity, using an onion peel strategy. This concentric technique presents the advantage of preserving the local information and therefore the continuity of the anatomy and does not require identification of any a priori normal brain tissues. The method is first evaluated on simulated artificial MS lesions and, second, we performed a power analysis to evaluate brain atrophy and ventricular growth in patients with MS. The method was compared to two different publicly available methods (FSL lesion fill and Lesion LEAP and more classic method approaches. The proposed method was shown to exceed the other methods in reproducing the fidelity of the images where the lesions were inpainted. The method also improved the power to detect brain atrophy or ventricular growth by decreasing the sample size by 25% in the presence of MS lesions.

  1. Neuronavigation. Principles. Surgical technique.

    Science.gov (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  2. Managing Carious Lesions: Consensus Recommendations on Terminology.

    Science.gov (United States)

    Innes, N P T; Frencken, J E; Bjørndal, L; Maltz, M; Manton, D J; Ricketts, D; Van Landuyt, K; Banerjee, A; Campus, G; Doméjean, S; Fontana, M; Leal, S; Lo, E; Machiulskiene, V; Schulte, A; Splieth, C; Zandona, A; Schwendicke, F

    2016-05-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community. © International & American Associations for Dental Research 2016.

  3. Contribuição ao estudo da microinfiltração in vitro de lesões cervicais não cariosas restauradas com diferentes materiais adesivos e técnicas In vitro evaluation of microleakage of noncarious cervical lesions restored with different adhesive materials and techniques

    Directory of Open Access Journals (Sweden)

    Adriana Bona MATOS

    1997-01-01

    Full Text Available A restauração de lesões cervicais não cariosas é um procedimento comum na clínica diária, havendo uma alta incidência de casos de perda da restauração, descoloração marginal e recidiva de cárie. A etiologia desse tipo de lesão é considerada multifatorial. Neste trabalho, avaliou-se a microinfiltração diante das seguintes variáveis: tipo de material utilizado (dois adesivos de quarta geração utilizados em conjunto com duas resinas compostas de tipos diferentes, ©microfillª e híbrida, dois métodos de polimerização dos sistemas adesivos (foto e dual e duas técnicas restauradoras (incremental e do incremento único. Na metodologia deste trabalho, utilizaram-se ciclagem térmica e mecânica, técnica de infiltração com nitrato de prata, cortes seriados e leitura dos resultados através de escala de escores. A microinfiltração foi menor quando se utilizou uma resina composta híbrida comparada à resina ©microfillª. Ao se utilizar o método de polimerização dual do sistema adesivo, a microinfiltração foi menor do que com o método somente fotopolimerizável. A técnica restauradora não exerceu influência sobre o padrão de microinfiltração encontrado nas restaurações de lesões cervicais não cariosasRestoration of noncarious cervical lesions is a usual clinical procedure, and there is a high incidence of restoration loss, marginal discoloration, and recurrent caries. All the factors that play an important role in this process have to be considered when studying this kind of lesion of complex multifactorial etiology. Microleakage was evaluated related to the type of material used (two fourth generation bonding systems used with two types of composite resins: hybrid and microfill, two polymerization methods for bonding systems (photo and dual cure and two restorative techniques (incremental and bulk. This study used thermal and mechanical cycling procedures, infiltration tests with silver nitrate solution

  4. Photothermal lesions in soft tissue induced by optical fiber microheaters.

    Science.gov (United States)

    Pimentel-Domínguez, Reinher; Moreno-Álvarez, Paola; Hautefeuille, Mathieu; Chavarría, Anahí; Hernández-Cordero, Juan

    2016-04-01

    Photothermal therapy has shown to be a promising technique for local treatment of tumors. However, the main challenge for this technique is the availability of localized heat sources to minimize thermal damage in the surrounding healthy tissue. In this work, we demonstrate the use of optical fiber microheaters for inducing thermal lesions in soft tissue. The proposed devices incorporate carbon nanotubes or gold nanolayers on the tips of optical fibers for enhanced photothermal effects and heating of ex vivo biological tissues. We report preliminary results of small size photothermal lesions induced on mice liver tissues. The morphology of the resulting lesions shows that optical fiber microheaters may render useful for delivering highly localized heat for photothermal therapy.

  5. Use of radioisotope scan in evaluation of intrascrotal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Riley, T.W.; Mosbaugh, P.G.; Coles, J.L.; Newman, D.M.; Van Hove, E.D.; Heck, L.L.

    1976-10-01

    There were 98 patients with a variety of intrascrotal lesions studied with a radioisotope 99mtechnetium-pertechnetate scanning technique. Retrospective analysis in 50 patients subjected to an operation revealed a 94 percent accuracy of the scan in the differential diagnosis of testicular torsion and epididymitis as compared to a clinical accuracy of 48 percent. In 7 patients with a scan diagnosis of epididymo-orchitis with abscess the diagnosis was confirmed during the operation or by followup examination. While the scan has been a simple, safe, rapid and reliable technique to differentiate acute and subacute lesions, it has proved to be of limited diagnostic significance in cases of chronic intrascrotal lesions and carcinoma.

  6. Arthroscopic Repair of a Posterior Bony Bankart Lesion.

    Science.gov (United States)

    Poehling-Monaghan, Kirsten L; Krych, Aaron J; Dahm, Diane L

    2015-12-01

    Posterior bony defects of the glenoid rim, particularly those associated with instability, are often a frustrating challenge for arthroscopists because of the defects' inaccessibility from standard portals. This challenge is enhanced when the lesion is chronic and fibrous malunion of the fragment makes mobilization difficult. We present our technique for arthroscopic repair of the relatively uncommon chronic posterior bony Bankart lesion. By use of lateral positioning and a standard anterior viewing portal and posterior working portal, as well as a strategically placed posterolateral accessory portal, the lesion is first freed from its malreduced position and ultimately repaired using suture anchor fixation of the bony fragment along with its associated labrum directly to the remaining glenoid rim. This technique, facilitated by precise portal placement, results in satisfactory fragment reduction, appropriate capsular tension, and restoration of anatomy.

  7. Fine needle aspiration of focal lung lesion under CT fluoroscopic guidance

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Shin, Hyun Joon; Choi, Young Chil; Park, Sang Woo; Yi, Jeong Geun; Park, Jeong Hee [College of Medicine, Konkuk University, Seoul (Korea, Republic of); Jin, Yong Hyun [Sung Ae Hospital, Seoul (Korea, Republic of)

    2006-07-15

    We wanted to assess the efficacy of using CT fluoroscopy during Fine Needle Aspiration (FNA) for focal lung lesion. We retrospectively reviewed 22 patients who had undergone FNA under CT fluoroscopic guidance. The final diagnosis of focal lung lesion was based on surgery, the results of biopsy taken from another site or the clinical diagnosis with imaging follow-up. We reviewed the imaging and recorded the location of the lesion, the lesion size and the depth from the puncture site. In 24 cases of 22 patients, 16 lesions were benign and 8 were malignant. The sensitivity and specificity for malignant lesions were 100%, and 75%, respectively. The mean size of the malignant lesions was 3.75 {+-} 1.68 cm, and that of the benign lesion was 3.05 {+-} 2.98 cm. The mean depth of the lesion divided by the size was 1.85 {+-} 1.09 for 20 lesions of the correct result group and 3.13 {+-} 1.73 for 4 lesions of the incorrect result group; the difference between the two groups was statistically different ({rho} = 0.030). The complications after FNA were pneumothoraces in three cases and parenchymal hemorrhage in one case, but no significant complication was noted after the procedures. We could perform the FNA accurately and safely under CT fluoroscopy guidance, so this technique can be used for FNA of focal lung lesion for obtaining a correct result with fewer complications.

  8. Nodular lesions and mesangiolysis in diabetic nephropathy.

    Science.gov (United States)

    Wada, Takashi; Shimizu, Miho; Yokoyama, Hitoshi; Iwata, Yasunori; Sakai, Yoshio; Kaneko, Shuichi; Furuichi, Kengo

    2013-02-01

    Diabetic nephropathy is a leading cause of end-stage renal failure all over the world. Advanced human diabetic nephropathy is characterized by the presence of specific lesions including nodular lesions, doughnut lesions, and exudative lesions. Thus far, animal models precisely mimicking advanced human diabetic nephropathy, especially nodular lesions, remain to be fully established. Animal models with spontaneous diabetic kidney diseases or with inducible kidney lesions may be useful for investigating the pathogenesis of diabetic nephropathy. Based on pathological features, we previously reported that diabetic glomerular nodular-like lesions were formed during the reconstruction process of mesangiolysis. Recently, we established nodular-like lesions resembling those seen in advanced human diabetic nephropathy through vascular endothelial injury and mesangiolysis by administration of monocrotaline. Here, in this review, we discuss diabetic nodular lesions and its animal models resembling human diabetic kidney lesions, with our hypothesis that endothelial cell injury and mesangiolysis might be required for nodular lesions.

  9. Genital lesions after consensual sexual intercourse: They are frequent and they last for several days

    DEFF Research Database (Denmark)

    Astrup, Birgitte Schmidt; Lauritsen, Jens; Ravn, Pernille

    Introduction: The significance of genital lesions in victims of rape is currently under debate in many countries. Legal experts are pointing at the lack of comprehensive knowledge of lesions sustained during consensual sexual intercourse as a key problem. The aim of this study was to provide...... insight into the duration of lesions, frequency of lesions seen with different investigative techniques and to identify pitfalls in the diagnosis of lesions. Materials and Methods: 98 women were examined within 48 hours of consensual sexual intercourse using the naked eye, the colposcope and toluidine......, respectively. The median survival time for lacerations was 24 hours (n=19) seen with the naked eye, 40 hours seen with the colposcope (n=28) and 80 hours seen with toluidine blue dye (n=26). Several important pitfalls in the diagnosis of lesions using the three techniques were identified. We propose a model...

  10. [Percutaneous diagnostic angioscopy. Primary lesions].

    Science.gov (United States)

    Carlier, C; Foucart, H; Baudrillard, J C; Cécile, J P

    1993-01-01

    Efficacy of percutaneous treatments of arterial affections requires the correct choice of indications, necessitating precise knowledge of elementary arterial lesions. Arterial endoscopy appears to be more specific than angiography for this use, since it allows direct vision in vivo of the lesion, a histopathologic approach compared with the non univocal images produced by angiography (for example, an arterial obstruction can result from varied causes). Different accidents to the endothelial surface can be observed: golden yellow atheromatous elevations on a straw yellow background, intimal flaps, mobile intra-luminal vegetations. Established atheromatous stenosis are smooth and regular, or on the contrary ulcerated and edged with irregular flaps capable of provoking an eccentric residual lumen. The vegetating atheromatous lesions may project into the lumen, often as calcified and thus pearly white scales adhering to the wall, or as larger occlusive lesions. When capable of being isolated, a thrombus often completes the stenosis: its recognition is therefore fundamental since its removal exposes the subjacent lesions to be treated. The fresh clot is coral shaped, bright red and mobile in the blood flow. Established clots are compact and greenish brown. At an advanced stage of atheroma the surface of the occluding clot is covered with a regular straw yellow endothelium. In the presence of a dissecting vessel the fibroscope may be introduced into the false channel, no longer showing typical endothelium but a coagulated mass interspersed with fibrous bands. Prosthetic stenosis result from either intimal hyperplasia or a suturing fault with plication.

  11. Oropharyngeal lesions in pityriasis rosea.

    Science.gov (United States)

    Ciccarese, Giulia; Broccolo, Francesco; Rebora, Alfredo; Parodi, Aurora; Drago, Francesco

    2017-07-17

    Pityriasis rosea (PR) is an exanthematous disease associated with the endogenous systemic reactivation of human herpesvirus-6 (HHV-6) and human herpesvirus-7 (HHV-7). Oropharyngeal lesions may be associated with the exanthema, but anecdotal evidence suggests that few dermatologists are aware of their occurrence. Classifying oropharyngeal lesions in PR, establishing their prevalence, and assessing their possible association with different PR forms. The records of all PR cases diagnosed in the Dermatology Clinic of Genoa University between 2003 and 2016 were retrospectively reviewed to examine sex and age of the patients, PR type, presence of enanthema, systemic symptoms, specific anti-HHV-6 and or HHV-7 serology, and HHV-6 and/or HHV-7 DNA loads. The oropharyngeal mucosa was carefully examined in 527 patients with PR. Painless oropharyngeal lesions were observed in 149 patients with PR (28%) and classified as erythematomacular, macular and papular, erythematovesicular, and petechial lesions. The petechial and macular and papular patterns were those most frequently observed. There was no statistically significant difference in the levels of HHV-6 and HHV-7 viremia in the plasma of patients with enanthema and those without. Because this was a retrospective study, biopsies on mucosal lesions were not performed. Our findings showed that enanthemas are frequently associated with forms of PR different from the classic form. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Spectroscopic Detection of Caries Lesions

    Directory of Open Access Journals (Sweden)

    Mika Ruohonen

    2013-01-01

    Full Text Available Background. A caries lesion causes changes in the optical properties of the affected tissue. Currently a caries lesion can be detected only at a relatively late stage of development. Caries diagnosis also suffers from high interobserver variance. Methods. This is a pilot study to test the suitability of an optical diffuse reflectance spectroscopy for caries diagnosis. Reflectance visible/near-infrared spectroscopy (VIS/NIRS was used to measure caries lesions and healthy enamel on extracted human teeth. The results were analysed with a computational algorithm in order to find a rule-based classification method to detect caries lesions. Results. The classification indicated that the measured points of enamel could be assigned to one of three classes: healthy enamel, a caries lesion, and stained healthy enamel. The features that enabled this were consistent with theory. Conclusions. It seems that spectroscopic measurements can help to reduce false positives at in vitro setting. However, further research is required to evaluate the strength of the evidence for the method’s performance.

  13. Stereotactic limbic leucotomy: surgical technique

    Science.gov (United States)

    Richardson, Alan

    1973-01-01

    The requirements for modern psychosurgery are safety and accuracy. Stereotactic techniques give the geometric accuracy and stimulation gives physiological information, which is important in determining lesion sites or at least lesion symmetry. The process whereby focal brain destruction is produced is ideally by a freezing probe, but equally effectively by coagulation. A number of small lesions is thus required. This at present is unavoidable if side effects are to be obviated. Careful continuing assessment of results is necessary to validate any surgical procedure. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:4618905

  14. Simplified Knotless Mattress Repair of Type II SLAP Lesions.

    Science.gov (United States)

    Chia, Marcus Robert; Hatrick, Cameron

    2015-12-01

    Arthroscopic repair of lesions of the superior labrum and biceps anchor has been shown to provide good to excellent results. We describe a simplified arthroscopic surgical technique using a single knotless anchor with a mattress suture configuration. This technique provides an effective and reproducible method to reattach and re-create the normal appearance of the superior labrum and biceps anchor in a time-efficient manner without the need for knot tying.

  15. Arthroscopic Repair of Chronic Bony Bankart Lesion Using a Low Anterior Portal

    OpenAIRE

    Brand, Jefferson C.; Westerberg, Paul

    2012-01-01

    We describe the repair of a chronic bony Bankart lesion in a case with recurrent instability using standard techniques and equipment for addressing anteroinferior glenohumeral instability. A 25-year-old man with recurrent instability and a chronic bony Bankart lesion with a Hill-Sachs lesion was treated. The inferior 2 sutures and knotless anchors are placed through a low anterior portal, which improves the angle of approach to the inferior portion of the glenoid that is fractured. The knotle...

  16. Minimally invasive treatment for esthetic enhancement of white spot lesion in adjacent tooth.

    Science.gov (United States)

    Lee, Ji-Hye; Kim, Dae-Gon; Park, Chan-Jin; Cho, Lee-Ra

    2013-08-01

    This article describes the treatment provided to a patient with the maxillary anterior teeth exhibiting severe secondary caries beneath the previous restoration and a white spot lesion on the adjacent incisor. Two implants were placed after extraction of hopeless teeth with the guided bone regeneration technique. A white spot lesion of the adjacent incisor was treated with minimally invasive treatment. This clinical report describes the multidisciplinary treatment for the white spot lesion and esthetic restoration of missing anterior teeth.

  17. Abfraction lesions reviewed: current concepts

    Directory of Open Access Journals (Sweden)

    Adriana de Fátima Vasconcelos Pereira

    2008-01-01

    Full Text Available Non-carious cervical lesions are characterized by structural loss near the cementoenamel junction, without the presence of caries. Anumber of theories have arisen to explain the etiology of such lesions, although the real causes remain obscure, as is reflected by the contradictory terminology used in the literature. In addition to describing acidic and abrasive processes documented as etiological factors, attention is given to the role of mechanical stress from occlusal load, which is the most accepted theory for the development of abfraction lesions. Considering that tensile stress leads to the failure of restorations in the cervical region and that this is a fruitful area for future research, the present study has highlighted diagnosis, prognosis and the criteria for treatment.

  18. Atrial lesion transmurality assessment using multi-fiber diffuse reflectance (Conference Presentation)

    Science.gov (United States)

    Singh-Moon, Rajinder P.; Hendon, Christine P.

    2017-02-01

    In non-pharmacological treatment of cardiac arrhythmias such as catheter ablation therapy, long-term treatment effectiveness is related in part to the quality of lesion generation. Superficial lesions may lead to arrhythmia recurrence by allowing recovery along conduction channels for arrhythmic impulses to propagate; conversely transmural lesions inhibit conduction. Conventional techniques rely on measurement of surrogate parameters such as change in bioelectrical impedance, or electrogram amplitude dampening as a qualitative assessment for lesion size. In previous work, we've demonstrated a relationship between lesion dimensions and spectroscopic parameters extracted using an optically-integrated ablation catheter. Though these metrics present some trend, a method to directly assess lesion transmurality maybe better suited. In this work, we report a method for direct recovery of lesion depth in cardiac tissue using diffusely reflected optical measurements and present initial in silico validation. Photon transport throughout a heterogeneous volume was simulated for a series of source-detector pairs and optical properties using a GPU-based Monte Carlo (MC) code. Results were used to generate a multi-dimensional look-up table for each collection geometry for partial to transmural lesions. A genetic algorithm-based two-step inversion method was employed to extract lesion transmurality. MC simulated optical measurements for various lesion sizes were generated using optical properties for ablated and normal cardiac tissue found in literature and were fitted using our algorithm. Recovered lesion depths ranged between 2-10% for lesions less than 3mm and were within 20% for lesions greater than 4mm. These results support the application of this technique for lesion validation for atrial tissue.

  19. Segmentation of multiple sclerosis lesions in MR images: a review

    Energy Technology Data Exchange (ETDEWEB)

    Mortazavi, Daryoush; Kouzani, Abbas Z. [Deakin University, School of Engineering, Geelong, Victoria (Australia); Soltanian-Zadeh, Hamid [Henry Ford Health System, Image Analysis Laboratory, Radiology Department, Detroit, MI (United States); University of Tehran, Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, Tehran (Iran, Islamic Republic of); School of Cognitive Sciences, Institute for Studies in Theoretical Physics and Mathematics (IPM), Tehran (Iran, Islamic Republic of)

    2012-04-15

    Multiple sclerosis (MS) is an inflammatory demyelinating disease that the parts of the nervous system through the lesions generated in the white matter of the brain. It brings about disabilities in different organs of the body such as eyes and muscles. Early detection of MS and estimation of its progression are critical for optimal treatment of the disease. For diagnosis and treatment evaluation of MS lesions, they may be detected and segmented in Magnetic Resonance Imaging (MRI) scans of the brain. However, due to the large amount of MRI data to be analyzed, manual segmentation of the lesions by clinical experts translates into a very cumbersome and time consuming task. In addition, manual segmentation is subjective and prone to human errors. Several groups have developed computerized methods to detect and segment MS lesions. These methods are not categorized and compared in the past. This paper reviews and compares various MS lesion segmentation methods proposed in recent years. It covers conventional methods like multilevel thresholding and region growing, as well as more recent Bayesian methods that require parameter estimation algorithms. It also covers parameter estimation methods like expectation maximization and adaptive mixture model which are among unsupervised techniques as well as kNN and Parzen window methods that are among supervised techniques. Integration of knowledge-based methods such as atlas-based approaches with Bayesian methods increases segmentation accuracy. In addition, employing intelligent classifiers like Fuzzy C-Means, Fuzzy Inference Systems, and Artificial Neural Networks reduces misclassified voxels. (orig.)

  20. Lesiones frecuentes en atletas profesionales

    OpenAIRE

    Doyel, Crevecoer

    2015-01-01

    Durante la práctica del atletismo frecuentemente ocurren lesiones, afectando principalmente a los miembros inferiores. Las causas que las originan son muy diversas y tienen diferentes características de acuerdo al tipo de modalidad realizada dentro del atletismo. Objetivo: Analizar las características de las lesiones más frecuentes en miembros inferiores, en atletas corredores profesionales, de diferentes distancias, de ambos sexos, de entre 18 y 40 años de edad, que practican atletismo en...

  1. Lesiones frecuentes en atletas profesionales

    OpenAIRE

    Doyel, Crevecoer

    2015-01-01

    Durante la práctica del atletismo frecuentemente ocurren lesiones, afectando principalmente a los miembros inferiores. Las causas que las originan son muy diversas y tienen diferentes características de acuerdo al tipo de modalidad realizada dentro del atletismo. Objetivo: Analizar las características de las lesiones más frecuentes en miembros inferiores, en atletas corredores profesionales, de diferentes distancias, de ambos sexos, de entre 18 y 40 años de edad, que practican atletismo en...

  2. Heterogeneity of Multiple Sclerosis Lesions in Multislice Myelin Water Imaging.

    Directory of Open Access Journals (Sweden)

    Tobias Djamsched Faizy

    Full Text Available To assess neuroprotection and remyelination in Multiple Sclerosis (MS, we applied a more robust myelin water imaging (MWI processing technique, including spatial priors into image reconstruction, which allows for lower SNR, less averages and shorter acquisition times. We sought to evaluate this technique in MS-patients and healthy controls (HC.Seventeen MS-patients and 14 age-matched HCs received a 3T Magnetic Resonance Imaging (MRI examination including MWI (8 slices, 12 minutes acquisition time, T2w and T1mprage pre and post gadolinium (GD administration. Black holes (BH, contrast enhancing lesions (CEL and T2 lesions were marked and registered to MWI. Additionally, regions of interest (ROI were defined in the frontal, parietal and occipital normal appearing white matter (NAWM/white matter (WM, the corticospinal tract (CST, the splenium (SCC and genu (GCC of the corpus callosum in patients and HCs. Mean values of myelin water fraction (MWF were determined for each ROI.Significant differences (p≤0.05 of the MWF were found in all three different MS-lesion types (BH, CEL, T2 lesions, compared to the WM of HCs. The mean MWF values among the different lesion types were significantly differing from each other. Comparing MS-patients vs. HCs, we found a significant (p≤0.05 difference of the MWF in all measured ROIs except of GCC and SCC. The mean reduction of MWF in the NAWM of MS-patients compared to HCs was 37%. No age, sex, disability score and disease duration dependency was found for the NAWM MWF.MWF measures were in line with previous studies and lesions were clearly visible in MWI. MWI allows for quantitative assessment of NAWM and lesions in MS, which could be used as an additional sensitive imaging endpoint for larger MS studies. Measurements of the MWF also differ between patients and healthy controls.

  3. Feasibility Study on MR-Guided High-Intensity Focused Ultrasound Ablation of Sciatic Nerve in a Swine Model: Preliminary Results

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, Elena A., E-mail: kayee@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Medical Physics (United States); Gutta, Narendra Babu, E-mail: gnbabu.aiims@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Monette, Sebastien, E-mail: monettes@mskcc.org [The Rockefeller University, Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (United States); Gulati, Amitabh, E-mail: gulatia@mskcc.org; Loh, Jeffrey, E-mail: jeffreyloh@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Anesthesiology-Critical Care (United States); Srimathveeravalli, Govindarajan, E-mail: srimaths@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Ezell, Paula C., E-mail: paula.ezell@intusurg.com [The Rockefeller University, Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (United States); Erinjeri, Joseph P., E-mail: erinjerj@mskcc.org; Solomon, Stephen B., E-mail: solomons@mskcc.org; Maybody, Majid, E-mail: maybodym@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States)

    2015-08-15

    IntroductionSpastic patients often seek neurolysis, the permanent destruction of the sciatic nerve, for better pain management. MRI-guided high-intensity focused ultrasound (MRgHIFU) may serve as a noninvasive alternative to the prevailing, more intrusive techniques. This in vivo acute study is aimed at performing sciatic nerve neurolysis using a clinical MRgHIFU system.MethodsThe HIFU ablation of sciatic nerves was performed in swine (n = 5) using a HIFU system integrated with a 3 T MRI scanner. Acute lesions were confirmed using T1-weighted contrast-enhanced (CE) MRI and histopathology using hematoxylin and eosin staining. The animals were euthanized immediately following post-ablation imaging.ResultsReddening and mild thickening of the nerve and pallor of the adjacent muscle were seen in all animals. The HIFU-treated sections of the nerves displayed nuclear pyknosis of Schwann cells, vascular hyperemia, perineural edema, hyalinization of the collagenous stroma of the nerve, myelin sheet swelling, and loss of axons. Ablations were visible on CE MRI. Non-perfused volume of the lesions (5.8–64.6 cc) linearly correlated with estimated lethal thermal dose volume (4.7–34.2 cc). Skin burn adjacent to the largest ablated zone was observed in the first animal. Bilateral treatment time ranged from 55 to 138 min, and preparation time required 2 h on average.ConclusionThe acute pilot study in swine demonstrated the feasibility of a noninvasive neurolysis of the sciatic nerve using a clinical MRgHIFU system. Results revealed that acute HIFU nerve lesions were detectable on CE MRI, gross pathology, and histology.

  4. Association between lesion location and language function in adult glioma using voxel-based lesion-symptom mapping.

    Science.gov (United States)

    Banerjee, Pia; Leu, Kevin; Harris, Robert J; Cloughesy, Timothy F; Lai, Albert; Nghiemphu, Phioanh L; Pope, Whitney B; Bookheimer, Susan Y; Ellingson, Benjamin M

    2015-01-01

    Management of language difficulties is an important aspect of clinical care for glioma patients, and accurately identifying the possible language deficits in patients based on lesion location would be beneficial to clinicians. To that end, we examined the relationship between lesion presence and language performance on tests of receptive language and expressive language using a highly specific voxel-based lesion-symptom mapping (VLSM) approach in glioma patients. 98 adults with primary glioma, who were pre-surgical candidates, were administered seven neurocognitive tests within the domains of receptive language and expressive language. The association between language performance and lesion presence was examined using VLSM. Statistical parametric maps were created for each test, and composite maps for both receptive language and expressive language were created to display the significant voxels common to all tests within these language domains. We identified clusters of voxels with a significant relationship between lesion presence and language performance. All tasks were associated with several white matter pathways. The receptive language tasks were additionally all associated with regions primarily within the lateral temporal lobe and medial temporal lobe. In contrast, the expressive language tasks shared little overlap, despite each task being independently associated with large anatomic areas. Our findings identify the key anatomic structures involved in language functioning in adult glioma patients using an innovative lesion analysis technique and suggest that expressive language abilities may be more task-dependent and distributed than receptive language abilities.

  5. Tratamiento de lesiones de caries interproximales mediante el uso de infiltrantes Treatment of approximal caries lesions using infiltrants

    Directory of Open Access Journals (Sweden)

    ML Marró Freitte

    2011-12-01

    Full Text Available Basados en el respeto por la estructura dentaria junto a un adecuado tratamiento y detención de las lesiones de caries, se ha desarrollado ICON®, un sistema que penetra los tejidos afectados con una resina de baja viscosidad fotopolimerizable (infiltrante sin necesidad de la apertura mecánica de una cavidad. De este modo se introducen los “infiltrantes” como herramientas para el tratamiento de las lesiones proximales. El “infiltrante” actúa bloqueando la progresión de la lesión de caries y estabilizando la estructura dentaria. En este reporte se muestra la técnica de infiltración con el uso del kit ICON®, mediante la presentación de un caso clínico de lesión proximal extendida al tercio externo de la dentina.Based on the respect for the tooth structure with adequate treatment and arrest of carious lesions, ICON ® has been developed. This system enters the affected tissue with a low-viscosity light-curing resin (infiltrant with no need for mechanical opening of a cavity. This will introduce the infiltrants as tools for the treatment of proximal lesions. The “infiltrant” works by blocking the progression of caries lesion and stabilizing tooth structure. This report shows the technique with the use of the ICON ® kit, by presenting a case of proximal carious lesion extended to the outer third of dentin.

  6. Disseminated paracoccidioidomycosis diagnosis based on oral lesions

    Directory of Open Access Journals (Sweden)

    Liana Preto Webber

    2014-01-01

    Full Text Available Paracoccidioidomycosis (PCM is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.

  7. Gabor filter for the segmentation of skin lesions from ultrasonographic images

    Science.gov (United States)

    Petrella, Lorena I.; Gómez, W.; Alvarenga, André V.; Pereira, Wagner C. A.

    2012-05-01

    The present work applies Gabor filters bank for texture analysis of skin lesions images, obtained by ultrasound biomicroscopy. The regions affected by the lesions were differentiated from surrounding tissue in all the analyzed cases; however the accuracy of the traced borders showed some limitations in part of the images. Future steps are being contemplated, attempting to enhance the technique performance.

  8. Cystic Lesions in Autoimmune Pancreatitis

    Directory of Open Access Journals (Sweden)

    Macarena Gompertz

    2015-11-01

    Full Text Available Autoimmune pancreatitis (AIP can be chronic or recurrent, but frequently completely reversible after steroid treatment. A cystic lesion in AIP is a rare finding, and it can mimic a pancreatic cystic neoplasm. Difficulties in an exact diagnosis interfere with treatment, and surgery cannot be avoided in some cases. We report the history of a 63-year-old male presenting with jaundice and pruritus. AIP was confirmed by imaging and elevated IgG4 blood levels, and the patient completely recovered after corticosteroid therapy. One year later, he presented with a recurrent episode of AIP with elevated IgG4 levels, accompanied by the appearance of multiple intrapancreatic cystic lesions. All but 1 of these cysts disappeared after steroid treatment, but the remaining cyst in the pancreatic head was even somewhat larger 1 year later. Pancreatoduodenectomy was finally performed. Histology showed the wall of the cystic lesion to be fibrotic; the surrounding pancreatic tissue presented fibrosis, atrophy and lymphoplasmacytic infiltration by IgG4-positive cells, without malignant elements. Our case illustrates the rare possibility that cystic lesions can be part of AIP. These pseudocysts appear in the pancreatic segments involved in the autoimmune disease and can be a consequence of the local inflammation or related to ductal strictures. Steroid treatment should be initiated, after which these cysts can completely disappear with recovery from AIP. Surgical intervention may be necessary in some exceptional cases.

  9. Self-inflicted skin lesions

    DEFF Research Database (Denmark)

    Ring, Hans Christian; Smith, Matthias Nybro; Jemec, Gregor B E

    2014-01-01

    The current literature on the management of self-inflicted skin lesions points to an overall paucity of treatments with a high level of evidence (randomized controlled trials, controlled trials, or meta-analyses). In order to improve the communication between dermatologists and mental health...

  10. Focal lesions of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Hedayati, B. [Royal national Orthopaedic Hospital Stanmore, Brockley Hill Stanmore, Department of Radiology, Middlesex (United Kingdom); Lewisham Hospital NHS Trust, Department of Radiology, London (United Kingdom); Saifuddin, A. [Royal national Orthopaedic Hospital Stanmore, Brockley Hill Stanmore, Department of Radiology, Middlesex (United Kingdom)

    2009-08-15

    Focal lesions of the patella may be identified during the investigation of anterior knee pain or as an incidental finding on radiological images. This pictorial review describes the radiographic appearances of a wide range of conditions that have been seen in this sesamoid bone. Where appropriate, computed tomography and magnetic resonance features have been included. (orig.)

  11. SLAP lesions: a treatment algorithm.

    Science.gov (United States)

    Brockmeyer, Matthias; Tompkins, Marc; Kohn, Dieter M; Lorbach, Olaf

    2016-02-01

    Tears of the superior labrum involving the biceps anchor are a common entity, especially in athletes, and may highly impair shoulder function. If conservative treatment fails, successful arthroscopic repair of symptomatic SLAP lesions has been described in the literature particularly for young athletes. However, the results in throwing athletes are less successful with a significant amount of patients who will not regain their pre-injury level of performance. The clinical results of SLAP repairs in middle-aged and older patients are mixed, with worse results and higher revision rates as compared to younger patients. In this population, tenotomy or tenodesis of the biceps tendon is a viable alternative to SLAP repairs in order to improve clinical outcomes. The present article introduces a treatment algorithm for SLAP lesions based upon the recent literature as well as the authors' clinical experience. The type of lesion, age of patient, concomitant lesions, and functional requirements, as well as sport activity level of the patient, need to be considered. Moreover, normal variations and degenerative changes in the SLAP complex have to be distinguished from "true" SLAP lesions in order to improve results and avoid overtreatment. The suggestion for a treatment algorithm includes: type I: conservative treatment or arthroscopic debridement, type II: SLAP repair or biceps tenotomy/tenodesis, type III: resection of the instable bucket-handle tear, type IV: SLAP repair (biceps tenotomy/tenodesis if >50 % of biceps tendon is affected), type V: Bankart repair and SLAP repair, type VI: resection of the flap and SLAP repair, and type VII: refixation of the anterosuperior labrum and SLAP repair.

  12. Current management of talar osteochondral lesions

    Science.gov (United States)

    Gianakos, Arianna L; Yasui, Youichi; Hannon, Charles P; Kennedy, John G

    2017-01-01

    Osteochondral lesions of the talus (OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation (BMS), or replacement procedures, such as autologous osteochondral transplantation (AOT). Reparative procedures are generally indicated for OLT < 150 mm2 in area. Replacement strategies are used for large lesions or after failed primary repair procedures. Although short- and medium-term results have been reported, long-term studies on OLT treatment strategies are lacking. Biological augmentation including platelet-rich plasma and concentrated bone marrow aspirate is becoming increasingly popular for the treatment of OLT to enhance the biological environment during healing. In this review, we describe the most up-to-date clinical evidence of surgical outcomes, as well as both the mechanical and biological concerns associated with BMS and AOT. In addition, we will review the recent evidence for biological adjunct therapies that aim to improve outcomes and longevity of both BMS and AOT procedures. PMID:28144574

  13. Minimal treatment of the carious lesion.

    Science.gov (United States)

    Mount, G J

    1991-02-01

    The development of reliable adhesive technology in the oral cavity has opened the way to an entirely new approach to the treatment of active carious lesions. The initial lesion, prior to complete penetration of the enamel, can often be controlled with remineralization techniques. However, once the dentine is breached, surgical intervention is required. With modern instrumentation, including fibre-optic lighting and magnification with binocular loupes, a more surgical approach has been developed, allowing removal of caries with very limited destruction of sound tooth structure. Experience over the last 5 years has led to the development of a classification of cavity designs as well as a reliable method of instrumentation and restoration based on the use of glass-ionomer cement and composite resin. The remineralization available through the glass-ionomer cements and the adhesion developed with both the cement and composite resin allows for maintenance of the original strength of the tooth along with a high resistance to further breakdown. The classification of cavity design is presented as well as a detailed description of the suggested instrumentation for the development of the cavities.

  14. Improved differentiation between MS and vascular brain lesions using FLAIR* at 7 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Kilsdonk, Iris D.; Wattjes, Mike P.; Lopez-Soriano, Alexandra; Jong, Marcus C. de; Graaf, Wolter L. de; Conijn, Mandy M.A.; Barkhof, Frederik [VU University Medical Center, Department of Radiology, De Boelelaan 1118, HZ, Amsterdam (Netherlands); Kuijer, Joost P.A. [VU University Medical Center, Department of Physics and Medical Technology, Amsterdam (Netherlands); Polman, Chris H. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Luijten, Peter R. [University Medical Center, Department of Radiology, Utrecht (Netherlands); Geurts, Jeroen J.G. [VU University, Department of Anatomy and Neurosciences, Amsterdam (Netherlands); Geerlings, Mirjam I. [University Medical Center, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands)

    2014-04-15

    To investigate whether a new magnetic resonance image (MRI) technique called T2*-weighted fluid attenuation inversion recovery (FLAIR*) can differentiate between multiple sclerosis (MS) and vascular brain lesions, at 7 Tesla (T). We examined 16 MS patients and 16 age-matched patients with (risk factors for) vascular disease. 3D-FLAIR and T2*-weighted images were combined into FLAIR* images. Lesion type and intensity, perivascular orientation and presence of a hypointense rim were analysed. In total, 433 cerebral lesions were detected in MS patients versus 86 lesions in vascular patients. Lesions in MS patients were significantly more often orientated in a perivascular manner: 74 % vs. 47 % (P < 0.001). Ten MS lesions (2.3 %) were surrounded by a hypointense rim on FLAIR*, and 24 MS lesions (5.5 %) were hypointense on T2*. No lesions in vascular patients showed any rim or hypointensity. Specificity of differentiating MS from vascular lesions on 7-T FLAIR* increased when the presence of a central vessel was taken into account (from 63 % to 88 %), most obviously for deep white matter lesions (from 69 % to 94 %). High sensitivity remained (81 %). 7-T FLAIR* improves differentiation between MS and vascular lesions based on lesion location, perivascular orientation and presence of hypointense (rims around) lesions. circle A new MRI technique T2*-weighted fluid attenuation inversion recovery (FLAIR*) was investigated. circle FLAIR* at 7-T MRI combines FLAIR and T2* images into a single image. circle FLAIR* at 7 T does not require enhancement with contrast agents. (orig.)

  15. Endoscopic mucosal resection in colorectal lesion: a safe and effective procedure even in lesions larger than 2 cm and in carcinomas

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Oliveira dos Santos

    2011-12-01

    Full Text Available CONTEXT: Endoscopic mucosal resection is a minimally invasive technique used in the treatment of colorectal neoplasms, including early carcinomas of different size and morphology. OBJECTIVES: To evaluate procedure safety, efficacy, outcomes, and recurrence rate in endoscopic mucosal resection of colorectal lesions. METHODS: A total of 172 lesions in 156 patients were analyzed between May 2003 and May 2009. All lesions showed pit pattern suggestive of neoplasia (Kudo types III-V at high-magnification chromocolonoscopy with indigo carmine. The lesions were evaluated for macroscopic classification, size, location, and histopathology. Lesions 20 mm or smaller were resected en bloc and lesions larger than 20 mm were removed using the piecemeal technique. Complications and recurrence were analyzed. Patients were followed up for 18 months. RESULTS: There were 83 (48.2% superficial lesions, 57 (33.1% depressed lesions, 44 (25.6% laterally spreading tumors, and 45 (26.2% protruding lesions. Mean lesion size was 11.5 mm ± 9.6 mm (2 mm-60 mm. Patients' mean age was 61.6 ± 12.5 years (34-93 years. Regarding lesion site, 24 (14.0% lesions were located in the rectum, 68 (39.5% in the left colon, and 80 (46.5% in the right colon (transverse, ascending, and cecum. There were 167 (97.1% neoplasms: 142 (82.5% adenomatous lesions, 24 (14.0% intramucosal carcinomas, and 1 (0.6% invasive carcinoma. En bloc resection was performed in 158 (91.9% cases and piecemeal resection in 14 (8.1%. Bleeding occurred in 5 (2.9% cases. Recurrence was observed in 4.1% (5/122 of cases and was associated with lesions larger than 20 mm (P<0.01, piecemeal resection (P<0.01, advanced neoplasm (P = 0.01, and carcinoma compared to adenoma (P = 0.04. CONCLUSIONS: Endoscopic mucosal resection of colorectal lesions is a safe and effective procedure, with low complication and local recurrence rates. Recurrence is associated with lesions larger than 20 mm and carcinomas.

  16. Petrous apex lesions in the pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, Rupa [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Son, Hwa Jung [University of Cincinnati College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Cincinnati, OH (United States); Koch, Bernadette L. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2014-03-15

    A variety of abnormal imaging findings of the petrous apex are encountered in children. Many petrous apex lesions are identified incidentally while images of the brain or head and neck are being obtained for indications unrelated to the temporal bone. Differential considerations of petrous apex lesions in children include ''leave me alone'' lesions, infectious or inflammatory lesions, fibro-osseous lesions, neoplasms and neoplasm-like lesions, as well as a few rare miscellaneous conditions. Some lesions are similar to those encountered in adults, and some are unique to children. Langerhans cell histiocytosis (LCH) and primary and metastatic pediatric malignancies such as neuroblastoma, rhabomyosarcoma and Ewing sarcoma are more likely to be encountered in children. Lesions such as petrous apex cholesterol granuloma, cholesteatoma and chondrosarcoma are more common in adults and are rarely a diagnostic consideration in children. We present a comprehensive pictorial review of CT and MRI appearances of pediatric petrous apex lesions. (orig.)

  17. Imaging of Chest Wall Lesions in Children

    Directory of Open Access Journals (Sweden)

    A. Hekmatnia

    2008-01-01

    Full Text Available Chest wall lesions in childhood include a wide range of pathologies; Benign lesions include lipoma, neurofibroma, lymphangioma, hemangioma, and mesenchymal hamartoma."nMalignant lesions include Neuroblastoma, Rhabdo-myosarcoma, Ewing sarcoma, and Askin tumor."nSystemic diseases such as leukemia, lymphoma, Langerhans cell histiocytosis, and also infections such as tuberculosis, and actinomycosis may also cause chest wall lesions."nThe imaging characteristics of these lesions are re-viewed, but only a minority of the lesions shows diagnostic imaging features, and most of lesions re-quire biopsy and histopathological examination for "ndefinitive diagnosis."nThe role of different modalities is discussed with an emphasis on magnetic resonance imaging for demonstrating lesion morphology and local spread. Computed tomography and neuclear medicine being used mainly to assess remote disease."nIn this lecture, we discuss about imaging of chest wall lesions in children.

  18. Relação entre técnicas e lesões em praticantes de judô Relación entre las técnicas y lesiones en los practicantes del judo Relationship between techniques and injuries among judo practitioners

    Directory of Open Access Journals (Sweden)

    Daniel Barsottini

    2006-02-01

    écnicos y el panorama del percentil de las lesiones encontradas. La muestra se constituyó de 78 informes de casos; se obtuvo a través de la aplicación de encuesta cerrada, en 46 atletas varones, con la edad promedio de 23 ± 10 años y, en 32 atletas mujeres con la edad promedio entre 19 ± 7 años. El tiempo de la práctica de los atletas masculinos era de 9 ± 6 años, mientras la graduación distribuida se comprendió entre 20% con la cinta negra, 50% con la cinta marrón y 30% con la graduación inferior a marrón. Los atletas presentaron tiempo de práctica de 5 ± 3 años, siendo 9% cinta negra, 25% cinta marrón y 66% la graduación inferior. A través de la aplicación de una encuesta, se observó que las lesiones pasaron con el predominio de 23% en la articulación de la rodilla, siguiendo por 16% para el hombro, 22% en los dedos de manos y pies, y las otras ocurrencias ascendieron a 39%. Las mismas fueron de 10% de lesiones ligeras, 9% moderadas y 63% de afecciones serias. La relación de ocurrencia de lesiones entrenando alcanzó al 71% de los casos, y 42% de este total pasaron cuando habia la participación de un antagonista más pesado. Los golpes más frecuentes que causaron lesiones fueron de Ippon-seoi Nague, con 23%, Tai otoshi con 22% y Uchi mata con 9%.Judo is a martial art created in 1882 characterized by a great number of techniques and philosophical basis, and it has been mentioned in several studies as one of the sports presenting a higher amount of injury occurrences. Nevertheless, there are few detailed surveys to allow performing a causal correlation between the technical aspects and the percentage picture of the injuries found in this sportive modality. The sampling was constituted by seventy-eight case reports attained after applying a close questionnaire in forty-six 23 years old ± 10 years male athletes, and thirty-two 19 years old ± 7 years female athletes. The mean time of practice for male athletes was 9 ± 6 years, and their level was

  19. Drilling techniques for osteochondritis dissecans.

    Science.gov (United States)

    Heyworth, Benton E; Edmonds, Eric W; Murnaghan, M Lucas; Kocher, Mininder S

    2014-04-01

    Although the advanced stages of osteochondritis dissecans remain challenging to treat, most early-stage lesions in skeletally immature patients, if managed appropriately, can be stimulated to heal. For stable lesions that do not demonstrate adequate healing with nonoperative measures, such as activity modification, weight-bearing protection, or bracing, drilling of the subchondral bone has emerged as the gold standard of management. Several techniques of drilling exist, including transarticular drilling, retroarticular drilling, and notch drilling. Although each technique has been shown to be effective in small retrospective studies, higher-powered prospective comparative studies are needed to better elucidate their relative advantages and disadvantages.

  20. Predictive value of exfoliative cytology in pigmented conjunctival lesions.

    Science.gov (United States)

    Keijser, Sander; van Luijk, Chantal M; Missotten, Guy S; Veselic-Charvat, Maud; de Wolff-Rouendaal, Didi; de Keizer, Rob J W

    2006-04-01

    Pigmented lesions of the conjunctiva are often difficult to classify clinically. Exfoliative cytology may be helpful, but reliable data regarding the sensitivity and specificity of this test are currently lacking. We determined the value of exfoliative cytology with regard to pigmented conjunctival lesions. A total of 294 smears from 182 patients were screened for malignancy within 6 months of exfoliative cytology. Smears were classified according to the following categories: grade 0 = insufficient material for diagnosis; grade 1 = normal conjunctival cells; grade 2 = melanocytes with mild atypia; grade 3 = melanocytes with moderate atypia, and grade 4 = melanocytes with severe atypia. The sensitivity, specificity, positive predictive value and negative predictive value of exfoliative cytology were 85%, 78%, 59% and 93%, respectively. Exfoliative cytology is a fast, easy and non-invasive technique that may be used in the evaluation of patients with a pigmented conjunctival lesion.

  1. Drug-eluting technologies in femoral artery lesions.

    Science.gov (United States)

    Deloose, K; Lauwers, K; Callaert, J; Maene, L; Keirse, K; Verbist, J; Peeters, P; Bosiers, M

    2013-04-01

    The treatment of femoropopliteal lesions has known an important evolution in the last years. An important limitation of current endovascular therapy remains the occurrence of restenosis. In order to minimize restenosis rates, drug eluting technologies are evolving. The use of drug-eluting stents (DES) in coronary arteries shows beneficial results, leading to investigation of DES in femoropopliteal arteries. In this article, we give an overview of current available data on treatment with drug eluting technologies in the superficial femoral artery (SFA). This paper summarizes also the current available data of the use of drug-coated balloons (DCB) in the femoropopliteal tract. Currently, no data are available on the use of DCB in long lesions. A drug eluting bioresorbable scaffold seems to be very promising in coronary arteries. The transfer to the peripheral area is nowadays ongoing. Which technique and device for which lesion and patient requires further investigation to build up a real evidence based SFA treatment strategy.

  2. Angioscopic observation of coronary lesions in Kawasaki disease

    Science.gov (United States)

    Ishikawa, Hiromi

    1993-05-01

    Kawasaki disease is an acute systematic angiitis, specifically affecting the coronary arteries in young children. Coronary aneurysms develop in 10 to 15% of patients with Kawasaki disease. The coronary aneurysm frequently changes into coronary stenosis and obstruction. Hitherto, we could observe and access the severity of these coronary lesions with the use of two dimensional echocardiography and selective coronary angiography. Angiography is the most sensitive means available for diagnosing significant coronary lesions and their severity. However, it is insensitive for detecting intraluminal minute and pathologic changes such as intimal thickening, regeneration of endothelium and thrombus. Recent advance in fiberscopie technology, enabled us to observe the inside of coronary artery percutaneously. We tried to use this angioscopic technique for the observation of coronary lesions in eight patients with Kawasaki disease at chronic stage.

  3. Late infiltration of post-orthodontic white spot lesions.

    Science.gov (United States)

    Neuhaus, Klaus W; Graf, Martina; Lussi, Adrian; Katsaros, Christos

    2010-11-01

    White spot lesion (WSL) infiltration has been recommended immediately after debonding of orthodontic brackets. It is however not clear if established inactive WSLs can also be masked through infiltration. Orthodontic treatment of a 19-year-old patient had to be terminated prematurely due to development of multiple WSLs of varying severity. Three months after debonding, the patient presented for lesion infiltration. After etching with 15% HCl gel and re-wetting of the dried surfaces it seemed that a good outcome could be expected. Lesion infiltration led to complete masking of less severe WSLs. The visual appearance of moderate and severe WSLs was improved but they were still visible after treatment. Inactive WSLs may not represent an increased caries risk, but patients are often bothered esthetically. Infiltration by repeated etching might be a viable approach even for inactive WSLs. Controlled clinical trials are needed to investigate the long-term performance of this technique.

  4. Covalently linked tandem lesions in DNA.

    Science.gov (United States)

    Patrzyc, Helen B; Dawidzik, Jean B; Budzinski, Edwin E; Freund, Harold G; Wilton, John H; Box, Harold C

    2012-12-01

    Reactive oxygen species (ROS) generate a type of DNA damage called tandem lesions, two adjacent nucleotides both modified. A subcategory of tandem lesions consists of adjacent nucleotides linked by a covalent bond. Covalently linked tandem lesions generate highly characteristic liquid chromotography-tandem mass spectrometry (LC-MS/MS) elution profiles. We have used this property to comprehensively survey X-irradiated DNA for covalently linked tandem lesions. A total of 15 tandem lesions were detected in DNA irradiated in deoxygenated aqueous solution, five tandem lesions were detected in DNA that was irradiated in oxygenated solution.

  5. Implant periapical lesion. Case report

    Directory of Open Access Journals (Sweden)

    Gregory Venetis, Fotis Iordanidis, Paraskevi Giovani, Lambros Zouloumis

    2011-04-01

    Full Text Available Ιmplant periapical lesion (IPL is probably not a uniform entity in all cases presented in the literature. Asseptic bone necrosis may be a cause for some of the IPLs, whilst the presence of microorganisms is not always detectable with conventional methods. A case of IPL in a male patient who underwent an extraction of 12 tooth and an immediate implantation at this site is presented. Eight months postoperatively, an IPL was revealed on radiologic examination. After surgical exploration, the IPL was removed and examined histologically and microbiologically. The implant was replaced with a longer one and a bone regeneration procedure was simultaneously carried out. From the study of the lesion and the patient’s followup, infection cannot be considered as primary cause information of presented IPL, but literature data suggests that classic histology and microbiology cannot exclude infection from IPL causatives.

  6. Pulmonary intravascular macrophages in the pathogenesis of bovine pulmonary lesions caused by Actinomyces pyogenes

    DEFF Research Database (Denmark)

    Leifsson, Páll Skúli; Basse, A.; Jensen, Henrik Michael Elvang

    1995-01-01

    Rabbit antisera raised against somatic antigens from two strains of Actinomyces pyogenes reacted specifically in a peroxidase anti-peroxidase technique which was developed for the location of the bacteria in formalin-fixed tissues. The technique was applied on experimental murine and spontaneous...... bovine lesions caused by A. pyogenes. By electron microscopy and immunohistochemistry it was demonstrated that pulmonary intravascular macrophages play a role in the uptake of A. pyogenes from the blood, and in the production of pyaemic pulmonary lesions...

  7. Discrimination between benign and malignant lesions of the breast using ultrasound disparity mapping

    Science.gov (United States)

    Steinberg, Bernard D.; Carlson, Donald L.; Birnbaum, Julia A.

    2001-05-01

    A technique called disparity mapping (DM) processes pairs of ultrasound B-scan images collected while a sonographer varies the probe pressure slightly on the breast surface. Dm measures the apparent displacement of the tissue about each image point and subsequently constructs a correlation map which represents the similarity between the speckle patterns around each point. The continuity of the lesion perimeter in the correlation image is used to separate benign from malignant lesions, with high continuity corresponding well with benign lesions and highly segmented perimeters correlating with malignancies. Twenty five solid masses were evaluated, and the results were compared with histology from core or surgical biopsy, or with cytology from fine needle aspiration. The results analyzed all lesions correctly (15 cancers and 10 benign lesions). There were no false positives or false negatives. The results suggest that DM may be a useful tool in digitally diagnosing breast lesions and consequently in reducing the number of unnecessary biopsies.

  8. Os Odontoideum: Rare Cervical Lesion

    Science.gov (United States)

    2011-11-01

    the articulation between C1 and the os odontoideum on flexion imaging. The remainder of his cervical vertebral bodies had normal alignment with no...appears normal. Figure 3. Flexion view of plain cervical spine. This image shows abnormal translation of the articulation between C1 and the C2 os...worldwide. Peer Reviewed Title: Os Odontoideum: Rare Cervical Lesion Journal Issue: Western Journal of Emergency Medicine, 12(4) Author: Robson

  9. Automatic segmentation of psoriasis lesions

    Science.gov (United States)

    Ning, Yang; Shi, Chenbo; Wang, Li; Shu, Chang

    2014-10-01

    The automatic segmentation of psoriatic lesions is widely researched these years. It is an important step in Computer-aid methods of calculating PASI for estimation of lesions. Currently those algorithms can only handle single erythema or only deal with scaling segmentation. In practice, scaling and erythema are often mixed together. In order to get the segmentation of lesions area - this paper proposes an algorithm based on Random forests with color and texture features. The algorithm has three steps. The first step, the polarized light is applied based on the skin's Tyndall-effect in the imaging to eliminate the reflection and Lab color space are used for fitting the human perception. The second step, sliding window and its sub windows are used to get textural feature and color feature. In this step, a feature of image roughness has been defined, so that scaling can be easily separated from normal skin. In the end, Random forests will be used to ensure the generalization ability of the algorithm. This algorithm can give reliable segmentation results even the image has different lighting conditions, skin types. In the data set offered by Union Hospital, more than 90% images can be segmented accurately.

  10. Follicular-patterned thyroid lesions

    Directory of Open Access Journals (Sweden)

    F. Fulya KÖYBAŞIOĞLU

    2009-01-01

    Full Text Available Aim: Our aim is to determine the minimal cytopathologic criteria needed to make differential diagnosis in follicular-patterned lesions of the thyroid gland.Materials and Methods: We reviewed 56 fine needle aspiration cytology specimens which were reported as “suspicious for follicular-patterned lesions of thyroid” between years 2001 and 2005 in our hospital and their histological slides. Parameters for cytopathologic assesment are cellularity, colloid formation, multilayered rosette formation, follicular cell rings, monolayered sheets, intact follicles, hyperplastic papillae, hyaline stromal fragments, intranuclear inclusions, nuclear grooves, angulated nuclei, nucleoli, cerebriform nuclei, nuclear size, macrophages, flame cells and Hurthle cells. Statistical analysis was performed using χ2 and Fisher's-exact tests and Kolmogorov-Simirnov test.Results: Four cytopathologic features–cerebriform nuclei, angulated nuclei, nuclear grooves and intranuclear inclusion- were constantly observed in the follicular variant of papillary carcinoma (p< 0.05. Diluted colloid, monolayered sheet, nuclear size, macrophage and nucleoli were frequently seen in nodular hyperplasia (p< 0.05. The nuclear size was the sole differential cytopathologic criteria between follicular adenoma and follicular carcinoma (p<0.05.Conclusion: Detailed cytopathologic examination was found to be important in differentiating follicular variant of papillary carcinoma from nodular hyperplasia. On the other hand, none of the cytopathologic findings were sufficient to distinguish follicular adenoma from follicular carcinoma. Therefore, cytopathologists should report such lesions as “follicular neoplasms”.

  11. Radio-guided localization of clinically occult breast lesions: current modalities and future directions.

    Science.gov (United States)

    Aydogan, Fatih; Velidedeoglu, Mehmet; Kilic, Fahrettin; Yilmaz, Halit

    2014-01-01

    The extensive availability of breast cancer screening programs and improvement in diagnostic imaging have led to more frequent detection of suspicious and clinically occult breast lesions. Early detection of tumor is important for breast-conserving treatment. Incomplete excision is a major risk factor for local recurrence. Following precise localization and removing the entire lesion while achieving adequate clear margins is the key factor for successful management of non-palpable breast lesions. For this purpose, several techniques such as wire-guided localization, intra-operative ultrasound guided resection, radio-guided occult lesion localization and radioactive seed localization have been described and applied. In this article, we overview the two commonly used localization techniques, radio-guided occult lesion localization and wire-guided localization, particularly describing their advantages and drawbacks.

  12. An Automatic System to Discriminate Malignant from Benign Massive Lesions on Mammograms

    CERN Document Server

    Retico, A; Fantacci, M E; Kasae, P

    2007-01-01

    Mammography is widely recognized as the most reliable technique for early detection of breast cancers. Automated or semi-automated computerized classification schemes can be very useful in assisting radiologists with a second opinion about the visual diagnosis of breast lesions, thus leading to a reduction in the number of unnecessary biopsies. We present a computer-aided diagnosis (CADi) system for the characterization of massive lesions in mammograms, whose aim is to distinguish malignant from benign masses. The CADi system we realized is based on a three-stage algorithm: a) a segmentation technique extracts the contours of the massive lesion from the image; b) sixteen features based on size and shape of the lesion are computed; c) a neural classifier merges the features into an estimated likelihood of malignancy. A dataset of 226 massive lesions (109 malignant and 117 benign) has been used in this study. The system performances have been evaluated terms of the receiver-operating characteristic (ROC) analys...

  13. Non-invasive endodontic treatment of large periapical lesions

    Directory of Open Access Journals (Sweden)

    Harry Huiz Peeters

    2008-09-01

    Full Text Available Background: In most cases of large periapical radiolucent lesions of pulpal origin, we often encounter a dilemmatic situation, such as whether to either treat these cases endodontically or surgically. Development of techniques, instruments and root medicaments as well as the tendency toward minimally invasive treatment, all support dentists to treat those cases using the minimal invasive principle (i.e. endodontically instead of surgically. Purpose: The purpose of this paper is to report and discuss the managing of periapical lesions by endodontic no invasive treatment. Case management: The patient with large periapical lesions were treated with noninvasive endodontic treatment. After 6 months, patients in this report were asymptomatic and radiolucencies had disappeared. When the root canal treatment is done according to accepted clinical principles and under aseptic condition, including cleaning, shaping, abturating as well as proper diagnosis, the healing process of the infected area will occur. Conclusion: Some lesions, however, may not be treated conservatively and may require surgical treatment for total elimination of the lesions.

  14. Analysis of skin line pattern for lesion classification.

    Science.gov (United States)

    She, Zhishun; Fish, Peter J

    2003-02-01

    It has been observed that skin patterning tends to be disrupted by malignant but not by benign skin lesions. This suggests that measurements of skin pattern disruption on simply captured white light optical skin images could be a useful contribution to a diagnostic feature set. Previous work using a measurement of line strength by a consistent high-value profiling technique followed by local variance measurement or a region agglomerative classifier to measure skin line pattern disruption was extremely promising but computationally intensive, suggesting that the idea of measuring skin pattern disruption was useful but a simpler method was required. The skin pattern was extracted by high-pass filtration and enhanced by adaptive anisotropic (spatial variant) filtering which smoothes along skin lines but not across them. The skin line main direction and direction variance were estimated using a local image gradient matrix and the difference of these measures across the lesion image boundary was used as a lesion classifier. A set of images of malignant melanoma and benign naevi were processed as above and the scatter plot of results in a two-dimensional feature (line direction and line variation difference) space showed excellent separation of benign and malignant lesions. An ROC plot enclosed an area of 0.88. The experimental results showed that the local line direction and the local line variation were promising features for distinguishing malignant melanoma from benign lesion and the methods used were effective and computationally low-cost. Copyright Blackwell Munksgaard 2003

  15. 组织声学特性对高强度聚焦超声温度场的影响%Effect of tissue acoustic properties on HIFU temperature field

    Institute of Scientific and Technical Information of China (English)

    张晓静; 张平; 朱元光; 孙武军; 菅喜岐; 李智华

    2010-01-01

    目的 数值仿真组织声学特性对高强度聚焦超声(HIFU)焦域处温度场的影响,为HIFU治疗安全性和可靠性提供理论依据.方法 以实测新鲜离体猪肝组织不同温度下的声速和衰减系数为依据,利用时域有限差分(FDTD)法数值仿真研究HIFU治疗过程中组织内声速、衰减系数的变化和温度场的分布,分析讨论声速和衰减系数变化对60 ℃以上可治疗区域大小、位置的影响.结果 随着照射时间的延长,焦域处肝组织温升增大,声速下降,声衰减系数增大.随着声速的变化,形成的可治疗区域变大,焦点位置向远离换能器方向移动;随着声衰减系数的变化,焦域大小和焦点位置几乎不变.结论 猪肝组织内声速的变化对可治疗焦域的位置和大小影响较大;声衰减系数的变化对焦域的影响较小.%Objective To improve the safety and reliability in high intensity focused ultrasound(HIFU)therapy, the effects of tissue acoustic properties on the high intensity focused ultrasound temperature field were investigated. Methods Based on the measured data of sound velocity and attenuation coefficient at different temperature, the variation of sound velocity and attenuation coefficient, and the temperature distribution in tissue during HIFU therapy was simulated using FDTD method. Moreover, the effects of the two variable acoustic parameters on the therapeutic region above 60 ℃ were evaluated. Results Tissue temperature raise, sound speed decreased and the attenuation coefficient increased in the focal region, along with the passage of the exposure time. Therapeutic region increased slightly and the focal point slightly moved away from the transducer when the sound velocity varied. There were negligible changes in the therapeutic region and the position of focal point when the attenuation coefficient changed alone in the study. Conclusion The variation of sound velocity can affect the size and location of the focal

  16. The Feasibility of Ultrasonography in Defining the Size of Jaw Osseous Lesions

    Directory of Open Access Journals (Sweden)

    Shoaleh Shahidi

    2015-12-01

    Full Text Available Statement of the Problem: Jaw bone lesions are common pathologic conditions. The role of ultrasonography in evaluation of the extra-osseous lesions is confirmed, however, this imaging modality is not the diagnostic routine for the intra-osseous jaw lesions. Purpose: The purpose of this study was to evaluate the efficiency of ultrasonography in diagnosis of intra-osseous jaw lesions concerning their size and content and also to study its correlation with the histopathological findings. Materials and Method: For this study, 15 patients with intra-osseous jaw lesions in the maxilla and mandible were selected from those referred to the Department of Oral Surgery. Panoramic imaging, computed tomography (CT or cone beam computed tomography (CBCT and ultrasonography (USG were performed for all the lesions. The size of the lesions was measured by USG and then compared with CT or CBCT. Moreover, the correlation amongst the echographic patterns and histopathologic results was evaluated. Results: In 12 cases, size values were in complete agreement with CT or CBCT. The size of 3 lesions could not be measured by the radiologist due to the thickness of buccal cortical plate. Conclusion: Findings of this study suggested that USG might be feasible in estimating the size of intra-osseous jaw lesions with little underestimation. This study also confirmed that ultrasound imaging was a very useful imaging technique which could provide significant diagnostic information regarding the content of jaw bone lesions where the buccal bone thickness was thin enough.

  17. Non-DSB clustered DNA lesions. Does theory colocalize with the experiment?

    Science.gov (United States)

    Nikitaki, Zacharenia; Nikolov, Vladimir; Mavragani, Ifigeneia V.; Plante, Ianik; Emfietzoglou, Dimitris; Iliakis, George; Georgakilas, Alexandros G.

    2016-11-01

    Ionizing radiation results in various kinds of DNA lesions such as double strand breaks (DSBs) and other non-DSB base lesions. These lesions may be formed in close proximity (i.e., within a few nanometers) resulting in clustered types of DNA lesions. These damage clusters are considered the fingerprint of ionizing radiation, notably charged particles of high linear energy transfer (LET). Accumulating theoretical and experimental evidence suggests that the induction of these clustered lesions appears under various irradiation conditions but also as a result of high levels of oxidative stress. The biological significance of these clustered DNA lesions pertains to the inability of cells to process them efficiently compared to isolated DNA lesions. The results in the case of unsuccessful or erroneous repair can vary from mutations up to chromosomal instability. In this mini review, we discuss of several Monte Carlo simulations codes and experimental evidence regarding the induction and repair of radiation-induced non-DSB complex DNA lesions. We also critically present the most widely used methodologies (i.e., gel electrophoresis and fluorescence microscopy [in situ colocalization assays]). Based on the comparison of different approaches, we provide examples and suggestions for the improved detection of these lesions in situ. Based on the current status of knowledge, we conclude that there is a great need for improvement of the detection techniques at the cellular or tissue level, which will provide valuable information for understanding the mechanisms used by the cell to process clustered DNA lesions.

  18. 利用EcoTILLING简化技术进行水稻基因型鉴定及单核苷酸多态性(SNP)检测%Application of Simplified Ecotype Targeting Induced Local Lesions in Genomes (EcoTILLING) Technique for Genotyping and Single Nucleotide Polymorphism(SNP) Detection in Rice

    Institute of Scientific and Technical Information of China (English)

    滕斌; 李泽福; 罗志祥; 吴敬德; 朱学桂; 宣红; 张瑛

    2012-01-01

    Ecotype targeting induced local lesions in genomes (EcoTILLING) is a high-throughput method of detection and analysis of single nucleotide polymorphism (SNP) variations in natural populations. However, it requires a substantial investment in sophisticated equipment and costly fluorescence labeled primers to detect CELI - cut products that limit its use in laboratories with common financial resources. The technology of traditional EcoTILLING had been appropriately improved in this study. Here, we simplified extraction procedure of the CELI enzyme, prepared heteroduplex DNA products for CEL I digestion by use of natural cooling method, and detected the CEL I-cleaved products through general silver staining. The results of activities of crude CEL I enzyme extracts showed that the activity of CEL I was high enough for detection of mismatch bases. Using the simplified EcoTILLING technique, the G/T polymorphism at the first intron 5' splice site of the Wx gene among 18rice (Oryza saliva L.) accessions were successfully genotyped. In addition, CEL I digested bands of a 417 bp fragment within the Wx gene of the 18 rice accessions were distinguished into several types. On comparisons with sequencing results, CEL I cut bands could accurately reflect the SNP variations between the materials. The results suggested that the simplified EcoTILLING is an effective method for SNP discovery and genotyping in rice that will provide powerful tool for rice functional genomics research.%EcoTILLING(ecotype targeting induced local lesions in genomes)是一种高通量检测和分析自然群体中单核苷酸多态性(single nucleotide polymorphism,SNP)变异的研究方法.由于该技术需要高级、精密的仪器设备和昂贵的荧光标记引物来检测CEL(celery)I的酶切产物,极大地限制了该技术的应用.本研究对传统EcoTILLING技术做了适当改进,简化了CELI酶的抽提步骤,采用自然冷却方法制备异源双链产物,普通银染检测CELI酶切

  19. Acute bony bankart lesion and surgical fixation

    National Research Council Canada - National Science Library

    Rosenthal, Michael D; Provencher, Matthew T

    2009-01-01

    ... therapist for evaluation. Anterior-posterior, scapular outlet, and axillary radiographic views demonstrated a bony glenoid lesion consistent with a bony Bankart lesion, which was best seen on the scapular outlet view...

  20. Lytic clavicular lesions in fibromatosis colli

    Energy Technology Data Exchange (ETDEWEB)

    Sartoris, D.J.; Parker, B.R.; Mochizuki, R.M.

    1983-06-01

    Two patients with fibromatosis colli (congenital torticollis) presented with lytic lesions in the clavicle at the insertion of the fibrosed clavicular head of the sternocleidomastoid muscle. Biopsy of one lesion showed intraosseous fibrosis. These lesions are probably not uncommon but radiographs are rarely performed in uncomplicated cases.

  1. Lesion Contrast Enhancement in Medical Ultrasound Imaging

    DEFF Research Database (Denmark)

    Stetson, Paul F.; Sommer, F.G.; Macovski, A.

    1997-01-01

    Methods for improving the contrast-to-noise ratio (CNR) of low-contrast lesions in medical ultrasound imaging are described. Differences in the frequency spectra and amplitude distributions of the lesion and its surroundings can be used to increase the CNR of the lesion relative to the background...

  2. Classification of melanocytic skin lesions from non-melanocytic lesions.

    Science.gov (United States)

    Iyatomi, Hitoshi; Norton, Kerri-Ann; Celebi, M; Schaefer, Gerald; Tanaka, Masaru; Ogawa, Koichi

    2010-01-01

    In this paper, we present a classification method of dermoscopy images between melanocytic skin lesions (MSLs) and non-melanocytic skin lesions (NoMSLs). The motivation of this research is to develop a pre-processor of an automated melanoma screening system. Since NoMSLs have a wide variety of shapes and their border is often ambiguous, we developed a new tumor area extraction algorithm to account for these difficulties. We confirmed that this algorithm is capable of handling different dermoscopy images not only those of NoMSLs but also MSLs as well. We determined the tumor area from the image using this new algorithm, calculated a total 428 features from each image, and built a linear classifier. We found only two image features, "the skewness of bright region in the tumor along its major axis" and "the difference between the average intensity in the peripheral part of the tumor and that in the normal skin area using the blue channel" were very efficient at classifying NoMSLs and MSLs. The detection accuracy of MSLs by our classifier using only the above mentioned image feature has a sensitivity of 98.0% and a specificity of 86.6% in a set of 107 non-melanocytic and 548 melanocytic dermoscopy images using a cross-validation test.

  3. Quantitative analysis of microcirculation in renal solid lesions with gamma curve fitting technique of contrast-enhanced ultrasound%肾脏良恶性病灶微循环血流灌注定量分析中超声造影伽马拟合分析技术的应用

    Institute of Scientific and Technical Information of China (English)

    李萍; 李凤华; 方华; 顾莉红; 杜晶; 黄翼然

    2009-01-01

    目的 评估超声造影伽马拟合分析技术对肾脏肿瘤微循环血流灌注定量分析的价值.方法 对50例肾脏实质内占位性病灶进行超声造影,将经DICOM3.0格式保存的动态图像导入SW-UCS-1型超声分析软件进行脱机分析,根据时间-强度曲线(TIC),得到上升支斜率(a3)、下降支曲率(a2)、达到时间(AT)、达峰时间(TTP)、基础强度(BI)、峰值强度、增强强度(AMP)、曲线下面积(AUC)、平均通过时间(MTT)、灌注指数(PI)等,并比较定量参数在肾脏恶性肿瘤和肾脏血管平滑肌脂肪瘤之间的差异.结果 肾脏恶性肿瘤多见灌注模式为快进快出,而慢进慢出多见于肾脏血管平滑肌脂肪瘤.肾脏恶性肿瘤和肾脏血管平滑肌脂肪瘤灌注模式分别为:快进快出28例和0例,快进慢出4例和1例,慢进快出5例和1例,慢进慢出1例和10例.TIC分析定量参数a3、AUC和PI在肾脏良恶性肿瘤比较中差异有统计学意义(P<0.05).结论 超声造影伽马拟合分析技术可以对肿瘤微循环血流灌注进行定量分析,有助于肾脏良恶性肿瘤鉴别.%Objective To evaluate the role of gamma curve fitting technique of contrast-enhanced ultrasound in quantitative analysis of microcirculation in renal solid lesions. Methods A total of fifty patients with renal parenchyma solid lesions were performed contrast-enhanced ultrasound. The images were analysed by computer with gamma fitting analysis of contrast-enhanced ultrasonic system. The quantitative parameters were obtained by the time-intensity curves, such as ascending slope (a3), descending slope (a2), arrival time (AT), time to peak intensity (TTP), basic intensity (BI), peak intensity, amplification (AMP), area under the curve (AUC), mean transit time (MTT) and perfusion index (PI). The parameters were compared between renal malignant and benign solid lesions. Results Fast-in and fast-out was the main perfusion mode in renal malignant tumors while slow-in and

  4. Lasers for vascular lesions: Standard guidelines of care

    Directory of Open Access Journals (Sweden)

    C R Srinivas

    2011-01-01

    Full Text Available Introduction: Lasers are a good therapeutic tool for congenital and acquired vascular lesions. Technological advances in lasers have reduced the adverse effects and increased the efficacy. Machines: Among the various lasers used for treating vascular lesions, pulsed dye laser (PDL has the best efficacy and safety data. The other machines that are widely available are Nd:YAG laser and intense pulse light (IPL. Rationale and scope of guideline: Much variation exists in different machines and techniques, and therefore, establishing standard guidelines has limitations. The guidelines recommended here indicate minimum standards of care for lasers on vascular lesions based on current evidence. Physician Qualification: Laser may be administered by a dermatologist, who has received adequate background training in lasers during post-graduation or later at a center that provides education and training in lasers, or in focused workshops, which provide such trainings. He/she should have adequate knowledge of the lesions being treated, machines, parameters, cooling systems, and aftercare. Facility: The procedure may be performed in the physician′s minor procedure room with adequate laser safety measures. Indications: PWS, hemangioma, facial telangiectasia, rosacea, spider angioma, pyogenic granuloma, venous lakes, leg veins. Contraindications: Absolute: Active local infection, photo-aggravated skin diseases, and medical conditions. Relative: Unstable vitiligo, psoriasis, keloid and keloidal tendencies, patient on isotretinoin, patient who is not cooperative or has unrealistic expectation. Patient Selection: Patient selection should be done after detailed counseling with respect to the course of lesions, different treatment options, possible results, cost, need for multiple treatments, and possible postoperative complications. Treatment Sessions: The number of treatments per lesion varies from 2 to 12 or more at 6-8 week intervals. All lesions may not clear

  5. Achilles tendon lesions in sport.

    Science.gov (United States)

    Williams, J G

    1993-09-01

    Achillodynia (Achilles tendon pain) is a significant source of disability to many people taking part in sports. Papers in the English language published since 1986 are reviewed here, grouped into specific subject areas including biomechanics, pathology, general clinical presentations, experimental treatments, steroids, podiatry and surgery. While there has been no dramatic breakthrough in the field, there have been various interesting advances with particular reference to imaging and conservative management, which will hopefully stimulate further studies. Many problems of Achilles tendon lesions in athletes remain unsolved, however, and much is yet to be done to provide adequate and generally effective methods of prevention and conservative treatment.

  6. Structure and mechanism for DNA lesion recognition

    Institute of Scientific and Technical Information of China (English)

    Wei Yang

    2008-01-01

    A fundamental question in DNA repair is how a lesion is detected when embedded in millions to billions of normal base pairs. Extensive structural and functional studies reveal atomic details of DNA repair protein and nucleic acid interactions. This review summarizes seemingly diverse structural motifs used in lesion recognition and suggests a general mechanism to recognize DNA lesion by the poor base stacking. After initial recognition of this shared struc-tural feature of lesions, different DNA repair pathways use unique verification mechanisms to ensure correct lesion identification and removal.

  7. Solitary lucent epiphyseal lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Gardner, D.J.; Azouz, E.M.

    1988-10-01

    We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. 40% of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyoxid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

  8. Detection and monitoring of early caries lesions

    DEFF Research Database (Denmark)

    Pretty, I A; Ekstrand, K R

    2016-01-01

    AIM: To review the current evidence base of detecting and monitoring early carious lesions in children and adolescents and a rationale proposed to ensure that such lesions are identified and appropriately managed. METHODS: The systematic literature search identified initially a review by Gomez...... of existing visible and radiographical systems to monitor lesions over time. Using low-cost intra-oral cameras facilitates the recording of lesion appearance in the patient record and may be of significant benefit in monitoring early lesions over time following their detection. This benefit extends...

  9. Subtraction Radiography for the Diagnosis of Bone Lesions in Dogs.

    Science.gov (United States)

    1984-05-31

    Avail ander Journal of Periodontology Dist Special Ř 211 East Chicago Avenue Room 924 Chicago, IL 60611 Dear Sirs: I m submitting an original...research article titled "Subtraction Radiography for the Diagnosis of Bone Lesions in Dogs" solely to the Journal of Periodontology for review and... clinical practice in our area. 60-70 Kvp would have produced more contrast in the radiographic films used for the conventional technique, but likely

  10. Dieulafoy's lesion of duodenum: a case report

    Directory of Open Access Journals (Sweden)

    Wagholikar Gajanan D

    2003-01-01

    Full Text Available Abstract Background Dieulafoy's lesion is an uncommon but important cause of recurrent upper gastrointestinal bleeding. Extragastric location of Dieulafoy's lesion is rare. We report two cases of Dieulafoy's lesion of the duodenum and discuss the management of this extremely uncommon entity. Case presentation Two cases of massive upper gastro-intestinal bleeding in young adults due to Dieulafoy's lesion of the duodenum are reported. Endoscopic diagnosis was possible in both cases. Hemostasis was achieved successfully by endoscopic adrenaline injection. The endoscopic appearance, pitfalls in the diagnosis and management of this rare lesion are discussed. Conclusions Endoscopic diagnosis of extragastric Dieulafoy's lesion can be difficult because of the small size and obscure location of the lesion. Increased awareness and careful and early endoscopic evaluation following the bleeding episode are the key to accurate diagnosis. Adrenaline injection is one of the important endoscopic modalities for control of bleeding.

  11. Ocular lesions in free-living raptors.

    Science.gov (United States)

    Murphy, C J; Kern, T J; McKeever, K; McKeever, L; MacCoy, D

    1982-12-01

    In a retrospective study, records of 931 raptors admitted to the Avian Clinic at the New York State College of Veterinary Medicine and to the Owl Rehabilitation Research Foundation were evaluated to determine the prevalence, cause, and distribution of ocular lesions. Some form of ocular lesion was identified in 135 (14.5%) birds. Of these, 90% were the result of physical injury. Collisions accounted for 33% of ocular lesions; gunshot wounds accounted for 11%. Unilateral lesions were more common than bilateral lesions, with the anterior segment being most frequently involved. Hyphema was the most common clinical finding. In a prospective study involving raptors admitted to the Avian Clinic from 1980-1982, it was found that 17 of 61 birds (28%) had some form of ocular lesion. The higher prevalence in this study was attributed to a lower proportion of juvenile cases and to increased detection of subtle lesions, especially those involving the posterior segment.

  12. Experimental techniques; Techniques experimentales

    Energy Technology Data Exchange (ETDEWEB)

    Roussel-Chomaz, P. [GANIL CNRS/IN2P3, CEA/DSM, 14 - Caen (France)

    2007-07-01

    This lecture presents the experimental techniques, developed in the last 10 or 15 years, in order to perform a new class of experiments with exotic nuclei, where the reactions induced by these nuclei allow to get information on their structure. A brief review of the secondary beams production methods will be given, with some examples of facilities in operation or under project. The important developments performed recently on cryogenic targets will be presented. The different detection systems will be reviewed, both the beam detectors before the targets, and the many kind of detectors necessary to detect all outgoing particles after the reaction: magnetic spectrometer for the heavy fragment, detection systems for the target recoil nucleus, {gamma} detectors. Finally, several typical examples of experiments will be detailed, in order to illustrate the use of each detector either alone, or in coincidence with others. (author)

  13. 一种用于高强度聚焦超声手术的八自由度机器人手术平台%A HIFU Surgery Using 8-DOF Robotic Surgery Platform

    Institute of Scientific and Technical Information of China (English)

    许剑波; 项林清; 曹志奎; 马培荪; 王文超

    2005-01-01

    机器人手术是未来外科手术的发展方向,高强度聚焦超声(High intensity focused ultrasound,HIFU)手术是一种崭新的无副作用癌症治疗方法.本文介绍了机器人集成超声手术系统、流程,并详细介绍了可以解决术中定位这一关键问题的八自由度机器人手术平台的设计、结构特征、运动机理.分别给出了C形臂和治疗床、C形臂和治疗头两个五维合成运动的可达工作空间分析.相对于已有的手术平台,该平台定位准确、便捷,可治疗的人体区域也更大,从而使治疗方案的设计更具灵活性.

  14. Effects of N2 O on the content of FHb and ICAM-1 in HIFU treatment patients%氧化亚氮对HIFU治疗患者FHb及ICAM-1含量的影响

    Institute of Scientific and Technical Information of China (English)

    陈佳; 但伶; 田泽丹; 黄燕; 周瑜; 张昭莉

    2014-01-01

    Objective To observe the effect of nitrous oxide (N2O) on the content of serum free hemoglobin ,and intercellular adhesion molecule‐1 (ICAM‐1) of patients with HIFU Therapy ,and investigate its action of tissue damage mechanism .Methods 50 patients with primary liver cancer undergoing HIFU surgery (ASA Ⅰ - Ⅱ class) were randomly divided into control group (group C) and experimental group(group N) ,25 patients of each group .General anesthesia method was used in both two groups , group C was by total intravenous anesthesia ,group N was adopted intravenous‐inhalation anesthesia .both two groups was adopted the same anesthesia induction method .anesthesia maintain of group N was joined N2 O on the basis of group C .both two groups were draw blood from the radial artery at the points of before anesthesia (T1 ) ,before operation (T2 ) ,1 h (T3 ) ,2 h (T4 ) ,3 h (T5 ) after intraoperative ,and 24 h after operation (T6 ) ,peroxidase reaction test and double antibody sandwich ELISA method were a‐dopted to detect the content of Fhb value and ICAM‐1 ;ultrasonography system of HIFU therapeutic instrument was used to meas‐ure the abdominal wall thickness of patients before and after operation .Results The content of FHb and ICAM‐1 in serum were significantly increased after operation than before with the anesthesia time (P<0 .05);compared with group C ,group N increased obviously at the same point in time (P<0 .05);preoperative and postoperative abdominal wall thickness value of group N was in‐creased significantly (P< 0 .05) .Conclusion It may be connected with N2 O enhanced ultrasound cavitation effect that the body produces more FHb and ICAM‐1 of group N in HIFU treatment ,and induces abdominal wall skin markedly swollen .%目的:观察氧化亚氮(N2O)对高强度聚焦超声(HIFU)治疗患者血清游离血红蛋白(FHb)及细胞间黏附分子1(ICAM‐1)含量的影响,探讨其组织损伤的作用机制。方法将50

  15. 高强度聚焦超声用于晚期胰腺癌病人的止痛作用研究%Researeh on Painkilling of HIFU in the Treatment to Late Adenocarcinoma of Pancreas

    Institute of Scientific and Technical Information of China (English)

    彭晶晶; 张涛

    2005-01-01

    目的探讨高强度聚焦超声(HIFU)对晚期胰腺癌止痛的疗效、并发症及安全性.方法应用FEP-BYO1高能聚焦超声肿瘤热疗机对42例晚期胰腺癌患者进行热疗,治疗时采用HIFU治疗病灶及腹腔神经丛的方法,观察治疗前后患者疼痛改变情况.结果 42例患者治疗后疼痛消失5例(11.9%),疼痛减轻21例(50.0%),疼痛无改变7例(16.6%),治疗前后均无疼痛9例(21%).JAMES评分:治疗前后评分差异存在显著意义(P<0.05).结论 HIFU治疗能有效的缓解晚期胰腺癌患者的疼痛.

  16. Photoacoustic discrimination of vascular and pigmented lesions using classical and Bayesian methods

    Science.gov (United States)

    Swearingen, Jennifer A.; Holan, Scott H.; Feldman, Mary M.; Viator, John A.

    2010-01-01

    Discrimination of pigmented and vascular lesions in skin can be difficult due to factors such as size, subungual location, and the nature of lesions containing both melanin and vascularity. Misdiagnosis may lead to precancerous or cancerous lesions not receiving proper medical care. To aid in the rapid and accurate diagnosis of such pathologies, we develop a photoacoustic system to determine the nature of skin lesions in vivo. By irradiating skin with two laser wavelengths, 422 and 530 nm, we induce photoacoustic responses, and the relative response at these two wavelengths indicates whether the lesion is pigmented or vascular. This response is due to the distinct absorption spectrum of melanin and hemoglobin. In particular, pigmented lesions have ratios of photoacoustic amplitudes of approximately 1.4 to 1 at the two wavelengths, while vascular lesions have ratios of about 4.0 to 1. Furthermore, we consider two statistical methods for conducting classification of lesions: standard multivariate analysis classification techniques and a Bayesian-model-based approach. We study 15 human subjects with eight vascular and seven pigmented lesions. Using the classical method, we achieve a perfect classification rate, while the Bayesian approach has an error rate of 20%.

  17. The Diagnostic Value of Superb Microvascular Imaging (SMI) in Detecting Blood Flow Signals of Breast Lesions

    Science.gov (United States)

    Ma, Yan; Li, Gang; Li, Jing; Ren, Wei-dong

    2015-01-01

    Abstract The correlation between color Doppler flow imaging (CDFI) and Superb Microvascular Imaging (SMI) for detecting blood flow in breast lesions was investigated, as was the diagnostic value of SMI in differentiating benign from malignant breast lesions. These lesions were evaluated using both CDFI and SMI according to Adler's method. Pathologic examination showed 57 malignant lesions and 66 benign lesions. The number of blood vessels in a single mass was detected by 2 techniques (SMI and CDFI), and the difference between the 2 values (SMI-CDFI) was calculated. The optimal threshold for the diagnosis of malignant neoplasms and the diagnostic performances of SMI, CDFI, and SMI-CDFI were calculated. For the total lesions and malignant lesions alone, the difference between SMI and CDFI for detecting blood flow was significant (P < 0.01), but the difference was not significant for benign lesions (P = 0.15). The area under the receiver operating characteristic curve was 0.73 (95% confidence interval [CI]: 0.64–0.82) for CDFI; 0.81 (95% CI: 0.74–0.89) for SMI; and 0.89 (95% CI: 0.82–0.95) for SMI-CDFI. Furthermore, the modality of “SMI-CDFI” showed the best diagnostic performance. SMI provides further microvessel information in breast lesions. The diagnostic modality of “SMI-CDFI” can improve the diagnostic performance of ultrasound in the differentiation between benign and malignant masses. PMID:26356718

  18. Lesion of the hip abductor mechanism

    Directory of Open Access Journals (Sweden)

    Caviglia Horacio

    2016-01-01

    Full Text Available Introduction: The disruption of the abductor muscles of the hip after hip revision surgery often causes limping, pain, and instability of the implant. The purpose of our paper is to describe a mesh technique to repair hip abductor mechanism injuries after hip revision. Patients and methods: Forty-six patients with hip abductor damage after prosthetic revision were treated. Inclusion criteria were: patients presenting with prosthetic loosening, complaint of pain, and with a positive Trendelenburg sign due to deficient abductor muscle mechanisms. Thirty-one were women (67.39% with an average age of 64 years (34–82 years. The number of previous revision surgeries was three (two to seven. The Merle d’Aubigné score and variants before and after treatment were also reported. Results: In the postoperative follow-up after hip revision with the mesh technique, the Merle d’Aubigné score improved and the Trendelenburg sign was negative in 78.3% of the patients (p < 0.001. Also, the Trendelenburg test with the knee flexed was negative in 60.9% (p < 0.001 and the stair-climbing test was negative in 60.9% of cases (p < 0.001. The gluteus medius test in the lateral position was negative in 52.2% of patients, and in the lateral position with the knee flexed it was negative in 47.8% of patients (p < 0.001. Discussion: Repair of the abductor mechanism with the mesh technique has proven effective for both partial and total lesions.

  19. Assessment of coincidence and defect sizes in Bankart and Hill-Sachs lesions after anterior shoulder dislocation: a radiological study.

    Science.gov (United States)

    Horst, K; Von Harten, R; Weber, C; Andruszkow, H; Pfeifer, R; Dienstknecht, T; Pape, H C

    2014-02-01

    Bankart and Hill-Sachs lesions are often associated with anterior shoulder dislocation. The MRI technique is sensitive in diagnosing both injuries. The aim of this study was to investigate Bankart and Hill-Sachs lesions with MRI to determine the correlation in occurrence and defect sizes of these lesions. Between 2006 and 2013, 446 patients were diagnosed with an anterior shoulder dislocation and 105 of these patients were eligible for inclusion in the study. All patients were examined using MRI. Bankart lesions were classified as cartilaginous or bony lesions. Hill-Sachs lesions were graded I-III using a modified Calandra classification. The co-occurrence of injuries was high [odds ratio (OR) = 11.47; 95% confidence interval (CI) = 3.60-36.52; p Bankart lesion and the grade of a Hill-Sachs lesion was found (ρ = 0.34; 95% CI = 0.16-0.49; p Bankart lesions co-occurred more often with large Hill-Sachs lesions (O  = 1.24; 95% CI = 1.02-1.52; p = 0.033). If either lesion is diagnosed, the patient is 11 times more likely to have suffered the associated injury. The size of a Hill-Sachs lesion determines the co-occurrence of cartilaginous or bony Bankart lesions. Age plays a role in determining the type of Bankart lesion as well as the co-occurrence of Bankart and Hill-Sachs lesions. This study is the first to demonstrate the use of high-quality MRI in a reasonably large sample of patients, a positive correlation of Bankart and Hill-Sachs lesions in anterior shoulder dislocations and an association between the defect sizes.

  20. Assessment of coincidence and defect sizes in Bankart and Hill–Sachs lesions after anterior shoulder dislocation: a radiological study

    Science.gov (United States)

    Von Harten, R; Weber, C; Andruszkow, H; Pfeifer, R; Dienstknecht, T; Pape, H C

    2014-01-01

    Objective: Bankart and Hill–Sachs lesions are often associated with anterior shoulder dislocation. The MRI technique is sensitive in diagnosing both injuries. The aim of this study was to investigate Bankart and Hill–Sachs lesions with MRI to determine the correlation in occurrence and defect sizes of these lesions. Methods: Between 2006 and 2013, 446 patients were diagnosed with an anterior shoulder dislocation and 105 of these patients were eligible for inclusion in the study. All patients were examined using MRI. Bankart lesions were classified as cartilaginous or bony lesions. Hill–Sachs lesions were graded I–III using a modified Calandra classification. Results: The co-occurrence of injuries was high [odds ratio (OR) = 11.47; 95% confidence interval (CI) = 3.60–36.52; p Bankart lesion and the grade of a Hill–Sachs lesion was found (ρ = 0.34; 95% CI = 0.16–0.49; p Bankart lesions co-occurred more often with large Hill–Sachs lesions (OR = 1.24; 95% CI = 1.02–1.52; p = 0.033). Conclusion: If either lesion is diagnosed, the patient is 11 times more likely to have suffered the associated injury. The size of a Hill–Sachs lesion determines the co-occurrence of cartilaginous or bony Bankart lesions. Age plays a role in determining the type of Bankart lesion as well as the co-occurrence of Bankart and Hill–Sachs lesions. Advances in knowledge: This study is the first to demonstrate the use of high-quality MRI in a reasonably large sample of patients, a positive correlation of Bankart and Hill–Sachs lesions in anterior shoulder dislocations and an association between the defect sizes. PMID:24452107

  1. Assessment of the Focal Hepatic Lesions Using Diffusion Tensor Magnetic Resonance Imaging.

    Science.gov (United States)

    Oussous, Siham Ait; Boujraf, Saïd; Kamaoui, Imane

    2016-01-01

    The goal is assessing the diffusion magnetic resonance imaging (dMRI) method efficiency in characterizing focal hepatic lesions (FHLs). About 28-FHL patients were studied in Radiology and Clinical Imaging Department of our University Hospital using 1.5 Tesla MRI system between January 2010 and June 2011. Patients underwent hepatic MRI consisting of dynamic T1- and T2-weighted imaging. The dMRI was performed with b-values of 200 s/mm(2) and 600 s/mm(2). About 42 lesions measuring more than 1 cm were studied including the variation of the signal according to the b-value and the apparent diffusion coefficient (ADC). The diagnostic imaging reference was based on standard MRI techniques data for typical lesions and on histology after surgical biopsy for atypical lesions. About 38 lesions were assessed including 13 benign lesions consisting of 1 focal nodular hyperplasia, 8 angiomas, and 4 cysts. About 25 malignant lesions included 11 hepatocellular carcinoma, 9 hepatic metastases, 1 cholangiocarcinoma, and 4 lymphomas. dMRI of soft lesions demonstrated higher ADC of 2.26 ± 0.75 mm(2)/s, whereas solid lesions showed lower ADC 1.19 ± 0.33 mm(2)/s with significant difference (P = 0.05). Discrete values collections were noticed. These results were correlated to standard MRI and histological findings. Sensitivity of 93% and specificity of 84% were found in diagnoses of malignant tumors with an ADC threshold of 1.6 × 10(-3) mm(2)/s. dMRI is important characterization method of FHL. However, it should not be used as single criteria of hepatic lesions malignity. MRI, clinical, and biological data must be correlated. Significant difference was found between benign and solid malignant lesions without threshold ADC values. Hence, it is difficult to confirm ADC threshold differentiating the lesion classification.

  2. Exploratory behavior and recognition memory in medial septal electrolytic, neuro- and immunotoxic lesioned rats.

    Science.gov (United States)

    Dashniani, M G; Burjanadze, M A; Naneishvili, T L; Chkhikvishvili, N C; Beselia, G V; Kruashvili, L B; Pochkhidze, N O; Chighladze, M R

    2015-01-01

    In the present study, the effect of the medial septal (MS) lesions on exploratory activity in the open field and the spatial and object recognition memory has been investigated. This experiment compares three types of MS lesions: electrolytic lesions that destroy cells and fibers of passage, neurotoxic - ibotenic acid lesions that spare fibers of passage but predominantly affect the septal noncholinergic neurons, and immunotoxin - 192 IgG-saporin infusions that only eliminate cholinergic neurons. The main results are: the MS electrolytic lesioned rats were impaired in habituating to the environment in the repeated spatial environment, but rats with immuno- or neurotoxic lesions of the MS did not differ from control ones; the MS electrolytic and ibotenic acid lesioned rats showed an increase in their exploratory activity to the objects and were impaired in habituating to the objects in the repeated spatial environment; rats with immunolesions of the MS did not differ from control rats; electrolytic lesions of the MS disrupt spatial recognition memory; rats with immuno- or neurotoxic lesions of the MS were normal in detecting spatial novelty; all of the MS-lesioned and control rats clearly reacted to the object novelty by exploring the new object more than familiar ones. Results observed across lesion techniques indicate that: (i) the deficits after nonselective damage of MS are limited to a subset of cognitive processes dependent on the hippocampus, (ii) MS is substantial for spatial, but not for object recognition memory - the object recognition memory can be supported outside the septohippocampal system; (iii) the selective loss of septohippocampal cholinergic or noncholinergic projections does not disrupt the function of the hippocampus to a sufficient extent to impair spatial recognition memory; (iv) there is dissociation between the two major components (cholinergic and noncholinergic) of the septohippocampal pathway in exploratory behavior assessed in the open

  3. Effect of fluoride, lesion baseline severity and mineral distribution on lesion progression.

    Science.gov (United States)

    Lippert, F; Butler, A; Lynch, R J M; Hara, A T

    2012-01-01

    The present study investigated the effects of fluoride (F) concentration, lesion baseline severity (ΔZ(base)) and mineral distribution on lesion progression. Artificial caries lesions were created using three protocols [methylcellulose acid gel (MeC), hydroxyethylcellulose acid gel (HEC), carboxymethylcellulose acid solution (CMC)] and with low and high ΔZ(base) groups by varying demineralization times within protocols. Subsequently, lesions were immersed in a demineralizing solution for 24 h in the presence of 0, 1, 2 or 5 ppm F. Changes in mineral distribution characteristics of caries lesions were studied using transverse microradiography. At baseline, the protocols yielded lesions with three distinctly different mineral distributions. Secondary demineralization revealed differences in F response between and within lesion types. In general, lowΔZ lesions were more responsive to F than highΔZ lesions. LowΔZ MeC lesions showed the greatest range of response among all lesions, whereas highΔZ HEC lesions were almost unaffected by F. Laminations were observed in the presence of F in all but highΔZ HEC and CMC lesions. Changes in mineral distribution effected by F were most pronounced in MeC lesions, with remineralization/mineral redeposition in the original lesion body at the expense of sound enamel beyond the original lesion in a dose-response manner. Both ΔZ(base) and lesion mineral distribution directly impact the F response and the extent of secondary demineralization of caries lesions. Further studies - in situ and on natural white spot lesions - are required to better mimic in vivo caries under laboratory conditions. Copyright © 2012 S. Karger AG, Basel.

  4. Treatment of metastatic brain lesion

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    A. M. Zaytsev

    2015-01-01

    Full Text Available Objective. Increasing survival in patients with secondary brain damage, and identifying the factors of favorable and adverse prognosis.Material and method. In P. A. Hertsen Moscow Oncology Research Institute from 2007 to 2013 there were treated 268 patients with brain metastases. The mean age was 55.8 years (from 24 to 81 years. Metastases of colorectal cancer identified in 7.8%, cases of lung cancer in 34%, melanoma 9.3 %, breast cancer in 26%, kidney cancer in 11%, with non-identified primary tumor in 4.5%, other tumors accounted for 6.7%. Solitary metastasis was diagnosed in 164 (61,19% patients, oligometastasis (2-3 - 72 (26,87% patients with polymetastasis (more than 3 – 32 (11,94% patients. In 106 (39,55% of patients with brain metastases it was the only manifestation of the generalization process. To control the radical removal of the tumor in 93 (34,7% patients we used the method of fluorescence navigation (FN with the drug Alasens. In 66 (24,6% patients intraoperatively was held a session of photodynamic therapy (PDT. In 212 (79,1% cases, the removal of metastasis performed totally, 55 (20,9% patients stated Subtotal removal.Results. The observation period for the patients ranged from 3 to 79 months. Survival median among the entire group of patients with metastatic brain lesion was 12 months. Overall survival was significantly dependent on RPA class, the volume of postoperative treatment, histological type of primary tumor, number of intracerebral metastases and the timing of the relapse-free period.Conclusions. Factors that affects the overall survival are the features of the histology of the primary lesion, multiplicity of metastatic lesions, RPA class and the synchronous nature of the metastasis. The median of overall survival of patients who did not receive after surgical treatment of a particular type of therapy was only 4 months. If to use the combined treatment (surgical treatment with the irradiation of the whole brain median

  5. Reactive Hyperplastic Lesions of the Oral Cavity

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    Hamideh Kadeh

    2015-03-01

    Full Text Available Introduction: Peripheral reactive lesions of soft tissue are common oral lesions that dentists face during routine examinations. Diagnosis and development of a treatment plan is difficult if dentists are not aware of the prevalence and clinical symptoms of these lesions. The frequency of these lesions differs across various populations. The aim of this study was to determine the frequency and distribution of oral reactive lesions over a period of 7 years (2006–2012.   Materials and Methods: In this retrospective study, available records from the archives of the Department of Pathology, Dental School and the two main hospitals in southeast of Iran (Zahedan over a period of 7 years (2006–2012 were reviewed. Information relating to the type of reactive lesion, age, gender and location was extracted and recorded on data forms. Data were analyzed using SPSS statistical software (V.18 using the chi-square and Fisher’s exact test.   Results: Of 451 oral lesions, 91 cases (20.2% were reactive hyperplastic lesions. The most common lesions were pyogenic granuloma and irritation fibroma, respectively. These lesions were more frequent in women (60% than men (40%. The most common locations of involvement were the gingiva and alveolar mucosa of the mandible, and lesions were more common in the 21–40-year age group. The relationship between age group and reactive lesions was statistically significant (P=0.01.   Conclusion:  The major findings in this study are broadly similar to the results of previous studies, with differences observed in some cases. However, knowledge of the frequency and distribution of these lesions is beneficial when establishing a diagnosis and treatment plan in clinical practice.

  6. [Management of the meniscal lesion].

    Science.gov (United States)

    Baillon, B; Cermak, K; Vancabeke, M

    2011-01-01

    About 1,5 million arthroscopies are each year performed in the world, 50 % for meniscal affections. The menisci participate in the femoro-tibial load transmission and in the joint shock absorption; they contribute to the knee stability and play a role in the joint lubrication. The menisci are therefore important structures, and, in the case of a lesion, surgical abstention or repair should be favoured. When a meniscectomy has to be performed, it should be economical, preserving the meniscal wall. Meniscectomy is contra-indicated in the child and in the case of knee osteoarthrosis. Meniscal healing is compromised if the knee is unstable. If after total meniscectomy a patient presents symptomatic early osteoarthrosis, without marked loss of alignment, meniscal allografting is a therapeutic option, especially at the lateral compartment.

  7. Trigeminal Neuralgia and Radiofrequency Lesioning

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    Andy R. Eugene

    2015-12-01

    Full Text Available Trigeminal Neuralgia is a disorder that is characterized with electrical-type shocking pain in the face and jaw. This pain may either present as sharp unbearable pain unilateral or bilaterally. There is no definite etiology for this condition. There are various treatment methods that are currently being used to relieve the pain. One of the pharmacological treatments is Carbamazepine and the most prevalent surgical treatments include Gamma Knife Surgery (GKS, Microvascular Decompression (MVD and Radiofrequency Lesioning (RFL. Although, MVD is the most used surgical method it is not an option for all the patients due to the intensity of the procedure. RFL is used when MVD is not suitable. In this paper we present the various treatments and Monte-Carlo based pharmacokinetic simulations of Carbamazepine in treatment of Trigeminal Neuralgia.

  8. Imaging findings of various calvarial bone lesions witha focus on osteolytic lesions

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    Yim, Young Hee; Moon, Won Jin; An, Hyeong Su; Cho, Joon [Konkuk University Medical Center, Konkuk University School of Medicine, Seoul (Korea, Republic of); Rho, Myung Ho [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    In this review, we present computed tomography (CT) and magnetic resonance imaging (MRI) findings of various calvarial lesions on the basis of their imaging patterns and list the differential diagnoses of the lesions. We retrospectively reviewed 256 cases of calvarial lesion (122 malignant neoplasms, 115 benign neoplasms, and 19 non-neoplastic lesions) seen in our institutions, and classified them into six categories based on the following imaging features: generalized skull thickening, focal skull thickening, generalized skull thinning, focal skull thinning, single lytic lesion, and multiple lytic lesions. Although bony lesions of the calvarium are easily identified on CT, bone marrow lesions are better visualized on MRI including diffusion-weighted imaging or fat-suppressed T2-weighted imaging. Careful interpretation of calvarial lesions based on pattern recognition can effectively narrow a range of possible diagnoses.

  9. SPECTRUM OF BENIGN BREAST LESIONS : A CYTOLOGIC STUDY

    Directory of Open Access Journals (Sweden)

    Nirmala

    2015-07-01

    Full Text Available INTRODUCTION: Open biopsy is widely considered to be the procedure of choice for diagnostic tissue sampling of bone tumors. However, associated disadvantages include in - patient procedure requiring hospitalization, risk of infection, hematoma formation and pathological fractures. As an alternative FNA cytology is increasingly used as a diagnostic modality. It is a challenging technique due to difficulties in approaching bone lesions and obtaining adequate material. AIMS: 1. To study the prevalence and distribution of various breast lesions in women of various age groups. 2. To classify the smears into C1 - C5 category . 3. To enumerate the difficulties encountered in this study. 4. To emphasize the role of FNAC in diagnostic workup in breast lesions. MATERIALS AND METHODS: FNAC was done on 208 cases of breast lesions from September 2011 to July 2012 in department of Pathology, Bowring hospital, BMC&RI, Bangalore. Cases presenting to the OPD with b r east lumps were subjected for FNAC. Aspirations were carried out with 10ml disposable syringe with a 22guage needle, materi al was obtained. Aspirates were smeared and few of them were immediately fixed with methanol and stained with H&E, rest of the smears were air dried for MGG staining. The diagnostic criteria C1 - C5 as recommended by NHS breast screening program has been inc orporated for reporting the slides along with pathological diagnosis wherever possible. RESULTS : 1. In countries with limited resources like India, FNAC may be used as the first line of diagnostic tool for evaluating breast lesions. 2. Breast FNA continues its monopoly over core biopsy and open excision biopsy. Benign conditions of breast can be diagnosed easily on FNA if done accurately. The current usage of C1 - C5 categories in typing the breast lesions gives a wide scope for pathologist to place the doubt ful lesions freely in the categories. However a disease specific diagnosis was preferred by the clinicians. 3. In

  10. Lesion classification using 3D skin surface tilt orientation.

    Science.gov (United States)

    She, Zhishun; Excell, P S

    2013-02-01

    Current non-invasive diagnostic procedures to detect skin cancer rely on two-dimensional (2D) views of the skin surface. For example, the most commonly-used ABCD features are extracted from the 2D images of skin lesion. However, because the skin surface is an object in three-dimensional (3D) space, valuable additional information can be obtained from a perspective of 3D skin objects. The aim of this work is to discover the new diagnostic features by considering 3D views of skin artefacts. A surface tilt orientation parameter was proposed to quantify the skin and the lesion in 3D space. The skin pattern was first extracted from simply captured white light optical clinical (WLC) skin images by high-pass filtering. Then the directions of the projected skin lines were determined by skin pattern analysis. Next the surface tilt orientations of skin and lesion were estimated using the shape from texture technique. Finally the difference of tilt orientation in the lesion and normal skin areas, combined with the ABCD features, was used as a lesion classifier. The proposed method was validated by processing a set of images of malignant melanoma and benign naevi. The scatter plot of classification using the feature of surface tilt orientation alone showed the potential of the new 3D feature, enclosing an area of 0.78 under the ROC curve. The scatter plot of classification, combining the new feature with the ABCD features by use of Principal Component Analysis (PCA), demonstrated an excellent separation of benign and malignant lesions. An ROC plot for this case enclosed an area of 0.85. Compared with the ABCD analysis where the area under the ROC curve was 0.65, it indicated that the surface tilt orientation (3D information) was able to enhance the classification results significantly. The initial classification results show that the surface tilt orientation has a potential to increase lesion classifier accuracy. Combined with the ABCD features, it is very promising to

  11. Clinical-histopathological concordance in head and neck lesions.

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    Sahily Espino Otero

    2009-03-01

    Full Text Available Background: Clinical-histopathological data contributes to a better diagnosis, assessment and treatment of head and neck lesions. Objective: To determine clinical-histopathological correlation of head and neck lesions. Methods: a descriptive, retrospective, observational study was developed in a series of cases (360 patients to determine the clinical diagnostic scope in relation to the histopathological techniques used in the Maxillary Surgery Service of “Gustavo Aldereguía Lima” hospital between June 2006 and 2007. Required data was taken from clinical histories and records from Pathological Anatomy, which were transferred to a form design for that purpose. Results: The age group of 0-19 years had the higher concordance among the studied groups (72,4%. 59, 7% of the studied cases had clinical-histopathological concordance, mainly in extra-oral lesions (60, 4% particularly in the vermilion border (82, 4 % and among the intra-oral the most common were those in the vestibular duct (100%. The most important lesions where clinical diagnosis did not coincide with histopathological diagnosis were fibroma with 23 in the intra-oral and warts and a total of 34 in extra-oral, followed by basal carcinomas. Conclusions: There is a significant correlation between clinical and histopathological diagnosis, suggesting high attention quality and correct application of the clinical method as central element in patients’ management.

  12. Intraoperative pathology consultation for pulmonary lesions: errors and deferrals.

    Science.gov (United States)

    Akyildiz, Elif Ulker

    2015-01-01

    The accuracy rate of frozen section constitutes an important step of quality assessment step in pathology practice. This study aimed to investigate pulmonary lesions that were incorrectly diagnosed or postponed for routine examination by pathologists at frozen section examination; it also aimed to discuss the reasons for difficult diagnoses and the various clues enabling the correct diagnosis to be made when such lesions are encountered. This study retrospectively reviewed the medical data of the thoracic surgery cases that underwent frozen section examination between 2009 and 2014. Frozen section errors and deferrals were identified in 25 cases. Fourteen (56%) lesions were of pulmonary parenchymal origin and 11 (44%) were of pleural origin. The number of cases in which the pathologists postponed the diagnosis without making any approach was 14. Of these, 9 (64%) were benign lesions such as bronchiectasis, fibrosis anthracosis, chronic inflammatory cell infiltration, chronic pleuritis, and mesothelial proliferation. The number of misdiagnosed cases was 11. Of these, 7 (64%) were of pulmonary and 4 (36%) were of pleural origin. Because the examination techniques of each pathology department may differ from one another, the comparative examination of frozen sections and routine sections would aid in becoming familiar with various pathologies and would be beneficial for pathologists in minimizing their diagnostic errors.

  13. Spectral lesion characterization on a photon-counting mammography system

    Science.gov (United States)

    Erhard, Klaus; Fredenberg, Erik; Homann, Hanno; Roessl, Ewald

    2014-03-01

    Spectral X-ray imaging allows to differentiate between two given tissue types, provided their spectral absorption characteristics differ measurably. In mammography, this method is used clinically to determine a decomposition of the breast into adipose and glandular tissue compartments, from which the glandular tissue fraction and, hence, the volumetric breast density (VBD) can be computed. Another potential application of this technique is the characterization of lesions by spectral mammography. In particular, round lesions are relatively easily detected by experienced radiologists, but are often difficult to characterize. Here, a method is described that aims at discriminating cystic from solid lesions directly on a spectral mammogram, obtained with a calibrated spectral mammography system and using a hypothesis-testing algorithm based on a maximum likelihood approach. The method includes a parametric model describing the lesion shape, compression height variations and breast composition. With the maximum likelihood algorithm, the model parameters are estimated separately under the cyst and solid hypothesis. The resulting ratio of the maximum likelihood values is used for the final tissue characterization. Initial results using simulations and phantom measurements are presented.

  14. Magnetic resonance imaging differential diagnosis of brainstem lesions in children

    Institute of Scientific and Technical Information of China (English)

    Carlo Cosimo Quattrocchi; Yuri Errante; Maria Camilla Rossi Espagnet; Stefania Galassi; Sabino Walter Della Sala; Bruno Bernardi; Giuseppe Fariello; Daniela Longo

    2016-01-01

    Differential diagnosis of brainstem lesions,either isolated or in association with cerebellar and supra-tentorial lesions,can be challenging. Knowledge of the structural organization is crucial for the differential diagnosis and establishment of prognosis of pathologies with involvement of the brainstem. Familiarity with the location of the lesions in the brainstem is essential,especially in the pediatric population. Magnetic resonance imaging(MRI) is the most sensitive and specific imaging technique for diagnosing disorders of the posterior fossa and,particularly,the brainstem. High magnetic static field MRI allows detailed visualization of the morphology,signal intensity and metabolic content of the brainstem nuclei,together with visualization of the normal development and myelination. In this pictorial essay we review the brainstem pathology in pediatric patients and consider the MR imaging patterns that may help the radiologist to differentiate among vascular,toxico-metabolic,infectiveinflammatory,degenerative and neoplastic processes. Helpful MR tips can guide the differential diagnosis: These include the location and morphology of lesions,the brainstem vascularization territories,gray and white matter distribution and tissue selective vulnerability.

  15. Cutaneous lesions in new born

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    Sachdeva Meenakshi

    2002-11-01

    Full Text Available Five hundred unselected newborn babies delivered in the Department of Obstetrics and Gynaecology, Unit II of SGBT Hospital attached to Government Medical College, Amritsar during April 2000 to October 2000 were examined for cutaneous lesions daily for the first five days after birth. Different cutaneous lesions were seen in 474(94. 8% newborns. The physiological skin changes observed in order of frequency were Epstein pearls in 305(61%, Mongolian spot in 301(60. 2%, superficial cutaneous desquamation in 200(40%, icterus in 128(25. 6%, milia in 119(23. 8%, sebaceous gland hyperplasia in 107 (21. 4%, occipital alopecia in 94(18. 8%, lanugo in 72(14. 4%, peripheral cyanosis in 47(9. 4%, breast hypertrophy in 29(5. 8% and miniature puberty in 28(5. 6% newborns. Of the transient non-infective skin diseases, erythema toxicum neonatorum was observed most commonly in 105(21 %, followed by miliaria rubra in 103(20. 6% and acne neonatorum in 27(5. 4% newborns. The naevi and other developmental defects in the descending order were salmon patch in 69(13. 8%, congenital melanocytic noevi in 10(2%, accessory tragi in 3(0.6%, spina bifida in 2(0.4%, hydrocephalus in 1(0.2% and poliosis in 1(0.2% newborns. Cradle cap was the only dermatitis observed in 50(10% newborns. One (0.2% case each of Harlequin ichthyosis and labial cyst was seen.

  16. Cone Beam Computed Tomography (CBCT Features of a Rare Fibro-Osseous Lesion: A Case Report

    Directory of Open Access Journals (Sweden)

    Mahrokh Imanimoghaddam

    2013-03-01

    Full Text Available Cone beam computed tomography is a useful technique for imaging the craniofacial lesions. It produces more realistic images that facilitate interpretation. Juvenile ossifying fibroma (JOF is a rare and benign fibro-osseous neoplasm that arises within the craniofacial bones, especially in the maxilla. Mandibular lesions can be seen in 10% of the cases.In both jaws, it has a predilection for the premolar and molar regions (it is mostly seen in premolar and molar regions. Radiographically, it can be present as a radiolucent, mixed or radiopaque lesion. Radiodensity varies from purely radiolucent masses to mixed densities with prominent radiopacity as the lesion matures.This case report highlights a JOF with large foci of odontome-like radiopacities in a 6-year-old boy's mandibular anterior region. The location of the lesion in the anterior mandible and comparatively rapid formation of large odontome-like radiopaque foci at this early agehas made it a rare entity.

  17. Diagnostic value of multi-slice spiral CT post-processing technique on sacroiliac joint lesions in patients with ankylosing spondylitis%多层螺旋CT后处理技术在强直性脊柱炎骶髂关节病变中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    亓立勇

    2012-01-01

    Objective To investigate the diagnostic value of multi-slice spiral CT(MSCT) and its multi-planar reconstruction(MPR) and curved planar reconstruction(CPR) on sacroiliac joint with ankylosing spondylitis(AS).Methods Fifty-six patients with AS proved clinically were examined and analyzed with MSCT and reconstruction.Then the CT manifestations of sacroiliace joints were analyzed.And choose a sagittal image respectively in the margin of the sacrum one-four,one-second and two-four.Then went down the sacrum line trace for CPR technique get double sided sacroiliac joint imaging.The images,MPR transect images and CPR image were analyed.Results Early CT findings included coarsearticular surface,interrupted jiont cortex,vague articular face,subcortical microcysts and sclerotic articular surface,while jiont space was normal.CT findings in progressive stage were uneven articular surface,damaged bony cortex,subcartilaginous bone microcyats,obviously sclerotic articular surface,extended jiontspace.In stable stage,CT findings included joint ankylosis,articular space dsiappearance,and sacroiliac ligament calcification.Fifty-six cases of AS patients,bilateral simultaneous involvement in 47 cases,unilateral involvement in 9 cases,axial image diagnosis,Ⅰ-Ⅱ grade 16 cases,Ⅲ-Ⅳ grade 26 cases.MPR image diagnosis of Ⅰ-Ⅱ grade 24 cases,Ⅲ-Ⅳ Grade 26 cases,CPR class Ⅰ diagnostic images-Ⅱ grade 29 cases,Ⅲ-Ⅳ grade in 26 cases,early diagnosis of axial images and reconstruction images were significantly different (P < 0.05),the late diagnosis rates were not significantly different (P > 0.05).Conclusions It is valuable to use MPR and CPR images to diagnosis sacroiliac joint lesions in patients with ankylosing spondylitis.Especially CPR image can be used to comprehensively observe sacroiliac joint,and it is more meaningful in early diagnosis of sacroiliac joint lesions in patients with AS.%目的 探讨多层螺旋CT(MSCT)多平面重组(MPR)技术和曲面重组(CPR

  18. Current status of conservative treatment of deep carious lesions.

    Science.gov (United States)

    Mattos, Juliana; Soares, Giulia Marins; Ribeiro, Apoena de Aguiar

    2014-06-01

    Traditionally, deep carious lesions are treated by removal of all carious tissue, which may lead to pulp exposure. To minimize this risk, conservative carious tissue removal techniques have been proposed, including partial removal and stepwise excavation. However, there is no consensus in the literature about which is the better technique. Thus, the aim of this article is to describe and discuss the main techniques for carious tissue removal, according to scientific evidence. It was observed that both stepwise excavation and partial carious tissue removal presented lower pulp exposure rates and higher success rates. Clinical Relevance: Clinicians must be aware that conservative carious tissue removal techniques, such as stepwise excavation and partial carious tissue removal, present lower pulp exposure rates and higher success rates than traditional methods.

  19. In vivo MR guided boiling histotripsy in a mouse tumor model evaluated by MRI and histopathology.

    Science.gov (United States)

    Hoogenboom, Martijn; Eikelenboom, Dylan; den Brok, Martijn H; Veltien, Andor; Wassink, Melissa; Wesseling, Pieter; Dumont, Erik; Fütterer, Jurgen J; Adema, Gosse J; Heerschap, Arend

    2016-06-01

    Boiling histotripsy (BH) is a new high intensity focused ultrasound (HIFU) ablation technique to mechanically fragmentize soft tissue into submicrometer fragments. So far, ultrasound has been used for BH treatment guidance and evaluation. The in vivo histopathological effects of this treatment are largely unknown. Here, we report on an MR guided BH method to treat subcutaneous tumors in a mouse model. The treatment effects of BH were evaluated one hour and four days later with MRI and histopathology, and compared with the effects of thermal HIFU (T-HIFU). The lesions caused by BH were easily detected with T2 w imaging as a hyper-intense signal area with a hypo-intense rim. Histopathological evaluation showed that the targeted tissue was completely disintegrated and that a narrow transition zone (<200 µm) containing many apoptotic cells was present between disintegrated and vital tumor tissue. A high level of agreement was found between T2 w imaging and H&E stained sections, making T2 w imaging a suitable method for treatment evaluation during or directly after BH. After T-HIFU, contrast enhanced imaging was required for adequate detection of the ablation zone. On histopathology, an ablation zone with concentric layers was seen after T-HIFU. In line with histopathology, contrast enhanced MRI revealed that after BH or T-HIFU perfusion within the lesion was absent, while after BH in the transition zone some micro-hemorrhaging appeared. Four days after BH, the transition zone with apoptotic cells was histologically no longer detectable, corresponding to the absence of a hypo-intense rim around the lesion in T2 w images. This study demonstrates the first results of in vivo BH on mouse tumor using MRI for treatment guidance and evaluation and opens the way for more detailed investigation of the in vivo effects of BH. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. Innovation in early breast cancer surgery: radio-guided occult lesion localization and sentinel node biopsy.

    Science.gov (United States)

    Paganelli, G; Veronesi, U

    2002-07-01

    The surgical management of non-palpable breast lesions remains controversial. At the European Institute of Oncology we have introduced a new technique, radio-guided occult lesion localization (ROLL) to replace standard methods and overcome their disadvantages. Regarding axillary dissection, probe-guided biopsy of the sentinel node (SN) is easy to apply, and the whole procedure is associated to a low risk of false negatives. We suggest that the SN technique should be widely adopted to stage the axilla in patients with breast cancer with clinically negative lymph nodes. Large-scale implementation of the sentinel node technique will reduce the cost of treatment as a result of shorter hospitalization times.

  1. Endo-periodontal lesion – endodontic approach

    OpenAIRE

    Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; C. Ionescu

    2014-01-01

    Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal t...

  2. Radiologic aspects of the Galeazzi lesion

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, A. de; Meoller, J.T.; Vestergaard-Andersen, T.

    1984-08-01

    In lesions of the forearm that included a fracture of the distal two thirds of the radial shaft, a concomitant disruption of the distal radio-ulnar joint was found in 20 out of 38 cases. In 15 cases a typical Galeazzi lesion was present. Dislocation of the distal radio-ulnar joint frequently goes unrecognized. The clinical significance of a lesion in the distal radio-ulnar joint is related to its prognostic value.

  3. Radiologic aspects of the Galeazzi lesion.

    Science.gov (United States)

    de Carvalho, A; Møller, J T; Vestergård-Andersen, T

    1984-08-01

    In lesions of the forearm that included a fracture of the distal two thirds of the radial shaft, a concomitant disruption of the distal radio-ulnar joint was found in 20 out of 38 cases. In 15 cases a typical Galeazzi lesion was present. Dislocation of the distal radio-ulnar joint frequently goes unrecognized. The clinical significance of a lesion in the distal radio-ulnar joint is related to its prognostic value.

  4. Management of Anal Squamous Intraepithelial Lesions

    OpenAIRE

    Pineda, Carlos E.; Welton, Mark L.

    2009-01-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is ...

  5. Hybrid Odontogenic Lesion: A Rare Entity

    Directory of Open Access Journals (Sweden)

    Reza Imani

    2017-03-01

    Full Text Available Hybrid tumors are very rare tumors composed of two different tumor entities, each of which conforms to an exactly defined tumor category. A 14-year-old boy was referred for an intraosseous painless lesion with a histopathological feature of multiple odontogenic lesions including calcifying odontogenic cyst, complex odontoma and ameloblastic fibro-odontoma. The final diagnosis considered to be a hybrid odontogenic lesion.

  6. The clinical spectrum of pigmented lesions.

    Science.gov (United States)

    Schaffer, J V; Bolognia, J L

    2000-07-01

    This article presents the clinical features of a spectrum of pigmented lesions. It begins with benign lesions that may be confused with melanocytic nevi, such as lentigines, seborrheic keratoses, and dermatofibromas. The next section focuses on the various types of melanocytic nevi, including congenital, blue, and Spitz nevi. A description of atypical nevi is provided, followed by an outline of the clinical characteristics of each subtype of cutaneous melanoma. The clinical characteristics of various pigmented lesions are illustrated.

  7. Harmonic motion imaging for focused ultrasound (HMIFU): a fully integrated technique for sonication and monitoring of thermal ablation in tissues.

    Science.gov (United States)

    Maleke, C; Konofagou, E E

    2008-03-21

    FUS (focused ultrasound), or HIFU (high-intensity-focused ultrasound) therapy, a minimally or non-invasive procedure that uses ultrasound to generate thermal necrosis, has been proven successful in several clinical applications. This paper discusses a method for monitoring thermal treatment at different sonication durations (10 s, 20 s and 30 s) using the amplitude-modulated (AM) harmonic motion imaging for focused ultrasound (HMIFU) technique in bovine liver samples in vitro. The feasibility of HMI for characterizing mechanical tissue properties has previously been demonstrated. Here, a confocal transducer, combining a 4.68 MHz therapy (FUS) and a 7.5 MHz diagnostic (pulse-echo) transducer, was used. The therapy transducer was driven by a low-frequency AM continuous signal at 25 Hz, producing a stable harmonic radiation force oscillating at the modulation frequency. A pulser/receiver was used to drive the pulse-echo transducer at a pulse repetition frequency (PRF) of 5.4 kHz. Radio-frequency (RF) signals were acquired using a standard pulse-echo technique. The temperature near the ablation region was simultaneously monitored. Both RF signals and temperature measurements were obtained before, during and after sonication. The resulting axial tissue displacement was estimated using one-dimensional cross correlation. When temperature at the focal zone was above 48 degrees C during heating, the coagulation necrosis occurred and tissue damage was irreversible. The HMI displacement profiles in relation to the temperature and sonication durations were analyzed. At the beginning of heating, the temperature at the focus increased sharply, while the tissue stiffness decreased resulting in higher HMI displacements. This was confirmed by an increase of 0.8 microm degrees C(-1)(r=0.93, ptissue became irreversibly stiffer, followed by an associated decrease in the HMI displacement (-0.79 microm degrees C(-1), r=-0.92, ptissues during FUS, HIFU or other thermal therapies.

  8. OASIS is Automated Statistical Inference for Segmentation, with applications to multiple sclerosis lesion segmentation in MRI.

    Science.gov (United States)

    Sweeney, Elizabeth M; Shinohara, Russell T; Shiee, Navid; Mateen, Farrah J; Chudgar, Avni A; Cuzzocreo, Jennifer L; Calabresi, Peter A; Pham, Dzung L; Reich, Daniel S; Crainiceanu, Ciprian M

    2013-01-01

    %]) and the radiologist 52% (95% CI: [38%, 66%]). OASIS obtains the estimated probability for each voxel to be part of a lesion by weighting each imaging modality with coefficient weights. These coefficients are explicit, obtained using standard model fitting techniques, and can be reused in other imaging studies. This fully automated method allows sensitive and specific detection of lesion presence and may be rapidly applied to large collections of images.

  9. Visible and occult microscopic lesions of endometriosis

    Directory of Open Access Journals (Sweden)

    Khaleque Newaz Khan

    2014-11-01

    Full Text Available Endometriosis is a multifactorial disease mostly affecting women of reproductive age and is associated with chronic pelvic pain and infertility. Even after 300 years, most of the literature claims that pathogenesis and/or pathophysiology of endometriosis is still elusive. Recurrence of pain and lesion continues to occur after effective medical or surgical therapies. Once generated within the pelvis due to retrograde entry of menstrual debris, peritoneal endometriotic lesions time-dependently change their color appearance resulting from certain biochemical change within lesions. A variable pattern of endometriotic lesions within the pelvis can be detected by laparoscopy as visible peritoneal endometriosis. It is generally believed that besides ovarian steroid hormones, the growth of endometriosis can be regulated by the innate immune system in the pelvic microenvironment by their interaction with endometrial cells and immune cells. Even with the careful eyes of an expert surgeon, we may sometimes miss detecting peritoneal lesion within the peritoneal cavity or deep into the peritoneum. In such a case, random collection of normal peritoneum may carry the possibility to identify some hidden endometriotic lesions by microscopy and these lesions can be named as occult (invisible microscopic endometriosis (OME. Here, we discuss the color appearance of peritoneal lesions and activity of these lesions by analysis of a panel of activity markers. Finally we discuss our recent findings on OME, their biological and clinical significance, and try to make a possible link in the origin between visible endometriosis and OME.

  10. Histopathological characterization of a Cameron lesion.

    Science.gov (United States)

    Katz, Jordan; Brar, Sonia; Sidhu, Jagmohan S

    2012-10-01

    Cameron lesions are linear erosions located at the neck of a hiatal hernia (HH) in patients with a large HH. The prevalence has been seen in up to 5% of patients with HH who undergo esophagogastroduodenoscopy, and they can be associated with overt gastrointestinal bleeding or anemia. These lesions occur due to vascular compression by the diaphragm in a large sliding HH. Histopathologic changes seen in the biopsy tissue of a Cameron lesion are due to ischemia, but this ischemia is reversible with treatment of HH. The existence of this entity and the histopathologic picture of a Cameron lesion is not well known to pathologists, and therefore, a microscopic picture of a Cameron lesion can be easily confused with ischemic gastritis. Ischemic gastritis is the result of atherosclerosis, usually seen in older people, unrelated to HH, and is not easily reversible. The authors received a gastric biopsy of a hiatal hernia without any associated clinical diagnosis of a Cameron lesion conveyed to the pathologist. This biopsy tissue showed ischemic changes in the gastric mucosa on microscopic examination. Diagnosis of ischemic gastritis was considered but ruled out after the case was discussed with the gastroenterologist. The correct diagnosis was made once the clinical diagnosis of HH with Cameron lesion (ie, a vertical red erosion) was made known to the pathologist. By reporting this case, the authors aim to increase awareness of Cameron lesion among pathologists so that they ask about the presence of a Cameron lesion before making the diagnosis of ischemic gastritis.

  11. Obstructive Lesions of the Pediatric Subglottis

    OpenAIRE

    Ida, Jonathan B.; Guarisco, J. Lindhe; Rodriguez, Kimsey H.; Amedee, Ronald G.

    2008-01-01

    Purpose: To compile information regarding obstructive subglottic lesions in children, including anatomy, pathogenesis, prevention, evaluation, and treatment options, required for implementation of a multi-faceted treatment plan.

  12. Obstructive Lesions of the Pediatric Subglottis

    OpenAIRE

    Ida, Jonathan B.; Guarisco, J. Lindhe; Rodriguez, Kimsey H.; Amedee, Ronald G.

    2008-01-01

    Purpose: To compile information regarding obstructive subglottic lesions in children, including anatomy, pathogenesis, prevention, evaluation, and treatment options, required for implementation of a multi-faceted treatment plan.

  13. Comet Lesions in Patients with Pseudoxanthoma Elasticum

    Directory of Open Access Journals (Sweden)

    Sinan Tatlıpınar

    2015-12-01

    Full Text Available Pseudoxanthoma elasticum (PXE is a genetic multisystemic disorder affecting the skin, eyes and cardiovascular system. Basic fundoscopic findings in PXE result from Bruch’s membrane involvement. The most important fundoscopic findings are angioid streaks. Other significant ocular findings are peau d’orange appearance, optic disc drusen, pattern dystrophy-like macular appearance, comet lesions, and choroidal neovascularization. Comet lesions are a pathognomonic ocular finding for PXE. The presence of both angioid streaks in the fundus and typical skin lesions should alert clinicians to PXE. Herein, we present two PXE cases with comet lesions.

  14. Simultaneous Whole-Brain Segmentation and White Matter Lesion Detection Using Contrast-Adaptive Probabilistic Models

    DEFF Research Database (Denmark)

    Puonti, Oula; Van Leemput, Koen

    2016-01-01

    In this paper we propose a new generative model for simultaneous brain parcellation and white matter lesion segmentation from multi-contrast magnetic resonance images. The method combines an existing whole-brain segmentation technique with a novel spatial lesion model based on a convolutional...... restricted Boltzmann machine. Unlike current state-of-the-art lesion detection techniques based on discriminative modeling, the proposed method is not tuned to o